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Bladder Catheterization Technique for Male Rhesus Monkeys.  

National Technical Information Service (NTIS)

Real-time collection of urine is advantageous in some physiological research. Human bladder catheterization procedures and equipment are not suitable for studies using the rhesus monkey (Macaca mulatta) because of anatomical and behavioral differences. We...

J. L. Saxton J. M. Garcia L. G. Meyer W. G. Lotz



Rhinoplasty - indications and techniques  

PubMed Central

Rhinoplasty is considered to be one of the most challenging procedures in otolaryngology head and neck surgery. Meticulous planning and excellent surgical skills are pre-requisites for reproducible good outcomes. More than 100 years after the first rhinoplasty, many controversies regarding indication and techniques remain unresolved. The aim of this article is to review current concepts and arguments.

Tasman, Abel-Jan



MONTI as continent catheterized stoma using serosal-lined trough "Ghoneim Abolenin" technique in ileocystoplasty  

PubMed Central

It is a great challenge to select and perform continent mechanism in a stoma for urinary reservoir. A new technique by combining MONTI ileal conduit with the serosal lined trough in order to achieve continent catheterizable stoma to the umbilicus as a part of augmentation ileocystoplasty. We applied serosal-lined trough as a continent mechanism with MONTI ileal tube in 12 years smart girl underwent ileocystoplasty for neuropathic bladder due to meylomeningocele in whom continence failed to be achieved by using Mitrofanoff with submucosal tunnel of the bladder as continent mechanism before, also the previous operation included left to right transuretero-ureterostomy, ureterocystoplasty and reimplantation of the right ureter. The patient became completely continent; she was able to do self-catheterization easily through the umbilical stoma using 16-French catheter and was able to wash the mucous easily. The capacity of the augmented bladder was 300ccs. She became independent from her mother and stopped using diapers, anticholinergic and antibiotics. Combining MONTI conduit with serosal-lined extramural valve trough (The Ghoneim technique) is an effective continent technique and gives wider channel for catheterization and washing out the mucous.

Sammour, Mohammed T.; Ajjaj, Abdulbari Bin



Techniques for phenotyping coronary artery disease in the cardiac catheterization laboratory for applications in translational research.  


The catheterization laboratory is an excellent resource for translational research projects requiring phenotypic analysis of coronary artery disease. Coronary angiography, a traditional method of quantifying coronary disease, remains useful for describing the extent and the severity of angiographic coronary disease but is limited by the fact that angiography only depicts the effect of atherosclerosis on the arterial lumen. For this reason, quantitative coronary angiography has been supplemented by intravascular ultrasound and other catheter-based techniques and non-invasive methods for studies involving atherosclerosis progression and regression. Other angiographic based techniques potentially useful in research include the semi-quantification of collateral circulation, thrombolysis in myocardial infarction (TIMI) frame count, and TIMI blush score. The invasive assessment of coronary flow reserve and fractional flow reserve is a valuable adjunctive technique and can be used to precisely quantify the extent of ischemia or the presence of microvascular disease. Intravascular ultrasound (IVUS) is currently considered the gold standard for early diagnosis of coronary atherosclerosis and for measuring plaque burden. The serial measurements of changes in plaque volume over time are a valuable method of discerning plaque progression and regression. Similarly, radiofrequency backscatter IVUS, a relatively new imaging modality, can be used to describe and track changes in plaque composition. PMID:21445697

Ragosta, Michael



Catheterization (image)  


... self catheterization is the process of introducing a catheter into the bladder by oneself. The goal of intermittent catheterization is to help prevent urinary tract infections for anyone who is unable to properly empty ...


Percutaneous Transhepatic Catheterization of the Portal Vein: A Combined CT- and Fluoroscopy-Guided Technique  

SciTech Connect

Combined CT- and fluoroscopy-guided transhepatic portal vein catheterization was performed in 44 patients selected for pancreatic islet cell transplantation. The method allowed catheterization with a single puncture attempt in 39 patients. In four patients two attempts and in one patient four attempts were necessary. One minor hematoma of the liver capsule occurred that required no further treatment. Compared with other methods the average number of puncture attempts was reduced.

Weimar, Bernd; Rauber, Klaus [Department of Diagnostic Radiology, Justus Liebig University of Giessen, Klinikstrasse 29, D-35392 Giessen (Germany); Brendel, Mathias D.; Bretzel, Reinhard G. [Department of Medicine, Medizinische Klinik III, Justus Liebig University of Giessen, Rodthohl 6, D-35392 Giessen (Germany); Rau, Wigbert S. [Department of Diagnostic Radiology, Justus Liebig University of Giessen, Klinikstrasse 29, D-35392 Giessen (Germany)



The ALARA concept in pediatric cardiac catheterization: techniques and tactics for managing radiation dose.  


The cardiac catheterization laboratory plays an important role in the management of children with congenital heart disease by not only enabling diagnosis but, in many cases, providing definitive therapy. The goal of the ALARA (As Low as Reasonably Achievable) concept as it applies to cardiac catheterization is to provide maximal diagnostic and therapeutic benefit while requiring the lowest possible radiation dose. A number of specific challenges unique to the setting of pediatric cardiac catheterization, such as higher heart rates, smaller cardiovascular structures, smaller body size, and wider variety of unusual anatomic variants with the potential need for relatively lengthy and complex studies, result in relatively high radiation doses (to the patient and, consequently, to laboratory personnel). In addition, the improved survival of patients with complex anatomy (e.g., palliated single ventricle anatomies) implies that many such children with chronic cardiac disease require frequent catheterizations within the first few years of life. These factors, coupled with the increased radiosensitivity of children and a longer lifespan ahead of them in which to possibly develop radiation-related sequelae, converge to create potentially ominous consequences. Attention to basic rules of radiation safety is, therefore, of tremendous importance in the pediatric cardiac catheterization laboratory. This review focuses on the importance of adequate planning of the study, optimizing image formation, management of fluoroscopy and cine angiography parameters, and the use of certain equipment features that might allow the cardiologist to lower the radiation dose without sacrificing image quality. PMID:16862415

Justino, Henri



The role of cardiac catheterization in adult congenital heart disease.  


The role of heart catheterization continues to evolve as the sophistication of cardiac MRI and CT improves and the breadth of interventional catheter techniques widens. This analysis is approached from four perspectives: (1) planning of the procedure, including information required, potential pitfalls, and equipment; (2) performance of the procedure, including sample run, coronary arteriography, chamber angiography, and angiography of selected lesions; (3) current role of heart catheterization, considering the impact of echo, MRI, and CT on indications for catheterization procedures and current interventional procedures; and (4) new and emerging interventions and speculation as to the future role of diagnostic heart catheterization in patients who have adult congenital heart disease. PMID:17098510

McLaughlin, Peter; Benson, Lee; Horlick, Eric



Extracorporeal life support of neonates with congenital cardiac defects: techniques used during cardiac catheterization and surgery.  


Neonatal patients with congenital cardiac defects require proper diagnosis often by cardiac catheterization before surgical repair. In our institution, patients whose echocardiograms reveal surgically correctable lesions, but who are severely decompensated, have been placed on Extracorporeal Life Support (ECLS) prior to catheterization or surgery. Subsequent management of ECLS and cardiopulmonary bypass (CPB) are dictated by the surgical procedure. Hypothermia can be utilized while on ECLS to facilitate low-flow CPB, or circulatory arrest. Total extracorporeal circulation may be performed with the ECLS circuit, or the patient may be transferred to a conventional CPB circuit during the procedure. If required, post surgical ECLS can be facilitated through prior cannulation. We have found pre-operative institution of ECLS, in the neonate with severe congenital cardiac defects, provides immediate control of hemodynamic and respiratory problems, lowers the risk of cardiac catheterization, and reduces the usage of blood products during surgery. PMID:10172067

Faulkner, S C; Chipman, C W; Moss, M M; Frazier, E A; Love, J C; Harrell, J E; Van Devanter, S H; Fasules, J W



Urinary Catheterization  


... hospital bed (near the floor). This position allows gravity to help the urine drain. An indwelling catheter ... are reusable, while others are disposable, single-use models. People who do CIC catheterization on themselves will ...


Cardiac catheterization and angiography. Third edition  

SciTech Connect

This book discusses the papers on cardiac catheterization and angiography. The topics covered are: historical perspective and present practice of cardiac catheterization; angiography principles and utilization of radiologic and cineangiographic equipment; complications, incidence and prevention of side effects of cardiac catheterization; techniques; blood flow measurement of heart; pressure measurement; diagnostic techniques of angiography; special catheter techniques; coronary angiography, temporary and permanent pacemakers, potential role of lasers in the cardiac catheterization and evaluation of cardiac function.

Grossman, W.



Male catheterization.  


The insertion of catheters into male emergency patients is fairly common practice and is associated with a worryingly high rate of infection. Everyday pressures within the department, along with the added stress of resuscitation can result in inappropriately trained or skilled staff undertaking this procedure. The issue of gender and whether female nurses should catheterize male patients may also affect this vulnerable group of patients. Acquiring the psychomotor skills of inserting a urethral catheter is only one part of preparation for practice. Emergency nurses must know when and when not to resort to catheterization. Choosing the type and size of catheter requires careful judgment. What will you do if insertion proves difficult? Prevention of infection is of paramount importance and there are an increasing number of evidence-based sources of information, which are crucial to formulating procedures and informing every day practice. In the pressured surroundings of A&E departments, it is easy to ignore the vulnerability of men requiring catheterization, both from a physical and psychological point of view. Making the effort to explain the procedure, listen to questions and concerns and record relevant details in the notes, will take only a few extra moments. There is no doubt that urinary catheterization is not without complications. It is associated with significant morbidity and occasionally, mortality. PMID:11855766

Hadfield-Law, L



Urinary Catheterization in Medical Wards  

PubMed Central

Aims: The study aims to determine the: 1. frequency of inappropriate catheterization in medical wards and the reasons for doing it. 2. various risk factors associated with inappropriate catheterization, catheter associated urinary tract infections (CAUTI) and bacterial colonization on Foley's catheters (BCFC). Settings and Design: Hospital-based prospective study. Materials and Methods: One hundred and twenty five patients admitted consecutively in the medical wards of a tertiary care hospital, who underwent catheterization with a Foley's catheter, at admission, have been included in the study. Patient profiles were evaluated using the following parameters: age, sex, diagnosis, functional status, mental status, indication, duration and place of catheterization, development of BCFC and CAUTI. Statistical tests used: Chi-square test. Results: Thirty-six out of 125 (28.8%) patients included were inappropriately catheterized. BCFC developed in 52.8% and 22.4% were diagnosed with a CAUTI. The most frequent indication for inappropriate catheterization was urinary incontinence without significant skin breakdown (27.8%). The risk factors for inappropriate catheterization were female sex (RR=1.29, 95% CI=0.99, 1.69, P<0.05) and catheterization in the emergency (RR=0.74, 95% CI=0.61, 0.90, P<0.05). The risk factors for developing a BCFC were age>60 years (RR=0.65, 95% CI=0.48, 0.89, P<0.05), non-ambulatory functional status (RR=0.57, 95% CI=0.39, 0.84, P<0.01), catheterization in the emergency (RR=2.01, 95% CI=1.17, 3.46, P<0.01) and duration of catheterization>3 days (RR=0.62, 95% CI=0.43, 0.89, P<0.01). The risk factors for acquiring a CAUTI were age>60 years (RR=0.47, 95% CI=0.25, 0.90, P<0.05), impaired mental status (RR=0.37, 95% CI=0.18, 0.77, P<0.01) and duration of catheterization>3 days (RR=0.24, 95% CI=0.10, 0.58, P<0.01). Conclusions: Inappropriate catheterization is highly prevalent in medical wards, especially in patients with urinary incontinence. The patients catheterized in the medical emergency and female patients in particular are at high risk. Careful attention to these factors can reduce the frequency of inappropriate catheterization and unnecessary morbidity.

Bhatia, Nirmanmoh; Daga, Mradul K; Garg, Sandeep; Prakash, S K



Cricopharyngeal myotomy: indications and technique.  


Available diagnostic tests evaluating cricopharyngeal dysmotility are expensive, uncomfortable, and unreliable for predicting the results of cricopharyngeal myotomy. Cricopharyngeal myotomy should be performed as a diagnostic test when a patient has "block" dysphagia (in which the food bolus stops rather than the swallow's being painful) localized to the cricoid level, and when no cancer is seen on esophagram. An effective surgical technique relies on the muscular distention provided by the inflated balloon cuff of a large endotracheal tube, and requires cutting the muscle fibers of the upper esophagus, the cricopharyngeus, and the hypopharynx in the posterior midline from a point 1 cm below the cricoid cartilage to the level of the thyrohyoid membrane. The cricopharyngeal limits are indistinct until the muscle fibers have been cut. Bougies, esophagoscopes, and cuffless endotracheal tubes insufficiently distend these muscle fibers. A "peanut" sponge in a Kelly clamp is used to identify and separate the last muscle fibers from the mucosa so they can be divided. These techniques minimize the risks of esophageal perforation and incomplete muscular transection. Our experience performing 54 cricopharyngeal myotomies is reported. PMID:1543330

McKenna, J A; Dedo, H H



Fallopian tube catheterization.  


The delicate fallopian tube is the anatomic pathway to human reproduction. Simple, inexpensive tools and techniques allow radiologists to access this structure for promoting, and preventing pregnancy. Results from centers worldwide have shown that catheter recanalization is possible in ~90% of women with proximal tubal occlusion using basic angiographic techniques familiar to all interventional radiologists. The American Society for Reproductive Medicine has recommended that patients in whom the hysterosalpingogram (HSG) demonstrates proximal tubal occlusion undergo fallopian tube catheterization with selective salpingography prior to more invasive and more costly infertility treatments. The pregnancy rate following fallopian tube recanalization is as high as 60% when the unblocked tubes are found to be normal and there is no history of tubal disease. In a population where the cause of infertility is less well-defined, tubal catheterization may not only help women conceive, but may also help to better define the underlying tubal abnormality. In the prevention of unwanted pregnancy, numerous materials and devices have been tested for blocking fallopian tubes. The ESSURE coil (Conceptus, Inc., Mountain View, CA) was FDA approved in 2002 for tubal sterilization by hysteroscopic placement. In some locales, radiologists are being asked to assist with this procedure or to place the coils fluoroscopically through fallopian tube catheterization. PMID:21326584

Thurmond, Amy Suzanne



The Effect of Suprapubic Catheterization versus Transurethral Catheterization after Abdominal Surgery on Urinary Tract Infection: A Randomized Controlled Trial  

Microsoft Academic Search

Background\\/Aim: Transurethral catheterization is generally associated with a higher incidence of urinary tract infections than suprapubic catheterization; however, suprapubic catheterization is associated with other disadvantages such as higher costs and a more difficult technique, and at the moment there is no consensus about the use of both catheter systems. Therefore, a prospective randomized study was performed to investigate the effects

A. H. Baan; H. Vermeulen; J. van der Meulen; P. M. M. Bossuyt; D. P. Olszyna; D. J. Gouma



Medial patellofemoral ligament reconstruction: indications and technique.  


Lateral instability of the patella is a common problem that often requires reconstruction of the proximal soft tissue restraints. The medial patellofemoral ligament (MPFL) has been demonstrated to be the major soft tissue stabilizer to prevent abnormal lateral displacement of the patella. In this chapter we will discuss the anatomy, biomechanics, indications, and technique for surgical reconstruction of the medial patellofemoral ligament. PMID:22878657

Schepsis, Anthony A; Rogers, Andrew J



Forecasting Terrorism: Indicators and Proven Analytic Techniques  

Microsoft Academic Search

\\u000a This forecasting methodology identifies 68 indicators of terrorism and employs proven analytic techniques in a systematic\\u000a process that safeguards against 36 of the 42 common warning pitfalls that experts have identified throughout history. The\\u000a complete version of this research provides: 1) a step-by-step explanation of how to forecast terrorism, 2) an evaluation of\\u000a the forecasting system against the 42 common

Sundri K. Khalsa



Cardiac catheterization and angiography, 3d Ed  

SciTech Connect

This textbook was first published in 1974 and subsequently revised in 1980. The current edition, in seven parts and 33 chapters, has been extensively rewritten, and new chapters have been added that present recently developed techniques. The references have been updated to 1985. The purpose of this work is to provide a concise description of the major techniques employed in cardiac catheterization and angiography. Part 1 deals with the history, general principles, and practice of cardiac catheterization and angiography. In part 2, various techniques of cardiac catheterization are discussed and compared. In part 3, techniques for the determination of cardiac output, pressure, resistance, valve area, and shunt flow are described. Part 4 deals briefly with coronary angiography, cardiac ventriculography, pulmonary angiography, and aortography. In part 5, techniques for evaluating cardiac function and intracardiac electrophysiology are presented. The characteristic hemodynamic and angiographic abnormalities in specific disorders are described in part 6. Part 7 deals with special catheter techniques.

Grossman, W.



Submuscular breast reconstruction--indications and techniques.  


We review the care and treatment of 93 patients who underwent submuscular breast reconstruction in our service between 1975 and 1980. The indications and clinical situations in which submuscular reconstruction has been useful include: following simple mastectomy; following modified radical mastectomy; following subcutaneous mastectomy (immediate or delayed reconstruction); in standard augmentation mammaplasty in selected patients; and with unusual, unsatisfactory, or dangerous preexisting breast conditions. Unusual indications include unsatisfactory subcutaneous placement with capsule formation after subcutaneous mastectomy; use of unsatisfactory or dangerous implants such as Ivalon and Etheron; and replacement of the old-fashioned Cronin gel implants with fixation patches. Submuscular placement has also been used to advantage in patients with excessively scarred, tenuous skin. Technical modifications in the submuscular implantation technique are detailed. We have used subserratus-subpectoral placement in most instances. Technical tips to keep the implant in a low position by division of the serratus attachments and limitations of upward dissection are detailed. Clinical studies on the upward migration of implants and pressures developed under the serratus and pectoralis muscles as measured by manometer are also detailed. PMID:7294671

Apfelberg, D B; Laub, D R; Maser, M R; Lash, H



[Anterior cruciate ligament reconstruction: indications and techniques].  


The anterior cruciate ligament (ACL) is a key structure for the knee joint stability and is frequently injured. Patients can be classified as "low-risk" or "high-risk" to have subsequent knee instability or meniscal injuries. This risk is based on the pre-injury level of sports participation and on the initial knee stability. For low-risk patients (mostly sedentary, senior), conservative treatment with physiotherapy leads to a satisfactory outcome. For high-risk patients (the young, competitive athlete), early ligament reconstruction is mandatory. Numerous ACL reconstruction techniques exist with auto- or allografts. However these guidelines must be adapted to the patient characteristics, motivations and expectations, in order to offer a treatment "a la carte". PMID:19160640

Duthon, Victoria B; Messerli, Guy; Menetrey, Jacques



[Indications and techniques of reconstruction after mastectomy].  


Reconstructive surgery takes an important place in breast cancer treatment. Immediate breast reconstruction is performed during the same operation as mastectomy. It is contraindicated following radiotherapy. Reconstruction performed after mastectomy is called differed breast reconstruction. It is completed 6 months after chemotherapy and 1 year after radiotherapy. Prosthetic breast reconstruction is indicated when tissues are of good qualities and breast are small. Autologous reconstruction is performed in case of radiotherapy or large breast. After breast reconstruction, imperfections can be corrected with autologous fat injection. PMID:23167073

Koch, Nathalie; Delaloye, Jean-François; Raffoul, Wassim



Routine preoperative cardiac catheterization necessary before repair of secundum and sinus venosus atrial septal defects  

SciTech Connect

Between January 1976 and July 1983, 217 patients with atrial septal defect underwent surgical repair at Children's Hospital. Thirty with a primum atrial septal defect and 26 who underwent cardiac catheterization elsewhere before being seen were excluded from analysis. Of the 161 remaining patients, 52 (31%) underwent preoperative cardiac catheterization, 38 because the physical examination was considered atypical for a secundum atrial septal defect and 14 because of a preexisting routine indication. One hundred nine (69%) underwent surgery without catheterization, with the attending cardiologist relying on clinical examination alone in 5, additional technetium radionuclide angiocardiography in 5, M-mode echocardiography in 13 and two-dimensional echocardiography in 43; both M-mode echocardiography and radionuclide angiography were performed in 24 and two-dimensional echocardiography and radionuclide angiography in 19. Since 1976, there has been a trend toward a reduction in the use of catheterization and use of one rather than two noninvasive or semiinvasive techniques for the detection of atrial defects. Of the 52 patients who underwent catheterization, the correct anatomic diagnosis was made before catheterization in 47 (90%). Two patients with a sinus venosus defect and one each with a sinus venosus defect plus partial anomalous pulmonary venous connection, partial anomalous pulmonary venous connection without an atrial septal defect and a sinoseptal defect were missed. Of 109 patients without catheterization, a correct morphologic diagnosis was made before surgery in 92 (84%). Nine patients with a sinus venosus defect, three with sinus venous defect and partial anomolous pulmonary venous connection, four with partial anomalous pulmonary venous return without an atrial septal defect and one with a secundum defect were incorrectly diagnosed.(ABSTRACT TRUNCATED AT 250 WORDS)

Freed, M.D.; Nadas, A.S.; Norwood, W.I.; Castaneda, A.R.



The retreatment: Indications, technique and results.  


Durability of endovascular treatment of intracranial aneurysms has always been an issue and a very strong point of criticism. Although studies on long-term results have made it clear that endovascular treatment safe and effective they, nonetheless showed retreatment after endovascular treatment is nearly 5-10 times more frequent than surgical clipping. Risk factors predisposing high probability of retreatment are aneurysm with dissecting nature, incomplete coiling, sac size larger than 10mm and localization at the bifurcations such as basilar tip. The indications for retreatment after endovascular treatment are not clear yet, although certain morphologic criteria can be used. Retreatment appears not to negate the initial advantage of endovascular treatment over surgical treatment and can be performed very small morbi-mortality numbers. PMID:23369856

Islak, Civan



Mandibular distraction in neonates: indications, technique, results  

PubMed Central

Background The Pierre Robin Sequence features were first described by Robin in 1923 and include micrognathia, glossoptosis and respiratory distress with an incidence estimated as 1:8,500 to 1:20,000 newborns. Upper airway obstruction and feeding difficulties are the main concerns related to the pathology. Mandibular distraction should be considered a treatment option (when other treatments result inadequate). Patiants and methods Ten patients between the ages of 1 month and 2 years with severe micrognathia and airway obstruction were treated with Mandibular Distraction Osteogenesis (MDO). All patients underwent fibroscopic examination of the upper airway and a radiographic imaging and/or computed tomography scans to detect malformations and to confirm that the obstruction was caused by posterior tongue displacement. All patients were evaluated by a multidisciplinary team. Indications for surgery included frequent apneic episodes with severe desaturation (70%). Gavage therapy was employed in all patients since oral feeding was not possible. The two tracheotomy patients were 5 months and 2 years old respectively, and the distraction procedure was performed to remove the tracheotomy tube. All patients were treated with bilateral mandibular distraction: two cases with an external multivector distraction device, six cases with an internal non-resorbable device and two cases with an internal resorbable device. In one case, the patient with Goldenhar's Syndrome, the procedure was repeated. Results The resolution of symptoms was obtained in all patients, and, when present, tracheotomy was removed without complications. Of the two patients with pre-existing tracheotomies, in the younger patient (5 months old) the tracheotomy was removed 7 days postoperatively. In the Goldenhar's syndrome case (2 years old) a Montgomery device was necessary for 6 months due to the presence of tracheotomy-inducted tracheomalacia. Patients were discharged when the endpoint was obtained: symptoms and signs of airway obstruction were resolved, PAS and maxillomandibular relationship improved, and tracheotomy, when present, removed. During the follow-up, no injury to the inferior alveolar nerve was noted and scarring was significant in only the two cases treated with external devices. Conclusion Mandibular Distraction Osteogenesis is a good solution in solving respiratory distress when other procedures are failed in paediatric patients with severe micrognatia.



Complications of transradial catheterization.  


Cardiac catheterization via the transradial approach has increased in the United States over the past few years; however, wide-scale adoption still lags in comparison to many international health care systems. Transradial catheterization has a unique set of complications and risks that each operator must appreciate. Radial artery spasm and radial artery occlusion are the most common complications, while bleeding complications such as hematomas and perforations are much less frequent. Each of these issues can be managed successfully with minor changes to one's practice. In this review of the current state of the art, the reader will develop an appreciation for the prevalence of each of the common complications as well as the less common, but potentially highly morbid, events. Throughout this evidence-based review, practical prevention strategies and specific treatment pathways are described for each issue that is covered. PMID:22115936

Dandekar, Vineet K; Vidovich, Mladen I; Shroff, Adhir R



Arrhythmias in cardiac catheterization laboratories.  


Several kinds of arrhythmias, such as ventricular arrhythmias, atrial fibrillation, bradycardias and conduction disturbances can occur in cardiac catheterization laboratories. The patients' characteristics, the type of procedure, the features of the target vessel and the type of lesion play important roles in the occurrence of arrhythmia. A majority of the arrhythmias tend to revert spontaneously, but special treatment must be given promptly when necessary. In this paper, we will review the pathophysiology, clinical importance and treatment strategies for arrhythmias that occurred during diagnostic cardiac catheterization and PCI in cardiac catheterization laboratories. PMID:18468208

Gorenek, Bulent



Outpatient cardiac catheterization and arteriography: Twenty-month experience at the Arizona Heart Institute  

PubMed Central

Arteriographic examination of the coronary, cerebral, and peripheral circulatory systems is the ultimate diagnostic technique for the identification and quantification of atherosclerotic occlusive disease. In the past, hospitalization has been required for this invasive procedure. Recently, however, the concept of outpatient catheterization and arteriography has become a reality. To investigate the integrity, safety, and cost-effectiveness of our outpatient invasive procedures laboratory, we analyzed our experience with 254 cardiac catheterizations and 174 peripheral arteriograms performed during a 20-month period. There were no deaths or major complications. Minor complications (11%) included bleeding from the cutdown site, nausea, numbness, and allergic reactions. Two patients with arrhythmias required cardioversion. Nine patients (2%) were transferred to the hospital for observation or immediate surgery due to the nature of their atherosclerotic lesions. This study reveals (1) the technical quality, safety, indications, and contraindications for outpatient catheterization and arteriography; (2) the enthusiastic patient acceptance of outpatient invasive diagnostic studies; (3) the economic impact of these procedures on escalating health-care costs; and (4) the potential for outpatient catheterization and arteriography on a broad scale.

Diethrich, Edward B.; Kinard, Sam A.; Pierce, Stephen A.; Koopot, Ravi



Myocardial Perfusion Scintigraphy: Techniques, Interpretation, Indications and Reporting  

PubMed Central

Myocardial perfusion single photon emission-computed tomography (MPS) has been one of the most important and common non-invasive diagnostic cardiac test. Gated MPS provides simultaneous assessment of myocardial perfusion and function with only one study. With appropriate attention to the MPS techniques, appropriate clinical utilization and effective reporting, gated MPS will remain a useful diagnostic test for many years to come. The aim of this article is to review the basic techniques of MPS, a simplified systematic approach for study interpretation, current clinical indications and reporting. After reading this article the reader should develop an understanding of the techniques, interpretation, current clinical indications and reporting of MPS studies.

Fathala, Ahmed



Doppler-guided retrograde catheterization system  

NASA Astrophysics Data System (ADS)

The purpose of this study was to investigate a Doppler guided catheterization system as an adjunctive or alternative methodology to overcome the disadvantages of left heart catheterization and angiography. These disadvantages include the biological effects of radiation and the toxic and volume effects of iodine contrast. Doppler retrograde guidance uses a 20 MHz circular pulsed Doppler crystal incorporated into the tip of a triple lumen multipurpose catheter and is advanced retrogradely using the directional flow information provided by the Doppler waveform. The velocity detection limits are either 1 m/second or 4 m/second depending upon the instrumentation. In a physiologic flow model of the human aortic arch, multiple data points revealed a positive wave form when flow was traveling toward the catheter tip indicating proper alignment for retrograde advancement. There was a negative wave form when flow was traveling away from the catheter tip if the catheter was in a branch or bent upon itself indicating improper catheter tip position for retrograde advancement. In a series of six dogs, the catheter was able to be accurately advanced from the femoral artery to the left ventricular chamber under Doppler signal guidance without the use of x-ray. The potential applications of a Doppler guided retrograde catheterization system include decreasing time requirements and allowing safer catheter guidance in patients with atherosclerotic vascular disease and suspected aortic dissection. The Doppler system may allow left ventricular pressure monitoring in the intensive care unit without the need for x-ray and it may allow left sided contrast echocardiography. With pulse velocity detection limits of 4 m/second, this system may allow catheter direction and passage into the aortic root and left ventricle in patients with aortic stenosis. A modification of the Doppler catheter may include transponder technology which would allow precise catheter tip localization once the catheter tip is placed in the aortic root. Such technology may conceivably assist in allowing selective coronary catheterization. These studies have demonstrated that Doppler guided retrograde catheterization provides an accurate method to catheterization the aortic root and left ventricular chamber without x-ray. In humans, it may prove useful in a variety of settings including the development of invasive ultrasonic diagnostic and therapeutic technology.

Frazin, Leon J.; Vonesh, Michael J.; Chandran, Krishnan B.; Khasho, Fouad; Lanza, George M.; Talano, James V.; McPherson, David D.



Deep Anterior Lamellar Keratoplasty: Indications, Surgical Techniques and Complications  

PubMed Central

The concept of lamellar keratoplasty (LK) is not new. However, it had been abandoned and largely replaced by the time-honored technique of penetrating keratoplasty (PK) because LK is technically demanding, time consuming and gives suboptimal visual outcomes due to interface irregularity arising from manual lamellar dissection. Recent improvements in surgical instruments and introduction of new techniques of maximum depth of corneal dissection as well as inherent advantages such as preservation of globe integrity and elimination of endothelial graft rejection have resulted in a re-introduction of LK as an acceptable alternative to conventional PK. This review article describes the indications, different techniques, clinical outcomes and complications of deep anterior LK.

Karimian, Farid; Feizi, Sepehr



Spectral analysis techniques for estimating power quality indices  

Microsoft Academic Search

This paper presents the theory, design and implementation of a real time virtual instrument to measure the power quality indices such as power factor, voltage harmonic distortion and current harmonic distortion as given by the IEEE standard. Windowing techniques offer an adjustable mechanism to detect low or high power harmonics as they have different leakage characteristics. Cross spectral density is

R. Zolfaghari; Y. Shrivastava; V. G. Agelidis



Surgical management of abdominal compartment syndrome; indications and techniques  

PubMed Central

The indications for surgical decompression of abdominal compartment syndrome (ACS) are not clearly defined, but undoubtedly some patients benefit from it. In patients without recent abdominal incisions, it can be achieved with full-thickness laparostomy (either midline, or transverse subcostal) or through a subcutaneous linea alba fasciotomy. In spite of the improvement in physiological variables and significant decrease in IAP, however, the effects of surgical decompression on organ function and outcome are less clear. Because of the significant morbidity associated with surgical decompression and the management of the ensuing open abdomen, more research is needed to better define the appropriate indications and techniques for surgical intervention.

Leppaniemi, Ari



Surgical management of PCL injuries: indications, techniques, and outcomes.  


The ideal treatment for posterior cruciate ligament (PCL) injuries is controversial and remains an active area of orthopedic research. The indications for surgery and the ideal method of reconstruction continue to be evaluated in biomechanical and clinical studies. Recent research has provided information on the anatomy and biomechanics of the PCL, and the merits and drawbacks of the transtibial compared with the tibial inlay technique, the use of single vs double-bundle reconstruction, and different graft options for reconstruction. This review discusses important factors in the surgical treatment of PCL injuries, with attention to the most current literature on these topics. PMID:23430587

Montgomery, Scott R; Johnson, Jared S; McAllister, David R; Petrigliano, Frank A



Auricular reconstruction: indications for autogenous and prosthetic techniques.  


Learning Objectives: After studying this article, the participant should be able to: 1. Describe the alternatives for auricular reconstruction. 2. Discuss the pros and cons of autogenous reconstruction of total or subtotal auricular defects. 3. Enumerate the indications for prosthetic reconstruction of total or subtotal auricular defects. 4. Understand the complexity of and the expertise required for prosthetic reconstruction of auricular defects. The indications for autogenous auricular reconstruction versus prosthetic reconstruction with osseointegrated implant-retained prostheses were outlined in Plastic and Reconstructive Surgery in 1994 by Wilkes et al. of Canada, but because of the relatively recent Food and Drug Administration approval (1995) of extraoral osseointegrated implants, these indications had not been examined by a surgical unit in the United States. The purpose of this article is to present an evolving algorithm based on an experience with 98 patients who underwent auricular reconstruction over a 10-year period. From this experience, the authors conclude that autogenous reconstruction is the procedure of choice in the majority of pediatric patients with microtia. Prosthetic reconstruction of the auricle is considered in such pediatric patients with congenital deformities for the following three relative indications: (1) failed autogenous reconstruction, (2) severe soft-tissue/skeletal hypoplasia, and/or (3) a low or unfavorable hairline. A fourth, and in our opinion the ideal, indication for prosthetic ear reconstruction is the acquired total or subtotal auricular defect, most often traumatic or ablative in origin, which is usually encountered in adults. Although prosthetic reconstruction requires surgical techniques that are less demanding than autogenous reconstruction, construction of the prosthesis is a time-consuming task requiring experience and expertise. Although autogenous reconstruction presents a technical challenge to the surgeon, it is the prosthetic reconstruction that requires lifelong attention and may be associated with late complications. This article reports the first American series of auricular reconstruction containing both autogenous and prosthetic methods by a single surgical team. PMID:11373570

Thorne, C H; Brecht, L E; Bradley, J P; Levine, J P; Hammerschlag, P; Longaker, M T



Clinical evaluation compared to pulmonary artery catheterization in the hemodynamic assessment of critically ill patients.  


Although pulmonary artery (PA) catheterization is frequently employed in the management of critically ill patients, there is little documentation that the information obtained alters patient management. This study evaluated prospectively this question in 103 PA catheterizations. Before catheterization, physicians were asked to predict the range of several hemodynamic variables, the presumed diagnosis, and their plan for therapy. After catheterization, each chart was reviewed. The hemodynamics at the time of catheterization and therapy within 8 h of catheterization were noted. Pulmonary artery occlusive (wedge) pressure (WP) was correctly predicted 30% of the time. Cardiac output, systemic vascular resistance (SVR), and right atrial pressure (RAP) were correctly predicted approximately 50% of the time. There was no significant difference in the ability to predict hemodynamics of subgroups with either hypotension or impaired oxygenation. After catheterization, planned therapy was altered in 58% of the cases. Unanticipated therapy was added in 30% of the cases. This study documents the difficulty of predicting accurately hemodynamics based solely on clinical evaluation. Thus, the information obtained by catheterization often leads to alterations in the therapeutic plan. We suggest that PA catheterization is both indicated and useful in the management of critically ill patients. PMID:6734221

Eisenberg, P R; Jaffe, A S; Schuster, D P



Interventional ultrasonography of the chest: Techniques and indications  

PubMed Central

Thoracic ultrasonography can be used for diagnostic purposes as well as a guide for diagnostic and therapeutic interventions. When the lesion or fluid collection has been located and the patient properly positioned, the angle of the needle is identified with respect to the transducer. The insertion tract should transgress the smallest possible area of aerated parenchyma. The needle can be introduced with a free-hand technique or with the aid of a needle guide. Correct planning of the procedure reduces intervention time and decreases the risk of complications. The main indications are superficial masses that require biopsy, pleural and parenchymal lesions formerly biopsied with CT or fluoroscopic guidance, and fluid collections that need to be drained. Ultrasound, thanks to its widespread use, simple execution, and low costs, represents a safe, manageable guide for thoracic interventions.

Almolla, J.; Balconi, G.



[Superselective catheterization of cerebral vessels].  


Superselective catheterization of 213 cerebral vessels in 84 patients with arteriovenous malformations (AVM) of the brain was conducted by means of different designs of balloon catheters and catheters without balloons. The authors performed superselective contrast study of 48 vessels of the 2nd order, 120 vessels of the 3rd order, and 45 vessels of the 4th order. Catheters were introduced into 35 branches of the anterior cerebral artery, 124 branches of the middle cerebral artery, anterior villous artery, catheters, twin-lumen balloon catheters and balloons with two catheters, balloon catheters with an opening in the head end of the balloon or those in which the balloon was made airtight temporarily, and catheters without balloons were tested. The authors prefer catheters with an open balloon and those without balloons for superselective catheterization of afferent vessels of AVM and for subsequent intravascular thrombosis. PMID:6506996

Serbinenko, F A; Lysachev, A G


Pediatric cardiac catheterization.  


The publications of 2000 and 2001 stress how interventional pediatric cardiology has moved from angioplasty to device placement. This review summarizes the important articles during the past year that evaluated the safety and efficacy of atrial septal defect devices, patent ductus occluders, and stents to treat coarctation of the aorta. The past year has also seen the emergence of old technologies that have been modified and expanded for new applications. The three areas of old technology reviewed are (1) using balloon angioplasty to palliate low birth weight infants with critical coarctation, (2) using coronary interventions in the pediatric patient, and (3) using balloon pulmonary angioplasty to treat patients with chronic thromboembolic pulmonary hypertension. Finally, this review describes the development of a new interventional technique, transcatheter implantation of a pulmonary valve, and outlines how real-time MRI in the next decade likely will replace x-ray fluoroscopy as the primary diagnostic and interventional imaging tool for the pediatric cardiologist. PMID:12015480

Rocchini, Albert P



Excellence in exotics: Practice tip: ferret urinary tract catheterization.  


In ferrets, urinary tract catheterization is most often indicated for neutered males with a urethral obstruction. Obstructions are commonly caused by prostatic enlargement secondary to adrenal tumor hormone production or, less commonly, by urolithiasis. A ferret with a urethral obstruction needs immediate intervention to relieve the obstruction. PMID:23532905

Hoefer, Heidi L



[Colon pouch as neorectum. Technique, indications and results].  


Colon pouch as neorectum. Technique, indications and results.The possibilities to preserve the intestinal continuity after surgery for rectal cancer have remarkably improved. After straight coloanal anastomosis the problem of a high stool frequency together with urgency was frequently to observe. The introduction of the colonic J-Pouch improved the functional outcome of rectal cancer-surgery very much. In a review of the literature the stool-frequency after one year was 0.5-4 bowel movements per day compared to 0.5-10 per day after straight coloanal anastomosis. Urgency was as well reduced. The parameter of urgency can be best expressed by measuring the urgency volume in balloon-volumetry. Here the volume for J-Pouch was 75 ml compared to 50 ml in straight coloanal anastomosis. At the beginning of colonic J-pouch-surgery evacuation disorders were more frequent observable. Clinical and experimental studies could demonstrate that a big pouch-size caused this problem. Since a pouch-length of 6 cm is used evacuation disorders are very rare. The improved perfusion of the side-to-end anastomosis in pouch-anastomosis reduces the rate of anastomotic leakage's (pouch 1.9 % vs. coloanal anastomosis 15.2 %). In published retrospective studies the oncological outcome is completely comparable to straight coloanal anastomosis. In the case of technical impossibility of J-pouch formation the ileocecal interponant is a possible alternative. This procedure has the same functional outcome. PMID:11819174

Kroesen, A J; Buhr, H J



Catheterization of the Hepatic Artery Via the Left Common Carotid Artery in Rats  

SciTech Connect

The commonly used approach for rat hepatic artery catheterization is via the gastroduodenal artery, which is ligated after the procedure. A new method of rat hepatic artery catheterization via the left common carotid artery (LCCA) is described. The LCCA is repaired after catheterization. The catheterization procedures included the following: (1) opening the rat's abdominal cavity and exposing the portion of abdominal aorta at the level of the celiac trunk; (2) separating and exposing the LCCA; inserting a microguidewire and microcatheter set into the LCCA via an incision; after placement into the descending aorta, the microguidewire and microcatheter are maneuvered into the hepatic artery under direct vision; (3) after transcatheter therapy, the catheter is withdrawn and the incision at the LCCA is repaired. This technique was employed on 60 male Sprague-Dawley rats with diethylnitrosamine-induced liver cancer, using a 3F microguidewire and microcatheter set. Selective hepatic artery catheterization was successfully performed in 57 rats. One rat died during the operation and five rats died within 7 days after the procedure. It is envisaged that as experience increases, the catheterization success rate will increase and the death rate will decrease. A new approach for selective hepatic artery catheterization via the LCCA in rats is introduced, which makes repeat catheterization of this artery possible and allows large embolization particles to be delivered by using a 3F catheter.

Li Xiao [West China Hospital, Sichuan University, Department of Radiology (China); Wang Yixiang, J. [AstraZeneca R and D (United Kingdom); Zhou Xiangping [West China Hospital, Sichuan University, Department of Radiology (China)], E-mail:; Guan Yongsong; Tang Chengwei [West China Hospital, Sichuan University, Department of Gastroenterology (China)



[Multisegmental en bloc spondylectomy. Indications, staging and surgical technique].  


OBJECTIVE: Description of the surgical technique including approaches and spinal reconstruction principles for patients scheduled for multilevel en bloc excision of vertebral tumors (multisegmental total en bloc spondylectomy) with the aim to attain tumor-free margins and minimize the risk of local and systemic tumor recurrence. Restoration of biomechanically sufficient spinal stability. Functional preservation and/or regaining of adequate neurological function. INDICATIONS: Primary malignant and benign, aggressive spinal tumors. Solitary metastatic tumors of biologically and prognostically favorable primary tumor (good prognostic scores). Extracompartmental, multisegmental vertebral tumor manifestations according to Tomita type 6. CONTRAINDICATIONS: Diffuse spinal/vertebral tumor spread according to Tomita type 7 (disseminated spinal metastatic disease). Detection of distant metastases in the staging investigation. Biologically unfavorable tumor entities or primary systemic malignant tumors/diffuse disseminated malignoma (Tomita score TECHNIQUE: Depending on tumor growth, sequential performance of the anterior and posterior approach for local tumor release and preparation/replacement of encased large vessels. Posterior approach via dorsomedial incision and exposure of the posterior vertebral elements. Costotransversectomy, resection of the facets, resection of paravertebral rib segments. Laminectomy in the tumor-free lamina segment, resection of the ligamentum flavum and paradural ligation of affected nerve roots, bilateral ligation of the segmental arteries. Digital extrapleural palpation and dissection to the anterior vertebral body parts. Insertion of S-shaped spatulas ventral to the anterior aspect of the spine, and dissection of the disc spaces and the posterior longitudinal ligament. Instrumentation of pedicle screws and unilateral rod fixation, mobilization and careful, manual turning out/rotation of the affected vertebral segments around the longitudinal axis of the spinal cord. Interpositioning of a carbon-composite cage from posterior filled with autologous bone. Completion of the posterior stabilization, soft tissue closure, Goretex patch fixation if required in cases of chest wall resections. POSTOPERATIVE MANAGEMENT: Intensive care monitoring with balanced volume replacement/transfusion. Postoperative adjuvant radiotherapy or chemotherapy, depending on the protocol and resection margins. PMID:22743631

Druschel, C; Disch, A C; Melcher, I; Luzzati, A; Haas, N P; Schaser, K-D



Complications associated with pediatric cardiac catheterization  

Microsoft Academic Search

Objectives. The aim of this study was to determine the relative risks of pediatric diagnostic, interventional and electrophysiologic catheterizations.Background. The role of the pediatric catheterization laboratory has evolved in the last decade as a therapeutic modality, although remaining an important tool for anatomic and hemodynamic diagnosis.Methods. A study of 4,952 consecutive pediatric catheterization procedures was undertaken.Results. Patient ages ranged from

Renato Vitiello; Brian W McCrindle; David Nykanen; Robert M Freedom; Lee N Benson



Ultrasound-assisted internal jugular vein catheterization in the ED.  


A prospective, descriptive study is reported on the use and success of ultrasound-assisted internal jugular central vein catheterization (CVC) in the emergency department (ED). In patients not in cardiac arrest who had an indication for internal jugular CVC, lines were placed by trained ED staff using ultrasound. Data were collected prospectively on age, sex, body habitus, indication, vein visibility, number of punctures and needle passes, and success. There were 40 attempts at internal jugular CVC in 34 patients and ultrasound was used in 32 of the 40 (80%) attempts. Incidences of successful puncture and cannulation using ultrasound were 93.8% (30 of 32) and 81.3% (26 of 32), respectively, compared with 62.5% (5 of 8) and 62.5% (5 of 8) in the landmark group. In 8 patients with no visual or palpable landmarks, cannulation was successful in 100% (7 of 7) using ultrasound and in 0% (0 of 1) using landmark technique. Ultrasound-assisted internal jugular CVC is an easily learned technique that is useful in the ED. It may be especially helpful in patients in whom landmarks are not visible and not palpable. PMID:9672463

Hrics, P; Wilber, S; Blanda, M P; Gallo, U




Microsoft Academic Search

Purpose:Clean intermittent catheterization (CIC) is commonly used in the management of voiding dysfunction associated with neurospinal dysraphism. We determined the incidence of genitourinary complications associated with this technique in a population of children with spina bifida.




Robotic myomectomy: a review of indications and techniques.  


The primary surgical techniques used in myomectomy are open surgery, laparoscopic surgery, and, recently, robot-assisted ("robotic") surgery. The optimal surgical treatment of myomas is still a subject of debate because of the limitations of minimally invasive techniques and the disadvantages of laparotomy. In this article, the authors discuss the technique and the application of robotic myomectomy in the treatment of uterine fibroids. PMID:21364851

Quaas, Alexander M; Einarsson, Jon I; Srouji, Serene; Gargiulo, Antonio R



[Sentinel node biopsy in breast cancer: techniques and indications].  


Sentinel node biopsy (SNB) has proved to be a useful and accurate procedure for lymph node staging in breast cancer and melanoma and should be standard of care in the treatment of these tumors. In other malignancies (colon, rectum, stomach, esophagus, head and neck and thyroid, cervix uteri) it is still under investigation. SNB in breast cancer was accepted as a sole and reliable diagnostic method in breast cancer from the panel of distinguished experts at the 8th international conference of primary therapy of early breast cancer 2003 in St. Gallen. Combination of the current techniques with radiocolloids and blue dye, applicated superficially (intradermal, subdermal, peri- and subareolar) and deeply (peritumoral, intratumoral, subtumoral) enables high identification rates and negative predictive values. It should be performed by teams consisting of surgeons, pathologists and nuclear medicine specialists with appropriate training and experience. Accepted indications are uni- and multifocal tumors smaller than 3 cm without suspicious findings in the axilla, furthermore SNB is indicated in patients with large ductal carcinoma in situ (>2cm) and/or with assumed microinvasion. Albeit SNB could be shown to be safe after preoperative chemotherapy and in multicentric breast cancer, due to lack of sufficient data it is still under discussion in these cases. Expedience of this procedure in other lymph node basins, along the mammaria interna vessels or in the infra- and supraclavicular region is considered to be at an investigative stage as well. SNB allows the pathologist to focus on a small number of nodes most likely to contain metastases. Application of serial sectioning and immunhistochemistry results in a more accurate staging than routine examination. Detection of additional micrometastases that are found in 10-15% leads to an upgrading from N0 to N1. Broad application and refurbishment led to scientific discussion of prognostic importance of micrometastases and its relevance according axillary dissection and adjuvant systemic treatment. Although many unicentric and multicentric observational studies validated by complete axillary dissection could demonstrate that SNB is accurate and suitable for all operable clinically node-negative breast cancers, longterm results and especially the incidence of axillary recurrence and its sequelae are outstanding. Findings of ongoing large prospective randomized trials like NSABP 32, Z0010 and Z0011 of the American College of Surgeons (ACOSOG), the AMAROS-Trial of the European Organisation of Research and Treatment of Cancer (EORTC) and the ALMANAC-Trial of the British Association of Surgical Oncology (BASO) will give a conclusive answer. Significant improvement in morbidity and quality of life measurements could be revealed several times in unicentric and even in muticentric studies like ALMANAC. Sentinel node biopsy is a team approach, requirements are good cooperation and well-defined stuctures of quality indicators and documentation. Participation in national clinical studies is recommended. PMID:15847190

Haid, Anton; Knauer, Michael; Köberle-Wührer, Roswitha; Wenzl, Etienne



Indications, techniques, and complications of major salivary gland extirpation.  


This article reviews major salivary gland anatomy and the differential diagnosis of salivary gland disease. The surgical technique for parotid and submandibular gland excision is described in detail. Possible complications and their management are also discussed, followed by a brief literature review of new surgical techniques. PMID:19608047

Hsu, Amy K; Kutler, David I



Doppler-guided retrograde catheterization system  

Microsoft Academic Search

The purpose of this study was to investigate a Doppler guided catheterization system as an adjunctive or alternative methodology to overcome the disadvantages of left heart catheterization and angiography. These disadvantages include the biological effects of radiation and the toxic and volume effects of iodine contrast. Doppler retrograde guidance uses a 20 MHz circular pulsed Doppler crystal incorporated into the

Leon J. Frazin; Michael J. Vonesh; Krishnan B. Chandran; Fouad Khasho; George M. Lanza; James V. Talano; David D. McPherson



[Labiaplasty: plastic or cosmetic surgery? Indications, techniques, results and complications].  


Labiaplasty is the surgical term for labia minora reduction. This procedure has become popular with plastic surgery patients because physical discomfort and cosmetic concerns are virtually always combined. Demand for this procedure is becoming common amongst very young patients who appear to have nurtured a complex since their early adolescent years, disturbing their love life. There are several possible corrective surgical techniques, the postoperative courses of which vary significantly. The traditional method (longitudinal resection) remains the most widely used, but requires resection of the larger part of the labia minora, which is why in our opinion the V plasty technique seems more appropriate. The benefits, technical details, complications and postoperative course of the V plasty technique are detailed by the author in this article. PMID:19223103

Benadiba, L



Immersion Fluid Refractive Indices Using Prism Minimum Deviation Techniques  

Microsoft Academic Search

Immersion fluids for 157 nm and 193 nm immersion lithography have been measured over the spectral range from 156 nm to 1700 nm in a nitrogen purged environment. The refractive index n and k of several candidate fluids have been measured using the prism minimum deviation technique implemented on a commercial Variable Angle Spectroscopic Ellipsometer (VASE®) system. For measurement the

Roger H. French; Min K. Yang; M. F. Lemon; R. A. Synowicki; Greg K. Pribil; Gerald T. Cooney; Craig M. Herzinger; Steven E. Green; John H. Burnett; Simon Kaplan


Primary cricotracheal resection in children: indications, technique and outcome  

Microsoft Academic Search

Objective: Treatment of subglottic stenosis has benefited greatly from development of grafting techniques such as larygontracheoplasty. Meanwhile, cricotracheal resection of the stenotic area and a major part of the cricoid cartilage have been shown to give excellent results in adults. Patients and methods: From June 1993 to June 2000, we performed cricotracheal resection, as the primary surgical procedure, for acquired

J. M. Triglia; R. Nicollas; S. Roman




Microsoft Academic Search

ABSTRACT Methods are presented for estimating an index of relative abundance,from trawl survey catch per tow data. The estimated variance of the index takes into account the within survey variability in catch and possible yearly changes in catchability. Applying the techniques to a series of surveys for yellowtail flounder, Limandaferrugin.ea,off the northeast coast of the United States yields an abundance

Michael Pennington


Laparoscopic Resection of the Left Pancreas: Technique and Indication  

Microsoft Academic Search

Laparoscopic pancreatic resections are rare procedures. A particular position is held by the left resection. In animal trials and 37 operations performed to date, this laparoscopic procedure has been positively assessed. The diseases operated upon were nearly exclusively benign. From November 1998 to July 2001, we performed 5 laparoscopic distal pancreatic resections at our hospital. The indications were: 2 adenocarcinomas;

E. Bärlehner; S. Anders; R. Schwetling



Comparison of catheterization and Doppler-derived pressure gradients in a canine model of subaortic stenosis.  


The relationship between Doppler-estimated and catheterization-measured pressure gradients was examined by repeated-measures linear regression analysis and difference plots in 15 dogs with naturally occurring subvalvular aortic stenosis. Thirty left ventricular outflow tract gradients were compared during sinus rhythm and 142 gradients during premature or postextrasystolic beats for the following pairs of data: (1) mean catheterization gradient versus mean Doppler gradient, (2) maximal instantaneous catheterization gradient versus maximal Doppler gradient, and (3) peak-to-peak catheterization gradient versus maximal Doppler gradient. The correlation between Doppler-derived and catheterization-derived pressure gradients was excellent (r = 0.99; p < 0.001) for the maximal instantaneous (sinus rhythm: standard error of the estimate [SEE] = 5.7 mm Hg; premature and postextrasystolic beats: SEE = 6.7 mm Hg) and mean gradients (sinus rhythm: SEE = 3.6 mm Hg; premature and postextrasystolic beats: SEE = 4.5 mm Hg). There was also a strong correlation between the peak-to-peak catheterization gradient and the maximal Doppler gradient (sinus rhythm: r = 0.99, p < 0.001, SEE = 5.3 mm Hg; premature and postextrasystolic beats: r = 0.97, p < 0.001, SEE = 7.2 mm Hg). Agreement between the two techniques was best for mean gradients and most disparate for the comparisons of maximal Doppler gradients and peak-to-peak catheterization gradients. PMID:9417203

Lehmkuhl, L B; Bonagura, J D; Jones, D E; Stepien, R L


Microsurgical epididymal sperm aspiration: indications, techniques and outcomes  

PubMed Central

Microsurgical epididymal sperm aspiration (MESA) refers to retrieval of sperm-containing fluid from optimal areas of the epididymis that are selected and sampled using high-power optical magnification provided by an operating microscope. Retrieved sperm are subsequently used for intracytoplasmic sperm injection (ICSI) to induce fertilization and pregnancy. MESA is considered by many experts to be the gold standard technique for sperm retrieval in men with obstructive azoospermia given its high yield of quality sperm, excellent reported fertilization and pregnancy rates, and low risk of complications. However, MESA must be performed in an operating room, requires microsurgical skills and is only useful for reproduction using ICSI. Herein we present an overview of the evaluation of candidate patients for MESA, the technical performance of the procedure and the outcomes that have been reported.

Bernie, Aaron M; Ramasamy, Ranjith; Stember, Doron S; Stahl, Peter J



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

SciTech Connect

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

Walser, Eric M., E-mail: [Mayo Clinic, Department of Radiology (United States)



[Catheterization of the tubal ostium using hysteroscopy under laparoscopic guidance].  


It is considered that one out of five couples present a transitory problem of infertility during their reproductive life and the most frequent cause is the tubarian pathology; from these, the proximal obstruction occupies between 25 and 30% of the cases. Unfortunatelly, the conventional method use to study tubarian patency such as histerosalpingography or the direct observation by laparoscopy and selective chromotubation, frequently do not allow to differentiate between an insufficient filling of the tubes, tubarian spasm or a true mechanical obstruction. There are certain selective tubarian cannulation techniques, for example, the catheterism with hysteroscopic guidance which is extremely usefull in the diagnosis of tubarian patency or in the confirmation of partial or total proximal tubal disease. The procedure permits to diagnosticate precisely the tubarian obstruction and also if it is due to the presence of a true pathology or simply functional, or secondary to a tubarian spasm; besides it also works as a therapeutic procedure since in the first case permits the lysis of laxe adherencies and the removal of the amorfus material that obstructs the tube and permits the catheterization. The present study determines the utility of catheterization of the tubarian ostium by hysteroscopy with laparoscopic control using the Novy (Cook, Ob/ Gyn) catheter in patients with infertility problems due to proximal obstruction of one or both of the fallopian tubes, to confirm or discard the presence of a pathological obstruction. The results are evaluated in terms of tubarian permeability and the pregnancy rate after the procedure. PMID:10327767

Salazar López-Ortíz, C; Mondragón Alcocer, H L; Hernández Vivar, L; Castro López, J L; Sánchez Solís, V



Complications of cardiac catheterization: one centre's experience.  

PubMed Central

Data on complication rates in a cardiac catheterization laboratory were prospectively gathered over a 6-year period. During this time 7960 catheterizations were performed. Death occurred in seven (0.1%) of the cases. The difference between the mortality rates for procedures performed with and without systemically administered heparin (0.04% and 0.2% respectively) was barely statistically significant (p less than 0.05). A significant complication occurred in 1.5% of the cases; however, most did not have long-term sequelae. No significant change in the annual rate of such complications was seen during the study period. Such a tabulation permits audit of quality of care, points out changing trends in morbidity and offers meaningful information on the safety of cardiac catheterization to referring physicians and their patients.

Morton, B C; Beanlands, D S



Neuropathic bladder and intermittent catheterization: social and psychological impact on children and adolescents.  


This paper describes part of larger study involving 40 families of children and adolescents with neuropathic bladder looking at the psychosocial impact of catheterization on them and their families. This study focuses on their experiences of clean intermittent catheterization (CIC) and self-catheterization (SC). Twenty-eight children and adolescents (11 males, 17 females; mean age 9 years, SD 2 years 7 months, range 5 to 20 years) with neuropathic bladder (mostly with spina bifida) participated in a semi-structured interview to explore their understanding of micturition and catheterization, and their views about the introduction and practical use of this technique. Participants were invited to draw self-portraits and figure diagrams to depict their understanding of CIC and SC. Age-appropriate self-esteem measures (Harter Pictorial Scale of Perceived Competence, the Self-Perception Profile, and the Culture-Free Self-Esteem Inventory) were administered to see if catheterization status affected emotional well-being. In an extension of this study, children's experiences of SC were explored by a postal questionnaire to all children successfully using SC who were attending the Paediatric Neuropathic Bladder Clinic. Children aged <5 years, those with learning difficulties, and those using indwelling catheters were excluded. From a total sample of 66 (31 females, 35 males), 52 parents and 42 children and adolescents (28 females and 14 males) responded. No significant difference was observed in self-esteem for those successfully catheterizing. Specific challenges involved learning SC and practical use of the technique. Concerns were leakage and being wet, and peers finding out about their continence management. Implications for the education, problem solving, and support of families and young people to promote cooperation and optimal benefits from catheterization are discussed. PMID:14995086

Edwards, Melinda; Borzyskowski, Malgorzata; Cox, Antony; Badcock, Janet



A rare complication of radial artery catheterization.  


An arterial pseudoaneurysm is a cavity which does not consist of three layers of arterial wall and is generally seen at femoral and radial artery sites due to bone fractures, arterial injuries and iatrogenic reasons such as catheterization. The treatment choice may be either surgical or conservative. Patients with pseudoaneurysm should be carefully followed and the treatment choice should be immediately decided to avoid possible complications. We report a case of pseudoaneurysm formation in the radial artery that occurred one week after arterial catheterization for coronary angiography. The treatment choice for this patient was surgical and he was discharged without any complications. PMID:21652670

Inan, Mustafa Bahadir; Acikgoz, Burak; Yazicioglu, Levent; Kaya, Bulent; Ozyurda, Umit


Indications and techniques of endoscopy in evaluation of cervical dysphagia: Comparison with radiographic techniques  

Microsoft Academic Search

The technique of fiberoptic endoscopic evaluation of swallowing disorders (FEES), and a comparison of its utility with that of videofluoroscopic examination in patients with dysphagia, was presented in a workshop session. Viewpoints were expressed by two speech pathologists and an otolaryngologist experienced in assessment and treatment of patients with dysphagia, and representative cases, illustrated withvideotaped FEES and videofluoroscopic studies, were

Thomas M. Kidder; Susan E. Langmore; Bonnie J. W. Martin



Coil Embolization Treatment in Pulmonary Artery Branch Rupture During Swan-Ganz Catheterization  

SciTech Connect

Rupture of the pulmonary artery or one of its branches during Swan-Ganz catheterization is a complication that is rare but remains fatal in almost 50% of cases. The risk factors and mechanisms involved in the pathogenesis of this accident have been widely reported. Management is twofold: resuscitation procedures and specific medical or even surgical treatment. We report a case of pulmonary artery rupture occurring during Swan-Ganz catheterization that was treated by coil embolization. This technique, which is quick and simple to use, would appear to be very promising. This is the first case of successful emergency treatment of pulmonary artery rupture using an endovascular technique.

Gottwalles, Yannick [Intensive Care Unit GHPCA, Saint Joseph Clinic, 16, Rue Roesselmann, F-68027 Colmar Cedex (France); Wunschel-Joseph, Marie-Eve; Hanssen, Michel [Interventional Cardiology Unit, General Hospital, 64, Avenue du Professeur Leriche, F-67504 Haguenau Cedex (France)



Cardiac Catheterization Services in Central Virginia 1981: Appropriateness Review Findings.  

National Technical Information Service (NTIS)

The Central Virginia Health Systems Agency (CVHSA) has developed and implemented specific criteria and standards for Cardiac Catheterization Services. These criteria are reviewed in the context of the current status of cardiac catheterization services in ...



Clean Intermittent Catheterization in the School Setting  

ERIC Educational Resources Information Center

|Spina bifida (SB) is a neural tube defect that causes many physical and mental disabilities. Bowel and bladder incontinence is the disability seen most often in these students that requires the school nurse's attention. Clean intermittent catheterization (CIC) provides the student with SB a vehicle to reach a satisfactory level of continence,…

Katrancha, Elizabeth D.



Percutaneous Extraluminal (Subintimal) Recanalization of a Brachial Artery Occlusion Following Cardiac Catheterization  

SciTech Connect

A 47-year-old woman presented with disabling right arm claudication 10 weeks after Sones cardiac catheterization via a brachial artery cut-down. A technique of extraluminal recanalization of the brachial artery occlusion, used to treat this patient, is described.

Bolia, Amman [Department of Radiology, Clinical Sciences Building, Leicester Royal Infirmary, PO Box 65, Leicester LE2 7LX (United Kingdom); Nasim, Akhtar; Bell, Peter R.F. [Department of Surgery, Clinical Sciences Building, Leicester Royal Infirmary, PO Box 65, Leicester LE2 7LX (United Kingdom)



Case-Series of Nurse-Administered Nitrous Oxide for Urinary Catheterization in Children  

Microsoft Academic Search

BACKGROUND: Children undergoing urologic imaging studies requiring urethral catheterization experience considerable discomfort and psychological distress. Nitrous oxide sedation may mitigate these detriments but the requirement for physician administration has limited the applicability of this technique. METHODS: Registered nurses underwent the nitrous oxide training requirements pre- scribed for state licensure of dentists and dental hygienists, with special emphasis on pediatric sedation

Judith L. Zier; Gloria J. Drake; Paul C. McCormick; Katherine M. Clinch; David N. Cornfield




Microsoft Academic Search

Purpose: Clean intermittent catheterization (CIC) is commonly used in the management of voiding dysfunction associated with neurospinal dysraphism. We determined the incidence of genitourinary complications associated with this technique in a population of children with spina bifida. Materials and Methods: The charts of all children younger than 13 years attending a multi- disciplinary spina bifida clinic between 1987 and 2002




Infection control guidelines for the cardiac catheterization laboratory: society guidelines revisited.  


In the early years of diagnostic cardiac catheterization, strict sterile precautions were required for cutdown procedures. Thirteen years ago, when the original guidelines were written, the brachial arteriotomy was still frequently utilized, femoral closure devices were uncommon, "implantables," such as intracoronary stents and PFO/ASD closure devices, were in their infancy, and percutaneous valve replacement was not a consideration. In 2005, the cardiac catheterization laboratory is a complex interventional suite with percutaneous access routine and device implantation standard. Despite frequent device implantation, strict sterile precautions are often not observed. Reasons for this include a decline in brachial artery cutdown, limited postprocedure follow-up with few reported infections, limited use of hats and masks in televised cases, and lack of current guidelines. Proper sterile technique has the potential to decrease the patient infection rate. Hand washing remains the most important procedure for preventing infections. Caps, masks, gowns, and gloves help to protect the patient by maintaining a sterile field. Protection of personnel may be accomplished by proper gowning, gloving, and eye wear, disposal of contaminated equipment, and prevention and care of puncture wounds and lacerations. With the potential for acquired disease from blood-borne pathogens, the need for protective measures is as essential in the cardiac catheterization laboratory as is the standard Universal Precautions, which are applied throughout the hospital. All personnel should strongly consider vaccination for hepatitis B. Maintenance of the cardiac catheterization laboratory environment includes appropriate cleaning, limitation of traffic, and adequate ventilation. In an SCAI survey, members recommended an update on guidelines for infection control in the cardiac catheterization laboratory. The following revision of the original 1992 guidelines is written specifically to address the increased utilization of the catheterization laboratory as an interventional suite with device implantation. In this update, infection protection is divided into sections on the patient, the laboratory personnel, and the laboratory environment. Additionally, specific CDC recommendation sections highlight recommendations from other published guidelines. PMID:16331649

Chambers, Charles E; Eisenhauer, Michael D; McNicol, Lynn B; Block, Peter C; Phillips, William J; Dehmer, Gregory J; Heupler, Frederick A; Blankenship, James C



[Lower lid entropion and ectropion. Indication, technique and key points of "classical" surgical methods].  


Lower lid malposition is common, increases with age and leads to impaired optical function of the ocular surface through chronic irritation of the conjunctiva and cornea. Numerous techniques have been described to reposition the lid margin to the globe and secure this position while maintaining intact motility. Some of these techniques have passed the test of time and have reached the status of "classic" standard procedures that need to be in the armamentarium of every oculoplastic surgeon. The aim of this article is to consider the merits of a selection of standard methods for the correction of lower lid entropion and ectropion by describing their indication, technique and key points. PMID:22532044

Schaudig, U; Heidari, P; Schumacher, S



Two new bioassay techniques for nitrofurans: Bacteroides fragilis and rec-Escherichia coli as indicator strains.  


Techniques for the microbiological assay of nitrofurans are described. In one the indicator strain is Bacteroides fragilis; use of this system enables concentrations of nifuratel and furazolidone of down to 0.7 micrograms/ml to be estimated. The other system uses a recombination-deficient (recA-uvrA-) mutant of Escherichia coli; with this indicator, concentrations of 0.2 micrograms/ml, or less, of five nitrofurans can be assayed. PMID:324721

Hamilton-Miller, J M; Kerry, D W; Reynolds, A V; Brumfitt, W



Complete heart block during cardiac catheterization in a normal individual.  


A 44-year-old white male who developed third-degree heart block during cardiac catheterization is presented. Right heart catheterization precipitated bifascicular block, right bundle branch block with left posterior hemiblock, and resulted in third-degree heart block during the left heart procedure. It is recommended that multiple electrocardiographic lead monitoring be considered during cardiac catheterization in order to recognize more easily high-risk conduction disturbances, ie a bifascicular block pattern with frontal plane axis shifts. PMID:6509544

Baird, C L; Borst, M P; Maxfield, D L



Spectral analysis techniques with Kalman filtering for estimating power quality indices  

Microsoft Academic Search

This paper presents the theory, design and implementation of two real time virtual instruments to measure the power quality indices such as current harmonic distortion, voltage harmonic distortion and power factor as given by the IEEE standard. Different windowing techniques are explored in the estimation of the spectra. Cross spectral analysis is used for the measurement of phase angles in

R. Zolfaghari; Y. Shrivastava; V. G. Agelidis; G. M. L. Chu



Indications, complications, and surgical techniques for pediatric tracheostomies[mdash ]An update  

Microsoft Academic Search

Background: With the decrease of life-threatening obstructive upper airway infections and the ongoing improvement of intensive care medicine, the role of tracheostomy in children has been changing considerably, until now. The aim of this study was to establish data regarding indications, complications, and techniques of pediatric tracheostomy, which would reflect the current state of science. Methods: The authors analyzed the

B. Kremer; A. I. Botos-Kremer; H. E. Eckel



Iatrogenic vertebral artery pseudoaneurysm due to central venous catheterization  

PubMed Central

Central venous lines have become an integral part of patient care, but they are not without complications. Vertebral artery pseudoaneurysm formation is one of the rarer complications of central line placement. Presented is a rare case of two pseudoaneurysms of the vertebral and subclavian artery after an attempted internal jugular vein catheterization. These were successfully treated with open surgical repair and bypass. Open surgical repair remains the gold standard of treatment. Endovascular repair of vertebral artery pseudoaneurysms has been described with promising outcomes, but long-term results are lacking. Ultimately, the best treatment of these iatrogenic injuries should start with prevention. Well-documented techniques to minimize mechanical complications, including inadvertent arterial puncture, should be practiced and taught in training programs to avoid the potentially devastating consequences.

Vasquez, Jay



Catheterization and embolization of a replaced left hepatic artery via the right gastric artery through the anastomosis: a case report  

PubMed Central

Introduction Conversion of multiple hepatic arteries into a single vascular supply is a very important technique for repeat hepatic arterial infusion chemotherapy using an implanted port catheter system. Catheterization of a replaced left hepatic artery arising from a left gastric artery using a percutaneous catheter technique is sometimes difficult, despite the recent development of advanced interventional techniques. Case presentation We present a case of a 70-year-old Japanese man with multiple hepatocellular carcinomas in whom the replaced left hepatic artery arising from the left gastric artery needed to be embolized. After several failed procedures, the replaced left hepatic artery was successfully catheterized and embolized with a microcatheter and microcoils via the right gastric artery through the anastomosis. Conclusion A replaced left hepatic artery arising from a left gastric artery can be catheterized via a right gastric artery by using the appropriate microcatheter and microguidewires, and multiple hepatic arteries can be converted into a single supply.



Complex regional pain syndrome following transfemoral catheterization.  


Complex regional pain syndrome (CRPS) (previously reflex sympathetic dystrophy) is a chronic pain condition usually resulting as a consequence of trauma or surgery. Though described occasionally after vascular surgery, it is distinctly rare after percutaneous cardiovascular procedures. We report a case of CRPS following trans- femoral catheterization-related groin pseudoaneurysm. To our knowledge, this is the first such report following transfemoral catheterization. A 36-year-old female underwent an electrophysiological study and AV node re-entry tachycardia ablation using the left femoral vein approach. One month later she presented complaining of numbness and tingling in her left foot with swelling and mild groin discomfort. A lower extremity duplex scan showed a left common femoral artery pseudoaneurysm that was partially thrombosed and subsequently resolved spontaneously. The patient had intractable symptoms of pain, temperature changes, color changes, and trophic changes of the left foot. Conventional angiography was done to rule out occlusive arterial disease but just showed very sluggish flow. Further evaluation with transcutaneous oxymetry and 3-phase bone scan was consistent with microvascular dysfunction and poor cutaneous blood flow suggestive of cold-type CRPS. In this case report, we also review the clinical features and the vascular changes associated with CRPS and discuss the pathophysiology of the syndrome from a cardiovascular specialist's perspective. Interventionalists should be aware that CRPS is a possible, albeit rare, condition that may follow many vascular procedures that they perform on a daily basis. PMID:22045092

Saad, Andre; Knolla, Raelene; Gupta, Kamal



Endovascular aortic aneurysm repair with chimney and snorkel grafts: indications, techniques and results.  


The chimney technique in endovascular aortic aneurysm repair (Ch-EVAR) involves placement of a stent or stent-graft parallel to the main aortic stent-graft to extend the proximal or distal sealing zone while maintaining side branch patency. Ch-EVAR can facilitate endovascular repair of juxtarenal and aortic arch pathology using available standard aortic stent-grafts, therefore, eliminating the manufacturing delays required for customised fenestrated and branched stent-grafts. Several case series have demonstrated the feasibility of Ch-EVAR both in acute and elective cases with good early results. This review discusses indications, technique, and the current available clinical data on Ch-EVAR. PMID:23674274

Patel, Rakesh P; Katsargyris, Athanasios; Verhoeven, Eric L G; Adam, Donald J; Hardman, John A



The risks of waiting for cardiac catheterization: a prospective study  

Microsoft Academic Search

Background: Few large, systematic, prospective studies have documented the char- acteristics and clinical outcomes of patients awaiting cardiac catheterization and the delays that they experience. The primary objective of this study was to quantify the waiting times, morbidity and mortality of patients waiting for catheterization. A secondary objective was to identify predictors of cardiac events that occur while patients are

Madhu K. Natarajan; Shamir R. Mehta; Douglas H. Holder; David R. Goodhart; Amiram Gafni; Donald Shilton; Rizwan Afzal; Koon Teo; Salim Yusuf


Prognostic Value of Left Ventricular Diastolic Dysfunction in Patients Undergoing Cardiac Catheterization for Coronary Artery Disease  

PubMed Central

We hypothesized that left ventricular (LV) diastolic dysfunction assessed by cardiac catheterization may be associated with increased risk for cardiovascular events. To test the hypothesis, we assessed diastolic function by cardiac catheterization (relaxation time constant (Tau) and end-diastolic pressure (EDP)) as well as Doppler echocardiography (early diastolic mitral annular velocity (e?) and a ratio of early diastolic mitral inflow to annular velocities (E/e?)) in 222 consecutive patients undergoing cardiac catheterization for coronary artery disease (CAD). During a followup of 1364 ± 628 days, 5 cardiac deaths and 20 unscheduled cardiovascular hospitalizations were observed. Among LV diastolic function indices, Tau > 48?ms and e? < 5.8?cm/s were each significantly associated with lower rate of survival free of cardiovascular hospitalization. Even after adjustment for potential confounders (traditional cardiovascular risk factors, the severity of CAD, and cardiovascular medications), the predictive value of Tau > 48?ms and e? < 5.8?cm/s remained significant. No predictive value was observed in EDP, E/e?, or LV ejection fraction. In conclusion, LV diastolic dysfunction, particularly impaired LV relaxation assessed by both cardiac catheterization and Doppler echocardiography, is independently associated with increased risk for cardiac death or cardiovascular hospitalization in patients with known or suspected CAD.

Fukuta, Hidekatsu; Ohte, Nobuyuki; Wakami, Kazuaki; Goto, Toshihiko; Tani, Tomomitsu; Kimura, Genjiro



Prognostic value of left ventricular diastolic dysfunction in patients undergoing cardiac catheterization for coronary artery disease.  


We hypothesized that left ventricular (LV) diastolic dysfunction assessed by cardiac catheterization may be associated with increased risk for cardiovascular events. To test the hypothesis, we assessed diastolic function by cardiac catheterization (relaxation time constant (Tau) and end-diastolic pressure (EDP)) as well as Doppler echocardiography (early diastolic mitral annular velocity (e') and a ratio of early diastolic mitral inflow to annular velocities (E/e')) in 222 consecutive patients undergoing cardiac catheterization for coronary artery disease (CAD). During a followup of 1364 ± 628 days, 5 cardiac deaths and 20 unscheduled cardiovascular hospitalizations were observed. Among LV diastolic function indices, Tau > 48?ms and e' < 5.8?cm/s were each significantly associated with lower rate of survival free of cardiovascular hospitalization. Even after adjustment for potential confounders (traditional cardiovascular risk factors, the severity of CAD, and cardiovascular medications), the predictive value of Tau > 48?ms and e' < 5.8?cm/s remained significant. No predictive value was observed in EDP, E/e', or LV ejection fraction. In conclusion, LV diastolic dysfunction, particularly impaired LV relaxation assessed by both cardiac catheterization and Doppler echocardiography, is independently associated with increased risk for cardiac death or cardiovascular hospitalization in patients with known or suspected CAD. PMID:22567531

Fukuta, Hidekatsu; Ohte, Nobuyuki; Wakami, Kazuaki; Goto, Toshihiko; Tani, Tomomitsu; Kimura, Genjiro



CathSim: an intravascular catheterization simulator on a PC.  


The development of a medical simulator that incorporates substantial training value and realism into an affordable product has been a huge challenge for the simulation community. A large hurdle to making an inexpensive simulator has been the high cost of the computers needed for adequate realism. We have met this challenge by developing CathSim, a low-cost medical simulator that integrates force feedback, multimedia, and 3D graphics simulation technology on an industry standard PC. This product is commercially available and is currently being used by numerous training institutions and hospitals. The CathSim system includes software and a force feedback interface device. The platform and device can be used to train health care providers to perform needle-stick medical procedures. Our first module teaches users the techniques of peripheral intravenous (i.v.) catheterization. Other training modules that will be added to the CathSim platform include central venous catheter (CVC) insertion and peripherally inserted central catheter (PICC) placement. This paper discusses the challenges of this project and the trade-offs and solutions that we developed to overcome them. We describe our process of analyzing and prioritizing the medical tasks necessary to correctly perform peripheral intravenous catheterization. This analysis and prioritization was used to decide which tasks would be included in the simulator and how the included tasks would be replicated. We discuss the method by which we obtained the needed realism in the 3D graphics rendering and in the tactile feedback of the input device. We illustrate how we blended together simulation and multimedia technology to ensure adequate immersion and training efficacy, while keeping the system cost to a minimum. PMID:10538388

Ursino, M; Tasto, J L; Nguyen, B H; Cunningham, R; Merril, G L



Routine left atrial catheterization for the post-operative management of cardiac surgical patients: is the risk justified?  

Microsoft Academic Search

Objective: To assess the risk\\/benefit ratio, including cost, associated with routine left atrial catheterization for the post-operative management of patients after cardiac surgery. Methods: From November 1991 to June 1998, out of 6187 open heart procedures performed at our institution, 5815 patients (94%) receive a left atrial monitoring line inserted invasively by a unique and reproducible technique. Catheters were removed

Francesco Santini; Giuseppe Gatti; Valentino Borghetti; Guido Oppido; Alessandro Mazzucco



[Correlation of the transaortic gradient determined with doppler echocardiography versus catheterization in patients with aortic stenosis].  


The purpose of this report is to evaluate the reliability of a non-invasive estimation of a transaortic gradient in patients with valvular aortic stenosis by doppler echocardiography. We compared the transvalvular gradients obtained by cardiac catheterization (invasive) versus the estimation by non-invasive technique such as continuous-wave doppler in 30 consecutive patients with valvular aortic stenosis. When compared the peak velocity (Vmax) of the aortic jet versus the gradient obtained by cardiac catheterization we found a correlation coefficient (r) of 0.83 and when compared the gradient obtained by both methods we found an r value of 0.85. These results show that the calculations of aortic gradient by echo-doppler, are reliable. Besides this method allowed us to establish the correct diagnosis and to follow up these patients. PMID:1854227

Illescas, J; Enciso, R; Vidrio, M; de la Torre, N; Baduí, E


Criteria and Standards for Cardiac Catheterization Laboratory Review.  

National Technical Information Service (NTIS)

The monograph is a technical assistance document specifically addressing cardiac catheterization laboratory diagnostic services. Its main role, under PL 93-641, is to aid Health Systems Agencies and State Health Planning and Development Agencies in the re...



Renal autoregulation in chronically catheterized conscious rats.  


We examined renal hemodynamics and arterial plasma renin activity (PRA) concurrently in trained chronically catheterized conscious rats during decreased and elevated renal arterial pressure (RAP). Control RAP had an absolute value of 112 +/- 2 mmHg (mean +/- SE). During inflation of a suprarenal aortic cuff, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were autoregulated down to 82% of control RAP. Within this range GFR averaged 107 +/- 5% and ERPF 114 +/- 10% of the control value. During inflation of the infrarenal aortic cuff, RAP increased by 24 +/- 2% to an absolute level of 139 +/- 5 mmHg; this elevation was associated with autoregulation of both GFR (100 +/- 5% of control) and ERPF (94 +/- 6% of control). Arterial PRA had an absolute value during control conditions of 2.1 +/- 0.2 ng ANG I X ml-1 X h-1. It was not significantly altered within the autoregulatory range, being 104 +/- 10% of control during lowered RAP and 120 +/- 15% of control during elevated RAP. Nor, in separate experiments, was PRA changed significantly during the transient state, i.e., at 5, 10, or 30 min after RAP was lowered to an autoregulatory level. These studies demonstrate that, in the conscious rat, there is considerable autoregulatory capacity both below and above resting arterial pressure, and that GFR and ERPF are autoregulated concomitantly. Arterial PRA was not altered significantly within the autoregulatory range. PMID:6380311

Conrad, K P; Brinck-Johnsen, T; Gellai, M; Valtin, H



[Sentinel node biopsy in breast cancer. Technique and indication-standard of care].  


Sentinel node biopsy proved to be a useful and accurate procedure for axillary staging in breast cancer. Combination of the current techniques with radiocolloids and blue dye, applicated superficial (intradermal, subdermal, peri- and subareolar) and deep (peritumoral, intratumoral, subtumoral) enable high indentification rates und negative predictive values. It should be performed by surgeons, pathologists and management teams of nuclear medicine with appropriate training and experience. Accepted indications are uni- and multifical tumor less than 3 cm without suspicious findings in the axilla, further in patients with large ductal carcinoma in situ and after preoperative chemotherapy. Sentinel node biopsy is still under discussion in patients with multicentric tumors and nodes outside of the axilla, although there are good results in applying this method, few data exist. Sentinel node biopsy is a team approach, prerequisites are good cooperation and well defined stuctures of qualities and documentation. Participation in national clinical studies are recommended. PMID:15938375

Haid, A



Measurement of Phloem Transport Rates by an Indicator-Dilution Technique 1  

PubMed Central

An indicator-dilution technique for the measurement of flow rates, commonly used by animal physiologists for circulation measurements, was adapted to the measurement of phloem translocation rates in the wheat (Triticum aestivum L.) peduncle. The approach is based on the observation that, during the transport of a given amount of solute, its mean concentration will be inversely proportional to flow rate. For phloem transport in the wheat peduncle, the necessary measurements are (a) the time course of tracer kinetics in the peduncle phloem, (b) the volume of sieve tubes and companion cells in the monitored segment of the peduncle, and (c) the amount of tracer transported past that point. The method was evaluated by in situ monitoring of 32PO4 transport in pulse-labeling experiments. Specific activities (i.e.32P concentrations) of phloem exudate were in good agreement with those calculated from in situ count rates and measured phloem areas. Mass transport rates, calculated from volume flow rates and phloem exudate dry matter content, also agreed well with expected mass transport rates based on measurements of grain growth rate and net CO2 exchange by the ear. The indicator-dilution technique appears to offer good precision and accuracy for short-term measurements of phloem transport rates in the wheast peduncle and should be useful for other systems as well. In contrast to velocities based on time-delay measurements, it is more precise, more accurate, and produces an estimate of mean, rather than maximum, velocity. Also, since only a single detector is required, it can be applied to very short transport paths.

Fisher, Donald B.



Vertical expandable prosthetic titanium rib (VEPTR): indications, technique, and management review.  


Surgical correction is generally indicated as the primary form of management in children with severe early onset scoliosis. Even so, conservative, nonsurgical treatment is always considered first, as surgical correction carries significant concomitant consequences, including but not limited to crankshaft phenomenon and, more importantly, inhibition of further spine, lung, and chest growth in skeletally immature patients. Fusionless surgical procedures assuage some of these risks, as they are characteristically associated with techniques necessitating spinal fusion. One device looks particularly promising in treating and managing severe early onset scoliosis, the vertical expandable prosthetic titanium rib (VEPTR)-a device that was initially targeted toward children with thoracic insufficiency syndrome (TIS). Despite its promising results in correction of severe early onset scoliosis, as well as associated rib and chest wall deformities, the VEPTR nevertheless has a complication rate comparable to other fusionless techniques. Continued modifications and research will hopefully beget a device that permits thoracic and spinal growth in skeletally immature patients yet with fewer postoperative complications. In this chapter, the authors review the clinical experience with VEPTR to date and present their results in 16 children with congenital scoliosis cared for at Shriners Hospital of Philadelphia. PMID:19585438

Shah, Shailja C; Birknes, John K; Sagoo, Sukh; Thome, Shelby; Samdani, Amer F



Burnei's "double X" internal fixation technique for supracondylar humerus fractures in children: indications, technique, advantages and alternative interventions  

PubMed Central

Background. The Study and Research Group in Pediatric Orthopedics-2012 initated this retrospective study due to the fact that in Romania and in other countries, the numerous procedures do not ensure the physicians a definite point of view related to the therapeutic criteria in the treatment of supracondylar fractures. That is why the number of complications and their severity brought into notice these existent deficiencies. In order to correct some of these complications, cubitus varus or valgus, Prof. Al. Pesamosca communicated a paper called "Personal procedure in the treatment of posttraumatic cubitus varus" at the County Conference from Bac?u, in June 24, 1978. This procedure has next been made popular by Prof. Gh. Burnei and his coworkers by operating patients with cubitus varus or valgus due to supracondylar humeral fractures and by presenting papers related to the subject at the national and international congresses. The latest paper regarding this problem has been presented at the 29th Annual Meeting of the European Pediatric Orthopedic Society in Zagreb, Croatia, April 7-10, 2010, being titled “Distal humeral Z-osteotomy for posttraumatic cubitus varus or valgus", having as authors Gh. Burnei, Ileana Georgescu, ?tefan Gavriliu, Costel Vlad and Daniela Dan. As members of this group, based on the performed studies, we wish to make popular this type of osteosynthesis, which ensures a tight fixation, avoids complications and allows a rapid postoperative activity. Introduction. The acknowledged treatment for these types of fractures is the orthopedic one and it must be accomplished as soon as possible, in the first 6 hours, by reduction and cast immobilization or by closed or open reduction and fixation, using one of the several methods (Judet, Boehler, Kapandji, San Antonio, San Diego, Burnei’s double X technique). The exposed treatment is indicated in irreducible supracondylar humeral fractures, in reducible, but unstable type, in polytraumatized patients with supracondylar fractures, in supracondylar fractures with vascular injury, in late presenting fractures, in case of loss of reduction under cast immobilization or in case of surgery with other types of fixation that is deteriorated. We have been using Burnei’s osteosynthesis for about 10 years. Aim. This paper aims to present the operative technique, its results and advantages. Materials and methods. 56 cases were treated with Burnei’s "double X" osteosynthesis in "Alexandru Pesamosca" Surgery Clinics, from 2001 to 2011. We used the Kocher approach and the aim of surgery was to obtain a fixation that does not require cast immobilization and that allows motion 24 hours after the surgery. The wires placed in "double X" must not occupy the olecranon fossa. The reduction must be anatomical and the olecranon fossa free. Flexion and extension of the elbow must be in normal range after surgery without crackles or limitations. This surgery was performed on patients with: • Loss of reduction after 10 days with cast immobilization; • Surgery with other types of fixation, deteriorated; • Polytraumatized patients with supracondylar fracture; • After neglected or late presenting fractures, without the orthopedic reduction made in emergency; • Fractures with edema and blistering. Results and complications. The patients’ ages ranged 3 to12 years old, the mean age for girls was 7,3 years and 6,8 for boys. The hospitalization ranged 3 to 7 days, the average period being of 5 days. The wires had been pulled out after 21 days. The total recovery of the flexion and extension motion of the elbow was, depending on the age, between 21 and 40 days with an average period of 30 days. There were 5 cases of minor complications: in 3 cases the wires migrated outwards up to the 10th day and in 2 cases the wires were found in the olecranon fossa. The CT exam highlighted the impingement effect and the wire that passed through the olecranon fossa had to be removed between the 7th and the 9th day. No reported cas

Georgescu, I; Gavriliu, S; Parvan, A; Martiniuc, A; Japie, E; Ghita, R; Draghici, I; Hamei, S; Tiripa, I; El Nayef, T; Dan, D



Percutaneous pelvic osteotomy in cerebral palsy patients: Surgical technique and indications  

PubMed Central

AIM: To describe the surgical technique of and indications for percutaneous pelvic osteotomy in patients with severe cerebral palsy. METHODS: Twenty-one non-ambulatory children and adolescents (22 hips) were consecutively treated with percutaneous pelvic osteotomy, which was used in conjunction with varus, derotational, shortening femoral osteotomy and soft tissue release, to correct progressive hip subluxation and acetabular dysplasia. The age, gender, Gross Motor Function Classification System level, side(s) of operated hip, total time of follow-up, immediate post-operative immobilization, complications, and the need for revision surgery were recorded for all patients. RESULTS: Seventeen patients (81%) were classified as GMFCS level IV, and 4 (19%) patients were classified as GMFCS level V. At the time of surgery, the mean age was 10.3 years (range: 4-15 years). The mean Reimers’ migration percentage improved from 63% (range: 3%-100%) pre-operatively to 6.5% (range: 0%-70%) at the final follow-up (P < 0.05). The mean acetabular angle (AA) improved from 34.1° (range: 19°-50°) pre-operatively to 14.1° (range: 5°-27°) (P < 0.05). Surgical correction of MP and AA was comparable in hips with open (n = 14) or closed (n = 8) triradiate cartilage (P < 0.05). All operated hips were pain-free at the time of the final follow-up visit, although one patient had pain for 6 mo after surgery. We did not observe any cases of bone graft dislodgement or avascular necrosis of the femoral head. CONCLUSION: Pelvic osteotomy through a less invasive surgical approach appears to be a valid alternative with similar outcomes to those of standard techniques. This method allows for less muscle stripping and blood loss and a shorter operating time.

Canavese, Federico; Rousset, Marie; Samba, Antoine; de Coulon, Geraldo



Treatment of post-catheterization femoral artery pseudo-aneurysm with para-aneurysmal saline injection.  


Femoral artery pseudoaneurysm is a common complication associated with cardiac catheterization procedures. Ultrasound-based techniques (e.g., mechanical compression, thrombin injection) and open surgical intervention are frequently used in the management of pseudoaneurysm. The investigators report their prospective experience with a novel method for the treatment of pseudoaneurysm after cardiac catheterization using ultrasound-guided, para-aneurysmal injection of physiologic saline. Sixty-four consecutive patients with pseudoaneurysms after cardiac catheterization were treated using normal saline (0.9% sodium chloride 25 to 60 ml) injected into the tissue surrounding the tract connecting the pseudoaneurysm with the femoral artery, followed by manual pressure of short duration. In none of the patients was concomitant antithrombotic therapy (aspirin [n = 63], clopidogrel [n = 45], unfractionated or low-molecular-weight heparin [n = 23], and warfarin [n = 5]) discontinued during the closure attempt. Fifty-nine of the 64 pseudoaneurysms (92%) were successfully occluded using saline injection. In 5 patients in whom saline injection failed, the pseudoaneurysms were successfully treated with thrombin injection (n = 4) or ultrasound-guided compression (n = 1). In all 64 patients, pseudoaneurysm closure was confirmed by ultrasound at 24 hours. The procedure was very well tolerated by the patients, and no side effects or complications were noted. In conclusion, ultrasound-guided saline injection affords a simple, safe, and effective alternative treatment for the closure of postcatheterization pseudoaneurysms. PMID:18471452

Finkelstein, Ariel; Bazan, Shmuel; Halkin, Amir; Herz, Izhak; George, Jacob; Miller, Hylton I; Keren, Gad; Banai, Shmuel



Fat grafting versus adipose-derived stem cell therapy: distinguishing indications, techniques, and outcomes.  


With adipose-derived stem cells (ASCs) at the forefront of research and potential clinical applications, it is important that clinicians be able to distinguish them from the fat grafting currently used clinically and to understand how the two approaches relate to one another. At times, there has been confusion in clinically considering the two therapies to be the same. This report is aimed at distinguishing clearly between fat grafting and ASC therapy with regard to the indications, harvesting, processing, application techniques, outcomes, and complications. Findings have shown that autologous fat transfer, a widely used procedure for soft tissue augmentation, is beneficial for reconstructive and cosmetic procedures used to treat patients with volume loss due to disease, trauma, congenital defects, or the natural process of aging. On the other hand, ASCs have been identified as an ideal source of cells for regenerative medicine, with the potential to serve as soft tissue therapy for irradiated, scarred, or chronic wounds. Recent advances in tissue engineering suggest that the supplementation of fat grafts with ASCs isolated in the stromal vascular fraction may increase the longevity and quality of the fat graft. Research suggests that ASC supplementation may be a great clinical tool in the future, but more data should be acquired before clinical applications. PMID:22069062

Tabit, Christina J; Slack, Ginger C; Fan, Kenneth; Wan, Derrick C; Bradley, James P



Development of Needle Insertion Manipulator for Central Venous Catheterization  

NASA Astrophysics Data System (ADS)

Central venous catheterization is a procedure, which a doctor insert a catheter into the patient’s vein for transfusion. Since there are risks of bleeding from arterial puncture or pneumothorax from pleural puncture. Physicians are strictly required to make needle reach up into the vein and to stop the needle in the middle of vein. We proposed a robot system for assisting the venous puncture, which can relieve the difficulties in conventional procedure, and the risks of complication. This paper reports the design structuring and experimental results of needle insertion manipulator. First, we investigated the relationship between insertion force and angle into the vein. The results indicated that the judgment of perforation using the reaction force is possible in case where the needling angle is from 10 to 20 degree. The experiment to evaluate accuracy of the robot also revealed that it has beyond 0.5 mm accuracy. We also evaluated the positioning accuracy in the ultrasound images. The results displays that the accuracy is beyond 1.0 mm and it has enough for venous puncture. We also carried out the venous puncture experiment to the phantom and confirm our manipulator realized to make needle reach up into the vein.

Kobayashi, Yo; Hong, Jaesung; Hamano, Ryutaro; Hashizume, Makoto; Okada, Kaoru; Fujie, Masakatsu G.


Cardiac catheterization and intervention in haemophilia patients: prospective evaluation of the 2009 institutional guideline.  


Ageing haemophilia patients are increasingly confronted with ischaemic heart disease (IHD). Treatment is complex because of the delicate equilibrium between bleeding and thrombosis. In 2009, we developed an institutional guideline on how to treat IHD in this patient population. The aim of this study was to evaluate feasibility and safety of this guideline. Haemophilia patients who underwent coronary angiography or percutaneous coronary intervention between January 2009 and June 2012 were included in the current case series. Nine diagnostic or therapeutic cardiac catheterizations were performed in six haemophilia patients. One patient with moderate haemophilia B was included, whereas the other patients had mild haemophilia A. In six of nine procedures, access to the circulation was gained via the radial artery. Only bare-metal stents were implanted, after which dual antiplatelet treatment was given for at least 4 weeks. During cardiac catheterization/intervention and dual antiplatelet treatment, clotting factor levels were corrected. No thrombotic or clinically relevant bleeding complications occurred. In one patient, a low-titre inhibitor recurred 10 months after catheterization. In-stent restenosis was diagnosed in one patient. This case series indicates that treatment according to the guideline is feasible and safe. Furthermore, based on the case series and developments in new guidelines for non-haemophilic patients with IHD, some adjustments on the 2009 guideline are proposed. PMID:23496171

Tuinenburg, A; Damen, S A J; Ypma, P F; Mauser-Bunschoten, E P; Voskuil, M; Schutgens, R E G



Invasive catheterization of the hepatic artery for preclinical investigation of liver-directed therapies in rodent models of liver cancer  

PubMed Central

Purpose: This study demonstrated invasive and reproducible hepatic artery catheterization in rats. A rigorously documented guide and pictorial essay describes the performance of an invasive hepatic artery catheterization technique suitable for the study of liver-targeted interventional procedures in rodent models of liver cancer. The goal was to produce a well-illustrated guide to hepatic artery catheterization under direct visualization via the gastroduodenal artery (GDA). Materials and Methods: 20 Sprague Dawley rats were inoculated with McA-RH7777 HCC cells in the left lateral liver lobe. Magnetic resonance imaging (MRI) was used to measure tumor growth. Catheter placement in the hepatic artery proper was performed by entry through the GDA under direct visualization after laparotomy. Digital subtraction angiography confirmed catheter placement in the hepatic artery proper. Antegrade blood flow to the liver was restored after catheter removal. Rats were euthanized after procedures; livers were harvested for hematoxylin and eosin (H&E) staining. Results: 85.0% of inoculated animals developed measurable tumors on MRI; average tumor size was 6.3 ± 2.3 mm × 4.3 ± 1.5 mm (mean ± SD). 94.1% of animals with tumors were successfully catheterized. H&E staining demonstrated tumor growth in all inoculated animals, including those with no measurable tumors on MRI. Conclusion: Invasive catheter placement in the hepatic artery of a rodent model of HCC can be performed reproducibly according to the techniques described in this tutorial. These catheterization techniques are ideal for a broad range of preclinical IR studies intending to evaluate the efficacy of intra-arterial therapies for the treatment of primary and metastatic liver tumors.

Sheu, Alexander Y; Zhang, Zhuoli; Omary, Reed A; Larson, Andrew C



New Technique and Indicators for Studies of Growth History of Zoned Crystals.  

National Technical Information Service (NTIS)

Two X-ray diffraction imaging techniques have been applied for the first time to the study of previously unnoted mosaic detail in color-zoned Brazilian tourmaline. The divergence source-image distortion (DSID) technique gives maximum values for misorienta...

C. O. Pollard



Arthroscopic indications and technique for artelon interposition arthroplasty of the thumb trapeziometacarpal joint.  


Advanced basal joint arthritis that has failed conservative treatment has traditionally been treated with some type of procedure that encompasses complete trapezial excision. An arthroscopic technique entailing only minimal trapezial debridement coupled with insertion of a synthetic interposition material is described. This provides the implicit benefits of a minimally invasive procedure, with less pain and faster recovery, along with the great advantage of trapezium preservation. The surgical technique is described along with a preliminary clinical series supporting its use. PMID:19060684

Badia, Alejandro



[Endonasal microsurgical treatment of lacrimal duct stenoses. Indications, technique and results].  


In a retrospective study we examined the indications, results and complications of endonasal microscopic dacryocystorhinostomy. Eighty-five operations were evaluated. Surgical success was proven in 83% for all indications using a combination of subjective judgement and objective findings. For the so-called classic indications--postsaccal stenosis, functional stenosis dacryolith and acute empyema--the operation was successful in 91% of cases. There were no permanent side effects. PMID:8449782

Weber, R; Draf, W; Kolb, P



La r?paration sphinct?rienne directe: points techniques, indications et r?sultats  

PubMed Central

L'incontinence anale est un handicap physique, psychique et social majeur qui a de nombreuses causes différentes. Les méthodes actuellement disponibles pour améliorer les symptômes de cette incontinence sont les méthodes médicales et de rééducation d'une part et les méthodes chirurgicales d'autre part. Quatre techniques chirurgicales répondent à ces objectifs pour la plupart des malades: la sphinctérorraphie, la neuromodulation des racines sacrées, et les deux techniques de substitution que sont le sphincter artificiel et la graciloplastie dynamisée. La réparation sphinctérienne directe est la technique la plus utilisée dans le traitement chirurgical de l'incontinence anale (IA) par lésion sphinctérienne. Cette technique est envisageable chez les malades ayant une incontinence fécale en rapport avec des lésions limitées du sphincter anal externe. La technique chirurgicale est simple (myorraphie par suture directe ou en paletot) et bien codifiée. Les résultats fonctionnels sont imparfaits et se dégradent avec la durée du suivi. Une continence parfaite après réparation sphinctérienne est rarement acquise de façon durable: le malade candidat à cette approche thérapeutique doit en être averti.

Laalim, Said Ait; Hrora, Abdelmalek; Raiss, Mohammed; Ibnmejdoub, Karim; Toughai, Imane; Ahallat, Mohammed; Mazaz, Khalid



Sharing Cardiac Catheterization Services: A Way to Improve Patient Care and Reduce Costs.  

National Technical Information Service (NTIS)

Cardiac catheterization is a procedure used to diagnose heart conditions. Many Federal cardiac catheterization laboratories are underused. However, if laboratories are shared, patient care could be improved and money could be saved. To facilitate sharing,...



Catheterization of the Hepatic Artery Via the Left Common Carotid Artery in Rats  

Microsoft Academic Search

The commonly used approach for rat hepatic artery catheterization is via the gastroduodenal artery, which is ligated after\\u000a the procedure. A new method of rat hepatic artery catheterization via the left common carotid artery (LCCA) is described.\\u000a The LCCA is repaired after catheterization. The catheterization procedures included the following: (1) opening the rat’s abdominal\\u000a cavity and exposing the portion of

Xiao Li; Yi-Xiang J. Wang; Xiangping Zhou; Yongsong Guan; Chengwei Tang



Autologous and Alloplastic Breast Reconstruction – Overview of Techniques, Indications and Results  

Microsoft Academic Search

It is important for any woman undergoing mastectomy to make an informed decision about reconstruction and to be provided with information about the technique, advantages and disadvantages. There is a high degree of patient satisfaction with breast reconstruction, but high levels of preoperative information and psychological support are necessary. Close collaboration between oncological and reconstructive surgeons or management by an

Mahdi Rezai; Maren Darsow; Sherko Kümmel; Stefan Krämer



Arthroscopy and Endoscopy of the Foot and Ankle: Indications for New Techniques  

Microsoft Academic Search

The scope of arthroscopy and endoscopy of the foot and ankle is expanding. New techniques are emerging to deal with diverse ankle pathology. Some of the conditions that can be dealt with arthroscopically are as follows: hallux valgus deformity, lesser toe deformity, first metatarsophalangeal instability, cock-up deformity of the big toe, peroneal tendon instability, lateral ankle and subtalar instability, hindfoot

Tun Hing Lui



Use of a Titanium Metallocene as a Colorimetric Indicator for Learning Inert Atmosphere Techniques  

NASA Astrophysics Data System (ADS)

A method is described to aid the instruction of undergraduate and graduate students in inert atmosphere techniques. A highly oxygen-sensitive organometallic compound, a titanium metallocene, changes color form blue to yellow when exposed to dioxygen contaminant, thereby providing an easily visualized monitor for students learning to manipulate the special glassware and operations typical of inert atmosphere reactions.

Nieter Burgmayer, Sharon J.



Arthroscopic Trans-capsular Axillary Nerve Decompression: Indication and Surgical Technique  

Microsoft Academic Search

Symptomatic axillary nerve compression is rare yet results in debilitating pain, weakness, and decreased athletic performance in some patients. If nonoperative modalities fail, surgical intervention is necessary to reduce symptoms and avoid functional decline. Traditionally, open techniques have been described to decompress the axillary nerve and are reported to provide satisfactory results. Similar to suprascapular nerve decompression, recent advances have

Peter J. Millett; Trevor R. Gaskill



Improving process throughput of Cardiac catheterization using Six Sigma Training  

Microsoft Academic Search

Healthcare is changing daily with the introduction of technology. Heart catheterization is one area that has excelled in the new technology that is constantly being introduced. Facilities are being built which provide patients with diagnostics and treatments that save lives daily. Due to the continual improvement of healthcare processes, it is also important to review process and continually improve efficiency.

Daphene Koch; Heather Hagg; Dianna Brown; Kenney Montgomery; Mark Manning



Hemodynamic effects of ketamine in children undergoing cardiac catheterization  

Microsoft Academic Search

Ketamine is used to supplement sedation during cardiac catheterization. We studied ketamine-induced circulatory changes in 28 acyanotic children (18 of whom had left-to-right shunts), aged 4–161 months (mean, 33 months). Oxygen consumption (\\u000a

William Berman; Raymond R. Fripp; Mark Rubler; Lorraine Alderete



Echocardiography, pulmonary artery catheterization, and radionuclide cineangiography in septic shock  

Microsoft Academic Search

Building on their prior contributions to the elucidation of myocardial dysfunction in sepsis [1-3], Jardin and colleagues present in this issue of Intensive Care Medicine a comparative analysis of measurements by echocardiography and pulmonary artery catheterization in 32 patients with septic shock [4]. Three principal findings are reported. First, invasive assessment of pulmonary artery occlusion pressure (PAOP), as a surrogate

R. E. Cunnion; Ch. Natanson



The dos and do knots of central venous catheterization.  


Central venous catheterization plays an important role in patients with end-stage renal disease undergoing hemodialysis. Placement of a right subclavian hemodialysis catheter was complicated by looping and entrapment of the guidewire. Computed tomographic and three-dimensional scans were essential in locating and determining that the guidewire was outside the vessel. PMID:22414709

Vetrugno, Luigi; Piccoli, Gianluca; Costa, Maria Gabriella; Pompei, Livia; Chiarandini, Paolo; Morelli, Angelo; Della Rocca, Giorgio



Use of n-butyl cyanoacrylate in abdominal and pelvic embolotherapy: indications and techniques, complications, and their management.  


The purpose of this article is to describe the indications for use of n-butyl cyanoacrylate (NBCA) in abdominal and pelvic embolotherapy, appropriate techniques for NBCA embolotherapy, and NBCA-related complications and their management. NBCA embolotherapy is a feasible and effective method for treating a variety of abdominal and pelvic vascular lesions or tumors; however, the techniques suitable for each case and knowledge of NBCA-related complications are essential to achieve favorable outcomes. PMID:22367776

Enokizono, Mikako; Sakamoto, Ichiro; Hayashi, Hideyuki; Sueyoshi, Eijun; Uetani, Masataka



Fracture of J-tipped guidewire during central venous catheterization and its successful removal under fluoroscopic guidance -A case report-  

PubMed Central

Central venous catheterization by Seldinger's technique uses a guidewire which may cause complications such as kinking, knotting and fracture. Fractured guidewire may lead to severe outcomes such as embolization, and removal of it may also cause problems such as vessel damage. We experienced a case of right internal jugular venous catheterization complicated by guidewire fracture entrapped in the central venous catheter, and its successful removal under fluoroscopic guidance using snare-loop. The patient recovered without any complications. When resistance is felt during insertion or withdrawal of the guidewire, force should not be applied to the guidewire and care should also be exercised when passing the tissue dilator over the guidewire. Clinicians should be aware of this rare complication and snare-loop technique could be considered as one of the methods for removal of the fractured guidewire.

Park, Sun Kyung; Yi, In-Kyong; Lee, Jae-Ho; Kim, Dae-Hee



Impact of an Educational Program on Bilateral Heart Catheterization Practice Patterns  

Microsoft Academic Search

The value and necessity of performing right heart catheterizations for coronary artery disease have been increasingly questioned. Preliminary analyses of the procedure among Medicare and Medicaid patients in New York State revealed significant inter-hospital variations in the frequencies with which such catheterizations were performed. These data suggested that right heart catheterizations (RHC) were being performed routinely. Medicare and Medicaid claims

Monte Malach; Pascal James Imperato; Raphael P. Nenner; Thomas Huang; Mary Beth Dearne



A prospective study on incidence and risk factors of arteriovenous fistulae following transfemoral cardiac catheterization  

Microsoft Academic Search

Background: A potentially harmful complication of cardiac catheterization is the arteriovenous fistula. Precise knowledge of possible factors predisposing for acquisition of iatrogenic AV-fistulae could enable cardiologists to perform a risk stratification for cardiac patients prior to catheterization. Methods: Over a period of 2 years, 10?271 consecutive patients who underwent cardiac catheterization were included in this study. Auscultation of a new

Stefan Martin Perings; Malte Kelm; Thomas Jax; Bodo Eckehard Strauer



Assessing soil quality indicator under different land use and soil erosion using multivariate statistical techniques.  


Soil degradation associated with soil erosion and land use is a critical problem in Iran and there is little or insufficient scientific information in assessing soil quality indicator. In this study, factor analysis (FA) and discriminant analysis (DA) were used to identify the most sensitive indicators of soil quality for evaluating land use and soil erosion within the Hiv catchment in Iran and subsequently compare soil quality assessment using expert opinion based on soil surface factors (SSF) form of Bureau of Land Management (BLM) method. Therefore, 19 soil physical, chemical, and biochemical properties were measured from 56 different sampling sites covering three land use/soil erosion categories (rangeland/surface erosion, orchard/surface erosion, and rangeland/stream bank erosion). FA identified four factors that explained for 82 % of the variation in soil properties. Three factors showed significant differences among the three land use/soil erosion categories. The results indicated that based upon backward-mode DA, dehydrogenase, silt, and manganese allowed more than 80 % of the samples to be correctly assigned to their land use and erosional status. Canonical scores of discriminant functions were significantly correlated to the six soil surface indices derived of BLM method. Stepwise linear regression revealed that soil surface indices: soil movement, surface litter, pedestalling, and sum of SSF were also positively related to the dehydrogenase and silt. This suggests that dehydrogenase and silt are most sensitive to land use and soil erosion. PMID:22791019

Nosrati, Kazem



MRI of the Breast: Technique, Indications and BI-RADS Classification  

Microsoft Academic Search

\\u000a Breast cancer comprises about 10% of all cancer incidences among women worldwide, making it the most common type of non-skin\\u000a cancer in females. In recent decades, great strides have been made toward early detection of breast cancer, with X-ray mammography\\u000a being the mainstay of breast imaging. However, there are some limitations inherent to this technique. Therefore, efforts have\\u000a been made

Rahel A. Kubik-Huch


[Oncologic imaging: indications for and limitations of modern cross-sectional imaging techniques].  


Cross-sectional imaging techniques, such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) CT are an integral part of the modern oncological workup. They are used for tumor detection and staging as well as for treatment evaluation and monitoring. Due to pathophysiological and histological differences there is no universal imaging protocol for the assessment of different forms of cancer. For instance, CT is still the standard technique for the detection and staging of lung cancer supplemented by PET which aids the exclusion of nodal involvement and the detection of distant metastases. For hepatocellular carcinoma on the other hand, MRI is the preferred imaging technique, particularly when used in conjunction with liver-specific contrast media - PET/CT is only of limited value. Finally, for neuroendocrine tumors there is a focus on special radiotracers, which, in the context of PET/CT, enable a highly specific whole-body assessment. Thus, knowledge of the pathophysiological and imaging characteristics of different tumors is essential for a personalized, state-of-the art management of oncology patients. PMID:23536032

Mayerhoefer, M E; Ba-Ssalamah, A; Prosch, H



Distally locked stems in revision hip arthroplasties: surgical technique and indications  

Microsoft Academic Search

In case of severe femoral bone loss, cementless revision hip arthroplasties require a stable initial distal fixation that\\u000a does not compromise a subsequent bone reconstruction. The locking mechanism provides initially reliable fixation, especially\\u000a if bone loss has spread to the distal femoral isthmus or when an extended trochanteric osteotomy (femorotomy) is indicated.\\u000a Locking stems can be used in all types

H. Migaud; O. May; M. Soenen; B. Miletic; P. Deroche; A. Gabrion; P. Mertl; J. Girard



[Eyelid approach and pediatric orbital tumors: indications and surgical technique. About three children].  


Interdisciplinary collaboration can offer unusual approaches for the treatment of orbital pathologies. The authors report their experience with the eyelid incision in treating three children with epidural orbitary hematoma, dermoid cyst of the upper outer quadrant and a dermoid cyst of the internal inferior quadrant. For all the children, removal was complete and cosmetic results satisfying. The authors discuss the indications and complications of this surgical approach. PMID:22425582

Marandat, S; Geronimo, M; Pech-Gourg, G; Degardin, N; Lena, G; Scavarda, D



Perioperative Complications in Children with Pulmonary Hypertension Undergoing Noncardiac Surgery or Cardiac Catheterization  

PubMed Central

BACKGROUND Pulmonary arterial hypertension (PAH) can lead to significant cardiac dysfunction and is considered to be associated with an increased risk of perioperative cardiovascular complications. METHODS We reviewed the medical records of children with PAH who underwent anesthesia or sedation for noncardiac surgical procedures or cardiac catheterizations from 1999 to 2004. The incidence, type, and associated factors of complications occurring intraoperatively through 48 h postoperatively were examined. RESULTS Two hundred fifty-six procedures were performed in 156 patients (median age 4.0 yr). PAH etiology was 56% idiopathic (primary), 21% congenital heart disease, 14% chronic lung disease, 4% chronic airway obstruction, and 4% chronic liver disease. Baseline pulmonary artery pressure was subsystemic in 68% patients, systemic in 19%, and suprasystemic in 13%. The anesthetic techniques were 22% sedation, 58% general inhaled, 20% general IV. Minor complications occurred in eight patients (5.1% of patients, 3.1% of procedures). Major complications, including cardiac arrest and pulmonary hypertensive crisis, occurred in seven patients during cardiac catheterization procedures (4.5% of patients, 5.0% of cardiac catheterization procedures, 2.7% of all procedures). There were two deaths associated with pulmonary hypertensive crisis (1.3% of patients, 0.8% of procedures). Baseline supra-systemic PAH was a significant predictor of major complications by multivariate logistic regression analysis (OR = 8.1, P = 0.02). Complications were not significantly associated with age, etiology of PAH, type of anesthetic, or airway management. CONCLUSION Children with suprasystemic PAH have a significant risk of major perioperative complications, including cardiac arrest and pulmonary hypertensive crisis.

Carmosino, Mario J.; Friesen, Robert H.; Doran, Aimee; Ivy, Dunbar D.



Log-Linear Techniques for the Analysis of Categorical Data: A Demonstration with the Myers-Briggs Type Indicator.  

ERIC Educational Resources Information Center

|Log-linear analysis (LLA) techniques for categorical variables are demonstrated and evaluated using data from the Myers-Briggs Type Indicator. Symmetrical LLA and asymmetrical LLA address questions of association and inference, respectively. Configural frequency analysis is examined as a strategy for whole types research. LLA approaches seem…

Salter, Daniel W.



Measurement of Refractive Indices and Study of Isotropic-Nematic Phase Transition by the Surface Plasmon Technique  

Microsoft Academic Search

The surface plasmon technique is employed to measure the refractive indices and to probe the nematic-isotropic phase transition of 4-cyano-4?-n-pentylbiphenyl. Coexistence of isotropic and nematic phases in a 60 mK range and a hysteresis effect of the phase transition have been observed. A diffuse droplet model is used to estimate the supercooling and superheating range.

K. C. Chu; C. K. Chen; Y. R. Shen



Bone grafting in surgery about the foot and ankle: indications and techniques.  


Bone grafting is a common procedure in foot and ankle surgery. Historically, autogenous bone graft has most often been harvested from the ipsilateral iliac crest. However, other sites offer similar volumes of cancellous bone and are associated with fewer complications. The ipsilateral proximal tibia, distal tibia, and calcaneus provide adequate amounts of bone graft material for most arthrodesis procedures about the foot and ankle. Emerging techniques have enabled the development of a seemingly unlimited supply of alternative bone graft materials with osteoconductive properties. The osteoprogenitor cells in bone marrow aspirates can be concentrated by use of selective retention systems. These aspirate-matrix composites may be combined with allograft preparations, resulting in a product that promotes osteoconduction, osteoinduction, and osteogenesis with limited morbidity. PMID:21292934

Fitzgibbons, Timothy C; Hawks, Michael A; McMullen, Scott T; Inda, David J



Vascular access in neonates and infants--indications, routes, techniques and devices, complications.  


Venous cannulation has been in regular use in neonates since the 1940s. This was at first through the umbilical vein, but the frequency of complications lead to other central and peripheral routes being used for infusion of fluid, nutrients and drugs. Today, peripheral venous access is preferred except for high volume fluid resuscitation, reliable infusion of irritant drugs and long-term parenteral nutrition. Intraosseous infusion provides a reliable alternative to peripheral veins for rapid infusion of fluid. Long, thin silastic catheters can be inserted through a peripheral venous cannulae for parenteral nutrition or other central venous infusions as an alternative to direct central venous cannulation using the Seldinger or other techniques. Broviac or Hickman catheters, inserted through a subcutaneous tunnel are only considered when central venous cannulation is likely to be needed for more than six weeks. The most common serious complication of vascular access is infection. Infection associated with central venous catheters is reduced by prophylactic vancomycin or teicoplanin. Other complications of central venous infusion are associated with cannulae malpositioning, bleeding and thrombosis. Distal hypoperfusion may follow arterial cannulation. Modern emergency and intensive care paediatrics is impossible without adequate venous and arterial vascular access. However no other skill for neonatal intensive care causes more anxiety in primary care providers or is more difficult to teach. PMID:10150755

Möller, J C; Reiss, I; Schaible, T



Surgery and Radiosurgery for Acromegaly: A Review of Indications, Operative Techniques, Outcomes, and Complications  

PubMed Central

Among multimodality treatments for acromegaly, the goals of surgical intervention are to balance maximal tumor resection while preserving normal pituitary function and maintaining patient safety. The resection of growth hormone-(GH-) secreting pituitary adenomas in the hands of experienced surgeons results in hormonal remission in 50–70% of patients. Acromegalic patients often have medical comorbidities and anatomical variations complicating anesthesia and surgical management. Despite these challenges, complications such as CSF leak or new hypopituitarism following surgery remain uncommon. Over the past decade, endoscopic approaches to pituitary tumors have improved visualization and facilitated identification of additional tumor using angled telescopes. Patients with persistent acromegaly following surgery require continued medical and/or radiation-based interventions. The adjunctive use of stereotactic radiosurgery offers hormonal remission in 40–50% of patients. In this article, the current preoperative evaluation, indications for surgery, surgical approaches, role of radiosurgery, complications, and remission criteria following operative resection of GH adenomas are reviewed.

Marquez, Yvette; Tuchman, Alexander; Zada, Gabriel



Surgery and radiosurgery for acromegaly: a review of indications, operative techniques, outcomes, and complications.  


Among multimodality treatments for acromegaly, the goals of surgical intervention are to balance maximal tumor resection while preserving normal pituitary function and maintaining patient safety. The resection of growth hormone-(GH-) secreting pituitary adenomas in the hands of experienced surgeons results in hormonal remission in 50-70% of patients. Acromegalic patients often have medical comorbidities and anatomical variations complicating anesthesia and surgical management. Despite these challenges, complications such as CSF leak or new hypopituitarism following surgery remain uncommon. Over the past decade, endoscopic approaches to pituitary tumors have improved visualization and facilitated identification of additional tumor using angled telescopes. Patients with persistent acromegaly following surgery require continued medical and/or radiation-based interventions. The adjunctive use of stereotactic radiosurgery offers hormonal remission in 40-50% of patients. In this article, the current preoperative evaluation, indications for surgery, surgical approaches, role of radiosurgery, complications, and remission criteria following operative resection of GH adenomas are reviewed. PMID:22518121

Marquez, Yvette; Tuchman, Alexander; Zada, Gabriel



Measurement of salivary cortisol in 2012 - laboratory techniques and clinical indications.  


The utility of measuring salivary cortisol has become increasingly appreciated since the early 1980s. Salivary cortisol is a measure of active free cortisol and follows the diurnal rhythm of serum or plasma cortisol. The saliva sample may be collected by drooling or through the use of absorbent swabs which are placed into the mouth until saturated. Salivary cortisol is therefore convenient for patients and research participants to collect noninvasively on an outpatient basis. Several assay techniques have been used to measure salivary cortisol, including radioimmunoassay and more recently liquid chromatography-tandem mass spectrometry. The analytical sensitivity varies between these assay methods, as does the potential for cross-reactivity with other steroids. The interpretation of salivary cortisol levels relies on rigorous standardization of sampling equipment, sampling protocols and assay technology with establishment of a local reference range. Clinically, the commonest use for salivary cortisol is measuring late-night salivary cortisol as a screening test for Cushing's syndrome. Several studies have shown diagnostic sensitivities and specificities of over 90%, which compares very favourably with other screening tests for Cushing's syndrome such as the 24-h urinary-free cortisol and the 1-mg overnight dexamethasone suppression test. There are emerging roles for the use of salivary cortisol in diagnosing adrenal insufficiency, particularly in conditions associated with low cortisol-binding globulin levels, and in the monitoring of glucocorticoid replacement. Finally, salivary cortisol has been used extensively as a biomarker of stress in a research setting, especially in studies examining psychological stress with repeated measurements. PMID:22812714

Inder, Warrick J; Dimeski, Goce; Russell, Anthony



Comparison of contrast enhanced magnetic resonance angiography with invasive cardiac catheterization for evaluation of children with pulmonary atresia  

PubMed Central

Complete assessment of the source of pulmonary blood supply and delineation of the anatomy of pulmonary arteries are essential for the management and prognostic evaluation of pulmonary atresia (PA) patients. Invasive cardiac catheterization is considered the gold standard imaging modality to achieve this. We investigated the role of contrast enhanced magnetic resonance angiography (MRA) to evaluate the pulmonary blood supply and the anatomy of the pulmonary arteries and compared this with cardiac catheterization in children with PA. We studied 20 children with PA. Median age was 2.5 years (range 6 months–13 years). All patients were examined with cardiac catheterization and contrast enhanced MRA, and the results of both modalities were compared. There was a complete agreement between both modalities in the detection of the main pulmonary artery morphology and determination of the confluence state of the central pulmonary arteries. There was an 88% agreement for patency of the ductus arteriosus and 66% for patency of the surgically placed shunt. There was a complete agreement between both techniques on determining the presence of collaterals more than 2.5 mm. Twenty-eight collaterals of less than 2.5 mm were detected only by contrast enhanced MRA. There was a strong correlation between both modalities in measuring the pulmonary arteries and collaterals diameter (P<0.001). Contrast enhanced MRA is a safe and accurate non-invasive technique to evaluate the pulmonary artery morphology and the sources of pulmonary blood supply in children with PA.

Romeih, Soha; Al-Sheshtawy, Fathia; Salama, Mai; Blom, Nico A.; Abdel-Razek, Ahmed; Al-Marsafawy, Hala; Elhendy, Abdou



[To FIV or not to FIV: Will gestational surrogacy be an indication for assisted reproductive techniques?].  


Gestational surrogacy covers three different and often mixed up situations. In the first case (that of full surrogacy), the surrogate mother carries and has the baby anonymously. The child has been conceived by artificial insemination with her own oocyte and the help of the financing father, who has legally recognised the child before birth. This constitutes surrogacy motherhood practice, which was condemned by a judgment of the French Court of Cassation, in 1991. In the second case (gestational surrogacy), the mother only carries an embryo conceived in vitro by the biological parents to whom she will give back the baby when he is born. The filiation tie between the child and his parents is thereby maintained, the surrogate mother's role being limited to that of gestation. In the third case, the surrogate mother carries an embryo, the result of in vitro fertilization of the oocytes of a donor and the father's sperm. From the moment that surrogacy is not at variance with any of our fundamental rights, we cannot but wish that, with the guarantee of a rigorous frame, it might become a medical indication for IVF, in precise circumstances of female infertility. PMID:16959522

Delaisi de Parseval, G



[Renal artery thrombosis in newborn infants undergoing umbilical artery catheterization].  


A prospective study to detect renal artery thrombosis by radionuclide renal scintigraphy in newborn infants who underwent umbilical arterial catheterization over a one year period was done: 62 babies were catheterized, 92% were preterm and 85% had severe respiratory distress syndrome that required mechanical ventilation, 25/62 (40.3%) survived and in all of them Tc-99m DMSA scans were taken at a median of 5 days after withdrawal of the umbilical artery catheters (range 9 h to 29 days). A baby with renovascular hypertension had a DMSA scan which showed segmental vascular defect in one kidney. Another patient had left iliac artery thrombosis and two others showed evidence of transient vasospasm. Death occurred in 37/62 (59.7%), 92% of whom underwent autopsy studies which showed aortoiliac thrombosis in 8.8%, all of them without clinical symptoms. Other 12 newborn infants who died without previous umbilical artery catheterization had no evidence of thrombosis at autopsy. PMID:2562489

Norero, C; Oto, M A; Morales, B; Benavides, A; Fuentealba, E U; Lagos, E; Amaral, H; Martínez, V


Usefulness of transesophageal echocardiography in the pediatric catheterization laboratory.  


Transesophageal echocardiography was performed in 51 children (aged 2 to 14 years, mean 4; weight 9 to 50 kg, mean 21) undergoing elective diagnostic or therapeutic cardiac catheterization. The interventional procedures were percutaneous balloon dilation of pulmonary (n = 8) and aortic (n = 2) valve stenosis, percutaneous closure of patent ductus arteriosus (n = 8), and attempted occlusion of Pott's anastomosis by the double umbrella device (n = 1). The diagnostic catheterizations were performed on preoperative children of whom 5 had undergone previous palliative procedures. Precise placement of the balloon across the valve, timing of balloon inflation and deflation according to real-time monitoring of ventricular function and immediate evaluation of results and complications were accomplished with transesophageal monitoring. The exact position of distal and proximal umbrellas of patent ductus occlusive devices was checked on transesophageal imaging and completeness of occlusion controlled on color Doppler. The only relevant information in the preoperative cases was the detection of a septic thrombus in a severely ill patient. With more experience and smaller probes, transesophageal echocardiography may become a new method of monitoring cardiac catheterization also in smaller children where it may reduce duration of the procedure and amount of contrast material. PMID:8498374

Tumbarello, R; Sanna, A; Cardu, G; Bande, A; Napoleone, A; Bini, R M



Remotely sensed indicators or urban land use intensity: Comparison of sub-pixel analysis techniques  

NASA Astrophysics Data System (ADS)

The goal of this dissertation is to investigate novel methods of remote sensing/geographic information system (GIS) technologies to improve the accuracy of mapping urban land cover. Medium spatial resolution remotely sensed imagery is comparatively very cheap, but has a critical drawback "mixed" pixels (i.e., mixtures of impervious surface, lawn and tree cover with a single pixel) in the complex urban landscape. Accordingly, there are two major research areas that I propose to address: (1) Improving the specificity and accuracy of remotely sensed indicators of human land use, with a focus on impervious surface, lawn and urban tree cover; and (2) Testing the utility of newly available high (IKONOS) and medium (Landsat ETM) resolution remotely sensed image data for such purposes. While previous studies have focused on the estimation of impervious surface, this study is the first to thoroughly investigate the lawn and tree cover as separate urban green space components. I tested three different sub-pixel analysis methods: Linear Mixture Model (LMM), Fuzzy c-means Clustering (FCM), and Self-Organizing Map Neural Network (SOM). Overall, the SOM method provided the best estimates of the three land cover components: impervious surface estimated ranged from +/-4˜12%, lawn ranged from +/-8˜11%, and tree ranged from +/-11˜19% as compared to reference data. The linear mixture assumption of the endmember spectra of LMM is upheld to a large extent as evidenced by the rather high accuracy of impervious surface estimation, but the spectral reflectance of lawn and urban tree are not linearly mixed. LMM and FCM do not correctly estimate pure pixels of lawn and urban tree, while SOM_LVQ estimates these pure pixels quite accurately. Providing higher spatial resolution by the merging of higher spatial resolution panchromatic and lower spatial resolution multispectral Landsat ETM imagery did not improve the estimation of urban land cover components. The results of this study provide comprehensive information of the utility of sub-pixel analysis for the estimation of urban land cover components and suggest that the comparatively accurate land cover estimation of urban land cover components is attainable from medium resolution satellite imagery. These results are significant in that they demonstrate that medium resolution remotely sensed imagery such as Landsat ETM can provide a cost effective image data source for urban monitoring.

Lee, Sangbum


Access-site complications and their management during transradial cardiac catheterization.  


Transradial access for cardiac catheterization is now widely accepted among the invasive cardiology community as a safe and viable approach with a markedly reduced incidence of major access-related complications compared with the transfemoral approach. As this access technique is now being used more commonly for cardiac catheterization, it is of paramount importance to be aware of its complications and to understand their prevention and management. Some of the common complications of transradial access include asymptomatic radial artery occlusion, nonocclusive radial artery injury and radial artery spasm. Among these complications, radial artery spasm is still a significant challenge. Symptomatic radial arterial occlusion, pseudoaneurysm and radial artery perforation are rarely reported complications of the transradial approach. Early identification of these rare complications and their immediate management is of vital importance. Arteriovenous fistula, minor nerve damage and complex regional pain syndrome are very rare but have been reported. Recently, granulomas have been reported to be associated with the use of a particular brand of hydrophilic sheaths during the procedure. Generally, access-site complications can be minimized by avoiding multiple punctures, selection of smaller sheaths, gentle catheter manipulation, adequate anticoagulation, use of appropriate compression devices and avoiding prolonged high-pressure compression. In addition, careful observation for any ominous signs such as pain, numbness and hematoma formation during and in the immediate postprocedure period is essential in the prevention of catastrophic hand ischemia. PMID:22651838

Bhat, Tariq; Teli, Sumaya; Bhat, Hilal; Akhtar, Muhammad; Meghani, Mustafain; Lafferty, James; Gala, Bhavesh



Cardiovascular procedures/diagnostic techniques and therapeutic procedures  

SciTech Connect

This book covers the technical and therapeutic aspects of cardiovascular procedures in immense detail. There are large and appropriate diagrams and tables. The topics of the chapters are tools for catheterization, venous access, arterial access, hemodynamic monitoring, cardiac catheterization and coronary arteriography, ergonovine provocation testing for coronary artery spasm, pulmonary angiography, endomyocredial biopsy, electrophysiologic studies, pericardiocentesis and drainage, intraaortic balloon pumping, direct current cardioversion and defibrilaltion, pacemaker implantation of the automatic implantable cardioverter/defibrillator, coronary angioplasty, thrombolytic therapy, transluminal catheter extraction and resolution of intracardiac catheter knots, cardiopulmonary resuscitation, contrast media toxicity and allergic reactions, radiation hazards, and medicolegal concerns. An appendix and index follow these chapters. In general, each chapter covers historical aspects, indications, complications, techniques, and preoperative and postoperative care.

Tilkian, A.G.; Daily, E.K.



Contrast-enhanced ultrasound performed under urgent conditions. Indications, review of the technique, clinical examples and limitations.  


Contrast-enhanced ultrasound (CEUS) is an imaging technique with various indications, most of which refer to scheduled examinations. However, CEUS can also be performed under urgent conditions for the investigation of many different clinical questions. This article reviews basic physics of ultrasound contrast agents and examines the commonest urgent clinical applications of CEUS. These include, among others, abdominal solid organ trauma and infarcts, scrotal and penile pathology and blood vessel imaging. Patients can be examined with a very short time delay at their bedside, without exposure to ionising radiation or risk of anaphylactic reaction and renal failure, while contraindications are minimal. CEUS technique is described for various urgent indications and imaging examples from our department's experience are presented. Safety matters and limitations of CEUS are also mentioned. Teaching Points • Contrast-enhanced ultrasound (CEUS) can be performed urgently for various clinical applications. • Abdominal indications include solid organ trauma and infarcts. • CEUS in abdominal organ trauma correlates well with CT and can replace it for patient follow-up. • CEUS images testicular torsion, infection and infarction, as well as testicular and penile trauma. • Blood vessels can be assessed with CEUS for obstruction, aneurysm, thrombosis and dissection. PMID:23247774

Cokkinos, Demosthenes D; Antypa, Eleni; Kalogeropoulos, Ioannis; Tomais, Dimitrios; Ismailos, Emmanuel; Matsiras, Ioannis; Benakis, Stylianos; Piperopoulos, Ploutarchos N



Combining two teaching techniques for young children on Aedes aegypti control: effects on entomological indices in western Mexico.  


A study of the effect of educating four- to six-year-old children in mosquito control was recently conducted in a city in the state of Jalisco, western Mexico. Four neighborhood districts were selected. Children attending one kindergarten in each of two experimental districts were taught mosquito control with a video from the American Mosquito Control Association (AMCA), joined to the use of the AMCA Touch Table Technique. The entomological indices monitored in the study decreased significantly (P<0.05) in houses in the experimental districts, apparently because parents acted on the comments and suggestions of the children and eliminated or monitored containers used as oviposition sites by mosquitoes. Based on these results, combining both techniques for teaching children mosquito control is a potentially useful tool for control efforts in Mexico and other places in Latin America. PMID:22548559

Martínez-Ibarra, José A; Nogueda-Torres, Benjamín; Meda-Lara, Rosa M; Montañez-Valdez, Oziel D; Rocha-Chávez, Gonzalo



High tibial osteotomy for the treatment of unicompartmental knee osteoarthritis: a review of the literature, indications, and technique.  


In the past decades, there has been varying support for high tibial osteotomy. This surgical procedure was originally popularized by Mark B. Coventry, MD in the 1960s, but fell out of favor with orthopedic surgeons as knee arthroplasty became more commonplace. In the past 10 years, osteotomy has been rediscovered as an important adjunct to cartilage repair procedures that rely on a normalized biomechanical environment. Furthermore, there has been an increase in the number of patients presenting with unicompartmental disease (eg, after prior meniscectomy) who are at an age and functional level that is not ideally suited for joint arthroplasty. High tibial osteotomy allows 70% to 85% of patients to delay arthroplasty for ? 5 to 10 years and 50% to 60% for ? 15 years. This article provides an overview of the indications, technique, complications, and outcomes of high tibial osteotomy, specifically the more commonly used opening wedge technique. PMID:22030940

Gomoll, Andreas H



Immediate catheterization laboratory management of acute femoral artery occlusion due to a vascular closure device  

PubMed Central

Acute limb ischemia due to vascular closure devices is an infrequent complication. However, its incidence is increasing because the use of these devices has become commonplace after cardiac catheterization and coronary angioplasty. It is therefore important for interventional cardiologists to be acquainted with the knowledge and cognitive skills of managing this complication in the catheterization laboratory. The present report describes a strategy to manage this complication in a cardiac catheterization laboratory that is not equipped with standard fluoroscopic equipment for peripheral interventions.

Chan, Albert W; Brown, Robert IG



[High output heart failure due to an iatrogenic arteriovenous fistula after cardiac catheterization].  


The occurrence of an arteriovenous fistula is a potential complication of cardiac catheterization. Most of these fistulas cause no harm. We report the clinical case of a 70 years old woman with high-output heart failure caused by an arteriovenous fistula (FAV) in the groin. The fistula was successfully closed by surgical repair and the heart failure was resolved. This case confirms the potential harmfulness for the vascular bed of certain surgical/endovascular interventions and intravascular monitoring techniques. When heart failure of uncertain etiology appears in patients previously submitted to one of the above mentioned procedures, a careful clinical examination can lead to a correct diagnosis of iatrogenic FAV, whose surgical correction is usually followed by the restoration of a normal cardiac function. PMID:20140291

Ministro, Augusto; Costa, Tiago; Cunha e Sá, Diogo; Evangelista, Ana; da Gama, A Dinis


Obtaining oblique technique source-to-skin distances for irregular field (Clarkson) calculations: The Mayo Off-axis Distance Indicator  

SciTech Connect

Significant dose inhomogeneities may exist between the supraclavicular fossa (SCF) and the internal mammary chain (IMC) regions in the irregular L-shaped (hockey stick) field associated with breast cancer treatments. This dose inhomogeneity exists, in part, because of a positive air gap in the SCF and a negative air gap in the IMC locations. Independent of treatment technique, (i.e., whether anterior-posterior (AP) or oblique fields are used), accurate source-to-skin distance (SSD) values for the SCF, IMC, and axilla are necessary when doing an irregular field (Clarkson) dose calculation. However, when an oblique technique is used to treat the hockey stick field, obtaining non-central-axis SSDs is not as straightforward as when an AP technique is employed. The Mayo Off-axis Distance Indicator was constructed to slide into the blocking tray slot of the simulator or treatment machine. This mechanical measuring device provides quick and accurate SSD measurements for non-central-axis points under either AP or, more importantly, oblique treatment conditions.

Lajoie, W.N. (Mayo Medical Center, Rochester, MN (USA))



Bacteriological examination of urine specimens from non-catheterized and catheterized dogs with symptoms of urinary tract infection.  


A bacteriological investigation of 199 urinary specimens from dogs with symptoms of urinary tract infections is presented. No bacterial growth was detected in 55.7% of all specimens examined. Isolation rates from urine specimens from noncatheterized and catheterized dogs were 35.2 and 66.7%, respectively, thus emphazising the importance of the sampling method and also that urinary tract infections in dogs can not be diagnozed solely on the basis of clinical symptoms. Bacteria belonging to the Enterobacteriaceae were most common isolated. Ampicillin was the drug to which resistance was least common (16.2%) while 79.1% of the strains examined were resistant to sulphonamide. PMID:693274

Wierup, M


Hemodynamic effects of ketamine in children undergoing cardiac catheterization.  


Ketamine is used to supplement sedation during cardiac catheterization. We studied ketamine-induced circulatory changes in 28 acyanotic children (18 of whom had left-to-right shunts), aged 4-161 months (mean, 33 months). Oxygen consumption (VO2) was measured continuously. In the 18 patients with shunts, the pulmonary to systemic flow ratio fell slightly (2.3 +/- 1.1 to 1.8 +/- 0.4, p less than 0.05). In all patients, the ratio of pulmonary (PVR) to systemic vascular resistance (SVR) rose from 0.16 +/- 0.09 to 0.28 +/- 0.21, p less than 0.001. Ketamine increases VO2, heart rate, cardiac output, and pulmonary arterial pressure (PAP). The rise in PAP is more consistent than the rise in PVR; resistance changes were greatest in patients with elevated resting PVR (r = 0.54). Caution should be used in administering ketamine to selected subjects; moreover, ketamine can confuse interpretation of cardiac catheterization data, especially if VO2 is assumed and not measured. PMID:2349145

Berman, W; Fripp, R R; Rubler, M; Alderete, L



Prevalence of renal artery stenosis in patients undergoing cardiac catheterization.  


To investigate the prevalence of significant renal artery stenosis (RAS ?50%), and to identify clinical predictors for significant RAS in patients with an elevated cardiovascular risk, such as those affected by ischemic heart disease. In patients with an elevated cardio-vascular risk, both atherosclerotic renovascular disease and coronary artery disease (CAD) are likely to occur. Prospectively from April 2007 to March 2008, all consecutive patients with ischemic heart disease undergoing non-emergent cardiac catheterization were also evaluated for atherosclerotic RAS by renal arteriography. A RAS ?50% was considered as significant. A total of 1,298 patients underwent cardiac and renal angiography. Significant RAS was found in 70 out of 1,298 patients (5.4%). The presence of peripheral vascular disease, eGFR <67 ml/min/1.73 m(2), age >66 years, dyslipidemia, CAD severity and pulse pressure >52 mmHg were independent clinical predictors of significant RAS, and jointly produced a ROC AUC of 0.79 (95% CI 0.73-0.85, P < 0.001). Based on these data, a prediction rule for significant RAS was developed, and it showed an adequate predictive performance with 64% sensitivity and 82% specificity. In a large cohort of patients undergoing coronary angiography, significant RAS is a relatively rare comorbidity (5.4%). A model based on simple clinical variables may be useful for the clinical identification of high CV risk patients who may be suitable for renal arteriography at the time of cardiac catheterization. PMID:21611779

Marcantoni, Carmelita; Carmelita, Marcantoni; Rastelli, Stefania; Stefania, Rastelli; Zanoli, Luca; Luca, Zanoli; Tripepi, Giovanni; Giovanni, Tripepi; Di Salvo, Marilena; Marilena, Di Salvo; Monaco, Sergio; Sergio, Monaco; Sgroi, Carmelo; Carmelo, Sgroi; Capodanno, Davide; Davide, Capodanno; Tamburino, Corrado; Corrado, Tamburino; Castellino, Pietro; Pietro, Castellino



Surgical approaches for the management of idiopathic thoracic scoliosis and the indications for combined anterior-posterior technique.  


The indications for surgical intervention in patients with idiopathic scoliosis have been well defined. The goals of surgery are to achieve fusion and arrest progressive curvature while restoring normal coronal and sagittal balance. As first introduced by Harrington, posterior fusion, the gold standard of treatment, has a proven record of success. More recently, anterior techniques for performing fusion procedures via either a thoracotomy or a retroperitoneal approach have been popularized in attempts to achieve better correction of curvature, preserve motion segments, and avoid some of the complications of posterior fusion such as the development of the flat-back syndrome. Anterior instrumentation alone, although effective, can be kyphogenic and has been shown to be associated with complications such as pseudarthrosis and instrumentation failure. Performing a combined approach in patients with scoliosis and other deformities has become an increasingly popular procedure to achieve superior correction of deformity and to minimize later complications. Indications for a combined approach (usually consisting of anterior release, arthrodesis with or without use of instrumentation, and posterior segmental fusion) include: prevention of crankshaft phenomenon in juvenile or skeletally immature adolescents; correction of large curves (75 degrees ) or excessively rigid curves in skeletally mature or immature patients; correction of curves with large sagittal-plane deformities such as thoracic kyphosis (> 90 degrees ) or thoracic lordosis (> 20 degrees ); and correction of thoracolumbar curves that need to be fused to the sacrum. Surgery may be performed either in a staged proceedure or, more commonly, in a single sitting. The authors discuss techniques for combined surgery and complication avoidance. PMID:17031912

Rauzzino, M J; Shaffrey, C I; Wagner, J; Nockels, R; Abel, M



Pulmonary hypertension in sickle cell disease: cardiac catheterization results and survival  

Microsoft Academic Search

Few results on cardiac catheterization have been published for patients with sickle cell disease (SCD) with pulmonary hypertension (PHTN). Their survival once this complication develops is unknown. We analyzed hemodynamic data in 34 adult patients with SCD at right-sided cardiac catheterization and determined the relationship of PHTN to patient sur- vival. In 20 patients with PHTN the aver- age systolic,

Oswaldo Castro; Mohammed Hoque; Bernice D. Brown



Noninvasive Doppler-derived myocardial performance index: Correlation with simultaneous measurements of cardiac catheterization measurements  

Microsoft Academic Search

A simple, reproducible, noninvasive Doppler index for the assessment of overall cardiac function has been described previously. The purpose of this study was to correlate the Doppler index with accepted indexes of cardiac catheterization of left ventricular performance. Thirty-four patients with ischemic heart disease or idiopathic dilated cardiomyopathy prospectively underwent a simultaneous cardiac catheterization and Doppler echocardiographic study. Invasive measurements

Chuwa Tei; Rick A. Nishimura; James B. Seward; A. Jamil Tajik



Radiation safety program for the cardiac catheterization laboratory.  


The Society of Cardiovascular Angiography and Interventions present a practical approach to assist cardiac catheterization laboratories in establishing a radiation safety program. The importance of this program is emphasized by the appropriate concerns for the increasing use of ionizing radiation in medical imaging, and its potential adverse effects. An overview of the assessment of radiation dose is provided with a review of basic terminology for dose management. The components of a radiation safety program include essential personnel, radiation monitoring, protective shielding, imaging equipment, and training/education. A procedure based review of radiation dose management is described including pre-procedure, procedure and post-procedure best practice recommendations. Specific radiation safety considerations are discussed including women and fluoroscopic procedures as well as patients with congenital and structural heart disease. PMID:21254324

Chambers, Charles E; Fetterly, Kenneth A; Holzer, Ralf; Lin, Pei-Jan Paul; Blankenship, James C; Balter, Stephen; Laskey, Warren K



Clearance by the liver in cirrhosis. II. Characterization of propranolol uptake with the multiple-indicator dilution technique.  


We studied the steady-state hepatic extraction and single-pass hepatic uptake of propranolol in isolated perfused livers from normal rats and compared these values with those of rats with carbon tetrachloride-induced cirrhosis, rats treated with chlorpromazine (an inhibitor of propranolol metabolism) and rats with acute liver injury. The kinetics of propranolol transport in the liver were characterized by means of the multiple-indicator dilution technique, and estimates of cellular influx, efflux and sequestration rate constants were obtained with a computer fit to the model of Goresky. The outflow pattern of propranolol in the hepatic veins was then resolved into throughput material, which had swept past the hepatocytes along with albumin, and returning material, which had entered the cells but returned in the outflow after escaping metabolic sequestration. The steady-state extraction of propranolol was significantly decreased in the three experimental groups compared with that in controls, but the outflow profile differed within each group. In cirrhotic animals, influx was markedly decreased and the sequestration rate constant remained unchanged; most of the propranolol in the outflow consisted of throughput material. In rats treated with chlorpromazine, the sequestration rate constant was decreased, and propranolol in the outflow was mainly returning material. In rats with acute liver injury, both influx and sequestration rate constants were decreased. Indicator dilution curves for nonsequestered tracers showed a decreased transit time for red blood cells and abnormal diffusion of albumin and sucrose into the space of Disse in cirrhotic rats compared with the other groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8406355

Gariépy, L; Fenyves, D; Kassissia, I; Villeneuve, J P



A novel radiocarbon dating technique applied to an ice core from the Alps indicating late Pleistocene ages  

NASA Astrophysics Data System (ADS)

Ice cores retrieved from high-altitude glaciers are important archives of past climatic and atmospheric conditions in midlatitude and tropical regions. Because of the specific flow behavior of ice, their age-depth relationship is nonlinear, preventing the application of common dating methods such as annual layer counting in the deepest and oldest part. Here we present a new approach and technique, allowing dating of any such ice core at arbitrary depth for the age range between ˜500 years B.P. and the late Pleistocene. This new, complementary dating tool has great potential for numerous ice core related paleoclimate studies since it allows improvement and extension of existing and future chronologies. Using small to ultrasmall sample size (100 ?g > carbon content > 5 ?g) accelerator mass spectrometry, we take advantage of the ice-included, water-insoluble organic carbon fraction of carbonaceous aerosols for radiocarbon (14C) dating. Analysis and dating of the bottom ice of the Colle Gnifetti glacier (Swiss-Italian Alps, 45°55'50?N, 7°52'33?E, 4455 m asl) has been successful in a first application, and the results revealed the core to cover most of the Holocene at the least with indication for late Pleistocene ice present at the very bottom.

Jenk, Theo M.; Szidat, SöNke; Bolius, David; Sigl, Michael; GäGgeler, Heinz W.; Wacker, Lukas; Ruff, Matthias; Barbante, Carlo; Boutron, Claude F.; Schwikowski, Margit



Hepatic laceration as a life-threatening complication of umbilical venous catheterization.  


Umbilical venous catheterization is an intravenous infusion route for maintenance fluids, medications, blood products, and parenteral nutrition in preterm neonates. However, this procedure may be associated with several complications, such as infection, thrombosis, vessel perforation, and cardiac and hepatic injuries. Hepatic laceration is a rare but life-threatening complication of umbilical venous catheterization that is a result of direct injury through the liver parenchyma. Here, we present a preterm newborn with hepatic laceration as a rare and serious complication of umbilical venous catheterization. PMID:21980821

Gülcan, Hande; Hanta, Deniz; Törer, Birgin; Temiz, Adbülkerim; Demir, Senay


The ‘lure and kill’ technique in Bactrocera oleae (Gmel.) control: effectiveness indices and suitability of the technique in area-wide experimental trials  

Microsoft Academic Search

The aim of this study is to evaluate the effectiveness of the ‘lure and kill’ technique, commonly called Mass Trapping (MT), compared with the larvicidal technique in olive fruit fly control. Data from different agro-ecological and management conditions were collected in several mass trapping areas in the regions of Tuscany and Liguria during 1999, 2000 and 2001. Data were organized

R. Petacchi; I. Rizzi; D. Guidotti



Cardiac Catheterization Within One to Three Days of Proximal Aortic Surgery is Not Associated with Increased Postoperative Acute Kidney Injury  

PubMed Central

Objective Cardiac catheterization shortly before coronary artery bypass grafting or valve surgery has been associated with increased postoperative acute kidney injury. The relationship between catheterization timing and acute kidney injury following proximal aortic surgery remains unknown. Methods Between August 2005 and February 2011, 285 consecutive patients underwent cardiac catheterization prior to elective proximal aortic surgery with cardiopulmonary bypass at a single institution. The association between timing of catheterization and postoperative acute kidney injury (defined as postoperative increase in serum creatinine ? 50% of baseline) was assessed using logistic regression analysis. Results Of 285 patients, 152 (53%) underwent catheterization on preoperative days 1-3 and 133 (47%) underwent catheterization on preoperative day 4 or before. Acute kidney injury occurred in 88 (31%) patients, three (1.1%) requiring dialysis. Acute kidney injury occurred in 37 (24%) patients catheterized on preoperative days 1-3, and 51 (38%) patients catheterized on preoperative day 4 or before. Catheterization on preoperative day 1-3 was not associated with an increased risk of acute kidney injury relative to catheterization on preoperative day 4 or before (unadjusted odds ratio 0.52, 95% confidence interval 0.31–0.86, P = 0.01; adjusted odds ratio 0.35, 95% confidence interval 0.17–0.73, P = 0.005). Conclusions Cardiac catheterization within one to three days of elective proximal aortic surgery appears safe and should be considered acceptable practice for patients at low-risk of acute kidney injury.

Andersen, Nicholas D.; Williams, Judson B.; Fosbol, Emil L.; Shah, Asad A.; Bhattacharya, Syamal D.; Mehta, Rajendra H.; Hughes, G. Chad



Diagnosis of thrombosis by catheter phlebography after prolonged central venous catheterization.  

PubMed Central

Sixty central venous catheterizations in 53 patients were prospectively studied with respect to phlebographic findings after prolonged parenteral nutrition. Phlebography was performed by a special technique on completion of the intravenous therapy. Under fluoroscopic control, the central venous catheter was slowly removed, while simultaneously contrast medium was continuously injected through it. Two types of thrombosis were demonstrated--sleeve thrombosis, on 25 occasions (42%), and mural veno-occlusive thrombosis, on five occasions (8%). On removal of the catheter the sleeve thrombosis peeled off the catheter and in several cases it was noticed that parts of the sleeve thrombus or the entire sleeve became detached and were carried away with the blood flow. Although the sleeve thrombus seldom gave rise to any symptoms, this type of thrombosis is of great importance in view of the risk of pulmonary embolism, especially in connection with removal of the catheter. With use of the described phlebographic technique thrombi of this type can be visualized. Images Fig. 1A. Fig. 1B. Fig. 2. Fig. 3. Fig. 4.

Brismar, B; Hardstedt, C; Jacobson, S



Primary hyperparathyroidism in a child. Use of jugular venous catheterization in diagnosis.  

PubMed Central

A 10-year-old boy with a parathyroid ademona is reported. Parathyroid hormone estimations of samples obtained by selective jugular venous catheterization were useful in diagnosis and for localizing the tumour before operation.

Gluckman, P D; Ferguson, R S; Osborne, D; Evans, M



Factors that affect back pain among Hong Kong Chinese patients after cardiac catheterization  

Microsoft Academic Search

BackgroundCardiac catheterization (CC) is a widely used cardiac investigation procedure in Hong Kong. However, back pain is frequently reported following CC due the prolonged bed rest after the procedure.

Sek Ying Chair; Kwai Moon Li; Sui Woon Wong



Incidence and Predictors of Radial Artery Occlusion Associated Transradial Catheterization  

PubMed Central

In this study, we sought to assess the incidence and predictors of radial artery occlusion (RAO), which is a significant complication of transradial cardiac catheterization. We prospectively evaluated the results of 106 patients who underwent coronary angiography and percutaneous coronary intervention (PCI) via the transradial approach (TRA). At the 3rd h of intervention, the radial artery was checked by palpation; color doppler ultrasonography was performed at the 24th h. Fluoroscopy duration, procedure success, and complications of the radial artery were recorded. The procedure was successfully completed in all patients. RAO was detected in eight female and two male patients. In terms of RAO, there was a statistically significant difference between males and females (p=0.019). Other parameters did not show a significant correlation with RAO. Altough did not have any effect on procedural success, eight patients developed transient radial artery spasm. Gender was not associated with radial arterial spasms (p=0.19). TRA in the diagnosis and treatment of coronary artery disease has shown high procedural success and low complication rates; it addition, it presents a low economic burden. It should be used widely and be involved in the routine cardiology residency program.

Tuncez, Abdullah; Kaya, Zeynettin; Aras, Dursun; Y?ld?z, Abdulkadir; Gul, Enes Elvin; Tekinalp, Mehmet; Karakas, Mehmet Fatih; K?sac?k, Halil Lutfu



A conductive catheter to improve patient safety during cardiac catheterization.  


A 60 Hz current, as small as 20 microamperemeter (rms) is capable of causing ventricular fibrillation when directly applied to the heart. Significant cost and engineering effort has been spent to construct monitoring equipment which satisfies the safety regulations requiring maximum leakage currents below this value. Patients undergoing cardiac catheterization are particularly at risk from electrical hazards, primarily because catheters are made from nonconductive materials. A conductive catheter should allow externally applied currents to leak through its walls before reaching the catheter tip. A new electrically conductive catheter was compared with a standard nonconductive catheter. Five dogs were studied, with 81 attempts to cause fibrillation. Sixty-hertz voltage between the catheter and an external electrode was increased until fibrillation occurred or 130 V was reached. Eight states were studied in randomized sequence: conductive or nonconductive catheter, guidewire or saline-filled and tip touching wall, or free in left ventricle (verified by fluoroscopy and cineangiography). The saline-filled and conductive catheter was safer in that fibrillation never occurred, while fibrillation nearly always occurred with the nonconductive catheter. A conductive guidewire negates the protection of the conductive catheter. The application of conductive catheters could reduce instrumentation costs in laboratories and intensive care units and improve patient safety. PMID:709775

Lipton, M J; Ream, A K; Hyndman, B H



Incidence and predictors of radial artery occlusion associated transradial catheterization.  


In this study, we sought to assess the incidence and predictors of radial artery occlusion (RAO), which is a significant complication of transradial cardiac catheterization. We prospectively evaluated the results of 106 patients who underwent coronary angiography and percutaneous coronary intervention (PCI) via the transradial approach (TRA). At the 3(rd) h of intervention, the radial artery was checked by palpation; color doppler ultrasonography was performed at the 24(th) h. Fluoroscopy duration, procedure success, and complications of the radial artery were recorded. The procedure was successfully completed in all patients. RAO was detected in eight female and two male patients. In terms of RAO, there was a statistically significant difference between males and females (p=0.019). Other parameters did not show a significant correlation with RAO. Altough did not have any effect on procedural success, eight patients developed transient radial artery spasm. Gender was not associated with radial arterial spasms (p=0.19). TRA in the diagnosis and treatment of coronary artery disease has shown high procedural success and low complication rates; it addition, it presents a low economic burden. It should be used widely and be involved in the routine cardiology residency program. PMID:24151442

Tuncez, Abdullah; Kaya, Zeynettin; Aras, Dursun; Y?ld?z, Abdulkadir; Gül, Enes Elvin; Tekinalp, Mehmet; Karaka?, Mehmet Fatih; K?sac?k, Halil Lütfü



Enterovesical fistula: a rare complication of urethral catheterization.  


This report describes the case of an eighty-two-year old lady with an indwelling urethral catheter inserted eight years prior to her presentation to manage her urinary incontinence. She underwent radiotherapy for muscle-invasive bladder cancer (stage T2b) in 1991 and had a laparotomy and drainage of an appendicular abscess in her early twenties. She presented with a short history of fecaluria, pneumaturia, and passage of urine per rectum. On laparotomy she was found to have an inflated catheter balloon that has eroded through the bladder wall into the lumen of a terminal ileal segment. To our knowledge this is the first reported case in literature of a patient developing an enterovesical fistula as a result of a urethral catheter eroding through the bladder wall into the bowel lumen. There are numerous known complications of long-term urethral catheterization. They include recurrent urinary tract infections, recurrent pyelonephritis, sepsis, urethral stricture, blocked and retained catheters, among many other reported complications. This case describes an unusual presentation secondary to an even more unusual complication. This should be considered when handling patients with indwelling urethral catheters inserted in unhealthy bladders. PMID:19657455

Hawary, Amr; Clarke, Laurence; Taylor, Alasdair; Duffy, Peter



Intravesical oxybutinin chloride in children with intermittent catheterization: sonographic findings.  


The sonographic findings in the bladder are presented in four children with myelomeningocele and neurogenic dysfunction of the bladder, who were treated with intermittent self-catheterization and intravesical oxybutinin chloride. All were referred for routine sonography of the urinary tract. Each had infused a crushed tablet of oxybutinin chloride intravesically 30-120 min before the examination. In two children, brightly echogenic, non-shadowing particles were suspended in the bladder urine. In one of these, the particles swirled giving the impression of a "snowstorm"; in the other, most of the particles gradually settled forming an irregular clump on the bladder base. In the remaining two children, the urine appeared diffusely hazy with innumerable tiny particles giving the impression of a fine mist filling the bladder. The sonographic appearance of the urine in the bladder after intravesical instillation of crushed tablets can be dramatic and can simulate pus, blood, fungus, or other debris in the bladder lumen. In the absence of clinical symptoms or hematuria, a history of recent infusion of medication into the bladder should be sought. PMID:7824373

Zerin, J M; DiPietro, M A; Ritchey, M L; Bloom, D A



The effects of music intervention on anxiety in the patient waiting for cardiac catheterization  

Microsoft Academic Search

Background: Hospitalization causes anxiety for many patients. It increases when patients anticipate their turn for cardiac catheterization. Music therapy reduces the psychophysiologic effects of anxiety and stress through the relaxation response.Aim: To determine the effects of music therapy an anxiety, heart rate and arterial blood pressure in patients waiting for their scheduled cardiac catheterization.Methods: In a quasi-experimental, pretest-posttest design, 101

Wallace J. Hamel



[Complications in the heart and vessels from the prolonged venous catheterization of burn patients].  


Under analysis were the results of 31 autopsies of patients with extensive (from 20 to 75% of the body surface) and deep burns who died of sepsis. In 15 patients peripheral and central veins were catheterized, the duration of staying the catheter in the veins varying from 7 till 80 days. A direct relationship between prolonged catheterization of the venous vessels in burned patients and the frequency of septic endocardites has been established. PMID:7385573

Bushuev, Iu I; Vazina, I R; Sosin, E Iu



Increased chromosome damage in pediatric heart catheterization patients after diagnostic fluoroscopy and cineangiography  

SciTech Connect

Chromosome damage (CD) and sister chromatid exchange (SCE) levels were studied in lymphocytes from 30 pediatric heart catheterization patients receiving radiation during diagnostic fluoroscopy and cineangiography procedures. Forty-eight-hour CD and 72-hr SCE cultures were prepared from sequential samples taken from each patient: samples 1-3 via the catheter the same day (1) before exposure, (2) after fluoroscopy, and (3) after cineangiography; and sample 4 by venipuncture the next morning. Significant increases in CD (dicentrics, rings, and fragments), but not SCE, were observed. From a mean base level of 0.4% cells with CD, the CD levels increased 2-3-fold in samples 3 and 4 (p = .001). Rings only occurred in samples 3 and 4. While increased CD levels also correlated with increasing age, body surface area, and weight, partial correlations controlling for these factors clearly indicate that the CD effects are principally attributable to the radiological procedures (p = .001). Increased CD levels correlated with both the roentgen dose of cineangiography exposure (p = .002) and the volume of contrast medium (p = .000); however, partial correlations, controlling for either factor, indicate that the contrast medium was the principal factor (p = .006).

Shafer, D.A.; Raviele, A.A.; Dunbar, V.G.; Click, L.A.



A rapid and non-surgical procedure for jugular catheterization of pigs.  


A rapid and non-surgical method for jugular catheterization in pigs was set up in 30 piglets of 6.2 kg, 23 pigs of 46 kg and 84 kg and two lactating multiparous sows. The animal was restrained on a V-shaped table (piglets) or with a rope around the mandible (slaughter pigs and sows). The vein was located with the Vacutainer system and a wire guide was inserted into the Vacutainer needle up to the vein lumen. When the needle was removed, the catheter was inserted over the wire guide and advanced until it penetrated the skin and thereafter, the vein wall. The catheter was fixed outside by a large tape and coiled inside a patch just behind the ears. The technique utilizes readily available material and is no more risky for the animal than a single blood sampling. Moreover, it can be performed within 15 to 20 min (including animal restraint) within pens. This new approach might have important implications not only for research purposes by facilitating repeated blood samplings but also for projects which require a rapid and easy method for testing of any kind of pharmaceutical or other type of products under husbandry conditions. PMID:10780845

Matte, J J



Ultrasound-guided supraclavicular central venous catheterization in patients with malignant hematologic diseases.  


We present two cases of central venous catheterization (CVC) in which an ultrasound-guided in-plane approach was used. Case 1 was a 60-year-old man with acute myelogenous leukemia in whom a right supraclavicular CVC was performed. He had pancytopenia (leukocytes 2,000/?L; erythrocytes 350 × 10(4)/?L; platelets 5.6 × 10(4)/?L), and abnormal coagulability (prothrombin time-international normalized ratio 1.35). A linear array transducer was positioned cephalad to the right clavicle and rotated 30° clockwise. The 21-gauge needle was manipulated from outside of the transducer. A CV catheter (CV legaforce EX(®); Terumo Co., Japan) was placed and stitched near the right clavicle. The patient felt no discomfort caused by the catheter. Case 2 was a 64-year-old women with malignant lymphoma whose right internal jugular vein was surrounded by abnormally enlarged lymph nodes. CVC was performed by the in-plane supraclavicular approach, avoiding puncture of the lymph node. This novel CVC technique is useful to minimize the risk of complications and patient discomfort by indwelling catheter. PMID:22547165

Yamauchi, Masanori; Sasaki, Hideaki; Yoshida, Tsukasa; Niiya, Tomohisa; Mizuno, Eri; Narimatsu, Eichi; Yamakage, Michiaki



[Interventional catheterization in the treatment of congenital and acquired heart defects].  


The treatment of heart defects by interventional catheterization started in 1982, when the first report on balloon dilatation of pulmonary valve stenosis was published. Similar techniques have since been extended to many other lesions. Presently, two types of catheter intervention have come into use. The first is dilatation of stenotic lesions by inflatable balloons: the main defects treated include pulmonary valve stenoses, aortic valve stenoses, coarctation of the aorta and peripheral pulmonary artery stenoses. Second, it is now possible to close defects and unwanted vessels, such as a persistent ductus arteriosus, with umbrella-like devices introduced through catheters. While balloon dilatation has clearly become the treatment of choice for pulmonary valve stenosis, other applications remain either controversial (e.g. balloon dilatation of coarctation) or experimental (e.g. closure of atrial or ventricular septal defects). Time will tell what is the exact role of interventional cardiology, keeping in mind that surgery provides excellent results with minimal morbidity and mortality in these lesions. PMID:2360010

Friedli, B; Meier, B



Extracellular volume and blood volume in chronically catheterized fetal sheep.  

PubMed Central

1. To determine the extracellular volume (ECV) in fetal sheep and its distribution between the plasma and interstitial spaces, ECV, blood volume (BV) and haematocrit were measured in ten chronically catheterized fetal sheep aged 121-133 days. Relationships with age, weight and other fetal variables, including glomerular filtration rate (GFR), were studied. 2. ECV was measured as the mean of the volumes of distribution of [3H]inulin and [14C]mannitol extrapolated to time zero. The time zero volume of distribution was 1506 +/- 79 ml (means +/- S.E.M.) for inulin and 1590 +/- 80 ml for mannitol. The ECV was 1548 +/- 79 ml (632 +/- 18 ml (kg fetal wt)-1). BV, measured using 51Cr-labelled red cells, was 351 +/- 27 ml (141 +/- 6 ml kg-1). Haematocrit, plasma volume and interstitial volume were 34 +/- 1%, 229 +/- 17 ml (92 +/- 3 ml kg-1) and 1319 +/- 63 ml (540 +/- 17 ml kg-1), respectively. 3. Interstitial volume per kilogram fell with increasing fetal weight (P = 0.026). BV per kilogram did not change with weight or age. 4. The plasma: interstitial volume ratio was 0.17 +/- 0.01. This ratio increased as fetal weight and age increased (P = 0.026 and P = 0.044), that is, the proportion of ECV that was contained outside the vascular compartment was lower in heavier or older fetuses. 5. Since GFR was 3.4 +/- 0.4 ml min-1, the entire fetal ECV was filtered by the fetal kidney only 3.1 +/- 0.3 times per day.

Gibson, K J; Lumbers, E R



Spectrophotometric Determination of the Dissociation Constant of an Acid-Base Indicator Using a Mathematical Deconvolution Technique  

ERIC Educational Resources Information Center

A laboratory experiment reinforces the concept of acid-base equilibria while introducing a common application of spectrophotometry and can easily be completed within a standard four-hour laboratory period. It provides students with an opportunity to use advanced data analysis techniques like data smoothing and spectral deconvolution to…

Alter, Krystyn P.; Molloy, John L.; Niemeyer, Emily D.



Spectrophotometric Determination of the Dissociation Constant of an Acid-Base Indicator Using a Mathematical Deconvolution Technique  

ERIC Educational Resources Information Center

|A laboratory experiment reinforces the concept of acid-base equilibria while introducing a common application of spectrophotometry and can easily be completed within a standard four-hour laboratory period. It provides students with an opportunity to use advanced data analysis techniques like data smoothing and spectral deconvolution to…

Alter, Krystyn P.; Molloy, John L.; Niemeyer, Emily D.



A novel radiocarbon dating technique applied to an ice core from the Alps indicating late Pleistocene ages  

Microsoft Academic Search

Ice cores retrieved from high-altitude glaciers are important archives of past climatic and atmospheric conditions in midlatitude and tropical regions. Because of the specific flow behavior of ice, their age-depth relationship is nonlinear, preventing the application of common dating methods such as annual layer counting in the deepest and oldest part. Here we present a new approach and technique, allowing

Theo M. Jenk; Sönke Szidat; David Bolius; Michael Sigl; Heinz W. Gäggeler; Lukas Wacker; Matthias Ruff; Carlo Barbante; Claude F. Boutron; Margit Schwikowski



The Validation of a New Stability-Indicating HPLC Technique Developed for the Quantitative Analysis of Rooperol Tetra-Acetate  

Microsoft Academic Search

A high performance liquid chromatographic method was developed for the quantitative analysis of rooperol tetra-acetate in the aqueous receptor phase of in vitro diffusion cells. System validation of the developed HPLC technique was carried out through the determination of the precision, limit of quantitation, sensitivity, linearity, and range of the system. In each of the above tests mentioned, an isocratic

S. C. Pefile; E. W. Smith; P. B. Kruger; C. F. Albrecht



[Spanish Cardiac Catheterization and Coronary Intervention Registry. 14th official report of the Spanish Society of Cardiology Working Group on Cardiac Catheterization and Interventional Cardiology (1990-2004)].  


This article presents the findings of the Spanish Society of Cardiology registry of cardiac catheterization and interventional cardiology in the year 2004. Data were obtained from 121 centers, which comprise almost all cardiac catheterization laboratories in Spain. Of these, 110 performed catheterization mainly in adults, and 11 carried out procedures in only pediatric patients. In 2005, 111,451 diagnostic catheterization procedures were performed, including 97,785 coronary angiograms. This was 6.6% higher than in 2003. The population-adjusted rate was 2263 coronary angiograms per million inhabitants. A total of 45,469 coronary interventions were performed, 12% more than in 2003. The population-adjusted rate was 1052 per million inhabitants. Coronary stents were used in 91.4% of procedures; 68,892 stents were implanted, which was 12% more than in 2003. Of these, 25,148 (36.5%) were drug-eluting stents. Some 7326 percutaneous coronary interventions were carried out in patients with acute myocardial infarction, 20.5% more than in 2003. These accounted for 16.1% of all percutaneous coronary interventions. Among non-coronary interventions, there was a decrease in the number of percutaneous mitral valvuloplasties (8%) and atrial septal defect closures (7%). In addition, there was a small increase in pediatric interventions (12%). Finally, it is important to note that the percentage of centers participating in the registry was high, what ensures that the data presented here are highly representative of the work carried out in cardiac catheterization laboratories in Spain. PMID:16324586

López-Palop, Ramón; Moreu, José; Fernández-Vázquez, Felipe; Hernández, Rosana



[Spanish Cardiac Catheterization and Coronary Intervention Registry. 15th official report of the Spanish Society of Cardiology Working Group on Cardiac Catheterization and Interventional Cardiology (1990-2005)].  


This article summarizes the findings contained in the 2005 registry of the Spanish Society of Cardiology Working Group on Cardiac Catheterization and Interventional Cardiology. Data were obtained from 128 centers, which comprise almost all cardiac catheterization laboratories in Spain. Of these, 118 performed catheterizations mainly in adults, while 10 carried out procedures in only pediatric patients. In 2005, 117,245 diagnostic catheterization procedures were performed, including 103,646 coronary angiograms, which was 5.9% more than in 2004. The population-adjusted rate was 2326 coronary angiograms per million inhabitants. A total of 51,689 coronary interventions were performed, which is 13.6% more than in 2004 and which corresponds to a rate of 1161 per million inhabitants. Coronary stents were used in 96% of procedures. Of the 80,569 stents implanted, 41,352 (51.3%) were drugeluting stents. Some 8341 percutaneous coronary interventions were carried out in patients with acute myocardial infarction, which is 13.8% more than in 2004. They accounted for 16.1% of all such interventions. Among the non-coronary interventions recorded, the number of percutaneous mitral valvuloplasties decreased by 7%. The number of procedures carried out to close atrial septal defects increased by 40% compared with 2004. The number of pediatric interventions increased by 1.7%. Finally, it is important to note that a large proportion of laboratories reported results, which helped to ensure that the data summarized here are highly representative of the work carried out at cardiac catheterization laboratories in Spain. PMID:17144990

López-Palop, Ramón; Moreu, José; Fernández-Vázquez, Felipe; Hernández Antolín, Rosana



Assessment of Soil Erodibility Indices for Conservation Reserve Program Lands in Southwestern Kansas Using Satellite Imagery and GIS Techniques  

Microsoft Academic Search

The soil erodibility index (EI) of Conservation Reserve Program (CRP) lands, which was the major criterion for CRP enrollment,\\u000a was assessed for six counties in southwestern Kansas using USGS seamless digital elevation model data and Geographical Informational\\u000a System techniques. The proportion of land areas with EI values of 8 or lower was less than 1% of the entire study area

Stephen L. Egbert



Phenolic acids from wheat show different absorption profiles in plasma: a model experiment with catheterized pigs.  


The concentration and absorption of the nine phenolic acids of wheat were measured in a model experiment with catheterized pigs fed whole grain wheat and wheat aleurone diets. Six pigs in a repeated crossover design were fitted with catheters in the portal vein and mesenteric artery to study the absorption of phenolic acids. The difference between the artery and the vein for all phenolic acids was small, indicating that the release of phenolic acids in the large intestine was not sufficient to create a porto-arterial concentration difference. Although, the porto-arterial difference was small, their concentrations in the plasma and the absorption profiles differed between cinnamic and benzoic acid derivatives. Cinnamic acids derivatives such as ferulic acid and caffeic acid had maximum plasma concentration of 82 ± 20 and 200 ± 7 nM, respectively, and their absorption profiles differed depending on the diet consumed. Benzoic acid derivatives showed low concentration in the plasma (<30 nM) and in the diets. The exception was p-hydroxybenzoic acid, with a plasma concentration (4 ± 0.4 ?M), much higher than the other plant phenolic acids, likely because it is an intermediate in the phenolic acid metabolism. It was concluded that plant phenolic acids undergo extensive interconversion in the colon and that their absorption profiles reflected their low bioavailability in the plant matrix. PMID:23971623

Nørskov, Natalja P; Hedemann, Mette S; Theil, Peter K; Fomsgaard, Inge S; Laursen, Bente B; Knudsen, Knud Erik Bach



On the development of improved adaptive models for efficient prediction of stock indices using clonal-PSO (CPSO) and PSO techniques  

Microsoft Academic Search

The present paper introduces a new clonal particle swarm optimisation (CPSO) and PSO techniques to develop efficient adaptive forecasting models for short and long-term prediction of S&P 500 and DJIA stock indices. The basic structure of the models is an adaptive linear combiner whose weights are iteratively updated by PSO and CPSO-based learning rules. The technical indicators are computed from

Ritanjali Majhi; Ganapati Panda; Gadadhar Sahoo; Abhishek Panda



The Use of MMF Screws: Surgical Technique, Indications, Contraindications, and Common Problems in Review of the Literature.  


Mandibulo-maxillary fixation (MMF) screws are inserted into the bony base of both jaws in the process of fracture realignment and immobilisation. The screw heads act as anchor points to fasten wire loops or rubber bands connecting the mandible to the maxilla. Traditional interdental chain-linked wiring or arch bar techniques provide the anchorage by attached cleats, hooks, or eyelets. In comparison to these tooth-borne appliances MMF screws facilitate and shorten the way to achieve intermaxillary fixation considerably. In addition, MMF screws help to reduce the hazards of glove perforation and wire stick injuries. On the downside, MMF screws are attributed with the risk of tooth root damage and a lack of versatility beyond the pure maintenance of occlusion such as stabilizing loose teeth or splinting fragments of the alveolar process. The surgical technique of MMF screws as well as the pros and cons of the clinical application are reviewed. The adequate screw placement to prevent serious tooth root injuries is still an issue to rethink and modify conceptual guidelines. PMID:22110819

Cornelius, Carl-Peter; Ehrenfeld, Michael



Outcome indicators in palliative care—how to assess quality and success. Focus group and nominal group technique in Germany  

Microsoft Academic Search

Purpose  The call for clinically relevant outcome criteria has been raised, as assessment of adequate quality of service providers\\u000a is essential with increasing momentum in the development of palliative care in most European countries. The aim of this study\\u000a is to investigate important dimensions and indicators for assessment and evaluation of palliative care from the perspective\\u000a of multi-disciplinary German experts working

Tania Pastrana; Lukas Radbruch; Friedemann Nauck; Gerhard Höver; Martin Fegg; Martina Pestinger; Josef Roß; Norbert Krumm; Christoph Ostgathe



Comparison of Ultrasonography-Guided Central Venous Catheterization Between Adult and Pediatric Populations  

SciTech Connect

The purpose of this study was to compare the technical success and complication rates of ultrasonography-guided central venous catheterization between adult and pediatric patients which have not been reported previously. In a 4-year period, 859 ultrasonography-guided central vein catheterizations in 688 adult patients and 247 catheterizations in 156 pediatric patients were retrospectively evaluated. Mean age was 56.3 years (range, 18 to 95 years) for adults and 3.3 years (range, 0.1 to 16.3 years) for children. The preferred catheterization site was internal jugular vein in 97% of adults and 85% of children. The technical success rate, mean number of punctures, and rate of single wall puncture were 99.4%, 1.04 (range, 1-3), and 83% for adults and 90.3%, 1.25 (range, 1-5), and 49% for children, respectively. All the differences were statistically significant (p < 0.05). Complication rates were 2.3% and 2.4% for adults and children, respectively (p > 0.05). Major complications such as pneumothorax and hemothorax were not seen in any group. In conclusion, ultrasonography-guided central venous catheterization has a high technical success rate, lower puncture attempt rate, and higher single wall puncture rate in adults compared to children. Complication rates are comparable in the two groups.

Tercan, Fahri [Baskent Universitesi, Adana Arastirma ve Uygulama Merkezi (Turkey)], E-mail:; Oguzkurt, Levent; Ozkan, Ugur [Baskent University Faculty of Medicine, Department of Radiology (Turkey); Eker, Hatice Evren [Baskent University Faculty of Medicine, Department of Anesthesiology (Turkey)



Contrast-enhanced ultrasound for imaging blunt abdominal trauma - indications, description of the technique and imaging review.  


Patients with blunt abdominal trauma are initially imaged with ultrasound (US) for the evaluation of free abdominal fluid. However, lacerations of solid organs can be overlooked. Although computed tomography (CT) is the gold standard technique for abdominal trauma imaging, overutilization, ionizing radiation, need to transport the patient and potential artifacts are well known disadvantages. Contrast-enhanced US (CEUS) can be used as an imaging tool between the two methods. It can easily and reliably reveal solid abdominal organ injuries in patients with low-energy localized trauma and decrease the number of CT scans performed. It can be rapidly performed at the patient's bedside with no need for transportation. There are only very few contraindications and anaphylactoid reactions are extremely rare. Altogether, CEUS has proved to be very helpful for the initial imaging of traumatic lesions of the liver, kidney and spleen, as well as for patient follow-up. PMID:22274907

Cokkinos, D; Antypa, E; Stefanidis, K; Tserotas, P; Kostaras, V; Parlamenti, A; Tavernaraki, K; Piperopoulos, P N



A Randomized Controlled Trial of Plastic Drape for Prevention of Hypothermia during Umbilical Catheterization.  


Objective To determine the efficacy of polyethylene plastic draping in preventing hypothermia during umbilical catheterization.Methods A randomized controlled trial was conducted in newborns who required umbilical catheterization. A sterile polyethylene plastic sheet covering the procedural field was used in the plastic group, and a sterile conventional cotton drape was used in the control group.Results Sixty infants were enrolled and randomly assigned to the plastic group (n = 30) and control group (n = 30). There were no significant differences in the baseline demographic data. The use of plastic drapes was associated with a higher rectal temperature compared with the control group. Incidence of hypothermia at the end of procedure were 20% and 50% in the plastic group and control group, respectively (p = 0.03).Conclusion Polyethylene plastic draping was superior to conventional cloth draping in maintaining rectal temperature and preventing hypothermia during umbilical catheterization. PMID:23359236

Nuntnarumit, Pracha; Swatesutipun, Buranee; Udomsubpayakul, Umaporn; Thanacharoenpipat, Pornjit



Recommended Criteria for Cardiac Catheterization in Patients with Aortic Valve Disease  

PubMed Central

Criteria for selection of patients with aortic valve disease for cardiac catheterization are described, based on a study of 81 cases. Children with aortic stenosis warrant catheterization at the time when the clinical diagnosis is made, but in adults this examination may be deferred until symptoms appear or left ventricular hypertrophy is recognized. In patients with pure aortic insufficiency catheterization may be deferred until symptoms appear. When severe stenosis and insufficiency co-exist, the valve is usually heavily calcified. Thirty-seven per cent of patients with aortic valve disease have co-existing mitral lesions and these patients are usually women, are fibrillating and, as a rule, have atrial enlargement in contrast to those with aortic valve disease only. On rare occasions, patients with mitral valve disease have clinically silent but angiographically demonstrable aortic insufficiency; therefore, aortography should precede open-heart correction of a mitral lesion so as to detect minor degrees of aortic insufficiency. ImagesFig. 2

Kavanagh-Gray, Doris



Stability-indicating assay of repaglinide in bulk and optimized nanoemulsion by validated high performance thin layer chromatography technique  

PubMed Central

A sensitive, selective, precise and stability-indicating high-performance thin-layer chromatographic (HPTLC) method for analysis of repaglinide both as a bulk drug and in nanoemulsion formulation was developed and validated. The method employed TLC aluminum plates precoated with silica gel 60F-254 as the stationary phase. The solvent system consisted of chloroform/methanol/ammonia/glacial acetic acid (7.5:1.5:0.9:0.1, v/v/v/v). This system was found to give compact spots for repaglinide (Rf value of 0.38 ± 0.02). Repaglinide was subjected to acid and alkali hydrolysis, oxidation, photodegradation and dry heat treatment. Also, the degraded products were well separated from the pure drug. Densitometric analysis of repaglinide was carried out in the absorbance mode at 240 nm. The linear regression data for the calibration plots showed good linear relationship with r2= 0.998 ± 0.032 in the concentration range of 50-800 ng. The method was validated for precision, accuracy as recovery, robustness and specificity. The limits of detection and quantitation were 0.023 and 0.069 ng per spot, respectively. The drug undergoes degradation under acidic and basic conditions, oxidation and dry heat treatment. All the peaks of the degraded product were resolved from the standard drug with significantly different Rf values. Statistical analysis proves that the method is reproducible and selective for the estimation of the said drug. As the method could effectively separate the drug from its degradation products, it can be employed as a stability-indicating one. Moreover, the proposed HPTLC method was utilized to investigate the degradation kinetics in 1M NaOH.

Akhtar, Juber; Fareed, Sheeba; Aqil, Mohd



Is Mitrofanoff a More Socially Accepted Clean Intermittent Catheterization (CIC) Route for Children and Their Families?  


Aim We aimed to examine the social impact of clean intermittent catheterization (CIC) on children with a neurogenic bladder and to compare the impact of urethral CIC with Mitrofanoff catheterization.Methods Questionnaires containing 29 questions about the social impact of CIC on the children and their families were administered with their parents or caregivers of 50 children (34 boys and 16 girls) using CIC. The mean (standard deviation [SD]) age of the children was 9.6 (4.32) years and duration on CIC was 6.1 (3.97) years.Results Seventeen children were using Mitrofanoff catheterization (group I) and 33 children urethral catheterization (group II). Of the respondents, 54% respondents reported that their children accept the use of CIC, 30% respondents reported that they do not like it, and 16% respondents reported that they always refuse and resist it. There was no difference in the level of acceptance between the two groups. Both groups reported that children were social (90%) and had close friends (88%). However, 50% felt that CIC affected mood, with 30% of the children displaying bad temper. Mitrofanoff catheterization was associated with fewer episodes of frequent urinary tract infection (p = 0.004) and greater adherence. All children from group I, who were older than 6 years, were attending school compared with 78% from group II. School performance was significantly better in group I (p = 0.022).Conclusion There was acceptance of CIC by most children but Mitrofanoff catheterization seemed to have a lower social impact in terms of school performance, adherence to therapy, and complications. PMID:23100057

Kari, Jameela; Al-Deek, Basem; Elkhatib, Lamis; Salahudeen, Sayed; Mukhtar, Najla; Ahmad, Rafif Al; Eldesoky, Sherif; Raboei, Enaam



A mathematical model for patient skin dose assessment in cardiac catheterization procedures.  


A mathematical model has been developed for the assessment of patient skin doses from cardiac catheterization procedures. This uses exposure and projection data stored in the DICOM image files. Since these contain only information about the acquisition runs, a correction is needed to estimate and include the contribution from fluoroscopy. Maximum skin doses calculated by the model were found to correlate well with those measured on Kodak EDR2 film. Three methods for including the contribution from fluoroscopy were investigated, and all successfully identified patients receiving skin doses in excess of 1 Gy. It is hoped to automate this tool for routine assessment of skin doses in our cardiac catheterization laboratories. PMID:16940375

Morrell, R E; Rogers, A T



Determining geographic areas and populations with timely access to cardiac catheterization facilities for acute myocardial infarction care in Alberta, Canada  

Microsoft Academic Search

BACKGROUND: This study uses geographic information systems (GIS) as a tool to evaluate and visualize the general accessibility of areas within the province of Alberta (Canada) to cardiac catheterization facilities. Current American and European guidelines suggest performing catheterization within 90 minutes of the first medical contact. For this reason, this study evaluates the populated places that are within a 90

Alka B Patel; Nigel M Waters; William A Ghali



Percutaneous transhepatic portal catheterization-modification of Chiba method and portal vein pressure in liver diseases.  


Percutaneous transhepatic portal catheterization was performed in 68 cases of liver diseases in the 2 year period from 1978 to 1980. The Chiba University method was modified. Portal vein catheterization was successful in 61 cases (90%). Selective splenic vein catheterization was successful in 55 of the 61 cases (90%) and selective superior mesenteric vein catheterization in 59 cases (97%). The liver was punctured an average of 4.6 times in order to successfully insert the catheter into the main portal vein, and the number of punctures was less than 10 in 57 of the 61 cases (93%). The portal vein pressure was 310+/-67 mm H2O in idiopathic portal hypertension (8 cases), 290+/-83 in liver cirrhosis (33 cases), 193+/-71 in chronic hepatitis (7 cases) and 166+/-50 in fatty liver (4 cases). Portal vein pressure rose from 205+/-75 to 380+/-55 mm H2O in 11 cases after forced Valsalva maneuver. No major complications were encountered. PMID:7136852

Ito, T; Itoshima, T; Kiyotoshi, S; Kawaguchi, K; Ogawa, H; Kitadai, M; Hattori, S; Maruyama, T; Tomoda, J; Morichika, S; Munetomo, F; Nagashima, H



Residual urine volumes after intermittent catheterization in men with spinal cord injury.  


Study design:Prospective cross-sectional study.Objectives:To investigate residual urine volumes after intermittent catheterization (IC) in men with spinal cord injury (SCI) and the effect of residual urine on the rate of symptomatic urinary tract infections (UTIs).Setting:Single SCI rehabilitation center in Switzerland.Methods:Sixty men experienced in IC (?6 months) emptied their bladder twice by IC. Immediately after catheterization, residual urine was determined by ultrasonography. Personal characteristics and bladder diary details (annual UTI rate, catheter type) were also collected.Results:The median residual urine volume was 7.0?ml (lower quartile (LQ): 0.0, upper quartile (UQ): 20.3?ml). No residual urine was observed after 42% (n=50) of all catheterizations (n=120). Unsatisfactory residual volumes (that is, >50?ml) were observed after 9% (n=11) of all catheterizations. There was no significant (P=0.95) difference between the median residual urine volume of men with recurrent (>2 UTIs per year) UTIs (2.5?ml, LQ: 0.0, UQ: 29.3?ml) and the volume of those with sporadic (?2 UTIs per year) UTIs (6.0?ml, LQ: 0.0, UQ: 20.0?ml).Conclusions:Bladder evacuation by IC is an efficient method, resulting in zero or small residual urine volumes. The small residual urine volumes generally observed after IC do not predispose for UTIs. PMID:23939190

Krebs, J; Bartel, P; Pannek, J



Increasing accuracy and decreasing latency during clean intermittent self-catheterization procedures with young children.  

PubMed Central

We examined the effects of simulation training on performance of clean intermittent self-catheterization procedures with 2 young girls. Simulation training was conducted, after which independent performance was assessed within a multiple baseline design. The training resulted in increased accuracy and decreased latency for both girls.

McComas, J J; Lalli, J S; Benavides, C



Novel miniature MRI-compatible fiber-optic force sensor for cardiac catheterization procedures  

Microsoft Academic Search

This paper presents the prototype design and development of a miniature MR-compatible fiber optic force sensor suitable for the detection of force during MR-guided cardiac catheterization. The working principle is based on light intensity modulation where a fiber optic cable interrogates a reflective surface at a predefined distance inside a catheter shaft. When a force is applied to the tip

Panagiotis Polygerinos; Pinyo Puangmali; Tobias Schaeffter; Reza Razavi; Lakmal D. Seneviratne; Kaspar Althoefer



A Randomized Control Trial of Right-Heart Catheterization in Critically Ill Patients  

Microsoft Academic Search

We investigated the impact of right-heart catheterization (RHC) on physiological status and stay in the intensive care unit. Thirty three of 148 potentially eligible patients were randomized. Fifty-two otherwise eligible patients were excluded because the attending physician felt that RHC was ethically mandated. Ten of 16 (63%) patients randomized to RHC, and 9 of 17 (53%) to no RHC, died

Gordon Guyatt



Nursing care in the prevention of renal failure caused by post-catheterism contrast  

Microsoft Academic Search

The purpose of this study was to identify the nursing scientific production on acute renal failure caused by post-catheterism iodized cardiac contrast, from 2002 to 2007, by analyzing its practical application. A critical analysis was further performed of the selected scientific production outlining nursing care. This study is a literature review of nursing articles, found through computerized search. Out of

Flavia Giron Camerini; Isabel Cruz



Evaluation of calibration methods for size estimation in the pediatric cardiac catheterization laboratory  

Microsoft Academic Search

Limited data are available on the accuracy of various calibration methods used to estimate the size of cardiovascular structures during interventional pediatric cardiac catheterizations. The aim of this study was to evaluate, in an experimental model, several of these commonly used calibration methods. Thoracic box models were constructed in 4 sizes to simulate average chest sizes of infants, children, adolescents,

Eytan Szmuilowicz; Mark S Sklansky; Nafiz Kiciman; Saskia Hilton; Abraham Rothman



Increased blood flow after catheterization and drainage in the chronically obstructed rabbit urinary bladder  

Microsoft Academic Search

Objectives. To determine the effect of drainage on rabbit bladder blood flow after 4 weeks of partial outlet obstruction. Previous studies have shown that catheterization and drainage of the urinary bladder in control rabbits resulted in a significant nitric oxide-induced increase of blood flow to the bladder. It was also shown that 4 weeks’ partial outlet obstruction caused a significant

Annette Schröder; Barry A Kogan; Jeremy Lieb; Robert M Levin



Radiation exposure of pediatric patients and physicians during cardiac catheterization and balloon pulmonary valvuloplasty  

SciTech Connect

Thermoluminescent dosimeters were applied to various areas of 61 pediatric patients and physicians to measure radiation doses during routine cardiac catheterization and during 4 cases of balloon pulmonary valvuloplasty. Radiation doses were measured during chest roentgenography, fluoroscopy and cineangiography. Average skin dose to the chest was 121 microGy during chest x-ray, 5,182 microGy during catheterization and 641 mGy during valvuloplasty. For the eyes, thyroid and gonads of the patients, the exposure during routine catheterization was equal to 0.4, 6 and 0.2 chest x-rays, respectively. Radiation dose of the operator was 3 microGy for the eyes and 6 miCroGy in the thyroid. About 56% of the operator's dose could be reduced by thyroid shields, and 80% by lead aprons. The assistant received only 1 microGy outside the thyroid shield. Therefore, the authors have concluded that the patients dose during routine catheterization is largely based on our experimental results, but the dose is acceptable based on the risk factor analysis. The skin dose to the right lateral chest of the patient during valvuloplasty is extremely high, perhaps as high as the equivalent of 1,000 chest x-rays. Besides the clinical benefits of valvuloplasty, the long-term radiation-related hazards to the patient should be carefully monitored.

Wu, J.R.; Huang, T.Y.; Wu, D.K.; Hsu, P.C.; Weng, P.S. (Department of Pediatrics, School of Medicine, Kaohsiung Medical College, Taiwan (China))



Subclavian artery pseudoaneurysm: a rare and serious complication of central venous catheterization in an infant  

Microsoft Academic Search

Serious complications of central venous access occur in 0.4–9.9% of patients undergoing attempted central venepuncture. We\\u000a report an unusual case of an 18-month-old infant in whom a right subclavian artery pseudoaneurysm developed rapidly after\\u000a attempted subclavian vein catheterization without US guidance failed.

Esad Koklu; Hakan Poyrazoglu; Ali Yikilmaz; Mehmet Canpolat; Bahadir Konuskan



History of Right Heart Catheterization: 100 Years of Experimentation and Methodology Development  

PubMed Central

The development of right heart catheterization has provided the clinician the ability to diagnose patients with congenital and acquired right heart disease, and to monitor patients in the ICU with significant cardiovascular illnesses. The development of bedside pulmonary artery catheterization has become a standard of care for the critically ill patient since its introduction into the ICU almost 40 years ago. However, adoption of this procedure into the mainstream of clinical practice occurred without prior evaluation or demonstration of its clinical or cost-effectiveness. Moreover, current randomized, controlled trials provide little evidence in support of the clinical utility of pulmonary artery catheterization in the management of critically ill patients. Nevertheless, the right heart catheter is an important diagnostic tool to assist the clinician in the diagnosis of congenital heart disease and acquired right heart disease, and moreover, when catheter placement is proximal to the right auricle (atria), this catheter provides an important and safe route for administration of fluids, medications, and parenteral nutrition. The purpose of this manuscript is to review the development of right heart catheterization that led to the ability to conduct physiologic studies in cardiovascular dynamics in normal individuals and in patients with cardiovascular diseases, and to review current controversies of the extension of the right heart catheter, the pulmonary artery catheter.

Nossaman, Bobby D.; Scruggs, Brittni A.; Nossaman, Vaughn E.; Murthy, Subramanyam N.; Kadowitz, Philip J.



Health Technology Assessment Reports, 1989. Number 6. Cardiac Catheterization in a Freestanding Setting.  

National Technical Information Service (NTIS)

Cardiac catheterization is a procedure used to diagnose and treat heart disease. The procedure involves inserting the tip of a small catheter into a patient's blood vessel and advancing it until the tip of the catheter is placed in or near the heart. When...

M. N. Jackson



Umbilical vein catheterization in the critical newborn: a review of anatomy and technique.  


Why attempt a UVC line when intraosseous access is often available and the literature has demonstrated its ease of placement and effectiveness even in neonates? This article is not intended to suggest giving up IO vascular access if you currently have it in your toolbox. The intent was to discuss an alternative to IO vascular access when it fails--for example, when a tibia is fractured during an IO attempt or is not an option for other reasons. The Fast-Cath UVC is another tool in the advance EMS clinician's arsenal that can be easily learned and utilized. It is an effective option for vascular access in the distressed newborn when other options have failed or are not available. PMID:23469464

Tomek, Scott; Asch, Susan



Long-term clinical outcomes of fat grafting by low-pressure aspiration and slow centrifugation (Lopasce technique) for different indications.  


Abstract Autologous fat grafts have been used successfully for structural fat grafting in facial, lip, and hand rejuvenation, body contour improvement, and traumatic defect restoration. The purposes of this study were to define a new fat graft harvesting and processing technique, which is named the "Lopasce technique" (low-pressure aspiration and slow centrifugation technique), and to evaluate the late clinical outcomes of fat grafting by this technique for different indications. A retrospective study was performed using the medical records of 21 patients (17 women and four men). The mean injected fat volume was 33.2 ± 34 cc (range 6-125 cc). The mean follow-up period was 13.2 ± 5.6 months (range 6-26 months). Postoperative results were evaluated by subjective and objective methods. In the subjective evaluation, 19 patients stated that there had been little resorption and that it was not necessary to repeat the fat grafting, one patient reported that the fat was resorbed in part, and one patient reported that the fat was resorbed completely. In the objective evaluation, the amount of fat graft taken in the recipient sites was between 60%-80% (average 70%) when compared with preoperative and late postoperative photographs of the patients at the 6- and 26-month follow-ups. Fat grafting is a simple, effective, and reproducible technique with a high satisfaction rate and few disadvantages or complications. We consider that structural fat grafting with the lopasce technique is an easy, effective, and long-lasting treatment for correction of congenital or acquired defects associated with various medical conditions. PMID:23952057

Ozkaya, Ozay; Egemen, Onur; Barutça, Seda Asfuro?lu; Akan, Mithat



Experience with Percutaneous Internal Jugular-Innominate Vein Catheterization  

PubMed Central

A specific technique of cannulation of the internal jugular innominate vein, presented herein, is not considered an innocuous procedure, but the incidence of serious complications is very low. In this technique a needle-in-catheter unit aids greatly in advancing the catheter through the vein. More than 62 percent of the catheters were left in place for more than five days. There was an 11.4 percent incidence of positive bacterial or fungal cultures from the catheter tip. Routine follow-up chest x-ray films demonstrated all the catheters in the innominate-superior vena cava venous system. ImagesFigure 1.Figure 2.Figure 3.Figure 4.

McConnell, Richard Y.; Fox, Robert T.



Sex differences in coronary catheterization and revascularization following acute myocardial infarction: Time trends from 1994 to 2003 in British Columbia  

PubMed Central

BACKGROUND: Studies before the turn of the century reported sex differences in procedure rates. It is unknown whether these differences persist. OBJECTIVES: To examine time trends and sex differences in coronary catheterization and revascularization following acute myocardial infarction (AMI). METHODS: A retrospective analysis was performed of all patients 20 years of age or older who were admitted to hospital in British Columbia with an AMI between April 1, 1994, and March 31, 2003. Segmented regression analysis was used to examine the inflection point of the time trend in 90-day catheterization rates post-AMI. Multivariable Cox regression modelling was used to evaluate sex differences in receiving catheterization and revascularization following AMI. RESULTS: Ninety-day coronary catheterization rates increased significantly over the study period for both men and women (P<0.0001 for trend), with a steeper increase beginning in September 2000. Women were less likely to undergo catheterization than men, even after adjustment for baseline differences; this sex effect was modified by age and care in the intensive care unit or cardiac care unit (ICU/CCU). Specifically, ICU/CCU admission eliminated the sex difference among patients who were younger than 65 years of age. Conditional on receiving cardiac catheterization post-AMI, female sex was not associated with a lower likelihood of receiving revascularization within one year (HR 0.96; 95% CI 0.91 to 1.02). CONCLUSIONS: Despite recent increases in catheterization rates post-AMI, women were less likely to undergo catheterization than men. Interestingly, access to ICU/CCU care removed the sex difference in catheterization access in patients younger than 65 years of age.

Sedlak, Tara L; Pu, Aihua; Aymong, Eve; Gao, Min; Khan, Nadia; Quan, Hude; Humphries, Karin H



Indications and Outcomes of the Components Separation Technique in the Repair of Complex Abdominal Wall Hernias: Experience From the Cambridge Plastic Surgery Department  

PubMed Central

Objectives: The components separation technique (CST) is a widely described abdominal wall reconstructive technique. There have, however, been no UK reports of its use, prompting the present review. Methods: Between 2008 and 2012, 13 patients who underwent this procedure by a single plastic surgeon (C.M.M.) were retrospectively evaluated. The indications, operative details, and clinical outcomes were recorded. Results: There were 7 women and 6 men in the series with a mean age of 53 years (range: 30-80). Patients were referred from a variety of specialties, often as a last resort. The commonest indication for CST was herniation following abdominal surgery. All operations except 1 were jointly performed with general surgeons (for bowel resection, stoma reversal, and hernia dissection). The operations lasted a mean of 5 hours (range: 3-8 hours). There were no major intra- and postoperative problems, except in 1 patient who developed intra-abdominal compartment syndrome, secondary to massive hemorrhage. All patients were satisfied with the cosmetic improvement in their abdominal contours. None of the patients have developed a clinical recurrence after a mean follow-up of 16 months (range: 3-38 months). Conclusions: The components separation technique is an effective method of treating large recalcitrant hernias but appears to be underutilized in the United Kingdom. The management of large abdominal wall defects requires a multidisciplinary approach, with input across a variety of specialities. Liaison with plastic surgery teams should be encouraged at an early stage and the CST should be more widely considered when presented with seemingly intractable abdominal wall defects.

Adekunle, Shola; Pantelides, Nicholas M.; Hall, Nigel R.; Praseedom, Raaj; Malata, Charles M.



Indications and outcomes of the components separation technique in the repair of complex abdominal wall hernias: experience from the cambridge plastic surgery department.  


Objectives: The components separation technique (CST) is a widely described abdominal wall reconstructive technique. There have, however, been no UK reports of its use, prompting the present review. Methods: Between 2008 and 2012, 13 patients who underwent this procedure by a single plastic surgeon (C.M.M.) were retrospectively evaluated. The indications, operative details, and clinical outcomes were recorded. Results: There were 7 women and 6 men in the series with a mean age of 53 years (range: 30-80). Patients were referred from a variety of specialties, often as a last resort. The commonest indication for CST was herniation following abdominal surgery. All operations except 1 were jointly performed with general surgeons (for bowel resection, stoma reversal, and hernia dissection). The operations lasted a mean of 5 hours (range: 3-8 hours). There were no major intra- and postoperative problems, except in 1 patient who developed intra-abdominal compartment syndrome, secondary to massive hemorrhage. All patients were satisfied with the cosmetic improvement in their abdominal contours. None of the patients have developed a clinical recurrence after a mean follow-up of 16 months (range: 3-38 months). Conclusions: The components separation technique is an effective method of treating large recalcitrant hernias but appears to be underutilized in the United Kingdom. The management of large abdominal wall defects requires a multidisciplinary approach, with input across a variety of specialities. Liaison with plastic surgery teams should be encouraged at an early stage and the CST should be more widely considered when presented with seemingly intractable abdominal wall defects. PMID:24058718

Adekunle, Shola; Pantelides, Nicholas M; Hall, Nigel R; Praseedom, Raaj; Malata, Charles M



Body weight limitations of United States cardiac catheterization laboratories including restricted access for the morbidly obese.  


A telephone survey was performed to determine the current weight limits of cardiovascular catheterization laboratories (n = 94) in the United States. The minimum, mean, and maximum weight limits of the catheterization laboratories in this survey were 160, 198.9, and 250 kg (350, 437.5, and 550 lb), respectively. Twenty-two percent of respondents (n = 21) referred to other institutions when asked what they did when patients were too heavy, and 70% of respondents (n = 66) could not provide an answer. In this population, 5.2 +/- 3.4 patients/hospital/year were rejected for being over the weight limit. In conclusion, these results provide useful information for the future management of this growing population. PMID:18638587

Vanhecke, Thomas E; Berman, Aaron D; McCullough, Peter A



Pseudoreflux and detrusor overactivity due to accidental ureteral catheterization during cytometry in a pediatric patient.  


We present the case of a 9-year-old girl with a neurogenic bladder who had accidental ureteral cannulation with the vesical catheter during cytometry. This is the first reported pediatric case described of this complication, the four prior cases all being in adults. The signs and symptoms of ureteral catheterization differed significantly in this patient from the adult cases. In our patient, malpositioning of the vesical catheter yielded a misleading pressure profile of primarily rhythmic pressure increases suggestive of severe detrusor overactivity and vesicoureteral reflux on fluoroscopy. The reading, however, actually reflected ureteric filling and peristalsis, and these findings resolved when the catheter was properly repositioned. This case highlights the possibility of inadvertent ureteral catheterization, and that, while rare, this complication should be kept in mind when new or unexpected DO or VUR is observed upon filling cystometry. PMID:23022154

Wolff, Gillian F; Smith, Phillip P



Pseudoaneurysm a rare complication of transradial cardiac catheterization: a case report.  


Transradial access for cardiac catheterization is a safe and viable approach with significantly lower incidence of major access-related complications compared with the transfemoral approach. As this form of access is getting wider acceptance among interventional cardiologists, awareness of its complications is of vital importance. Asymptomatic radial artery occlusion, non-occlusive radial artery injury and radial artery spasm are commonly reported complication of this approach. Symptomatic radial arterial occlusion, pseudoaneurysm and radial artery perforation are rarely reported complications of transradial approach. Early identification of these uncommon complications and their urgent management is of significant importance. We present the case of an 80-year-old lady who developed pseudoaneurysm a week after transradial cardiac catheterization managed with surgical excision with no long-term sequela. PMID:23508390

Bhat, Tariq; Bhat, Hilal; Teli, Sumaya; Rajiv, Bartaula; Akhtar, Muhammad; Gala, Bhavesh



Flaccid Leg Paralysis Caused by a Thoracic Epidural Catheterization: A Case Report  

PubMed Central

We report a case of a 44-year-old patient with paralysis of the left leg who had a thoracic epidural catheterization after general anesthesia for abdominal surgery. Sensory losses below T10 and motor weakness of the left leg occurred after the surgery. Magnetic resonance image study demonstrated a well-defined intramedullary linear high signal intensity lesion on T2-weighted image and low-signal intensity on T1-weighted image in the spinal cord between T9 and L1 vertebral level, and enhancements of the spinal cord below T8 vertebra and in the cauda equina. Electrodiagnostic examination revealed lumbosacral polyradiculopathy affecting nerve roots below L4 level on left side. We suggest that the intrinsic spinal cord lesion and nerve root lesion can be caused by an epidural catheterization with subsequent local anesthetic injection.

Jeon, Byoung Hyun; Bang, Heui Je; Lee, Gyung Moo; Kwon, Oh Pum



Vertebral artery thrombosis and subsequent stroke following attempted internal jugular central venous catheterization  

PubMed Central

Complications arising from internal jugular venous catheterization are uncommon. Injury to the carotid artery is reported as one of the more common injuries. Vertebral artery injuries are rare and include pseudoaneurysm formation, arteriovenous fistulas, lacerations, and dissection with thrombus formation. Occasionally, such injuries initially go unnoticed and have the potential to cause catastrophic outcomes, leaving clinicians and families wondering what transpired. A thorough autopsy can not only help discern the cause of death, but also help to bring closure to the family. Here we present a case of an unexpected death 3 days following surgery for idiopathic scoliosis in a 17-year-old male. During the surgical procedure, a right internal jugular venous catheterization was attempted but aborted after several failed tries. Twenty-four hours after the procedure, the patient became obtunded and progressed to brain death. At autopsy, he was found to have a right transmural vertebral artery puncture wound with thrombosis leading to a massive posterior circulatory stroke.

Van Vrancken, Michael J.



A simple and effective regimen for prevention of radial artery spasm during coronary catheterization.  


Radial artery spasm occurs frequently during the transradial approach for coronary catheterization. Premedications with nitroglycerin and verapamil have been documented to be effective in preventing radial spasms. Verapamil is relatively contraindicated for some patients with left ventricular dysfunction, hypotension and bradycardia. We would like to know whether nitroglycerin alone is sufficient for the prevention of radial artery spasm. We conducted a randomized controlled trial to compare the spasmolytic effect between heparin alone, heparin plus nitroglycerin and heparin plus nitroglycerin and varapamil during transradial cardiac catheterization. In this study, a total of 406 patients underwent transradial cardiac catheterization and intervention. After successful cannulation and sheath insertion of radial arteries, 133 patients in group A received 3,000 units of heparin, 100 microg of nitroglycerin and 1.25 mg of verapamil via sheath, 135 patients in group B received 3,000 units of heparin and 100 microg of nitroglycerin, and 93 patients in group C received 3,000 units of heparin. Five patients in group A (3.8%), 6 patients in group B (4.4%) and 19 patients in group C (20.4%) showed radial spasms. There is no statistically significant difference between groups A and B (p = 0.804), but there are strong statistically significant differences between groups A and C (p = 0.001) and groups B and C (p = 0.003). Intra-arterial premedication with 100 microg nitroglycerin and 3,000 units of heparin is effective in preventing radial spasms during transradial cardiac catheterization. PMID:16254422

Chen, Chih-Wei; Lin, Chin-Lon; Lin, Tin-Kwang; Lin, Chih-Da



A Segmentation Algorithm for X-ray 3D Angiography and Vessel Catheterization  

Microsoft Academic Search

Vessel Catheterization is a clinical procedure usually performed by a specialist by means of X-ray fluoroscopic guide with contrast-media. In the present paper, we present a simple and efficient algorithm for vessel segmentation which allows vessel separation and extraction from the background (noise and signal coming from other organs). This would reduce the number of projections (X-ray scans) to reconstruct

Danilo Franchi; Luigi Rosa; Giuseppe Placidi



Effect of Laboratory Acclimation on Food and Water Consumption of Pregnant Sheep After Fetal Catheterization  

Microsoft Academic Search

The objectives of this study were to determine 1) the time required for food and water consumption of late-gestation pregnant sheep to stabilize after a 6- to 7-h shipment by truck and 2) whether the duration of laboratory acclimation altered food and\\/or water consumption of pregnant sheep after fetal and maternal vascular catheterization. We used a semi-quantitative scale and a




Coronary arterial lesions of Kawasaki disease: Cardiac catheterization findings of 1100 cases  

Microsoft Academic Search

Summary  In our institute, 1100 patients with a history of Kawasaki disease have been catheterized for selective coronary arteriography.\\u000a Their age at examination ranged from four months to 13 years. Coronary artery lesions (CAL) were found in 262 patients. As\\u000a far as the type of the CAL was concerned, occlusion was noted in 20 (7.6%), segmental stenosis in 15 (5.7%), localized

Atsuko Suzuki; Tetsuro Kamiya; Naoshi Kuwahara; Yasuo Ono; Toru Kohata; Osahiro Takahashi; Koji Kimura; Makoto Takamiya



Painless intravenous catheterization by intradermal jet injection of lidocaine: a randomized trial  

Microsoft Academic Search

Study Objective: To compare efficacy and cost of lidocaine cutaneous anesthesia by two jet injectors to routine needle infiltration for pain relief of intravenous (IV) catheterization, hypothesizing that jet injection of lidocaine is less painful than its needle infiltration.Design: Randomized, prospective, controlled trial.Setting: University hospital outpatient surgical unit.Participants: 75 surgical patients ASA I and II.Interventions: Three groups of 25 patients

Elemer K Zsigmond; Patrick Darby; Heidi M Koenig; Eric F Goll



Argument identification for arterial branching predications asserted in cardiac catheterization reports.  

PubMed Central

The language describing coronary vasculature provides a suitable paradigm for research in semantic interpretation of anatomical text. As a pilot project we investigate the possibility of highly accurate retrieval of arterial branching relationships asserted in cardiac catheterization reports. Our methodology relies on the cooperation of underspecified linguistic analysis and structured domain knowledge. The satisfactory results of formal evaluation on both a training and testing set support the promise of this approach.

Rindflesch, T. C.; Bean, C. A.; Sneiderman, C. A.



Carotid-jugular arteriovenous fistula: case report of an iatrogenic complication following internal jugular vein catheterization  

Microsoft Academic Search

Central venous catheterization is frequently performed for perioperative management and long-term intravenous access. Although the complications of central venous catheter insertion have been widely reported, there are few reports of carotid-jugular arteriovenous fistula formation. We describe a case of a carotid-jugular arteriovenous fistula following the insertion of a double-lumen catheter for hemodialysis access. We provide recommendations for the prevention and

Kurt P Droll; Alan G Lossing



Correspondence of aortic valve area determination from transesophageal echocardiography, transthoracic echocardiography, and cardiac catheterization  

Microsoft Academic Search

The correspondence of aortic valve area measurements from transesophageal echocardiography, transthoracic echocardiography, and cardiac catheterization was determined in 100 patients with severe aortic stenosis (aortic valve area ? 0.75 cm2), moderate aortic stenosis (aortic valve area >0.75 to ? 1.2 cm2), mild aortic stenosis (aortic valve area > 1.2 to ?2.0 cm2), and nonstenotic aortic valves (aortic valve area >2.0

Chong-Jin Kim; Hans Berglund; Toshihiko Nishioka; Huai Luo; Robert J. Siegel



Two-fluid non-Newtonian models for blood flow in catheterized arteries — A comparative study  

Microsoft Academic Search

Steady flow of blood through catheterized arteries is studied by assuming the blood as a two-fluid model with the suspension\\u000a of all the erythrocytes in the core region as a non-Newtonian fluid and the plasma in the peripheral layer as a Newtonian\\u000a fluid. The non-Newtonian fluid in the core region of the artery is modeled as (i) Casson fluid and

D. S. Sankar; Usik Lee



Catheter interventions in congenital heart disease without regular catheterization laboratory equipment: the chain of hope experience in Rwanda.  


This report describes the feasibility and safety of cardiac catheterization in a developing country without access to a regular cardiac catheterization laboratory. The equipment used for imaging consisted of a monoplane conventional C-arm X-ray system and a portable ultrasound machine using the usual guidewires and catheters for cardiovascular access. In this study, 30 patients, including 17 children younger than 2 years and 2 adults, underwent catheterization of the following cardiac anomalies: patent ductus arteriosus (20 patients) and pulmonary valve stenosis (9 patients, including 2 patients with critical stenosis and 3 patients with a secundum atrial septal defect). Except for two cases requiring surgery, the patients were treated successfully without complications. They all were discharged from hospital, usually the day after cardiac catheterization, and showed significant clinical improvement in the follow-up evaluation. Cardiac catheterization can be performed safely and very effectively in a country with limited resources. If patients are well selected, this mode of treatment is possible without the support of a sophisticated catheterization laboratory. PMID:22644416

Senga, John; Rusingiza, Emmanuel; Mucumbitsi, Joseph; Binagwaho, Agnès; Suys, Bert; Lys, Christine; Carbonez, Karlien; Ovaert, Caroline; Sluysmans, Thierry



O/sub 2/ exchange between blood and brain tissues studied with /sup 18/O/sub 2/ indicator-dilution technique  

SciTech Connect

A technique has been developed to record /sup 18/O/sub 2/ dilution curves of an organ in vivo by use of /sup 51/Cr-labeled erythrocytes as a reference tracer. The technique employs anaerobic sampling of venous outflow following an intraarterial injection of tracer-laden blood and off-line determination of (/sup 18/O/sub 2/) and (/sup 51/Cr) profiles in the venous outflow. O/sub 2/ and reference indicator-dilution curves of cerebral circulation were recorded in eight experiments with six halothane-anesthetized dogs. Autologous blood labeled with the tracers was injected into a carotid artery, and brain venous outflow was sampled from the sagittal sinus. The total net extraction of O/sub 2/ tracer was equal to the extraction of elemental O/sub 2/. Instantaneous extraction of /sup 18/O/sub 2/ along the outflow curve fell linearly with time, from an initial value of 0.6-0.7 to very small or even negative values toward the end of a pulse. This indicates that O/sub 2/ undergoes a flow-limited distribution. In all experiments, the mean transit time of unmetabolized /sup 18/O/sub 2/ was longer than the mean transit time of the Cr tracer. An index of the tissue O/sub 2/ dilution space, hence the mean tissue PO/sub 2/, is calculated from this data with the use of a modified central volume principle. This estimate of mean tissue PO/sub 2/ increases as a linear function of sagittal sinus PO/sub 2/ with a slope of 0.97. The method may provide an index of the critical PO/sub 2/ of venous blood, the PO/sub 2/ below which O/sub 2/ diffusion from blood to tissue may limit its rate of metabolic uptake.

Grieb, P.; Forster, R.E.; Strome, D.; Goodwin, C.W.; Pape, P.C.



Comparison of contrast echocardiography versus cardiac catheterization for detection of pulmonary arteriovenous malformations.  


Because clinical diagnosis of pulmonary arteriovenous malformations (AVMs) is difficult and cardiac catheterization invasive, contrast echo has been used to aid in the diagnosis. Correlation between contrast echo and catheterization data in these patients remains poorly defined. We examined the ability to detect pulmonary AVMs by contrast echocardiography, pulmonary angiography, and pulmonary vein saturations in patients who have undergone cavopulmonary (Glenn) shunts. Pulmonary vein saturations were obtained from catheterization reports. Blinded observers reviewed angiographic and contrast echo data retrospectively in 27 patients who had undergone a Glenn shunt and in 19 controls with biventricular hearts. Contrast echo was positive in 68 of 99 lungs (69%). Angiography showed AVMs in 65 of 98 lungs (66%). Pulmonary vein desaturation was found in 13 of 45 lungs sampled (29%). Only 10 of 38 lungs with positive contrast echo had pulmonary vein desaturation, but only 1 patient had pulmonary vein desaturation without positive contrast echo. The degree of desaturation did not correlate with severity of contrast echo return; 6 of 11 patients with 3+ contrast echo studies had normal pulmonary vein saturations. In a control group of patients with biventricular hearts, only 1 of 19 (5.3%) contrast echos was weakly positive. Contrast echo correlates poorly with angiography and pulmonary vein saturation for evaluation of AVMs. Contrast echo is extremely sensitive and often positive despite normal pulmonary vein saturation. Assessment of pulmonary vein desaturation in 100% oxygen may improve its sensitivity and correlation with contrast echo. Additional studies are needed to follow patients with mildly positive contrast echo studies to enable determination of their clinical relevance. PMID:11809429

Feinstein, Jeffrey A; Moore, Phillip; Rosenthal, David N; Puchalski, Michael; Brook, Michael M



A Segmentation Algorithm for X-ray 3D Angiography and Vessel Catheterization  

SciTech Connect

Vessel Catheterization is a clinical procedure usually performed by a specialist by means of X-ray fluoroscopic guide with contrast-media. In the present paper, we present a simple and efficient algorithm for vessel segmentation which allows vessel separation and extraction from the background (noise and signal coming from other organs). This would reduce the number of projections (X-ray scans) to reconstruct a complete and accurate 3D vascular model and the radiological risk, in particular for the patient. In what follows, the algorithm is described and some preliminary experimental results are reported illustrating the behaviour of the proposed method.

Franchi, Danilo; Rosa, Luigi; Placidi, Giuseppe [Department of Science and Biomedical Technologies, University of L'Aquila, Via Vetoio 10, 67100 Coppito, L'Aquila (Italy)



A Segmentation Algorithm for X-ray 3D Angiography and Vessel Catheterization  

NASA Astrophysics Data System (ADS)

Vessel Catheterization is a clinical procedure usually performed by a specialist by means of X-ray fluoroscopic guide with contrast-media. In the present paper, we present a simple and efficient algorithm for vessel segmentation which allows vessel separation and extraction from the background (noise and signal coming from other organs). This would reduce the number of projections (X-ray scans) to reconstruct a complete and accurate 3D vascular model and the radiological risk, in particular for the patient. In what follows, the algorithm is described and some preliminary experimental results are reported illustrating the behaviour of the proposed method.

Franchi, Danilo; Rosa, Luigi; Placidi, Giuseppe



Carotid jugular arteriovenous fistula: an unusual complication of internal jugular vein catheterization in children.  


Central venous catheterization is essential in the management of patients requiring long-term intravenous access. Various risks during central line insertion have been described in the medical literature, including the potentially life-threatening complication of iatrogenic arteriovenous fistula (AVF). We describe a novel case of carotid jugular AVF following implanted port (BardPort® by C.R. Bard, Inc.) insertion in a pediatric oncology patient who had suffered cerebral infarct due to thromboembolism. Pediatr Blood Cancer 2012; 59: 1302-1304. © 2012 Wiley Periodicals, Inc. PMID:22415906

Chan, Ching Ching; Lee, Vincent; Chu, Winnie; Tam, Yuk Him; Li, Chi Kong; Shing, Matthew Ming Kong



Cardiac Catheterization  

Microsoft Academic Search

\\u000a Invasive pediatric cardiology developed as a subspecialty over the past four decades after first pediatric angiogram was performed\\u000a by Agustin Castellanos in 1937 [1]. With the introduction of the balloon septostomy by William Rashkind to alleviate cyanosis\\u000a in transposition of the great arteries [2], the field of interventional pediatric cardiology was initiated and subsequently\\u000a expanded explosively. It plays a role

Jacqueline Kreutzer


Lysine from cooked white rice consumed by healthy young men is highly metabolically available when assessed using the indicator amino acid oxidation technique.  


Cooked white rice (CWR) provides up to 71% of the dietary protein for many people worldwide. The protein digestibility-corrected amino acid (AA) score is the method adopted by FAO/WHO to evaluate protein quality. Our group has proposed the metabolic availability (MA) of AAs as another determinant of protein quality. It measures the percentage of an indispensable AA that is incorporated during protein synthesis. This study is the first to our knowledge to assess the MA of l-lysine (L-Lys) from CWR in humans using the indicator AA oxidation (IAAO) technique. Three amounts of L-Lys, 10, 15, and 19 mg?·?kg(-1)?·?d(-1) (= 28.5, 42.8, and 54.3% of the mean L-Lys requirement of 35 mg?·?kg(-1)?·?d(-1)), were studied in 5 healthy young men in a repeated-measures design. To test the principle that the Maillard reaction has an effect on the MA of LLys, we also assessed the MA of L-Lys in oven-browned, cooked rice (n = 3) in the amount of 19 mg?·?kg(-1)?·?d(-1) L-Lys. The MA of L-Lys was estimated by comparing the IAAO response with varying L-Lys intakes in rice compared with the IAAO response to varying l-Lys intakes in the reference protein (crystalline AA mixture patterned after egg protein) using the slope ratio method. The MA of L-Lys from CWR was high (97%), but the effect of the Maillard reaction reduced it to 70%. The results show that despite its relatively low content in rice, L-Lys has a high MA when the rice is cooked without being browned. PMID:23325920

Prolla, Ivo R D; Rafii, Mahroukh; Courtney-Martin, Glenda; Elango, Rajavel; da Silva, Leila P; Ball, Ronald O; Pencharz, Paul B



Real-time respiratory motion tracking: roadmap correction for hepatic artery catheterizations  

NASA Astrophysics Data System (ADS)

Nowadays, hepatic artery catheterizations are performed under live 2D X-ray fluoroscopy guidance, where the visualization of blood vessels requires the injection of contrast agent. The projection of a 3D static roadmap of the complex branches of the liver artery system onto 2D fluoroscopy images can aid catheter navigation and minimize the use of contrast agent. However, the presence of a significant hepatic motion due to patient's respiration necessitates a real-time motion correction in order to align the projected vessels. The objective of our work is to introduce dynamic roadmaps into clinical workflow for hepatic artery catheterizations and allow for continuous visualization of the vessels in 2D fluoroscopy images without additional contrast injection. To this end, we propose a method for real-time estimation of the apparent displacement of the hepatic arteries in 2D flouroscopy images. Our approach approximates respiratory motion of hepatic arteries from the catheter motion in 2D fluoroscopy images. The proposed method consists of two main steps. First, a filtering is applied to 2D fluoroscopy images in order to enhance the catheter and reduce the noise level. Then, a part of the catheter is tracked in the filtered images using template matching. A dynamic template update strategy makes our method robust to deformations. The accuracy and robustness of the algorithm are demonstrated by experimental studies on 22 simulated and 4 clinical sequences containing 330 and 571 image frames, respectively.

Atasoy, Selen; Groher, Martin; Zikic, Darko; Glocker, Ben; Waggershauser, Tobias; Pfister, Marcus; Navab, Nassir



Effectiveness of enoxaparin for prevention of radial artery occlusion after transradial cardiac catheterization.  


The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (RA) occlusion after transradial access for diagnostic and interventional cardiac procedures. RA occlusion is a potential complication of transradial cardiac catheterization. Conventionally, unfractionated heparin is used for prevention of RA occlusion. Effectiveness of low molecular weight heparins for prevention of this complication has not been tested before. Fifty transradial catheterizations were performed for diagnostic and/or interventional cardiac procedures in 39 patients. All the patients received 60 mg enoxaparin through the radial sheath at the beginning of the procedure for prevention of RA occlusion. RA patency was evaluated by Doppler examination. Patients were assessed for postprocedural RA occlusion at discharge and 5.5 +/- 2.8 days follow-up. RA occlusion was detected after 2 of the 50 transradial accesses, yielding a RA occlusion rate of % 4. In this study we found a low rate of RA occlusion with use of enoxaparin during transradial access. Enoxaparin is safe and effective in transradial procedures with a RA occlusion rate comparable to use of unfractionated heparin. PMID:19479198

Feray, Hasan; Izgi, Cemil; Cetiner, Diler; Men, Ebubekir Emre; Saltan, Yelda; Baltay, Ayhan; Kahraman, Reyhan



Home screening for bacteriuria in children with spina bifida and clean intermittent catheterization  

PubMed Central

Background Significant bacteriuria (SBU) and urinary tract infections (UTIs) are common in patients with spina bifida and neuropathic detrusor sphincter dysfunction. Laboratory agar plated culture is the gold standard to establish SBU. It has the disadvantage of diagnostic and subsequent therapeutic delay. Leukocyte esterase tests (LETs) and dip slides proved to be useful in the general populations to exclude SBU and UTI. The aim of this study was to evaluate the reliability of LET and dip slide in children with spina bifida without symptoms of UTI. The reliability in children with asymptomatic SBU was not studied before. Methods In one hundred and twelve children with spina bifida on clean intermittent catheterization LETs and dip slides were compared with laboratory cultures. Both tests and agar plated cultures were performed on catheterized urine samples. The hypothesis was that the home tests are as accurate as laboratory cultures. Results A SBU was found in 45 (40%) of the 112 laboratory cultures. A negative LET excluded SBU (negative predictive value 96%), while a positive LET had a positive predictive value of 72%. The false positive rate was 28%. Dip slide determination of bacterial growth had no added value, other than serving as transport medium. Conclusions In spina bifida children, leukocyte esterase testing can be used to exclude significant bacteriuria at home, while dip slide tests have no added value to diagnose or exclude significant bacteriuria.



Non-inferiority of short-term urethral catheterization following fistula repair surgery: study protocol for a randomized controlled trial  

PubMed Central

Background A vaginal fistula is a devastating condition, affecting an estimated 2 million girls and women across Africa and Asia. There are numerous challenges associated with providing fistula repair services in developing countries, including limited availability of operating rooms, equipment, surgeons with specialized skills, and funding from local or international donors to support surgeries and subsequent post-operative care. Finding ways of providing services in a more efficient and cost-effective manner, without compromising surgical outcomes and the overall health of the patient, is paramount. Shortening the duration of urethral catheterization following fistula repair surgery would increase treatment capacity, lower costs of services, and potentially lower risk of healthcare-associated infections among fistula patients. There is a lack of empirical evidence supporting any particular length of time for urethral catheterization following fistula repair surgery. This study will examine whether short-term (7 day) urethral catheterization is not worse by more than a minimal relevant difference to longer-term (14 day) urethral catheterization in terms of incidence of fistula repair breakdown among women with simple fistula presenting at study sites for fistula repair service. Methods/Design This study is a facility-based, multicenter, non-inferiority randomized controlled trial (RCT) comparing the new proposed short-term (7 day) urethral catheterization to longer-term (14 day) urethral catheterization in terms of predicting fistula repair breakdown. The primary outcome is fistula repair breakdown up to three months following fistula repair surgery as assessed by a urinary dye test. Secondary outcomes will include repair breakdown one week following catheter removal, intermittent catheterization due to urinary retention and the occurrence of septic or febrile episodes, prolonged hospitalization for medical reasons, catheter blockage, and self-reported residual incontinence. This trial will be conducted among 512 women with simple fistula presenting at 8 study sites for fistula repair surgery over the course of 24 months at each site. Discussion If no major safety issues are identified, the data from this trial may facilitate adoption of short-term urethral catheterization following repair of simple fistula in sub-Saharan Africa and Asia. Trial registration Identifier NCT01428830.



Development and validation of a simple model to predict severe coronary artery disease after myocardial infarction: Potential impact on cardiac catheterization use in the United States and Canada  

Microsoft Academic Search

Background Improved patient selection may optimize the efficiency of cardiac catheterization in both high- and low-rate regions. The purpose of this study was to develop and validate a clinical model for predicting high-risk coronary artery disease (CAD) after myocardial infarction (MI) and to examine the model's potential impact on the use rate of both US and Canadian catheterization practices. Methods

Wayne B. Batchelor; Daniel B. Mark; J. David Knight; Christopher B. Granger; Paul W. Armstrong; Robert M. Califf; Eric D. Peterson



Is the intraosseous access route fast and efficacious compared to conventional central venous catheterization in adult patients under resuscitation in the emergency department? A prospective observational pilot study  

Microsoft Academic Search

BACKGROUND: For patients' safety reasons, current American Heart Association and European Resuscitation Council guidelines recommend intraosseous (IO) vascular access as an alternative in cases of emergency, if prompt venous catheterization is impossible. The purpose of this study was to compare the IO access as a bridging procedure versus central venous catheterization (CVC) for in-hospital adult emergency patients under resuscitation with

Bernd A Leidel; Chlodwig Kirchhoff; Viktoria Bogner; Julia Stegmaier; Wolf Mutschler; Karl-Georg Kanz; Volker Braunstein



Comparison of role of early (less than six hours) to later (more than six hours) or no cardiac catheterization after resuscitation from out-of-hospital cardiac arrest.  


Despite reports of patients with resuscitated sudden cardiac arrest (rSCA) receiving acute cardiac catheterization, the efficacy of this strategy is largely unknown. We hypothesized that acute cardiac catheterization of patients with rSCA would improve survival to hospital discharge. A retrospective cohort of 240 patients with out-of-hospital rSCA caused by ventricular tachycardia or fibrillation was identified from 11 institutions in Seattle, Washington from 1999 through 2002. Patients were grouped into those receiving acute catheterization within 6 hours (?6-hour group, n = 61) and those with deferred catheterization at >6 hours or no catheterization during the index hospitalization (>6-hour group, n = 179). Attention was directed to survival to hospital discharge, neurologic status, extent of coronary artery disease, presenting electrocardiographic findings, and symptoms before arrest. Propensity-score methods were used to adjust for the likelihood of receiving acute catheterization. Survival was greater in patients who underwent acute catheterization (72% in the ?6-hour group vs 49% in the >6-hour group, p = 0.001). Percutaneous coronary intervention was performed in 38 of 61 patients (62%) in the ?6-hour group and 13 of 170 patients (7%) in the >6-hour group (p <0.0001). Neurologic status was similar in the 2 groups. A significantly larger percentage of patients in the acute catheterization group had symptoms before cardiac arrest and had ST-segment elevation on electrocardiogram after resuscitation. Age, bystander cardiopulmonary resuscitation, daytime presentation, history of percutaneous coronary intervention or stroke, and acute ST-segment elevation were positively associated with receiving cardiac catheterization. In conclusion, in this series of patients who sustained out-of-hospital cardiac arrest, acute catheterization (<6 hours of presentation) was associated with improved survival. PMID:22100026

Strote, Justin A; Maynard, Charles; Olsufka, Michele; Nichol, Graham; Copass, Michael K; Cobb, Leonard A; Kim, Francis



Comparison of Role of Early (<6 Hours) to Later (>6 Hours) or No Cardiac Catheterization Following Resuscitation From Out-of-hospital Cardiac Arrest  

PubMed Central

Despite reports of patients with resuscitated sudden cardiac arrest (rSCA) receiving acute cardiac catheterization, the efficacy of this strategy is largely unknown. We hypothesized that acute cardiac catheterization of patients with rSCA would improve survival to hospital discharge. A retrospective cohort of 240 patients with out-of-hospital rSCA due to ventricular tachycardia or fibrillation was identified from 11 institutions in Seattle, Washington, between 1999 and 2002. Patients were grouped into those receiving acute catheterization within 6 hours (? 6 hours group, n = 61) and into those with deferred catheterization at > 6 hours or no catheterization during the index hospitalization (>6 hours group, n = 179). We directed attention to survival to hospital discharge, neurologic status, extent of coronary artery disease presenting electrocardiographic (ECG) findings, and pre-arrest symptoms. Propensity score methods were used to adjust for the likelihood of receiving acute catheterization. Survival was greater in patients who underwent acute catheterization ? 6 hours group (72%) vs. >6 hours group (49%) (p=0.001). Percutaneous coronary intervention was performed in 38/61 (62%) of patients in ? 6 hours group, and 13/170 (7%) in > 6 hours group, p<0.0001. Neurologic status was similar for both groups. A significantly higher percentage of patients in the acute catheterization group had symptoms prior to cardiac arrest, and had ST-segment elevation on post-resuscitation ECG. Age, bystander cardiopulmonary resuscitation, daytime presentation, history of percutaneous coronary intervention or stroke, and acute ST elevation were all positively associated with receiving cardiac catheterization. In conclusion, in this series of patients who sustained out-of-hospital cardiac arrest, acute catheterization (within 6 hours of presentation) was associated with improved survival.

Strote, Justin A.; Maynard, Charles; Olsufka, Michele; Nichol, Graham; Copass, Michael K.; Cobb, Leonard A.; Kim, Francis



A non-Newtonian fluid flow model for blood flow through a catheterized artery—Steady flow  

Microsoft Academic Search

In this paper the effects catheterization and non-Newtonian nature of blood in small arteries of diameter less than 100?m, on velocity, flow resistance and wall shear stress are analyzed mathematically by modeling blood as a Herschel–Bulkley fluid with parameters n and ? and the artery and catheter by coaxial rigid circular cylinders. The influence of the catheter radius and the

D. S. Sankar; K. Hemalatha



Evaluation of calibration methods for size estimation in the pediatric cardiac catheterization laboratory.  


Limited data are available on the accuracy of various calibration methods used to estimate the size of cardiovascular structures during interventional pediatric cardiac catheterizations. The aim of this study was to evaluate, in an experimental model, several of these commonly used calibration methods. Thoracic box models were constructed in 4 sizes to simulate average chest sizes of infants, children, adolescents, and adults. Four anatomic positions were studied: aortic valve in posteroanterior projection, pulmonary valve in lateral projection, and isthmus in posteroanterior and lateral projections. The following calibration methods were examined: (1) a 5Fr pigtail catheter or a 1-cm radio-opaque marker catheter, placed at the level of the anatomic structure, (2) a body surface marker in multiple positions, and (3) a 1 x 1-cm radio-opaque rectilinear grid placed either at the center of the thorax or in an anatomic position. Three independent observers made size estimations. The most accurate method for size estimation, in all anatomic positions and for all box sizes, was the 1-cm radio-opaque marker catheter (mean error catheterizations, catheters with radio-opaque markers within the structure of interest were the most accurate. The use of surface markers in larger patients may introduce significant error, risking a potentially inadequate or adverse outcome from the intervention. PMID:10922440

Szmuilowicz, E; Sklansky, M S; Kiciman, N; Hilton, S; Rothman, A



The current role of direct vision internal urethrotomy and self-catheterization for anterior urethral strictures  

PubMed Central

Introduction: Direct visual internal urethrotomy (DVIU) followed by intermittent self-dilatation (ISD) is the most commonly performed intervention for urethral stricture disease. The objective of this paper is to outline the current scientific evidence supporting this approach for its use in the management of anterior urethral strictures. Materials and Methods: A Pubmed database search was performed with the words “internal urethrotomy” and “internal urethrotomy” self-catheterization. All papers dealing with this subject were scrutinized. Cross-references from the retrieved articles were also viewed. Only English language articles were included in the analyses. Studies were analyzed to identify predictors for success for DVIU. Results: Initial studies showed excellent outcomes with DVIU with success rates ranging from 50% to 85%. However, these studies reported only short-term results. Recent studies with longer followup have shown a poor success rate ranging from 6% to 28%. Stricture length and degree of fibrosis (luminal narrowing) were found to be predictors of response. Repeated urethrotomies were associated with poor results. Studies involving intermittent self-catheterization following DVIU have shown no role in short-term ISD with one study reporting beneficial effects if continued for more than a year. A significant number of studies have shown long-term complications with SC and high dropout rates. Conclusions: DVIU is associated with poor long-term cure rates. It remains as a treatment of first choice for bulbar urethral strictures <1 cm with minimal spongiofibrosis. There is no role for repeated urethrotomy as outcomes are uniformly poor. ISD, when used for more than a year on a weekly or biweekly basis may delay the onset of stricture recurrence.

Dubey, Deepak



Subcutaneous rehydration: updating a traditional technique.  


Subcutaneous (SC) rehydration therapy (SCRT), originally referred to as "hypodermoclysis," shows promise as an alternative to intravenous (IV) fluid administration for treatment of dehydration. A simple, safe, and effective technique, SCRT is indicated for treatment of mild-to-moderate dehydration. Augmentation of SCRT with administration of a recombinant human formulation of the hyaluronidase enzyme at the infusion site gives rise to SC fluid administration rates up to 5-fold faster than those achieved without the enzyme, making the technique more clinically practical. Unlike older, animal-derived forms of hyaluronidase, recombinant human hyaluronidase has a lower chance of allergic reactions with repeated dosing. Clinical trials have demonstrated that recombinant human hyaluronidase effectively and safely facilitates fluid delivery in adults and children and is well accepted by parents and clinicians. In the emergency department setting, SCRT may be an appropriate alternative to IV fluid administration in certain situations because it is less invasive and generally less painful, while still permitting administration of appropriate volumes of rehydration fluids. Subcutaneous rehydration therapy appears to be particularly useful in patients who present with mild-to-moderate dehydration and have had failed attempts at oral rehydration. The SC route also provides benefits in patients with small, collapsed, or difficult-to-visualize veins or in those who may be agitated or distressed by IV catheterization. Continued research will further clarify the role of recombinant human hyaluronidase-facilitated SCRT in the rehydration treatment algorithm. PMID:21378529

Spandorfer, Philip R



Further fMRI Validation of the Visual Half Field Technique as an Indicator of Language Laterality: A Large-Group Analysis  

ERIC Educational Resources Information Center

|The best established lateralized cerebral function is speech production, with the majority of the population having left hemisphere dominance. An important question is how to best assess the laterality of this function. Neuroimaging techniques such as functional Magnetic Resonance Imaging (fMRI) are increasingly used in clinical settings to…

Van der Haegen, Lise; Cai, Qing; Seurinck, Ruth; Brysbaert, Marc



Practical value of echo Doppler evaluation of aortic and mitral stenosis: a comparative study with cardiac catheterization.  


This retrospective analysis compares data derived by echocardiography and cardiac catheterization in the evaluation of aortic and mitral valve stenosis. Sixty-seven patients, aged 69 +/- 12 years, underwent 76 catheterization procedures. In all studies the Doppler recording was technically adequate. In 64 studies of patients with aortic stenosis, correlation was good between the gradient obtained at catheterization (peak 51 +/- 28 mm Hg, mean 48 +/- 24 mm Hg) and the Doppler gradient (peak 73 +/- 29 mm Hg, mean 41 +/- 17 mm Hg) (R = 0.78 peak, 0.77 mean). In 15 studies the aortic valve area, 0.8 +/- 0.2 cm2, calculated by the simplified continuity equation, correlated well with the catheterization valve area, 0.7 +/- 0.3 cm2, calculated by the Gorlin equation (R = 0.80). In 14 studies in mitral stenosis patients, the mean gradient at catheterization was 11 +/- 5 mm Hg compared to the Doppler gradient of 8 +/- 4 mm Hg (R = 0.58). The mitral valve area was 1.1 +/- 0.3 cm2 by the Gorlin equation and 1.2 +/- 0.3 cm2 by echo Doppler, using pressure half-time. When cardiac rhythm, the presence and severity of regurgitation, and the cardiac index were analyzed, none was shown to have demonstrable influence on the accuracy of the Doppler study. Doppler echocardiography can be used reliably to assess valvular stenosis in a clinical, noninvasive laboratory where routine tests are performed and interpreted by more than one individual. PMID:2228721

Bitar, J; Douthat, L; Alam, M; Rosman, H S; Lebeis, M; Goldstein, S; Khaja, F



[Indications for different types of urinary diversion].  


When urinary diversion is indicated, patient information concerning the advantages and disadvantages of different types of urinary diversion and their choices is of utmost importance for the functional outcome and patient satisfaction. There is a variety of choices for incontinent urinary diversion (ureterocutaneostomy, ileal conduit, colonic conduit) and continent urinary diversion (continent anal urinary diversion, continent cutaneous urinary diversion and urethral bladder substitution). In the individual case, the choices may be limited by patient criteria and/or medical criteria. Important patient criteria are preference, age and comorbidity, BMI, motivation, underlying disease and indication for cystectomy. Medical criteria which possibly limit choices of type of urinary diversion are kidney function/upper urinary tract status and limitations concerning the gastrointestinal tract, concerning urethra/sphincter as well as the ability and motivation to perform intermittent self-catheterization. Preoperative information may use simulation of certain postoperative scenarios (urethral self-catheterization, fixation of water-filled conduit bags, holding test for anal liquids) to allow the individual patient to choose the optimal type of urinary diversion for his/her given situation from the mosaic of choices and possible individual limitations. PMID:22419009

Thüroff, J W; Hampel, C; Leicht, W; Gheith, M K; Stein, R



BONE GRAFT SUBSTITUTES Dr. S.M. Tuli, Consultant Orthopaedic Surgeon, VIMHANS, New Delhi Indications, Biomechanics and Techniques of Lower Cervical Spine Instrumentation  

Microsoft Academic Search

Basically the indications for instrumentation of the lower cervical spine (C3-C7) are to provide immediate stability or to enhance stability to the unstable spine. To access the instability of the spine the three column model was introduced. The anterior column comprises the anterior half of the vertebral body and anterior half of the intervertebral disc as well as the anterior

Wee Fu Tan


Environmental Indicators  

NSDL National Science Digital Library

Environment Canada has developed a set of environmental indicators that are easily measurable and provide useful clues on the state of the environment. This Web site provides a listing of those indicators that Environment Canada monitors. For each indicator, there is a detailed description of the environmental indicator, how it relates to larger environmental problems, and what is being done to reduce the threat. A number of Web links are provided for further information on each indicator.




EPA Science Inventory

An international symposium on ecological indicators was developed to explore both the potential of ecological indicators and the issues surrounding their development and implementation. his symposium presented state-of-the-science information on the identification, application re...


Adaptation to myocardial ischemia during repeated dynamic exercise in relation to findings at cardiac catheterization.  


It has been suggested that the myocardium is able to recruit endogenous protective mechanisms in response to repeated ischemia and reperfusion. We set out to study whether this is manifested in patients with coronary artery disease in the form of fewer signs of myocardial ischemia during the second of two successive exercise tests and whether any relations exist between ischemia adaptation and findings at cardiac catheterization. Twenty-one patients with typical angina pectoris symptoms underwent two repeated bicycle exercise tests with identical protocols, followed by cardiac catheterization and coronary angiography the next day. The first exercise test was discontinued whenever a 2 mm ST depression in the electrocardiogram (ECG) was achieved or further exercise was limited by symptoms. The second exercise test was performed after disappearance of the symptoms or ST depression or both. Kaplan-Meier survival analysis for the appearance of a 1 mm ST depression demonstrated improved ischemia tolerance during the second test, when the required time for its appearance was significantly longer (6.5 +/- 0.8 min vs 4.5 +/- 0.5 min; p = 0.005). The maximal intensity of anginal pain was lower during the second exercise (2.2 +/- 1.0 min vs 0.7 +/- 0.3 min in Borg's scale; p < 0.001), and the time required for disappearance of the ST depression was shorter after this exercise (3.0 +/- 0.8 min vs 6.2 +/- 0.9 min; p = 0.003), with a similar tendency in the disappearance of angina. The rate-pressure product on the appearance of a 1 mm ST depression was significantly higher during the second test (17,990 +/- 1210 mm Hg x min-1 vs 15,960 +/- 869 mm Hg x min-1; p = 0.009). Eighteen of the patients had three-vessel disease, as evidenced by coronary angiography, and the change in the time required for the appearance of a 1 mm ST depression in the repeated exercise tests was inversely correlated with the severity of the left anterior descending (LAD) coronary artery obstruction (r = -0.61; p = 0.006) and left ventricular end-diastolic pressure (r = -0.50; p = 0.03). No significant correlation with the degree of collateral vessels was found. We conclude that most patients with extensive coronary artery disease are able to increase their tolerance of ischemia during repeated dynamic exercise and that increased vasodilation and oxygen delivery are the major mechanisms for this warm-up phenomenon. On the other hand, collaterals visible in routine resting anglography do not predict the degree of adaptation to ischemia during repeated dynamic exercise. PMID:8721640

Ylitalo, K; Jama, L; Raatikainen, P; Peuhkurinen, K



Low weight as an independent risk factor for adverse events during cardiac catheterization of infants.  


BACKGROUND: Studies have documented the importance of procedure type and hemodynamic variables on the incidence of procedure related adverse events (AE) after cardiac catheterization. However, little is known about the impact of low weight on the incidence and severity of AE. Methods: Data were prospectively collected using a multicenter registry (C3PO). Infants <1 year were divided into four weight categories: <2 kg, 2-3 kg, 3-5 kg, ?5 kg. AE severity was classified as level 1-5 (none, minor, moderate, major, death). RESULTS: Eight centers submitted details on 3,679 cases (34% diagnostic) performed in infants <1 year from 2/07 to 6/10: <2 kg: 57 (1.5%), 2-3 kg: 403 (11%), 3-5 kg: 1,527 (41.5%), ?5 kg: 1,692 (46%). AE occurred in 20% of cases (<2 kg: 28%, 2-3 kg: 25%, 3-5 kg: 23%, ?5 kg: 16%) with 41% of all AE being level 3-5 AE. Death occurred more frequently in the <2 kg group (12%), 71% of which were interventional cases. The case-related mortality in all other weight groups was <1%. By multivariable analysis, weight <2 kg, 2-3 kg, and 3-5 kg were independent risk factors for high severity (level 3-5) AE (<2 kg: OR 2, 95%CI 1.1-3.6; 2-3 kg: OR 1.4, 95%CI 1-1.8; 3-5 kg: OR 1.3, 95%CI 1.1-1.5), with similar findings for all AE. Blood transfusions were more common in lower weight categories (<2 kg: 42%, 2-3 kg: 29%, 3-5 kg: 25%, ?5 kg: 15%, p<0.001). Conclusions: The risk of AE during cardiac catheterization of infants increases with lower weight. Infants who weigh less than 2 kg have a significantly higher risk of adverse events (most notably death) even after correcting for hemodynamic vulnerability and procedure type risk group. © 2012 Wiley Periodicals, Inc. PMID:23436647

Backes, Carl H; Cua, Clifford; Kreutzer, Jacqueline; Armsby, Laurie; El-Said, Howaida; Moore, John W; Gauvreau, Kimberlee; Bergersen, Lisa; Holzer, Ralf J



Interventional catheterization decreases plasma levels of atrial natriuretic peptide (ANP) in children with congenital heart defects.  


Atrial natriuretic peptide (ANP) is one of the cardiac peptides implicated in volume and sodium homeostasis. We investigated the effect of interventional catheterization on plasma levels of ANP, aldosterone, and cortisol in 28 children with various congenital heart defects (CHD). Patients were divided by age into two groups: group A--infants and children over 3 months of age (n = 22), and group B--newborns (n = 6). These were compared to age-matched control groups. In group A, interventions included pulmonic valvotomy (n = 8), aortic valvotomy (n = 4), balloon angioplasty of native coarctation of the aorta (n = 3), balloon dilatation of the mitral valve (n = 1), and Rashkind double umbrella closure of patent ductus arteriosus (n = 6). Group B interventions included pulmonic valvotomy (n = 3), aortic valvotomy (n = 1), and balloon atrial septosomy (n = 2). In group A, mean ANP levels were markedly higher than in age-matched controls (125.2+/-15.8 vs. 24.6+/-4.6 pg/ml) (P <0.0001), and decreased immediately after intervention (75.6+/-11.4 pg/ml, P <0.02), and more markedly on follow-up (42.9+/-5.0 pg/ml, P < 0.0001). In group B (newborns), mean basal plasma levels were high before and after intervention and were not different from age-matched controls (243+/-42.1 vs. 220.8+/-16.2 pg/ml). There was a significant decrease on follow-up measurement (62.1+/-12.7 pg/ml, P < 0.005). In both groups, plasma cortisol levels increased significantly immediately following catheterization (P < 0.02), and normalized on follow-up. Basal aldosterone levels were normal in group A and high in Group B (9.9+/-3.8 vs. 167.6+/-16.9 ng/dl) (P < 0.001). It is suggested that plasma ANP levels are increased in children with CHD, without overt heart failure, and decrease significantly following successful intervention. In newborns with CHD, the physiological high ANP levels obscure the effect of the CHD. PMID:9736347

Zeevi, B; Gil-Ad, I; Zabreski, R; Berant, M; Laron, Z; Weizman, A; Blieden, L C



New technical approaches in stereotaxic catheterization of cerebral ventriculi: implications for the L-arginine/NO synthase/nitric oxide cascade.  


In order to study the actions of certain substances at cerebral level, a stereotactic device for ensuring a precise catheterization of points in certain cerebral areas was used. For the operation technique was used a stereotaxic atlas specifically designed for rat brain (G. Paxinos, C. Watson, 1998), which offers all the necessary information for the identification of the trepanation. Stereotaxic implantation of cannules in the brain is useful for microinjecting solutions containing various substances (in amounts of microl), directly and targeted in the anatomical structures of the brain. The technique described can use either metalic or silastic cannules, that have variable lumen (usually for adapting a Hamilton syringe). The cannules can be implanted at cerebroventricular level, having the possibility to target all the cerebral ventricles. The intracerebroventricular (icv) administration of L-arginine induces a significant increase of response latency for mechano-algesic test. The most obvious changes are induced following the administration of the association of L-NAME with L-arginine, situation when is manifested an important increase of the response latency, starting with 5 minutes post-administration and continuing up to 45 minutes determination. The increase is significantly higher compared with the results obtained with L-arginine alone. A similar evolution is registered in the case of the plantar test. PMID:15984658

Manolidis, G; Neam?u, C; Vasincu, D; Jaba, Irina-Maria; R?d??anu, Oana; Mungiu, O C


Stability-indicating spectrophotometric methods for determination of tazarotene in the presence of its alkaline degradation product by derivative spectrophotometric techniques.  


The stability of tazarotene (TZ) was investigated and two stability-indicating methods-namely, first derivative and a derivative ratio spectrophotometric method-were used to determine tazarotene in the presence of its alkaline degradation product (HD) using methanol as a solvent. A linear relationship was obtained in the range 1-10 µg ml?¹ for both methods. By applying the proposed methods, it was possible to determine tazarotene in its pure powdered from with accuracy 99.35 ± 1.410 (n = 10) for the first derivative method and 99.45 ± 1.053 (n = 10) for the derivative ratio method. First derivative and derivative ratio methods were used for the analysis of laboratory-prepared mixtures containing different ratios of tazarotene and its degradation product and they were valid in the presence of up to 70% and 80% degradation product, respectively. The proposed methods were validated and found to be suitable as stability-indicating assay methods for tazarotene in pharmaceutical formulations. PMID:20878894

Badawy, Amr M; El-Alim, Abd El-Aziz B Abd; Saad, Ahmed S



Thermal indicator for wells  


Minute durable plate-like thermal indicators are employed for precision measuring static and dynamic temperatures of well drilling fluids. The indicators are small enough and sufficiently durable to be circulated in the well with drilling fluids during the drilling operation. The indicators include a heat resistant indicating layer, a coacting meltable solid component and a retainer body which serves to unitize each indicator and which may carry permanent indicator identifying indicia. The indicators are recovered from the drilling fluid at ground level by known techniques.

Gaven, Jr., Joseph V. (Oakton, VA); Bak, Chan S. (Newbury Park, CA)



Intermittent self-catheterization and the risk of squamous cell cancer of the bladder: An emerging clinical entity?  

PubMed Central

There are only 7 cases reported in the literature of squamous cell cancer of the bladder in patients performing intermittent self-catheterization (ISC). We report on an eighth case, and the first case described in a patient with a Mitrofanoff continent appendicovesicostomy. A description of the case and review of the literature are presented. Risk factors for squamous cell cancer include recurrent urinary tract infections, keratinising squamous metaplasia (leukoplakia) and local mucosal trauma from intermittent self-catheterization. There is no recognized or validated monitoring program for patients performing ISC who may also have these risk factors. Reasonable protocols may include regular urinary cytology and cystoscopy with random or targeted bladder biopsies. Squamous cell cancer may present late in this cohort of patients and is associated with a dismal prognosis.

Casey, Rowan G.; Cullen, Ivor M.; Crotty, Tom; Quinlan, David M.



Radial artery sterile granulomatous reaction secondary to hydrophilic-coated sheath used for transradial cardiac catheterization: a case series.  


Radial access has lower risk of vascular complication for cardiac catheterization and is rapidly replacing femoral access. There are few unique complications associated with this approach. We present 3 cases of sterile granulomatous reaction associated with a specific hydrophilic radial sheath and possibly contribution by radial wrist band [TR band; Terumo Medical used for hemostasis after sheath removal (2101 cotton tail lane somerset NJ, USA)]. Awareness of this association will help clinicians use appropriate preventive measures. PMID:22323832

De Leon, Dexter; Swank, Gary; Mirza, M Ayoub



Building Hospital Management Capacity to Improve Patient Flow for Cardiac Catheterization at a Cardiovascular Hospital in Egypt  

PubMed Central

Background Quality improvement (QI) has been shown to be effective in improving hospital care in high-income countries, but evidence of its use in low- and middle-income countries has been limited to date. The impact of a QI intervention to reduce patient waiting time and overcrowding for cardiac catheterization—the subset of procedures associated with the most severe bottlenecks in patient flow at the National Heart Institute in Cairo—was investigated. Methods A pre-post intervention study was conducted to examine the impact of a new scheduling system on patient waiting time and overcrowdedness for cardiac catheterization. The sample consisted of 628 consecutive patients in the pre-intervention period (July–August 2009) and 1,607 in the postintervention period (September–November 2010). Results The intervention was associated with significant reductions in waiting time and patient crowdedness. On average, total patient waiting time from arrival to beginning the catheterization procedure decreased from 208 minutes to 180 minutes (13% decrease, p < .001). Time between arrival at registration and admission to inpatient ward unit decreased from 33 minutes to 24 minutes (27% decrease, p < .001). Patient waiting time immediately prior to the catheterization laboratory procedure decreased from 79 minutes to 58 minutes (27% decrease, p < .001). The percentage of patients arriving between 7:00 A.M. and 9:00 A.M. decreased from 88% to 44% (50% decrease, p < .001), reducing patient crowding. Conclusion With little financial investment, the patient scheduling system significantly reduced waiting time and crowdedness in a resource-limited setting. The capacity-building effort enabled the hospital to sustain the scheduling system and data collection after the Egyptian revolution and departure of the mentoring team in January 2011.

Wong, Rex; Hathi, Sejal; Linnander, Erika L.; Banna, Adel El; Maraghi, Mohamed El; Din, Randah Zain El; Ahmed, Ashraf; Hafez, Abdel Rahman; Allam, Adel A.; Krumholz, Harlan M.; Bradley, Elizabeth H.



Prognostic utility of the exercise thallium-201 test in ambulatory patients with chest pain: comparison with cardiac catheterization  

Microsoft Academic Search

The goal of this study was to determine the prognostic utility of the exercise thallium-201 stress test in ambulatory patients with chest pain who were also referred for cardiac catheterization. Accordingly, 4 to 8 year (mean +\\/- 1SD, 4.6 +\\/- 2.6 years) follow-up data were obtained for all but one of 383 patients who underwent both exercise thallium-201 stress testing

S. Kaul; D. R. Lilly; J. A. Gascho; D. D. Watson; R. S. Gibson; C. A. Oliner; J. M. Ryan; G. A. Beller



Relationship of asymptomatic bacteriuria and renal scarring in children with neuropathic bladders who are practicing clean intermittent catheterization  

Microsoft Academic Search

Objective: To determine whether untreated asymptomatic bacteriuria is associated with renal scarring in children with neuropathic bladders managed with clean intermittent catheterization (CIC). Design: Retrospective study of 207 patients aged 1 to 30 years (mean 11.9 ± 5.5 years) treated with CIC for a mean duration of 6.6 ± 3.9 years by the spina bifida program at Children's National Medical

M. C. Ottolini; C. M. Shaer; H. G. Rushton; M. Majd; E. C. Gonzales; K. M. Patel



Urodynamic Parameters Development and Complications of Clean Intermittent Self-Catheterization in Chinese Schoolchildren with Neurogenic Underactive Bladder  

Microsoft Academic Search

Objective: To evaluate the urodynamic parameters, development of bladder function and complications of clean intermittent self-catheterization (CIC) in Chinese schoolchildren with neurogenic underactive bladder. Methods: Ninety-three children with neurogenic underactive bladder were successfully treated with CIC or combined with oxybutynin for two years follow-up. According to bladder compliance before CIC, they were subdivided into a normal bladder compliance (NBC) group

Qing Wei Wang; Dong Kui Song; Xue Pei Zhang; Yu Dong Wu; Rui Li Zhang; Jin Xing Wei; Jian Guo Wen



Intracardiac aspiration for life-threatening air embolism during cardiac catheterization in tetralogy of Fallot: an aborted sudden death.  


Accidental introduction of air into veins can occur during a variety of surgical operations or diagnostic procedures. High mortality rate results without early diagnosis and appropriate treatment. This is due to "air lock" at the right ventricular outflow tract, compromising the left ventricular filling. We describe a 2-year-old male with Tetralogy of Fallot who developed air embolism due to unexpected rupture of Swan-Gang catheter during a cardiac catheterization study, which was managed successfully by intracardiac aspiration. PMID:23117324

Garg, Naveen; Moorthy, Nagaraja; Goel, Pravin K



Direct dissolution of gallstones with methyl tert-butyl ether (MTBE) via endoscopic transpapillary catheterization in the gallbladder (ETCG)  

Microsoft Academic Search

In a pilot study of direct dissolution therapy of gallstones with methyl tert-butyl ether (MTBE), endoscopic transpapillary\\u000a catheterization in the gallbladder (ETCG) was performed. Complete dissolution was seen in 8 out of 12 (66%) patients and partial\\u000a dissolution was seen in 2 (16%) patients. In one of the 8 complete dissolution patients, combined extracorporeal shock wave\\u000a lithotripsy (ESWL) and dissolution

Naohito Uchida; Toshiaki Nakatsu; Shuko Hirabayashi; Atsushi Minami; Hiroki Fukuma; Toru Ezaki; Syed Ahmed Morshed; Chiaki Fuke; Kiyoshi Ameno; Iwao Ijiri; Mikio Nishioka



[One session diagnostic heart catheterization and balloon dilatation ("prima vista"-PTCA): results and risks].  


Percutaneous transluminal coronary angioplasty (PTCA) immediately after elective diagnostic cardiac catheterization ("prima vista"-PTCA) was performed in 124 patients (group 1) with typical angina pectoris (96 men, 28 women; mean age 60 +/- 10 [25-86] years). In a case-control analysis the results and complications, as well as the volume of contrast media and amount of radiation exposure were compared with a group of patients with similar symptoms (group 2) who during the same period had undergone angiography at another hospital and subsequently PTCA in our department (96 men, 28 women; mean age 60 +/- 8 [39-78] years). The success rate in group 1 (122 of 138 stenoses: 92.1%) was similar to that in group 2 (122 of 138 stenoses: 88.4%). Complications (coronary artery dissection with occlusion, emergency operation, myocardial infarction) were rare in both groups (8 vs 5; difference not significant). But the combined procedure (group 1) used lower volumes of contrast medium (341 +/- 131 vs 250 +/- 113 ml; P < 0.001) and the cumulative fluoroscopic time was lower (33.7 +/- 19.5 vs 26.5 +/- 12.4 min; P < 0.002). With optimal logistic conditions, "prima vista"-PTCA under elective circumstances is a useful and patient-friendly alternative to the conventional two-session diagnostic and therapeutic procedures. PMID:8306851

Lund, G K; Nienaber, C A; Hamm, C W; Terres, W; Kuck, K H



Effect of guidance during cardiac catheterization on emotional, cognitive and behavioral outcomes.  


AIMS: Percutaneous coronary intervention (PCI) may be perceived as a frightening experience. Some psychological factors are known correlates of recovery and rehabilitation of cardiac patients. Our objective was to investigate the emotional, cognitive and behavioral effects of patient guidance during their cardiac catheterization. METHODS: We performed a randomized trial comparing a patient group that was instructed while watching the monitor screen during their PCI (study group) and another group that was not (controls). Replies to questionnaires measuring emotional, cognitive and behavioral variables known to be associated with cardiac patients' health status, rehabilitation and quality of life were collected 1 day and 1 month after the procedure. RESULTS: The study group included 57 patients and the control group included 51 patients. Most patients (?87%) were men at the mean age of 60. They were well matched for reasons for referral to PCI. The study group reported less pain, a more positive affect, greater self-efficacy and stronger intentions to change health-related behaviors than the control group. At 1 month following the procedure, the study group evaluated their general health as significantly better, and reported a less negative affect, less cardiac anxiety, greater functional self-efficacy and more positive outcome expectancies regarding diet, and quitting smoking than the controls. CONCLUSION: A simple adjustment in the standard PCI protocol can become a highly beneficial psychological intervention for enhancing patient outcomes. PMID:23756409

Shiloh, Shoshana; Steinvil, Arie; Drori, Erga; Peleg, Shira; Abramowitz, Yigal; Banai, Shmuel; Finkelstein, Ariel



Calibration of Kodak EDR2 film for patient skin dose assessment in cardiac catheterization procedures  

NASA Astrophysics Data System (ADS)

Kodak EDR2 film has been calibrated across the range of exposure conditions encountered in our cardiac catheterization laboratory. Its dose-response function has been successfully modelled, up to the saturation point of 1 Gy. The most important factor affecting film sensitivity is the use of beam filtration. Spectral filtration and kVp together account for a variation in dose per optical density of -10% to +25%, at 160 mGy. The use of a dynamic wedge filter may cause doses to be underestimated by up to 6%. The film is relatively insensitive to variations in batch, field size, exposure rate, time to processing and day-to-day fluctuations in processor performance. Overall uncertainty in the calibration is estimated to be -20% to +40%, at 160 mGy. However, the uncertainty increases at higher doses, as the curve saturates. Artefacts were seen on a number of films, due to faults in the light-proofing of the film packets.

Morrell, Rachel E.; Rogers, Andy



Escherichia coli Isolates Causing Asymptomatic Bacteriuria in Catheterized and Noncatheterized Individuals Possess Similar Virulence Properties ?  

PubMed Central

Urinary tract infections (UTIs) are among the most common infectious diseases of humans, with Escherichia coli being responsible for >80% of all cases. Asymptomatic bacteriuria (ABU) occurs when bacteria colonize the urinary tract without causing clinical symptoms and can affect both catheterized patients (catheter-associated ABU [CA-ABU]) and noncatheterized patients. Here, we compared the virulence properties of a collection of ABU and CA-ABU nosocomial E. coli isolates in terms of antibiotic resistance, phylogenetic grouping, specific UTI-associated virulence genes, hemagglutination characteristics, and biofilm formation. CA-ABU isolates were similar to ABU isolates with regard to the majority of these characteristics; exceptions were that CA-ABU isolates had a higher prevalence of the polysaccharide capsule marker genes kpsMT II and kpsMT K1, while more ABU strains were capable of mannose-resistant hemagglutination. To examine biofilm growth in detail, we performed a global gene expression analysis with two CA-ABU strains that formed a strong biofilm and that possessed a limited adhesin repertoire. The gene expression profile of the CA-ABU strains during biofilm growth showed considerable overlap with that previously described for the prototype ABU E. coli strain, 83972. This is the first global gene expression analysis of E. coli CA-ABU strains. Overall, our data suggest that nosocomial ABU and CA-ABU E. coli isolates possess similar virulence profiles.

Watts, Rebecca E.; Hancock, Viktoria; Ong, Cheryl-Lynn Y.; Vejborg, Rebecca Munk; Mabbett, Amanda N.; Totsika, Makrina; Looke, David F.; Nimmo, Graeme R.; Klemm, Per; Schembri, Mark A.



[Werner Forssmann: "the typical man before his time!" - self-experiment shows feasibility of cardiac catheterization].  


Going trough the literature on the history of cardiac catheterization, it is obvious that some authors tend to imprecise reporting or omitting important facts; thus, the truth has been misrepresented deceiving conception. This also applies to Werner Forssmann;s experiments that he conducted on himself that yielded centuries later in awarding him with the Nobel Prize along with the American physicians André Frédéric Cournand and Dickinson Woodruff Richards. With the Nobel Prize outstanding achievements in science were honoured that had opened a new chapter in the history of medicine: diagnostics in cardiology with the aid of a cardiac catheter. Since Forssmann}s article on this experiment gave rise to controversies right from being published, his nomination for the Nobel Prize caused a dispute among German physicians as opposed to his co-nominees; hence, he had to face severe hostility and adverseness. In this review less known details are to be disclosed that resulted in Forssmann;s devastating suicide as well as facets of the biography of a physician who was accused of fraud and charlatanism. This was revoked centuries after an American cardiologist appreciated him as "the typical man before his time". PMID:18293251

Goerig, Michael; Agarwal, Kamayni



Predictors of inpatient outcomes in hospitalized patients after left heart catheterization.  


Clinical and laboratory factors predicting inpatient outcomes, specifically in-hospital mortality and length of stay (LOS), have not been defined for hospitalized patients specifically referred for left heart catheterization and coronary angiography (LHC). The objective of the study was to determine these outcomes and their predictors in hospitalized patients after LHC. Multivariate logistic regression models were used to identify risk factors for in-hospital mortality and Cox proportional hazards models were used to identify factors determining LOS in 9,420 consecutive patients hospitalized for LHC. Odds ratio for in-hospital mortality and hazard ratio for prolonged LOS were derived. The strongest predictors of mortality were advanced age, left ventricular (LV) end-diastolic pressure (EDP), LV ejection fraction (EF), systemic blood pressure, and renal insufficiency. Predictors of prolonged LOS were LVEDP, LVEF, 3-vessel coronary artery disease, and valvular disease. Clinical and laboratory characteristics of patients with an LVEF > or =50% were also compared with those of patients with an LVEF <50%. Predictors of mortality and LOS remained the same for patients with an LVEF <50%. For an LVEF > or =50%, LVEDP also determined LOS and chronic renal insufficiency provided predictive power to mortality and LOS in this subgroup. In conclusion, several readily attainable clinical and laboratory parameters predict inpatient mortality and LOS in hospitalized patients referred for LHC. PMID:19195507

Li, Yun You; Bush, Charles A; Orsini, Anthony; Mi, Zhibao; Leier, Carl V



Prevalence of central vein stenosis following catheterization in patients with end-stage renal disease.  


To determine prevalence of central vein stenosis following catheterization with double-lumen temporary catheters, we performed color Doppler sonography in 100 consecutive patients. We detected central vein stenosis in 18 cases; 11 patients in subclavian vein (SCV), 4 patients in internal jugular vein (IJV) and SCV, 2 patients in SCV and brachiocephalic vein, and 2 patients in IJV stenosis. There were statistical difference between groups with and without stenosis regarding time from discontinuation of catheters and use of aspirin (ASA). We could not find any statistical difference between these two groups regarding age, sex, duration of having chronic kidney disease (CKD), and duration of catheter remaining in place. We also found that there was a high proportion of stenosis in patients who still had catheter in their veins (15 from 44 patients, 34%) in comparison with patients who had already the catheters removed from their veins (3 from 56 patients, 5%). We conclude that stenosis of central veins can result from long indwelling time of central catheter used for hemodialysis. Aspirin may have a protective role against stenosis. PMID:20814149

Naroienejad, Minoo; Saedi, Dariush; Rezvani, Asieh



Oxidation states of iron as an indicator of the techniques used to burn clays and handcraft archaeological Tupiguarani ceramics by ancient human groups in Minas Gerais, Brazil  

NASA Astrophysics Data System (ADS)

Ceramics of the Tupiguarani Tradition typically have in common the burning characteristics, their forms and decoration motifs. Dating such ceramic pieces with the radiocarbon method indicate that these artifacts were probably handcrafted between 1,500 and 500 years before the present. Fragments ceramic utensils were collected in the archaeological site of Beltrão, in the municipality of Corinto, state of Minas Gerais, Brazil. A fragment of about 50 mm in diameter and 15 mm thick, with a color gradation across the ceramic wall ranging from red, on one side, grayish, in the middle, and orange, on the opposite side, was selected for a more detailed examination. The fragment was transversely cut and a series of subsamples were separated from different points along the piece wall, in layer segments of ~3 mm. All subsamples were analyzed with Mössbauer spectroscopy at room temperature and 80 K. Results reveal that hematite is the magnetically ordered phase. A Fe2 + component (relative spectral area, 50 %) appears for the grayish subsample. According to these first results, the red subsample seems to be the side that had direct contact with fire used to burn the precursor clay in air. The grayish middle layer is probably due to the clay mixed with some ashes. Mössbauer data reveal that the orange layer, corresponding to the opposite side of the ceramic relatively to the direct fire, does contain about the same Fe2 + :Fe3 + ratio but much lower proportion of ?-Fe2O3 than the red layer.

Floresta, D. L.; Ardisson, J. D.; Fagundes, M.; Fabris, J. D.; Macedo, W. A. A.



Determination of cytoplasmic calcium concentration in Dryopteris spores: a developmentally non-disruptive technique for loading of the calcium indicator fura-2.  


Germination of Dryopteris spores is mediated by the physiologically active, far-red-absorbing form of phytochrome, Pfr, and external Ca2+ is necessary for the transduction of the light signal. Because knowledge about the cytoplasmic calcium ion concentration, [Ca2+]i, is of great importance for understanding the role of calcium during signal transduction, this value was measured using fura-2 in fern spores undergoing the normal developmental progression into germination. Fura-2 was loaded into the spores by electroporation, which does not disrupt the normal process of germination. The intensity of the fluorescence emission of the loaded fura-2 was analysed by a microspectrophotometric assay of single spores, and successful loading could be obtained by the application of ten electrical pulses (field strength 7.5 kV cm-1, half-life (time constant) 230 microseconds). Fura-2 was alternately excited by light of wavelengths 355 and 385 nm through an inverted fluorescence microscope, and the emitted fura-2 fluorescence was collected by a silicon-intensified video camera. The cytoplasmic calcium ion concentration was calculated from the ratio of the camera output obtained for both wavelengths and displayed by a pseudo-color technique. Spores responded to changes of the extracellular Ca2+ concentration, and this observation is considered as evidence that fura-2 is loaded into the cytoplasm. The substitution of a low external [Ca2+] (1 mM ethyleneglycol-bis(2-aminoethylether)-N,N,N',N'-tetraacetic acid (EGTA)) by 1 mM CaCl2 caused a fast increase of [Ca2+]i from approx. 50 nM to above 500 nM. In contrast, the subsequent substitution of CaCl2 by EGTA decreased [Ca2+]i again below 100 nM within 0.5 h. Furthermore, the application of ionomycin could initiate a change in [Ca2+]i according to the Ca2+ gradient established between the extracellular medium and cytoplasm. In spores sown on a Ca(2+) -free medium, [Ca2+]i, analysed in a buffer containing EGTA, was found to be around 50 nM during the first days of cultivation, independent of the irradiation protocol. However, if spores were grown in darkness on a Ca(2+) -containing medium and analysed in EGTA, [Ca2+]i was significantly higher (> or = 500 nM). In red-light-irradiated spores, [Ca2+]i was found to decrease with increasing time after irradiation, and was determined to be less than 100 nM when analysis was done 44 h after germination was initiated by the light treatment. PMID:11538116

Scheuerlein, R; Schmidt, K; Poenie, M; Roux, S J



Twenty-seven years of complication-free life with clean intermittent self-catheterization in a patient with spinal cord injury: A case report  

Microsoft Academic Search

Mizuno K, Tsuji T, Kimura A, Liu M, Masakado Y, Chino N. Twenty-seven years of complication-free life with clean intermittent self-catheterization in a patient with spinal cord injury: a case report. Arch Phys Med Rehabil 2004;85:1705–7.Currently, clean intermittent self-catheterization (CISC) is the most prevalent method of bladder management in patients with spinal cord injury (SCI) at discharge from rehabilitation centers.

Katsuhiro Mizuno; Tetsuya Tsuji; Akio Kimura; Meigen Liu; Yoshihisa Masakado; Naoichi Chino



Catheter length preference in wheelchair-using men who perform routine clean intermittent catheterization.  


Study design:Prospective, unblinded, multicenter, randomized, controlled, cross-over study assessing user preference and ease of use characteristics of two gel intermittent catheters in 81 self-catheterizing wheelchair-using men.Objectives:To evaluate the male user's preference between a 30-cm and a 40-cm intermittent catheter (Apogee Intermittent Catheter, Hollister Incorporated, Libertyville, IL, USA) regarding the ease of insertion and removal, ability to control the catheter during insertion, bladder emptying confidence and ease of draining urine into a receptacle or connecting to a urine bag.Setting:Multiple institutions in the United States.Methods:Subjects were randomized to order of catheter use, using both 10 test catheters (30-cm) and 10 control catheters (40?cm). All catheters were 12 or 14 French and identical in design and composition, except length. Safety was assessed during the entire study period regarding adverse events (AE) and adverse device events (ADE). Subjects evaluated their ease of use characteristics after each catheter use and final catheter preference.Results:Subjects preferred the Apogee 40-cm intermittent catheter (91.4%) over the 30-cm length (8.6%). The preference was due to subject confidence of complete bladder emptying (70%), more satisfactory length (74%) and easier to drain into a receptacle (58%) with a portable urinal being the most utilized (37%), followed by toilet (35%). The only AE/ADE reported was minor urethral bleeding in one subject and minor pain in another subject, both with the 30-cm catheter. None were reported with the 40-cm catheter.Conclusions:The Apogee 40-cm catheter was the preferred intermittent catheter due to subject confidence in bladder emptying, ease of catheter manipulation and the ease of draining urine into a receptacle. PMID:23896665

Costa, J A; Menier, M; Doran, T J; Köhler, T S



A micro blood sampling system for catheterized neonates and pediatrics in intensive care unit.  


A new micro blood sampling system has been designed, fabricated, and characterized to reduce iatrogenic blood loss from the catheterized neonates and pediatrics in intensive care unit by providing micro-volume of blood to analytical biomedical microdevices which can do point-of-care testing for their critical care. The system can not only save enormous iatrogenic blood loss through 1 to 10 ?L of blood sampling and re-infusion of 1 to 5 mL of discard blood but also reduce the infection risk through the closed structure while satisfying the key criteria of the blood sampler. The sampled blood preserved its quality without rupturing of red blood cells verified by blood potassium concentrations of 3.86 ± 0.07 mM on the sampled blood which is similar to 3.81 ± 0.04 mM measured from the blood which did not go through the system. The sampling volume among the sampling channels showed consistency with the relative standard deviation of 1.41 %. In addition to the micro blood sampling capability, the sampling system showed negligible sample cross-contamination. The analyte-free samples collected after aspirating 7,500 times higher signal sample showed the same output signal as blank. The system was also demonstrated not to cause air-embolism by having no bubble generation during flushing procedure and the system was verified as leak-free since there was no fluid leakage under 30 times higher pressure than central venous pressure for 24 h. PMID:23150205

Jung, Wooseok; Ahn, Chong H



Intermittent Catheterization and Recurrent Urinary Tract Infection in Spinal Cord Injury  

PubMed Central

Purpose: To study the association of recurrent symptomatic urinary tract infections (UTIs) with the long-term use of clean intermittent catheterization (CIC) for the management of neurogenic bladder in patients with spinal cord injury (SCI). Methods: Retrospective study of 61 SCI patients with neurogenic bladder managed by CIC. Subjects were selected from 210 SCI patients seen at the Yale Urology Medical Group between 2000 and 2010. Medical UTI prophylaxis (PRx) with oral antimicrobials or methenamine/ascorbic acid was used to identify patients with recurrent UTI. The number of positive cultures (?103 cfu/mL) within a year prior to starting PRx was used to confirm the recurrence of UTI. Results: Fifty-one male and 10 female subjects were managed with CIC. Forty-one (67%) subjects were placed on medical PRx for symptomatic recurrent UTI. Seventeen (28%) subjects had at least 3 positive cultures within the year prior to starting PRx. Fifteen of 20 (75%) subjects not on PRx had no complaints of UTI symptoms in the final year of follow-up. Conclusion: Recurrent symptomatic UTIs remain a major complication of long-term CIC in SCI patients. Although CIC is believed to have the fewest number of complications, many SCI patients managed with long-term CIC are started on medical PRx early in the course of management. Future studies are needed to determine the efficacy of routine UTI PRx in these patients as well as determine what factors influence why many patients on CIC experience frequent infections and others do not.

Edokpolo, Leonard U.; Stavris, Karen B.; Foster, Harris E.



Fungal Urinary Tract Infection in Burn Patients with Long-Term Foley Catheterization  

PubMed Central

Purpose It is well known that fungi become predominant microorganisms in the urine of patients with long-term Foley catheters. This study was conducted to evaluate the lengths of time for fungi to cause urinary tract infection (UTI) and to identify predictors of fungal UTI in burn patients with long-term Foley catheters. Materials and Methods A total of 93 patients who did not have infection at the time of admission but later had fugal UTI were evaluated. Urinalysis, urine culture, and Foley catheter indwelling were done at admission. All patients were administered prophylactic antibiotics from admission. Urine cultures were run every week, and catheters were changed every 2 weeks for each patient. Results Three of the 93 patients (3.2%) displayed fungal UTI at the 1st week of catheter indwelling. However, most patients (78.5%) displayed fungal UTI from 2nd to 5th week after catheter indwelling. The most prevalent fungus identified was Candida tropicalis (60.2%). By univariate logistic regression analysis, only the total body surface area burned (TBSAB) was predictive of fungal UTI in burn patients (p=0.010). By multivariate logistic regression analysis, underlying disease (p=0.032) and TBSAB (p=0.036) were predictors of fungal UTI. Patients with higher TBSAB were more likely to display shorter intervals from Foley catheterization to fungal UTI. Conclusions Fungal UTI was initially found at the 1st week of urinary catheter indwelling, but the majority of cases occurred after the 1st week and appeared earlier in patients with underlying disease or higher TBSAB. Underlying disease and TBSAB were predictors of early fungal UTI.

Kim, Jinsup; Kim, Dae Sung; Lee, Yong Seong



Scanning laser Doppler is a useful technique to assess foot cutaneous perfusion during femoral artery cannulation  

PubMed Central

Background: Measurement of cardiac output and extravascular lung water in critically ill patients using femoral artery double-indicator dilution involves femoral artery catheterization. The potential risk of vascular compromise to the limb may be exacerbated in patients receiving vasopressors. The utility of scanning laser Doppler flowmetry to measure changes in pedal perfusion following catheterization was assessed. Results: There were no significant changes in mean occlusion pressures or in cutaneous perfusion between either leg or between measurement time points, immediately after or 24 h following insertion of the catheters. Conclusions: Scanning laser Doppler flowmetry is easily used to assess changes in foot perfusion and the effect of interventions that may reduce blood flow to the skin of the foot. Femoral artery catheterization for double-indicator dilution measurements does not reduce calf occlusion pressures or foot skin perfusion in patients receiving vasopressor drugs.

Boyle, Nicholas H; Roberts, Peter C; Ng, Bernice; Berkenstadt, Haim; McLuckie, Angela; Beale, Richard J; Mason, Robert C



Chemical sympatholysis: indications, technique and complications.  


Chemical sympatholysis is commonly performed for palmar or plantar hyperhidrosis, Buerger's disease, critical lower limb ischaemia where there is no revascularization option available and palliation of pain. The outcome varies from symptomatic improvement to failure, which may result in limb loss in the case of ischaemic limbs. PMID:19069269

Durai, Rajaraman; Hoque, Happy



Vacuum sealing: indication, technique, and results  

Microsoft Academic Search

Summary  Vacuum sealing is a new therapeutic concept to achieve secure and rapid wound healing in traumatic soft tissue damage (\\u000a and closed fractures), in acute and, as an intermediate measure, in chronic infections. The tissue defect is filled in with\\u000a open-porous polyvinylalcohol-foam and the entire wound surface is covered with a semipermeable transparent Polyurethane drape.\\u000a Using Redon-drainage tubes and vacuum

W. Fleischmann; U. Becker; M. Bischoff; H. Hoekstra



Retrograde Approach to a Diverticular Kidney Stone through a Vesicoureteral Cohen's Reimplantation: A Novel Surgical Technique  

PubMed Central

Cohen's technique is the standard treatment of vesicoureteral reflux in children. Its disadvantage is still the classic difficulty in subsequent retrograde ureteral access, requiring the use of percutaneous techniques in the treatment of kidney stones. We describe a novel surgical technique for retrograde catheterization of an adult ureter by a flexible ureterorenoscope, thereby facilitating the treatment of a symptomatic diverticular kidney stone. We compare our technique to other methods described in the literature.

Khalil, Fahd; Tligui, Mohamed; Traxer, Olivier



Chemical Indicators.  

ERIC Educational Resources Information Center

|This science sourcebook was written for intermediate grade teachers to provide guidance in teaching a specially developed unit on chemical indicators. Directions and suggestions for guiding student science activities are given. Some of the activities concern soil testing, crystals, and household powders such as sugar and salt. A list of necessary…

Prombain, Dorothy R.; And Others


ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: American College of Cardiology Foundation Appropriate Use Criteria Task Force Society for Cardiovascular Angiography and Interventions American Association for Thoracic Surgery American Heart Association, American Society of Echocardiography American Society of Nuclear Cardiology Heart Failure Society of America Heart Rhythm Society, Society of Critical Care Medicine Society of Cardiovascular Computed Tomography Society for Cardiovascular Magnetic Resonance Society of Thoracic Surgeons.  


The American College of Cardiology Foundation, in collaboration with the Society for Cardiovascular Angiography and Interventions and key specialty and subspecialty societies, conducted a review of common clinical scenarios where diagnostic catheterization is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of noninvasive imaging appropriate use criteria. The 166 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). Diagnostic catheterization may include several different procedure components. The indications developed focused primarily on 2 aspects of diagnostic catheterization. Many indications focused on the performance of coronary angiography for the detection of coronary artery disease with other procedure components (e.g., hemodynamic measurements, ventriculography) at the discretion of the operator. The majority of the remaining indications focused on hemodynamic measurements to evaluate valvular heart disease, pulmonary hypertension, cardiomyopathy, and other conditions, with the use of coronary angiography at the discretion of the operator. Seventy-five indications were rated as appropriate, 49 were rated as uncertain, and 42 were rated as inappropriate. The appropriate use criteria for diagnostic catheterization have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. © 2012 Wiley Periodicals, Inc. PMID:22678595

Patel, Manesh R; Bailey, Steven R; Bonow, Robert O; Chambers, Charles E; Chan, Paul S; Dehmer, Gregory J; Kirtane, Ajay J; Wann, L Samuel; Ward, R Parker; Douglas, Pamela S; Patel, Manesh R; Bailey, Steven R; Altus, Philip; Barnard, Denise D; Blankenship, James C; Casey, Donald E; Dean, Larry S; Fazel, Reza; Gilchrist, Ian C; Kavinsky, Clifford J; Lakoski, Susan G; Le, D Elizabeth; Lesser, John R; Levine, Glenn N; Mehran, Roxana; Russo, Andrea M; Sorrentino, Matthew J; Williams, Mathew R; Wong, John B; Wolk, Michael J; Bailey, Steven R; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Shaw, Leslee; Stainback, Raymond F; Allen, Joseph M



Economic Indicators  

NSDL National Science Digital Library

Both scholars and those with a penchant for statistics will want to bookmark this fine website created and maintained by the federal government. The site provides monthly compilations of economic indicators covering prices, wages, production, business activity, purchasing power, credit, money, and Federal finance. Visitors can use the search engine to type in their desired terms, or they can browse every month from January 1998 forward via a series of drop down tabs. For those who might be looking for more specific data, the "Search Tips" feature is quite useful. The site also contains links to the Federal Reserve Archival System for Economic Research (FRASER), which contains economic indicators back to 1948. Overall, the site will be a real boon to those looking for high quality, accurate information regarding current and past economic trends and patterns in the United States.


Carotid-jugular arteriovenous fistula and cerebrovascular infarct: a case report of an iatrogenic complication following internal jugular vein catheterization.  


Central venous catheterization is frequently performed for perioperative management and long-term intravenous access. Although complications associated with central venous catheter insertion have been widely reported, there are few reports of carotid-jugular arteriovenous fistula formation. Endovascular procedures are associated with a risk of immediate and delayed thromboembolic and ischemic complications. We describe a case of a carotid-jugular arteriovenous fistula and a cerebrovascular infarct following the insertion of a double-lumen catheter for hemodialysis access. We provide recommendations for the prevention and the early detection of this iatrogenic complication. PMID:21231999

Bahcebasi, Sami; Kocyigit, Ismail; Akyol, Lutfi; Unal, Aydin; Sipahio?lu, Murath H; Oymak, Oktay; Utas, Cengiz



Change vector analysis to categorise land cover change processes using the tasselled cap as biophysical indicator: description: implementing Landsat TM and ETM to detect land cover and land use changes in the mount Cameroon region using the CVA technique with the tasselled cap as biophysical indicator.  


The continuous extraction of wood and the conversion of forest to small- and large-scale agricultural parcels is rapidly changing the land cover of the mount Cameroon region. The changes occur at varying spatial scales most often not more than 2ha for the small-scale subsistence farms and above 10ha for the extensive agricultural plantations of cocoa and palm. Given the importance of land use and land cover data in conservation planning, accurate and efficient techniques to provide up-to-date change information are required. A number of techniques for realising the detection of land cover dynamics using remotely sensed imagery have been formulated, tested and assessed with the results varying with respect to the change scenario under investigation, the information required and the imagery applied. In this study the Change Vector Analysis (CVA) technique was implemented on multitemporal multispectral Landsat data from the Thematic Mapper (TM) and Enhanced Thematic Mapper (ETM) sensors to monitor the dynamics of forest change in the mount Cameroon region. CVA was applied to multi-temporal data to compare the differences in the time-trajectory of the tasseled cap greenness and brightness for two successive time periods - 1987 and 2002. The tasseled cap was selected as biophysical indicator because it optimises the data viewing capabilities of vegetation, representing the basic types of land cover - vegetation, soil and water. Classes were created arbitrarily to predict the technique's potential in monitoring forest cover changes in the mount Cameroon region. The efficiency of the technique could not be fully assessed due to the inavailability of sufficient ground truth data. Assessment was based on the establishment of an error matrix of change versus no-change. The overall accuracy was 70%. The technique nevertheless demonstrated immense potentials in monitoring forest cover change dynamics especially when complemented with field studies. PMID:18193332

Siwe, Rene Ngamabou; Koch, Barbara



Social indicators.  


The notions of social indicators and social accounting, expressed by analogy with the national economic accounts, generated excitement in the 1960's, and the interest continues to grow if we may judge from governmental activity and the publication of programmatic and research papers. But the concepts which focused much of the early enthusiasm gave exaggerated promise of policy applications and provided an unproductive basis for research. The essential theoretical prerequisites for developing a system of social accounts-defining the variables and the interrelationships among them-are missing. It is now realized that evaluation research, particularly experimentation, must be relied on for evaluation of government programs. Through the development and analysis of descriptive time series and the modeling of social processes, we will be able to describe the state of the society and its dynamics and thus improve immensely our ability to state problems in a productive fashion, obtain clues as to promising lines of endeavor, and ask good questions. But these activities cannot measure program effectiveness. Finally, we must be skeptical about definitions of the social indicators enterprise which confine it to social engineering efforts. The issue is not whether social indicators are useful for policy but, rather, how this usefulness comes about. The interest in social indicators has stimulated a revival of interest in quantitative, comparative, social analysis (60), in the analysis of social change, in conceptual and measurement work on such topics as prejudice, crime, and learning, and in the development of models of social processes. The fruit of these efforts will be more directly a contribution to the policy-maker's cognition than to his decisions. Decision emerges from a mosaic of inputs, including valuational and political, as well as technical components. The work we have described deals with only one type of input; it is a contribution to the intellectual mapping process which is essential if decisionmakers are to know what it is that has changed, and how the change has come about. The character of the scientific contribution will, of course, vary with the subject. Models of a few social processes, such as those pertaining to social mobility and population dynamics, are in varying degrees of development and application. But for many other areas, the appropriate question is not "How does it work?" but "How has it changed?" And for still others, the question is "What is it?" The work of the Berkeley sociologists on the measurement of prejudice illustrates very well the interaction between measurement and conceptual development that is required to answer the question "What is it?" In the present state of work on this topic, the appropriate hypotheses are not so much concerned with the relationships of the phenomenon to others in a causal system, as they are with the nature of the phenomenon itself. What is being tested is a set of propositions that certain ways of thinking about social reality are productive, that a phenomenon as conceptualized is "there" in the reality being measured, and that the investigators have found a set of measures which tell us something we need to know about changes in the society. It is apparent that many different types of work go on under the rubric of social indicators. What is important is that the field be seen as an arena for long-term development, as an effort of social scientists to push forward developments in concepts and in methodology that promise payoffs to both science and public policy.Such a view is reflected in the funding commitments of the National Science Foundation, which supports many of the research projects reported above. What we may expect of this work was aptly stated by Duncan (61): The value of improved measures of social change ... is not that they necessarily resolve theoretical issues concerning social dynamics or settle pragmatic issues,of social policy, but that they may permit those issues to be argued more produ

Sheldon, E B; Parke, R



[Harvest techniques for cord blood after delivery of placenta].  


We describe harvest techniques for cord blood after delivery of the placenta. The umbilical vein is punctured or catheterized, and then placental/cord blood is aspirated with syringes contained anticoagulants. Other method of collection, which has been undertaken in the Cord Blood Bank of the New York Blood Center, is to drain blood into a collection-bag by gravity. The collection bags with anticoagulants are manufactured by TERUMO and BAXTER HEALTHCARE CO. PMID:10475027

Ohnuma, K; Nishihira, H



Lumbar phlebography by catheterization of the lateral sacral and ascending lumbar veins with abdominal compression.  


The lumbar epidural veins are opacified by injection of the lateral sacral and ascending lumbar veins with abdominal compression. This technique provides a good opacification of the entire lumbar epidural venous system. Some anatomical points are discussed and clarified. The interest of the technique in the diagnosis of discal herniations is emphasized. PMID:958619

Theron, J; Houtteville, J P; Ammerich, H; Alves de Souza, A; Adam, H; Thurel, C; Rey, A; Houdart, R



Combined Hepatic Vein, Umbilicoportal Vein, and Superior Mesenteric Artery Catheterization in Portal Hypertension: Estimation of the Portal Fraction of Total Hepatic Blood Flow in Cirrhotic Patients 1  

PubMed Central

Hemodynamic data were obtained in 13 cirrhotic patients with severe portal hypertension, undergoing combined hepatic vein, umbilicoportal vein, and superior mesenteric artery catheterization. The relative clearance of indocyanine green, the portohepatic gradient (difference between the free portal venous pressure and the free hepatic venous pressure), and the estimated hepatic blood flow were measured. The portal fraction (PF) of total hepatic blood flow was calculated in all patients using indicator dilution curves obtained from the portal bifurcation, a right hepatic vein, and when possible a left hepatic vein (six cases) after injection of 51Cr-labeled red blood cells (51Cr RBC) into the superior mesenteric artery. Flows were overestimated because of loss of indicator through spontaneous portosystemic shunts; however, the ratio between hepatic and portal indicator dilution curves can be used to calculate the portal fraction of total hepatic blood flow since no extrahepatic shunts existed after the bifurcation of the portal vein (as shown on portography). In 10 patients, 15 series of curves were calculable and the PF varied between 30.1 and 100% (mean ± SE: 71.1 ± 6.2%). In the three other patients, only delayed activity from recirculation was detected from portal and hepatic vein samples and PF was 0%; in these three cases, portography and arteriography revealed spontaneous portacaval shunting with reverse and/or stagnant circulation in the portal vein. In the 13 patients, no correlation existed between PF and the relative clearance of indocyanine green or the portohepatic gradient, parameters generally used as indices of severity in cirrhosis. In 10 patients, no correlation was found between PF and the estimated hepatic blood flow. These data indicate that 51Cr RBC dilution curves can be used for the estimation of the portal fraction of total hepatic blood flow in conscious cirrhotic patients before portacaval shunts. Using this methodology, it could be assessed whether any critical level of portal fraction exists above which poor clinical results occur after portacaval shunting. This measurement could eventually be helpful in determining the appropriate surgical procedure to be applied in individual cases. ImagesFIG. 4FIG. 5aFIG. 5bFIG. 5c

Huet, P. M.; Lavoie, P.; Legare, A.; Viallet, A.



Specialized Health Plan for Cardiac Surgery and Cardiac Catheterization for Regional Health Planning Council, Newark, New Jersey. New Jersey Health Service Area 2.  

National Technical Information Service (NTIS)

The intent of this plan is to describe the needs and standards for cardiac surgery units and cardiac catheterization services, applicable to the five counties of this Health Service Area. A cardiac surgery center is capable of performing open heart surger...



Psychological Predictors of Symptoms of Urinary Tract Infection and Bacteriuria in Patients Treated with Clean Intermittent Catheterization: A Prospective 7Year Study  

Microsoft Academic Search

Objective: One of the major clinical problems in relation to clean intermittent catheterization (CIC) are symptoms of urinary tract infection (UTI) and bacteriuria. The aim of the present work was to study to what extent measures of psychological well-being, distress and neurotic personality traits in patients performing CIC could predict symptoms of UTI or bacteriuria 7 years later. Patients and

August Bakke; Ulrik Fredrik Malt



Bicaval and standard techniques in orthotopic heart transplantation: Medium-term experience in cardiac performance and survival  

Microsoft Academic Search

Objective: The aim of this study was to compare the medium-term results of right heart pressures, tricuspid valve dysfunction, overall cardiac performance, and survival between the bicaval and standard techniques. Method: Between 1991 and 1997, 201 heart transplantations were performed in our center. Right heart catheterization was performed up to 12 months after transplantation. Echocardiography was used to assess left

Tarek Aziz; Malcolm Burgess; Richard Khafagy; Alison Wynn Hann; Colin Campbell; Ali Rahman; Abdul Deiraniya; Nizar Yonan



Direct dissolution of gallstones with methyl tert-butyl ether (MTBE) via endoscopic transpapillary catheterization in the gallbladder (ETCG).  


In a pilot study of direct dissolution therapy of gallstones with methyl tert-butyl ether (MTBE), endoscopic transpapillary catheterization in the gallbladder (ETCG) was performed. Complete dissolution was seen in 8 out of 12 (66%) patients and partial dissolution was seen in 2 (16%) patients. In one of the 8 complete dissolution patients, combined extracorporeal shock wave lithotripsy (ESWL) and dissolution therapy was carried out successfully. These 8 patients were followed up for 12-20 months with regular ultrasonography. During this period, 1 patient underwent laparoscopic cholecystectomy due to stone recurrence. Thickening of the gallbladder wall was seen in 2 patients, but there were no other complications. Using Tsuchiya's classification based on ultrasound, complete dissolution was seen in type Ia stones. This pilot study suggests that the direct dissolution of gallstones with MTBE via ETCG might be a useful and safe non-invasive treatment in patients with cholesterol stones in preserved gallbladders. PMID:7951860

Uchida, N; Nakatsu, T; Hirabayashi, S; Minami, A; Fukuma, H; Ezaki, T; Morshed, S A; Fuke, C; Ameno, K; Ijiri, I



Transcatheter Thrombolysis with High-Dose Bolus Tissue Plasminogen Activator in Iatrogenic Arterial Occlusion after Femoral Arterial Catheterization  

SciTech Connect

Purpose: To assess the efficacy of percutaneous local thrombolysis with high-dose bolus recombinant tissue plasminogen activator (rt-PA) in patients with acute limb ischemia due to arterial thrombosis after cardiac catheterization.Methods: We treated eight patients (7 men; mean age 56 years) with thrombotic occlusion of both the common femoral artery (CFA) and external iliac artery (EIA) in six patients and of the CFA only in two patients. Two 5 mg boluses of rt-PA were injected into the proximal clot through a 5 Fr end-hole catheter and subsequently two additional boluses of 5 mg rt-PA were given through a catheter with multiple side-holes. In case of a significant amount of residual thrombus, a continuous infusion of 2.5 mg/hr of rt-PA was started.Results: Successful lysis was achieved in all patients. The mean duration of lysis was 2 hr 41 min. The mean total amount of rt-PA delivered was 23.16 mg. In four patients unmasked flow-limited dissections confined to the CFA were managed by prolonged balloon dilatation, while in the remaining four patients with extension of the dissection to the external iliac artery one or two Easy Wallstents were implanted. There was prompt relief of lower limb ischemic symptoms and signs in all patients. Two groin hematomas were conservatively treated.Clinical and color Doppler flow imaging follow-up with a mean duration of 15 months, showed no reappearance of ischemic symptoms or development of restenosis in any of the patients. One patient died 6 months after thrombolysis.Conclusions: Transcatheter thrombolysis with high-dose bolus rt-PA is a safe and effective treatment inpatients with iatrogenic arterial occlusion after femoral catheterization. Underlying dissections should be treated by prolonged balloon dilatation but stent implantation is often required.

Tsetis, Dimitrios K. [Medical School of Heraklion, Department of Radiology, University Hospital Heraklion, 71500 Heraklion-Stravrakia, Crete (Greece); Kochiadakis, George E. [Medical School of Heraklion, Department ofCardiology, University Hospital of Heraklion, Crete (Greece); Hatzidakis, Adam A. [Medical School of Heraklion, Department of Radiology, University Hospital Heraklion, 71500 Heraklion-Stravrakia, Crete (Greece); Skalidis, Emannuel I. [Medical School of Heraklion, Department of Cardiology, University Hospital of Heraklion, Crete (Greece); Chryssou, Evangelia G.; Tritou, Ioanna N. [Medical School of Heraklion, Department of Radiology, University Hospital Heraklion, 71500 Heraklion-Stravrakia, Crete (Greece); Vardas, Panos E. [Medical School of Heraklion, Department of Cardiology, University Hospital of Heraklion, Crete (Greece); Gourtsoyiannis, Nicholas C. [Medical School of Heraklion, Department ofRadiology, University Hospital Heraklion, 71500 Heraklion-Stravrakia, Crete (Greece)



Screening & profiling of quorum sensing signal molecules in Pseudomonas aeruginosa isolates from catheterized urinary tract infection patients  

PubMed Central

Background & objectives: Catheter associated urinary tract infections are the second most common nosocomial infections and Pseudomonas aeruginosa is the third most common organism responsible for these infections. In this study P. aeruginosa isolates from catheterized urinary tract infection patients were screened and profiled for the presence of different type of quorum sensing (QS) signal molecules. Methods: Screening and quantitation of AHLs was done by using cross feeding assay and by determining ?-galactosidase activity respectively using Escherichia coli MG4 as reporter strain. Further, AHL profiles were determined by separating AHLs on TLC coupled with their detection using Chromobacterium violaceum CV026 and Agrobacterium tumifaciens A136 biosensor strains. Results: All uroisolates from catheterized patients having urinary tract infections were found to be producers of QS signal molecules. There were differences in amounts and type of AHL produced amongst uroisolates of P. aeruginosa. Several AHLs belonging to C4-HSL, C6-HSL, oxo-C6-HSL, C8-HSL, C10-HSL and C12-HSL were determined in these strains. Interpretation & conclusions: Simultaneous use of more than one reporter strain and assay method proved useful in determining the AHLs profile in uroisolates of P. aeruginosa. Observed differences in the amounts and types of AHLs may reflect differences in virulence potential of P. aeruginosa to cause UTIs which can be further confirmed by employing animal model system. The present study speculates that production of QS signal molecules may act as a new virulence marker of P. aeruginosa responsible for causing catheter associated UTIs and can be considered as futuristic potential drug targets towards treatment of UTIs.

Kumar, Ravi; Chhibber, Sanjay; Gupta, Varsha; Harjai, Kusum



Cardiac magnetic resonance versus routine cardiac catheterization before bidirectional Glenn anastomosis: Long-term follow-up of a prospective randomized trial.  


OBJECTIVES: A previously published randomized clinical trial comparing cardiac magnetic resonance (CMR) versus routine catheterization in patients with functional single ventricle before bidirectional Glenn (BDG) operation demonstrated similar short-term post-BDG outcomes. We sought to assess late outcomes in this cohort to ascertain any long-term effects of this evaluation strategy. METHODS: Retrospective review of enrolled patients through most recent follow-up was performed on all 82 patients in the original cohort, at a median age of 8.8 years. RESULTS: Of these, 76 (93%) underwent Fontan operation; 2 died before Fontan. Baseline demographics, anatomic factors, and age at BDG did not differ between those randomized to CMR versus catheterization. Although pre-BDG CMR patients were younger at Fontan (2.4 vs 2.7 years; P = .02), baseline weight, body surface area, oxygen saturation, ventricular function, and degree of atrioventricular valve regurgitation were similar. Catheterization before Fontan (n = 76) demonstrated similar hemodynamic parameters including pulmonary vascular resistance and mean pulmonary artery, atrial, and ventricular end-diastolic pressures. CMR patients had comparable rates of transcatheter interventions (71% vs 79%; P = .6), including coil occlusion of systemic-pulmonary collaterals (66% vs 61%; P = .29). At Fontan surgery, short-term complications, hospital length of stay, and the percent meeting a 5-part definition of successful Fontan operation were not different (71% vs 55%; P = .23). CONCLUSIONS: Pre-BDG CMR and catheterization groups had equivalent clinical and hemodynamic profiles before Fontan and similar post-Fontan outcomes at a median follow-up of 8 years after BDG. For selected patients, a pre-BDG evaluation with CMR is an acceptable alternative to catheterization. PMID:23380513

Brown, David W; Gauvreau, Kimberlee; Powell, Andrew J; Lang, Peter; Del Nido, Pedro J; Odegard, Kirsten C; Geva, Tal



ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.  


The American College of Cardiology Foundation, in collaboration with the Society for Cardiovascular Angiography and Interventions and key specialty and subspecialty societies, conducted a review of common clinical scenarios where diagnostic catheterization is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of noninvasive imaging appropriate use criteria. The 166 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). Diagnostic catheterization may include several different procedure components. The indications developed focused primarily on 2 aspects of diagnostic catheterization. Many indications focused on the performance of coronary angiography for the detection of coronary artery disease with other procedure components (e.g., hemodynamic measurements, ventriculography) at the discretion of the operator. The majority of the remaining indications focused on hemodynamic measurements to evaluate valvular heart disease, pulmonary hypertension, cardiomyopathy, and other conditions, with the use of coronary angiography at the discretion of the operator. Seventy-five indications were rated as appropriate, 49 were rated as uncertain, and 42 were rated as inappropriate. The appropriate use criteria for diagnostic catheterization have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. PMID:22578925

Patel, Manesh R; Bailey, Steven R; Bonow, Robert O; Chambers, Charles E; Chan, Paul S; Dehmer, Gregory J; Kirtane, Ajay J; Wann, L Samuel; Ward, R Parker



Introducing ultrasound-guided vein catheterization into clinical practice: A step-by-step guide for organizing a hands-on training program with inexpensive handmade models  

Microsoft Academic Search

IntroductionCentral vein catheterization (CVC) plays a central role in hospital patient management. Compared with the use of traditional anatomical landmarks, ultrasound-guidance is associated with higher CVC success rates, fewer complications, and more rapid central venous access. The use of US-guided CVC in clinical practice has not become widespread, largely because anesthesiology and general surgery residents receive limited training in this

S. Di Domenico; M. Licausi; E. Porcile; F. Piaggio; B. Troilo; M. Centanaro; U. Valente



Linear vs. Quadratic Optimization Algorithms for Bias Correction of Left Ventricle Chamber Boundaries in Low Contrast Projection Ventriculograms Produced from Xray Cardiac Catheterization Procedure  

Microsoft Academic Search

Cardiac catheterization procedure produces ventriculograms which have very low contrast in the apical, anterior and inferior\\u000a zones of the left ventricle (LV). Pixel-based classifiers operating on these images produce boundaries which have systematic\\u000a positional and orientation bias and have a mean error of about 10.5 mm. Using the LV convex information, comprising of the\\u000a apex and the aortic valve plane,

Jasjit S. Suri; Robert M. Haralick; Florence H. Sheehan



Superiority of quantitative exercise thallium-201 variables in determining long-term prognosis in ambulatory patients with chest pain: a comparison with cardiac catheterization  

SciTech Connect

The purpose of this study was to determine the prognostic utility of quantitative exercise thallium-201 imaging and compare it with that of cardiac catheterization in ambulatory patients. Accordingly, long-term (4 to 9 years) follow-up was obtained in 293 patients who underwent both tests for the evaluation of chest pain: 89 had undergone coronary artery bypass graft surgery within 3 months of testing and were excluded from analysis, 119 experienced no cardiac events and 91 had an event (death in 20, nonfatal myocardial infarction in 21 and coronary artery bypass operations performed greater than 3 months after cardiac catheterization in 50). When all variables were analyzed using Cox regression analysis, the quantitatively assessed lung/heart ratio of thallium-201 activity was the most important predictor of a future cardiac event (chi 2 = 40.21). Other significant predictors were the number of diseased vessels (chi 2 = 17.11), patient gender (chi 2 = 9.43) and change in heart rate from rest to exercise (chi 2 = 4.19). Whereas the number of diseased vessels was an important independent predictor of cardiac events, it did not add significantly to the overall ability of the exercise thallium-201 test to predict events. Furthermore, information obtained from thallium-201 imaging alone was marginally superior to that obtained from cardiac catheterization alone (p = 0.04) and significantly superior to that obtained from exercise testing alone (p = 0.02) in determining the occurrence of events. In addition, unlike the exercise thallium-201 test, which could predict the occurrence of all categories of events, catheterization data were not able to predict the occurrence of nonfatal myocardial infarction. The exclusion of bypass surgery and previous myocardial infarction did not alter the results.

Kaul, S.; Finkelstein, D.M.; Homma, S.; Leavitt, M.; Okada, R.D.; Boucher, C.A.



Outcome of patients with post acute myocardial infarction ischemia hospitalized in intensive cardiac care units with and without on-site catheterization laboratories  

Microsoft Academic Search

Background: This study addresses the impact of availability of on-site catheterization laboratories on the 1-year survival of patients with post-acute myocardial infarction ischemia (P-AMI-I), a high-risk subgroup of AMI patients. Methods: A prospective 5 month national survey was conducted in 1996 in all operating intensive care units (ICCUs) in Israel (N=26) and included 2377 patients. Four hundred and three (17%)

David S Blondheim; Shmuel Gottlieb; Solomon Behar; Alon T Marmor



Superiority of quantitative exercise thallium-201 variables in determining long-term prognosis in ambulatory patients with chest pain: a comparison with cardiac catheterization  

Microsoft Academic Search

The purpose of this study was to determine the prognostic utility of quantitative exercise thallium-201 imaging and compare it with that of cardiac catheterization in ambulatory patients. Accordingly, long-term (4 to 9 years) follow-up was obtained in 293 patients who underwent both tests for the evaluation of chest pain: 89 had undergone coronary artery bypass graft surgery within 3 months

Sanjiv Kaul; Dianne M. Finkelstein; Sunichi Homma; Marcia Leavitt; Robert D. Okada; Charles A. Boucher



The influence of patient size on dose conversion coefficients: a hybrid phantom study for adult cardiac catheterization  

NASA Astrophysics Data System (ADS)

In this study, the influence of patient size on organ and effective dose conversion coefficients (DCCs) was investigated for a representative interventional fluoroscopic procedure—cardiac catheterization. The study was performed using hybrid phantoms representing an underweight, average and overweight American adult male. Reference body sizes were determined using the NHANES III database and parameterized based on standing height and total body mass. Organ and effective dose conversion coefficients were calculated for anterior-posterior, posterior-anterior, left anterior oblique and right anterior oblique projections using the Monte Carlo code MCNPX 2.5.0 with the metric dose area product being used as the normalization factor. Results show body size to have a clear influence on DCCs which increased noticeably when body size decreased. It was also shown that if patient size is neglected when choosing a DCC, the organ and effective dose will be underestimated to an underweight patient and will be overestimated to an underweight patient, with errors as large as 113% for certain projections. Results were further compared with those published for a KTMAN-2 Korean patient-specific tomographic phantom. The published DCCs aligned best with the hybrid phantom which most closely matched in overall body size. These results highlighted the need for and the advantages of phantom-patient matching, and it is recommended that hybrid phantoms be used to create a more diverse library of patient-dependent anthropomorphic phantoms for medical dose reconstruction.

Johnson, Perry; Lee, Choonsik; Johnson, Kevin; Siragusa, Daniel; Bolch, Wesley E.



Online PC-based integration of digital intracoronary ultrasound images into angiographic images during cardiac catheterization.  


In recent years, intravascular ultrasound (IVUS) has evolved as an important adjunct to angiography, providing insights that are significantly altering conventional paradigms in diagnosis and therapy. However, major drawbacks in the use of IVUS relied on the fact that a heavy console had to be moved from lab to lab, and extensive time for set up and image analysis. This additional time and the decrease in patients' through-put has not been applicable in clinical practice for many labs. Our manuscript concerns a novel PC-based platform for IVUS that enables the online intergration of digital intracoronary ultrasound images into angiographic images. This new technique offers remote operation, multiple control devices and custom viewing options. The PC-based platform enables IVUS images to be viewed simultaneously from multiple vantage points in the lab, and allows for multiple user interfaces. PMID:17698226

Sievers, Burkhard; Böse, Dirk; Sack, Stefan; Philipp, Sebastian; Wieneke, Heinrich; Erbel, Raimund



Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas  

PubMed Central

Monochorionic (MC) twin pregnancies are associated with significantly higher morbidity and mortality rates than dichorionic twins. Approximately 50% of MC twin pregnancies develop complications arising from the shared placenta and associated vascular connections1. Severe twin-to-twin syndrome (TTTS) is reported to account for approximately 20% of these complications2,3. Inter-twin vascular connections occur in almost all MC placentas and are related to the prognosis and outcome of these high-risk twin pregnancies. The number, size and type of connections have been implicated in the development of TTTS and other MC twin conditions. Three types of inter-twin vascular connections occur: 1) artery to vein connections (AVs) in which a branch artery carrying deoxygenated blood from one twin courses along the fetal surface of the placenta and dives into a placental cotyledon. Blood flows via a deep intraparenchymal capillary network into a draining vein that emerges at the fetal surface of the placenta and brings oxygenated blood toward the other twin. There is unidirectional flow from the twin supplying the afferent artery toward the twin receiving the efferent vein; 2) artery to artery connections (AAs) in which a branch artery from each twin meets directly on the superficial placental surface resulting in a vessel with pulsatile bidirectional flow, and 3) vein to vein connections (VVs) in which a branch vein from each twin meets directly on the superficial placental surface allowing low pressure bidirectional flow. In utero obstetric sonography with targeted Doppler interrogation has been used to identify the presence of AV and AA connections4. Prenatally detected AAs that have been confirmed by postnatal placental injection studies have been shown to be associated with an improved prognosis for both twins5. Furthermore, fetoscopic laser ablation of inter-twin vascular connections on the fetal surface of the shared placenta is now the preferred treatment for early, severe TTTS. Postnatal placental injection studies provide a valuable method to confirm the accuracy of prenatal Doppler ultrasound findings and the efficacy of fetal laser therapy6. Using colored dyes separately hand-injected into the arterial and venous circulations of each twin, the technique highlights and delineates AVs, AAs, and VVs. This definitive demonstration of MC placental vascular anatomy may then be correlated with Doppler ultrasound findings and neonatal outcome to enhance our understanding of the pathophysiology of MC twinning and its sequelae. Here we demonstrate our placental injection technique.

Jelin, Eric B.; Schecter, Samuel C.; Gonzales, Kelly D.; Hirose, Shinjiro; Lee, Hanmin; Machin, Geoffrey A.; Rand, Larry; Feldstein, Vickie A.



[Simultaneous treatment of pulmonary valve stenosis and patent ductus arterious by interventional catheterization].  


The association of pulmonary valve stenosis and patent ductus arteriosus is uncommonly found in clinical practice of pediatric cardiology. The authors describe 2 patients with this association that were successfully treated in the same procedure by interventional cardiology: first case, a 14 month old boy was submitted to percutaneous pulmonary valvoplasty with reduction of systolic gradient between pulmonary artery and right ventricle from 71 to 3 mmHg. The 2.0 mm of diameter and conical shape duct was successfully occluded using a 38-5-5 coil; second case, a 20 month old girl was submitted to percutaneous pulmonary valvoplasty with reduction of systolic gradient between pulmonary artery and right ventricle from 60 to 5 mmHg. An attempt to close the 3.5 mm of diameter and concial shape duct using coil was performed, but the device embolized into the pulmonary artery. After immediate retrieval, a 12 mm Rashkind umbrella was implanted. Indication of treatment of both conditions, technical aspects and complications related to the procedures, and patients follow up are also discussed. PMID:9497525

Pedra, C A; Pedra, S R; Esteves, C A; Braga, S L; Fontes, V F



Do umbilical vein catheterization and sepsis lead to portal vein thrombosis? A prospective, clinical, and sonographic evaluation.  


Extrahepatic portal vein obstruction (EHPVO) affects 20-30% of all patients with portal hypertension in India. The etiopathogenesis of this disease is unknown. In retrospective studies, umbilical vein cannulation and sepsis have been alleged to cause portal thrombosis. This prospective study was undertaken to detect clinically and by serial sonography whether thrombosis and consequent obstruction of the splenoportal venous system develops after umbilical vein catheterization and sepsis. Forty-seven children who had undergone exchange transfusion for hyperbilirubinemia, belonging to two different age groups, were studied. Twenty-two new-borns (Group A) were studied within 4 weeks of birth and later at 3-month intervals until the age of 12 months and subsequently at 24 months. Another group of 25 children (Group B), 1- to 5-year-olds who had earlier undergone exchange transfusion and 15 healthy newborns (Group C) were also screened. In Group A, seven (29%) neonates had septicemia, and in five, the splenic vein could not be initially visualized. The splenic vein was not seen in five of the 15 newborns in Group A who had no umbilical sepsis. Twenty-one of the 22 neonates in Group A were followed-up, and the splenic vein was well visualized and found patent on subsequent ultrasound in all of them. In Group B, four (16%) children had umbilical sepsis. None of these or the other Group B children showed any thrombosis or obstruction of the splenoportal system. The portal vein and its branches and the splenic vein were visualized in all healthy (Group C) neonates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8145094

Yadav, S; Dutta, A K; Sarin, S K



Evaluation of a new PVC-free catheter material for intermittent catheterization: A prospective, randomized, crossover study  

PubMed Central

Objective. Polyvinyl chloride (PVC) is commonly used as a catheter material in catheters for clean intermittent catheterization (CIC) but, owing mainly to environmental concerns, a PVC-free material has been proposed. The objective of this study was to compare patients' tolerability for catheters made of PVC and a newly developed PVC-free material. Material and methods. This was a prospective, randomized, crossover study in 104 male patients with maintained urethra sensibility who practised CIC. The patients evaluated in a randomized order a PVC and a PVC-free LoFric® catheter after 1 week's use of each. The material properties and tolerability, i.e. reported perceived discomfort, of each catheter were compared and adverse events documented. Results. Twenty-nine (28%) and 15 (14%) patients reported discomfort when using the PVC catheter and the PVC-free LoFric catheter, respectively. A comparison showed that five patients (5%) reported discomfort with the PVC-free and not with the PVC catheter, and 19 patients (18%) reported discomfort with the PVC and not with the PVC-free catheter (p = 0.0066). Forty patients reported a total of 91 adverse events, of which the most common were discomfort in terms of pain, a burning sensation and bleeding. Conclusions. Generally low discomfort rates were reported in the study population, suggesting a high tolerance for CIC with catheters of both the PVC and the PVC-free materials. The lowest discomfort was, however, found when CIC was performed using the PVC-free LoFric catheter.

Greis, Gunvor; Johansson, Birgit; Grundtmann, Agneta; Pahlby, Yvonne; Torn, Solveig; Axelberg, Hanna; Carlsson, Petrea



Biological Indicators of Watershed Health  

NSDL National Science Digital Library

This recently launched site on biological indicators, from the Environmental Protection Agency, is a gem, offering basic yet critical information on the what, where, why, and how of biological indicators. Presented in straightforward language, the site sets out to educate viewers about the importance of biological indicators -- those organisms that, because of their sensitivity to changes in the environment, "can provide accurate information about the health of a specific river, stream, lake, wetland, or estuary." The site is organized into seven main sections: Why use Indicators?, Key Concepts, Learn About State Programs, Biocriteria Resources, Fish as Indicators, Invertebrates as Indicators, and Periphyton as Indicators. In each section, a series of brief statements (with accompanying color photographs) leads the viewer through the logic, techniques, and methods used to assess watershed health. A collection of links rounds out the site.


Nuclear cardiology techniques in the assessment of ischemic heart disease.  


Invasive techniques of cardiac catheterization and angiography have become the gold standard for the diagnosis and management of patients with ischemic heart disease. More recently there has been a remarkable development of noninvasive imaging techniques which has resulted in improved ability to select patients in need of invasive investigations and in a more complete understanding of the physiological and clinical significance of information obtained from such invasive investigations. The value and limitations of the 3 most common techniques, radionuclide ventriculography, myocardial perfusion scintigraphy and acute myocardial infarction scintigraphy, are discussed in this review in relation to the assessment of patients with proven or suspected ischemic heart disease. These nuclear cardiology techniques are now available in most hospitals with nuclear medicine equipment; a good understanding of the strengths and weaknesses of each technique is essential for optimal clinical use. PMID:3015470

Manyari, D E; Frais, M A; Smith, E R



The Comparison between the Echocardiographic Data to the Cardiac Catheterization Data on the Diagnosis, Treatment, and Follow-Up in Patients Diagnosed as Pulmonary Valve Stenosis  

PubMed Central

Background Isolated pulmonary valve stenosis (PS) makes up 6-9% of all congenital heart defects among children. The initial gold standard for diagnosis, follow-up of PS is by echocardiography. However, the most accurate diagnosis still remains to be measurement of the pressure gradient through transcatheterization. The purpose of this study is to compare the difference between the echocardiographic data to the cardiac catheterization data on the diagnosis, treatment, and follow-up in patients diagnosed as PS, and to see what parameters should be closely monitored. Methods A total of 112 patients (Male : Female = 46 : 66) who underwent balloon pulmonary valvuloplasty (BPV) at Severance Cardiovascular Hospital, between December, 2002 to August, 2012 were retrospectively analyzed. The patients were all under 16 years of age and critical PS patients who underwent BPV were excluded from this study. Results The pre-BPV right ventricle (RV)-pulmonary artery (PA) systolic pressure gradient and post-BPV systolic pressure gradient showed statistically significant decrease. The pre-BPV RV-PA systolic pressure gradient and 3 month post-BPV systolic pressure gradient showed statistically significant decrease. The consistency between the echocardiographic data and cardiac catheterization data shows statistically significant consistency. The mean pressure gradient and systolic pressure gradient on the echocardiography shows high consistency when comparing with the cardiac catheterization data. Conclusion Our study shows that BPV in PS is a safe and effective procedure in children and adolescent. The standard echocardiographic evaluation of PS, during diagnosis and follow-up, should include mean transpulmonic pressure gradient, as well as the peak systolic pressure gradient. The success of the procedure should be held off until at least 3 months, only if the patients do not show any symptoms.

Kim, Do Hoon; Park, Su-Jin; Jung, Jo Won; Kim, Nam Kyun



Self catheterization - male  


... insert your catheter: Wash your hands well with soap and water. Collect your supplies: catheter (open and ... your penis with Betadine (an antiseptic cleaner), towelette, soap and water, or baby wipes the way your ...


Urine culture - catheterized specimen  


... you may feel pressure. If you have a urinary tract infection , you may have some pain when the catheter ... on their own If you might have a urinary tract infection If you cannot empty your bladder (urinary retention)


[Comparison of continuous wave Doppler and heart catheterization in the determination of the mean transvalvular gradient in mitral stenosis. A simultaneous beat to beat analysis].  


Continuous wave Doppler echocardiography (CWD) is widely used in the assessment of pressure gradients in patients with valvular heart disease, utilizing the simplified Bernoulli equation. However determination of non-simultaneous mean pressure gradient (MG) in mitral stenosis (MS) from CWD recordings has often been described as being unsatisfactory. Therefore, the purpose of this study was to compare the estimates of trans-mitral MG derived from CWD with gradients measured simultaneously at cardiac catheterization (beat to beat analysis). We studied 3 patients (pts) with MS (1 man and 2 women, aged 55, 55 and 62 years respectively); one patient (pt) was in sinus rhythm and 2 were in atrial fibrillation. In each pt the trans-mitral flow velocity curve was obtained simultaneously with trans-mitral gradient measured directly at cardiac catheterization (cath). In this way it was possible to obtain a beat to beat correlation between Doppler and cath in 181 beats taken from the 3 pts. These beats were selected from a total number of 321 beats because of their excellent quality for analysis (74 beats were obtained from the first pt, 38 from the second pt and 69 from the third pt). Mean diastolic velocity, defined as the mean of maximal velocities throughout diastole, was obtained for each beat by planimetring the envelope of the spectral velocity profile. MG was calculated from mean velocity by applying the simplified Bernoulli equation (delta P = 4V2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3181658

Moro, E; Pignoni, P; Caprioglio, F; Nicolosi, G L; D'Angelo, G; Pavan, D; Dall'Aglio, V; Burelli, C; Zanuttini, D



Is the intraosseous access route fast and efficacious compared to conventional central venous catheterization in adult patients under resuscitation in the emergency department? A prospective observational pilot study  

PubMed Central

Background For patients' safety reasons, current American Heart Association and European Resuscitation Council guidelines recommend intraosseous (IO) vascular access as an alternative in cases of emergency, if prompt venous catheterization is impossible. The purpose of this study was to compare the IO access as a bridging procedure versus central venous catheterization (CVC) for in-hospital adult emergency patients under resuscitation with impossible peripheral intravenous (IV) access. We hypothesised, that CVC is faster and more efficacious compared to IO access. Methods A prospective observational study comparing success rates and procedure times of IO access (EZ-IO, Vidacare Corporation) versus CVC in adult (?18 years of age) patients under trauma and medical resuscitation admitted to our emergency department with impossible peripheral IV catheterization was conducted. Procedure time was defined from preparation and insertion of vascular access type until first drug or infusion solution administration. Success rate on first attempt and procedure time for each access route was evaluated and statistically tested. Results Ten consecutive adult patients under resuscitation, each receiving IO access and CVC, were analyzed. IO access was performed with 10 tibial or humeral insertions, CVC in 10 internal jugular or subclavian veins. The success rate on first attempt was 90% for IO insertion versus 60% for CVC. Mean procedure time was significantly lower for IO cannulation (2.3 min ± 0.8) compared to CVC (9.9 min ± 3.7) (p < 0.001). As for complications, failure of IO access was observed in one patient, while two or more attempts of CVC were necessary in four patients. No other relevant complications, like infection, bleeding or pneumothorax were observed. Conclusion Preliminary data demonstrate that IO access is a reliable bridging method to gain vascular access for in-hospital adult emergency patients under trauma or medical resuscitation with impossible peripheral IV access. Furthermore, IO cannulation requires significantly less time to enable administration of drugs or infusion solutions compared to CVC. Because CVC was slower and less efficacious, IO access may improve the safety of adult patients under resuscitation in the emergency department.

Leidel, Bernd A; Kirchhoff, Chlodwig; Bogner, Viktoria; Stegmaier, Julia; Mutschler, Wolf; Kanz, Karl-Georg; Braunstein, Volker



Coronary arteriography and angioplasty  

SciTech Connect

This book explores biomedical radiography of the heart. Topics considered include six bench marks in the history of cardiac catheterization; normal coronary anatomy; anomalies of the coronary arteries; pathoanotomy of the coronary arteries and complications; indications, limitations, and risks of coronary arteriography and left ventriculography; catheterization techniques in coronary arteriography and left ventriculography: the Sones technique; catheterization techniques in coronary arteriography and left ventriculography: the Judkins technique; modification of Judkins catheters; catheterization techniques in coronary arteriography and left ventriculography multipurpose technique; new views in coronary arteriography; quantitative evaluation of left ventricular function; complications of coronary arteriography: management during and following the procedure; interpretation of coronary arteriograms and left ventriculograms; prevalence and distribution of disease in patients catheterized for suspected coronary disease at Emory University Hospital; the Cardiac Catheterization Laboratory; selection for surgery or percutaneous transluminal coronary angioplasty; intracoronary thrombolysis; and percutaneous transluminal coronary angioplasty.

King, S.B.; Douglas, J.S.



Evolution of carotid stenting: indications.  


While carotid angioplasty and stenting has been clearly established as a minimally invasive alternative to endarterectomy for patients with carotid occlusive disease, its indications continue to evolve, being refined as more controlled data of large studies are being accumulated. The purpose of this article is to review the current evidence supporting the application of the technique in certain subsets of patients, and the relative contraindications for its use. PMID:18565410

Chaer, Rabih A; Makaroun, Michel S



Indicators of Sustainable Development  

NSDL National Science Digital Library

This resource reviews indicators for monitoring progress toward sustainable development. Such indicators are important to decision-makers and policy-makers at all levels. The United Nations Commission on Sustainable Development (CSD) adopted 58 Indicators of Sustainable Development (ISDs) along with methodology sheets that are now available for all countries to use. Indicators for the atmosphere environmental subtheme include emissions of greenhouse gases, consumption of ozone depleting substances, and ambient concentration of air pollutants in urban areas. In addition to indicators for the atmosphere there are indicators for land, ocean, seas, coasts, fresh water, and biodiversity. For each of the indicators the site offers topics for relevance, methodological description, assessment of data, agencies involved, and references. The CSD indicator set and methodological descriptions are currently undergoing revision. An updated set is expected to be released in 2006.



EPA Science Inventory

The Ecological Indicator Program in NERL is developing indicators for two key purposes. The first is to characterize the biological condition of shallow streams and large rivers. The second is to develop diagnostic indicators to evaluate the causes of impairment to these commun...


Indices of landscape pattern  

Microsoft Academic Search

Landscape ecology deals with the patterning of ecosystems in space. Methods are needed to quantify aspects of spatial pattern that can be correlated with ecological processes. The present paper develops three indices of pattern derived from information theory and fractal geometry. Using digitized maps, the indices are calculated for 94 quadrangles covering most of the eastern United States. The indices

R. V. O'Neillr; J. R. Krummel; R. H. Gardner; G. Sugihara; B. Jackson; D. L. DeAngelist; B. T. Milne; M. G. Turner; B. Zygmunt; S. W. Christensen; V. H. Dale; R. L. Graham



Riser position indication apparatus  

Microsoft Academic Search

This patent describes a Riser Position Indication Apparatus for disposition between an offshore vessel and a riser, the riser being moveable with respect to the offshore vessel. The riser position indication apparatus comprises: vessel connection means operatively engaged with the vessel to secure the riser position indication apparatus to the vessel, riser connection means operatively engaged with the riser to



Endosaccular thrombosis of cerebral aneurysms: strategy, indications, and technique.  


Endovascular occlusion of a cerebral aneurysm refers to the induction of thrombosis within the aneurysm by any of several methods, all of which make use of devices delivered through the bloodstream of the parent vessel. The type of endovascular treatment most commonly used today for aneurysm treatment is the detachable platinum microcoil designed by Guglielmi, known as the GDC. The GDC has been used more frequently and successfully over the last decade as a treatment alternative to microneurosurgical clip ligation. A continual and rapid technological evolution and increasing clinical experience of neurosurgeons and neuroradiologists using this technology have been important contributors to its success. Endovascular coil embolization may hold advantages over microneurosurgical clip ligation under selected clinical circumstances. It is also necessary to acknowledge and outline the disadvantages of this form of treatment in an unbiased manner. PMID:10565873

Thomas, J E; Armonda, R A; Rosenwasser, R H



Anal incontinence—sphincter ani repair: indications, techniques, outcome  

Microsoft Academic Search

Introduction  Fecal incontinence is a debilitating problem that has many different causes. There also are many treatments options, from\\u000a behavioral modification to sphincteroplasty to artificial anal sphincter and colostomy. In a society with an aging population,\\u000a fecal incontinence is an ever-increasing problem and will continue to grow.\\u000a \\u000a \\u000a \\u000a Discussion  Treatment plans need to be individually tailored for each patient. The surgeon should be

Susan Galandiuk; Leslie A. Roth; Quincy J. Greene



Nucleoplasty as an Alternative Intradiscal Therapy: Indications and Technique  

Microsoft Academic Search

This study was designed to determine the outcome of treatment of herniated intervertebral discs with Nucleoplasty (Arthrocare Spine, Sunnyvale, CA, USA). Nucleoplasty, a minimally invasive procedure for treating the contained herniated intervertebral discs, was introduced recently. Nucleoplasty utilizes coblation technology for ablating and coagulating soft tissue for partial disc removal. Sixty-five patients underwent Nucleoplasty at Hanyang University Hospital from August

Koang Hum Bak; Seong Hoon Oh; Jae Min Kim; Hyeong Joong Yi; Cheong Jin Hwan; Choong Hyun Kim


Les lèvres dépassées. Techniques de reconstruction et indications  

Microsoft Academic Search

Labial tissue defects that extend beyond the anatomic boundary of the labial region confront us with two distinct reconstructive problems.When the extension is centrifugal towards the periphery, the tissue loss is essentially tegumentary. The reconstructive aim in this case is not only to restore tissues of the perilabial areas with the best possible morphologic and functional harmony but also to

J Lebeau; H Sadek



Partial breast irradiation: a review of techniques and indications  

PubMed Central

The addition of whole-breast external beam radiotherapy (EBRT) to breast-conserving surgery results in a significant reduction in the risk of death due to breast cancer, but this may be offset by an increase in deaths from other causes and toxicity to surrounding organs. Because of this, and with a view to patterns of local recurrence, irradiation of the tumour bed has been explored in selected patients with early breast cancer using a variety of radiotherapeutic modalities. This review article explores the treatment options for partial breast irradiation and examines their role within the field of breast cancer treatment.

Stewart, A J; Khan, A J; Devlin, P M



Acromioclavicular joint instability—reconstruction indications and techniques  

Microsoft Academic Search

Injuries to the acromioclavicular joint are common and may lead to instability or degenerative changes requiring surgical intervention. The spectrum of injury ranges from sprain to disruption of the acromioclavicular and coracoclavicular ligaments, which provide horizontal and vertical stability to the distal clavicle. Most injuries are the result of direct trauma to the acromioclavicular joint. The majority of injuries can

Brent A Ponce; Peter J Millett; Jon J. P Warner



Indications and operative techniques for combined aortoesophageal resection  

Microsoft Academic Search

Combined aortoesophageal resection was performed in 8 patients, including 7 with esophageal carcinoma and 1 with aortoesophageal\\u000a fistula. Aortic resection procedures included segmental resection with permanent aorto-aortic bypass (1 case), segmental resection\\u000a with graft interposition (1 case), semicircumferential resection with patch aortoplasty (3 cases), wedge resection with lateral\\u000a aortorr-haphy (1 case), and resection of adventitia (2 cases). Protective methods during

Yuji Ichiyoshi; Hideyuki Kawahara; Satoshi Taga; Ichiro Yoshino; Toshihiro Ohsaki; Hiroyuki Kohno; Kosei Yasumoto



Tibial osteotomy for genu varum. Indications, preoperative planning, and technique.  


Valgus osteotomy of the proximal tibia remains the treatment of choice for the young active patient with a progressively symptomatic varus knee and mild to moderate secondary osteoarthritis. Although the natural history of the varus knee is not well established, it is widely accepted that patients with varus malalignment who develop meniscal injuries or progressive cartilage wear will inevitably develop more severe medial compartment osteoarthritis unless the abnormal mechanics of the knee are corrected. PMID:8028888

Murphy, S B



[Surgical ablation of atrial fibrillation. Indications, techniques and results].  


Catheter ablation has been the preferred choice of treatment for many patients with atrial fibrillation (AF) and advanced to a first line treatment option. However, incomplete ablation lines and varying long-term success rates remain a problem in certain subgroups, especially patients with persistent AF or large left atria. Alternative energy sources and advances in the device design have shifted the surgeons' focus on less invasive procedures. Minimally invasive performed endocardial ablation or even endoscopical ablation on the beating heart reveals success rates of 90?% freedom from atrial fibrillation at 2 years independent from the duration or type of AF. The randomized FAST-trial demonstrated superiority of endoscopic ablation compared to catheter ablation after 1 year. Given the multiple theories of the mechanism causing AF and the results that can be achieved by minimally invasive surgery, a thoroughly assessment of the individual patients is mandatory and surgery should be considered in all symptomatic patients who have failed catheter ablation or who are not good candidates for catheter ablation. PMID:23595229

Weimar, Timo; Hanke, Thorsten; Doll, Nicolas



[Severe pelvic injuries: indications and techniques of skeletal fixation].  


The aim of this work is to assess the role of immediate Hoffmann's external fixation frame and delayed posterior internal fixation in the management of severe pelvic injuries. We have also analysed the role of selective arteriography and embolization for controlling pelvic fractures hemorrhage and the relationship between embolization and external fixation in the management of severe bleeding. We reviewed 112 patients with severe pelvic injuries admitted to our hospital from 1986 to 1998 (71 males, 41 females). The average age was 39.8 years, mean ISS 31.2. Unstable pelvic ring fracture was present in 59 (52.6%) patients at admission in the emergency room: hemorrhagic shock in 43 patients (38.3%). Fourteen (12.5%) patients died. Eight deaths (57%) were directly caused by hemorrhagic shock, two secondary to major caval lesion, three brain lesions and two respiratory failure. The last patient died secondary to MOF. Twenty-three patients (20.5%) with unstable fracture underwent pelvic fracture ring fixation surgery: eleven (9.8%) Hoffmann's anterior external fixation frame (hemorrhage control in all patients) and eight (7.1%) delayed internal posterior fixation. Six (5.3%) patients underwent arteriography and embolization: hemorrhage was stopped in all cases and no patient died in this group. PMID:10392195

Garbuglia, A; Bossi, E; Ronzani, C; Sallusti, M; Bazzoni, D; Donzelli, T; Marini, A; Tiberio, G



Internal jugular vein cannulation: A comparison of three techniques  

PubMed Central

Context: Ultrasound-guided internal jugular vein (IJV) cannulation is known for increasing success rate and decreasing rate of complications. The ultrasound image can be used as a real time image during cannulation or to prelocate the IJV before attempting cannulation. Aims: This study compares both the ultrasound-guided technique with the classical anatomical landmark technique (central approach) for right IJV cannulation in terms of success rate, complications, and time for cannulation. Settings and Design: A prospective, randomized, observational study was conducted at a tertiary care hospital. Material and Methods: One hundred twenty patients requiring IJV cannulation were included in this study and were randomly allocated in three groups. Number of attempts, success rate, venous access time, catheterization time, and complications were observed in each group. Statistical Analysis Used: Statistical analysis was performed using STATA-9 software. Demographic data were compared using one-way analysis of variance (ANOVA). Nonparametric data were compared using the Kruskall–Wallis test, and multiple comparisons were done applying The Mann–Whitney test for individual pairs of groups. Nominal data were compared by applying the Chi-square test and Fisher exact test. Results: Successful cannulation (?3 attempt) was achieved in 90.83% of patients without any statistical significant difference between the groups. Venous access time and catheterization time was found to be significantly less in both the ultrasound groups than the anatomical land mark group. Number of attempts and success in first attempt was similar between the groups. Conclusions: Both the ultrasound techniques are found to be better than the anatomical landmark technique. Further, ultrasound-guided prelocation was found to be as effective as ultrasound guided real-time imaging technique for right IJV cannulation.

Ray, Bikash R; Mohan, Virender K; Kashyap, Lokesh; Shende, Dilip; Darlong, Vanlal M; Pandey, Ravindra K



Compositional Bayesian indicator estimation  

Microsoft Academic Search

Indicator kriging is widely used for mapping spatial binary variables and for estimating the global and local spatial distributions\\u000a of variables in geosciences. For continuous random variables, indicator kriging gives an estimate of the cumulative distribution\\u000a function, for a given threshold, which is then the estimate of a probability. Like any other kriging procedure, indicator\\u000a kriging provides an estimation variance

Carolina Guardiola-Albert; Eulogio Pardo-Igúzquiza



[Indications of central venous access in the context of acute renal insufficiency].  


Central vascular access indications in acute renal failure have never been precised by clinical studies. This is probably due to the epidemiology of acute renal failure and to heterogeneity of acute renal failure patients. Schematically, acute renal failure can be divided into three groups of increasing gravity: isolated non complicated acute renal failure, complicated acute renal failure, and severe acute renal failure that arises in the setting of multiple organ failure syndrome. Central vascular access indications, such as catheters type and vascular sites of insertion are actually based on many clinical and technical considerations. These considerations include the gravity of acute renal failure, the need of emergency extracorporeal renal replacement therapy, the modalities of such therapy, and the expected catheterism duration. PMID:11811011

Mamzer-Bruneel, M F; Carron, P L; Touam, M; Péraldi, M N; Kreis, H



Indicator principal component kriging  

Microsoft Academic Search

An alternative to multiple indicator kriging is proposed which approximates the full coindicator kriging system by kriging the principal components of the original indicator variables. This transformation is studied in detail for the biGaussian model. It is shown that the cross-correlations between principal components are either insignificant or exactly zero. This result allows derivation of the conditional cumulative density function

V. Suro-Pérez; A. G. Journel



Developing SOLEC Forest Indicators  

Microsoft Academic Search

Covering roughly half of the basin landmass, forests are a vital inland component of the Great Lakes basin ecosystem. Adding forest indicators to the SOLEC suite has been a priority in recent years, and SOLEC 2004 will be marked by the submission of data on the first three indicators of forest health. Healthy forests are crucial to maintaining and restoring

Mervyn Han


Tamper indicating packaging  

Microsoft Academic Search

Protecting sensitive items from undetected tampering in an unattended environment is crucial to the success of non-proliferation efforts relying on the verification of critical activities. Tamper Indicating Packaging (TIP) technologies are applied to containers, packages, and equipment that require an indication of a tamper attempt. Examples include: the transportation and storage of nuclear material, the operation and shipment of surveillance

M. J. Baumann; J. C. Bartberger; T. D. Welch



Chronic Disease Indicators  

NSDL National Science Digital Library

The Chronic Disease Indicators (CDI) is a cross-cutting set of 97 indicators that were developed by consensus and that allows states and territories and large metropolitan areas to uniformly define, collect, and report chronic disease data that are important to public health practice and available for states, territories and large metropolitan areas. 

Control, Center F.


Indicators for energy security  

Microsoft Academic Search

The concept of energy security is widely used, yet there is no consensus on its precise interpretation. In this research, we have provided an overview of available indicators for long-term security of supply (SOS). We distinguished four dimensions of energy security that relate to the availability, accessibility, affordability and acceptability of energy and classified indicators for energy security according to

Bert Kruyt; D. P. van Vuuren; H. J. M. de Vries; H. Groenenberg



Energy-conservation indicators  

Microsoft Academic Search

A series of Energy Conservation Indicators were developed for the Department of Energy to assist in the evaluation of current and proposed conservation strategies. As descriptive statistics that signify current conditions and trends related to efficiency of energy use, indicators provide a way of measuring, monitoring, or inferring actual responses by consumers in markets for energy services. Related sets of




Chemical calcium indicators  

Microsoft Academic Search

Our understanding of the underlying mechanisms of Ca2+ signaling as well as our appreciation for its ubiquitous role in cellular processes has been rapidly advanced, in large part, due to the development of fluorescent Ca2+ indicators. In this chapter, we discuss some of the most common chemical Ca2+ indicators that are widely used for the investigation of intracellular Ca2+ signaling.

R. Madelaine Paredes; Julie C. Etzler; Lora Talley Watts; Wei Zheng; James D. Lechleiter



Rehabilitation Indicators: An Overview.  

ERIC Educational Resources Information Center

|The purpose of the Rehabilitation Indicators Project is to develop a method, rehabilitation indicators (RI's), for defining multi-dimensionally the benefits that accrue to rehabilitation clients. RI's are presented as descriptors of observable elements of the rehabilitation client's life space with each descriptor inherently meaningful to client…

Brown, Margaret M.; And Others


Photomultiplier tube saturation indicator  


A photomultiplier tube saturation indicator is formed by supplying a supplemental light source, typically a light emitting diode (LED), adjacent to the photomultiplier tube. A switch allows the light source to be activated. The light is forwarded to the photomultiplier tube by an optical fiber. If the probe is properly light tight, then a meter attached to the indicator will register the light from the LED. If the probe is no longer light tight, and the saturation indicator is saturated, no signal will be registered when the LED is activated. This photomultiplier tube is used with alpha contamination probes.

Ruch, J.F.; Urban, D.J.



New England Economic Indicators  

NSDL National Science Digital Library

New England Economic Indicators, a monthly publication from the Federal Reserve Bank of Boston, contains articles on subjects including labor market conditions, consumer prices, consumer confidence, and electricity sales.


Tamper indicating packaging.  

National Technical Information Service (NTIS)

Protecting sensitive items from undetected tampering in an unattended environment is crucial to the success of non-proliferation efforts relying on the verification of critical activities. Tamper Indicating Packaging (TIP) technologies are applied to cont...

M. J. Baumann J. C. Bartberger T. D. Welch



HITRAN 2012 refractive indices  

NASA Astrophysics Data System (ADS)

The HITRAN 2012 compilation of the real and imaginary refractive indices of the materials in aerosols and cloud particles is reviewed. Additions to HITRAN 2012 focus upon materials that are absorptive (i.e. minerals, burning vegetation, brown carbon, desert dust, and volcanic ash). The HITRAN-RI program, created to facilitate usage of the indices, is discussed. The HITRAN-RI program inter-compares the indices of different data sets and calculates optical properties (i.e. extinction, scattering, absorption, single scattering albedo, backscattering, and asymmetry parameter) for user specified size distributions and particle types. The instructional component of HITRAN-RI introduces the user to Mie calculations for spheres and coated spheres, and applies various mixing rules by which one calculates the effective indices of a multi-component particle.

Massie, S. T.; Hervig, M.



Energy-Conservation Indicators.  

National Technical Information Service (NTIS)

A series of Energy Conservation Indicators were developed for the Department of Energy to assist in the evaluation of current and proposed conservation strategies. As descriptive statistics that signify current conditions and trends related to efficiency ...

D. B. Belzer



Riser position indication apparatus  

SciTech Connect

This patent describes a Riser Position Indication Apparatus for disposition between an offshore vessel and a riser, the riser being moveable with respect to the offshore vessel. The riser position indication apparatus comprises: vessel connection means operatively engaged with the vessel to secure the riser position indication apparatus to the vessel, riser connection means operatively engaged with the riser to secure the riser position indication apparatus to the riser, flexible weight means having one end connected to one of the connection means and the other end operatively engaged with the other of the connection means, weight signal transmitter means associated with at least one end of the flexible weight means and operative to produce a continuous output signal which varies as a function of the weight of the weight means suspended from one end of the connection means.

Moore, B.B.



Health expectancy indicators.  

PubMed Central

An outline is presented of progress in the development of health expectancy indicators, which are growing in importance as a means of assessing the health status of populations and determining public health priorities.

Robine, J. M.; Romieu, I.; Cambois, E.



World Development Indicators  

NSDL National Science Digital Library

Published by the World Bank Group, World Development Indicators is an annual report containing statistical data on global topics such as people, environment, the economy, and states and markets. The Website for World Development Indicators provides all of the text of the report, but it only contains a small selection of the tables offered in the actual report, which is available on CD ROM for purchasing.


Multidimensional poverty indices  

Microsoft Academic Search

.   This paper explores the axiomatic foundation of multidimensional poverty indices. Departing from the income approach which\\u000a measures poverty by aggregating shortfalls of incomes from a pre-determined poverty-line income, a multidimensional index\\u000a is a numerical representation of shortfalls of basic needs from some pre-specified minimum levels. The class of subgroup consistent\\u000a poverty indices introduced by Foster and Shorrocks (1991) is

Kai-yuen Tsui



Purification Techniques for Living Rickettsiae.  

National Technical Information Service (NTIS)

Numerous techniques for the purification of Rickettsiae exist at the present moment. Their high number indicates the extent of the problem. To obtain purified Rickettsiae which are still viable, techniques which involve simple centrifugation in the presen...

M. Capponi J. Giuntini K. Kawai



A comparison of voltage stability indices  

Microsoft Academic Search

Voltage stability has become a very important issue of power systems analysis. This paper discusses some important aspects related to voltage stability indices in electric power systems. Some techniques previously studied in the literature are analyzed and a comparison of the performance of several indices is presented. The effectiveness of the analyzed methods are demonstrated through numerical studies in IEEE

Claudia Reis; F. P. Maciel Barbosa



[Percutaneous vertebroplasty: methods, indications, results].  


Percutaneous vertebroplasty (PVP) is a radiologically guided therapeutic procedure, which consists of percutaneous injection of a liquid polymer (bone cement) into a destroyed vertebral body. PVP was invented in 1984, in France, first for treating vertebral body haemangioma. Since its introduction the indications have been expanded progressively and today PVP is indicated mainly for treatment of vertebral haemangioma, malignant vertebral tumor and osteoporotic vertebral compression fracture. The unique advantage of this technique is that besides the stabilization of the vertebral body--and partly in connection with this--it affords prompt and lasting pain relief. Based on published data the success rate of the procedure is 80-100% with a complication rate of 1-10%. Thus, PVP is a valuable minimally invasive tool, providing immediate pain relief and early mobility in carefully selected patients. However, further work is needed to define the benefits of PVP compared to the standard treatment. The purpose of this paper is to demonstrate the technique by analyzing scientific reports published to date and summarizing the first author's own experience gained at the University Hospital of Geneva, Department of Neuroradiology, Switzerland. PMID:12674801

Baráth, Krisztina; Martin, Jean-Baptiste; Fasel, H Jean; Tokunaga, Koji; Szikora, István; Martos, János; Nyáry, István; Rüfenacht, A Daniel



Universal Indicator Rainbow Trout  

NSDL National Science Digital Library

In this activity, learners cut out a fish and then "paint" it using universal indicator and acids and bases. The initial coat of indicator changes the color of the paper (it will turn a salmon color if the paper is acidic, and green if it is considered acid-free). From there, adding acids (such as lemon juice) and bases (such as laundry detergent) will further change the color. Universal indicator responds to a wide range of acids and bases, so other home chemicals (shampoo, vinegar, etc.) could be tried to create different colors. For older learners, a paper pattern other than a "rainbow trout" (such as a rainforest bird or other colorful animal) can be used.

Society, American C.



Enzymatic temperature change indicator  


A temperature change indicator is described which is composed of an enzyme and a substrate for that enzyme suspended in a solid organic solvent or mixture of solvents as a support medium. The organic solvent or solvents are chosen so as to melt at a specific temperature or in a specific temperature range. When the temperature of the indicator is elevated above the chosen, or critical temperature, the solid organic solvent support will melt, and the enzymatic reaction will occur, producing a visually detectable product which is stable to further temperature variation.

Klibanov, Alexander M. (Newton, MA); Dordick, Jonathan S. (Iowa City, IA)



Generalization of topological indices  

NASA Astrophysics Data System (ADS)

A generalized (molecular) graph-theoretical matrix is introduced in such a way that the adjacency and distance matrices of (molecular) graphs are particular cases of it. By using this matrix, two new molecular graph-theoretical vectors and a vector-matrix-vector multiplication procedure, a generalized invariant is introduced. This invariant permits a generalization of some of the classical topological indices (TIs). Thus, Wiener W index, Zagreb M1 and M2 indices, Balaban J index, Harary H number, Randic ? index and valence connectivity index ?v resulted as particular cases of an infinite set of molecular descriptors that can be derived from the same invariant.

Estrada, Ernesto



Trends & Indicators: Enrollment Period  

ERIC Educational Resources Information Center

|Since New England Board of Higher Education (NEBHE) began publishing tables and charts exploring "Trends & Indicators" in New England higher education more than a half-century ago, few figures have grabbed as much attention as college "enrollment" data. These local, state, regional and national data go beyond simple headcounts of students going…

Harney, John O.





The travel time of a nuclear shock wave from its point of origin to a location can be determined accurately by an apparatus for noting and comparably recording both zerotime, as indicated by the electromagnetic transient associated with the nuclear detonation, and shock wave arrival time.

Sander, H.H.



Triboluminescent indicator system  


There is provided a light emitting device comprising a plurality of triboluminescent particles dispersed throughout a low density, frangible body and activated by rapidly crushing the body in order to transfer mechanical energy to some portion of the particles. The light emitted by these mechanically excited particles is collected and directed into a light conduit and transmitted to a detector/indicator means.

Goods, Steven H. (Livermore, CA); Dentinger, Paul M. (Sunol, CA); Whinnery, Jr., Leroy L. (Danville, CA)



Universal Indicator Rainbow Trout  

NSDL National Science Digital Library

In this activity on page 2 of the PDF, learners discover how color changes can help scientists distinguish between acids and bases. Learners create colorful rainbow trout artwork using universal indicator solution and various household liquids. Safety note: learners must wear safety goggles.

Society, American C.



Flies as forensic indicators.  


Synanthropic flies, particularly calliphorids, are initiators of carrion decomposition and, as such, are the primary and most accurate forensic indicators of time of death. The relevant biology and forensic applications of the egg, larva, pupa, and young adult are discussed for various species, with emphasis on thermal history and age markers. PMID:1941921

Greenberg, B



Platyhelminths as paleogeographical indicators  

Microsoft Academic Search

Turbellarians do not feature as examples in the present discussions on the theory and method of analytical biogeography. It is argued, however, that turbellarian distributional records form good examples of large-scale biogeographic patterns resulting from continental breakup. Some turbellarian taxa also indicate biogeographic links across the Pacific Ocean, which can be visualized readily by means of track construction. Amphi-pacific organismal

Ronald Sluys



Establishing maintenance performance indicators  

SciTech Connect

Maintenance Performance Indicators (PI) specify where the maintenance department is and which direction it is going allowing for a quick and accurate assessment of the performance of the Maintenance Management Program (MMP). Establishing PI`s for the maintenance department will allow a measure of productivity and a means of feedback for methods improvement. Effective performance of the maintenance department directly effects plant profitability. Improvements in the quality and productivity of the maintenance work force will significantly reduce maintenance costs. The level of performance attained by the maintenance work force is usually guessed at. Guessing will not identify areas needing improvement or help to initiate a corrective action. Maintenance PI`s are required for maintenance departments whose goal is to control maintenance costs while increasing productivity. The application of basic statistical methods will allow a maintenance department to know where they are and which direction they are going. The data presented in this paper is a representation of indicators used in industry as well as developed indicators to establish a complete maintenance performance indicator program. The methodology used in developing this program can be used as a way to manage a cost effective maintenance management program.

Baca, B.



"Healthy" Human Development Indices  

ERIC Educational Resources Information Center

|In the Human Development Index (HDI), life expectancy is the only indicator used in modeling the dimension "a long and healthy life". Whereas life expectancy is a direct measure of quantity of life, it is only an indirect measure of healthy years lived. In this paper we attempt to remedy this omission by introducing into the HDI the morbidity…

Engineer, Merwan; Roy, Nilanjana; Fink, Sari



Landscape-based Indicators  

EPA Science Inventory

The report is based on data and experience gained through the GLNPO-funded Great Lakes Coastal Wetland Consortium (GLCWC) and the EPA-STAR funded Great Lakes Ecological Indicators Project (GLEI). EPA-MED author Trebitz and other MED personnel were collaborators on the GLEI proje...


Antibacterial effects of Tungsten nanoparticles on the Escherichia coli strains isolated from catheterized urinary tract infection (UTI) cases and Staphylococcus aureus.  


A significant proportion of all incidents of nosocomial infections in acute-care hospitals is due to contaminated catheters. Alternative strategies e.g. antibiotics as well as surface modifications have been devised in an attempt to reduce the incidence of catheter-associated urinary tract infections (CAUTI), but most have proven unsuccessful. Therefore, the race to identify such substances which can combat pathogenic bacteria is ongoing in order to improve the quality of health care. Novel technologies such as the potential use of antiseptic or antimicrobial coatings on catheters hold promise for reducing these infections in the fight against antimicrobial resistance. In this study, the bactericidal activity of newly synthesized tungsten-nanoparticles was tested on clinical multiple drug resistant Escherichia coli isolates from UTI patients with indwelling catheters and Staphylococcus aureus reference strain. The results suggest that the particles tested in this study certainly mediate the inhibition of bacterial growth. We believe that the fabrication of W-NPs on catheters could possibly prevent them from being contaminated by pathogens and hence provide continuous protection of the site. This study is the first of its type testing the antibacterial effects of W-NPs on clinical bacterial isolate from catheterized human UTI case. PMID:21213591

Syed, Muhammad Ali; Manzoor, Umair; Shah, Ismat; Bukhari, S Habib Ali



[Erythropoietin: indications and measurement].  


Erythropoietin (EPO) is the principal haematopoietic growth factor of the red blood cell line. Its major role is to stimulate the red blood cell production. EPO synthesis by peritubular cells in the kidney is regulated by oxygen concentration and must lead adaptation of the organism to face many different physiological situations. An imbalance can lead either to anaemia or polycythemia. Synthetic EPO, so-called recombinant, has definitively changed the treatment in the anaemia of chronic renal failure and regularly find new indications, legal (anaemia of cancer, anaemia of chronic inflammatory syndromes, myelodysplastic syndromes, neurology, cardiology...) or illegal (doping substance in sport). This article reviews the physiology, the role and the indications of EPO in clinical routine practice and define why and how EPO should be measured. We also focus on the analytical requirements for serum EPO concentration determination, especially in the differential diagnosis of polycythemias (secondary polycythemia/Polycythemia Vera). PMID:19789122

Klein, E; Georges, A; Brossaud, J; Bosredon, K de; Bordenave, L; Corcuff, J-B


Indicators for Inquiry  

NSDL National Science Digital Library

Fifth-grade students use homemade plant-based acid/base indicators to learn about matter at an age-appropriate level and develop process skills. As a result of completing this lesson sequence the students should be able to perform many tasks using process skills such as observing chemical changes; identifying acids and bases by performing tests; classifying common household substances as acidic, basic (alkaline), or neutral; and developing a scheme for solving a performance-based scenario.

Townsend, Jeffery; Bunton, Kim



Bacterial Indicators of Viruses  

Microsoft Academic Search

The association between human enteric viruses and disease is well established. However, determining the presence of all of\\u000a the many types of viruses that are pathogenic to humans in food and water is not practical at this time. Because enteric bacteria\\u000a are usual inhabitants of the human intestinal tract, they have been used as indicators of fecal pollution and the

Samuel R. Farrah


Focusing techniques  

Microsoft Academic Search

We use the paraxial geometric optics model of image formation to derive a set of camera focusing techniques. These techniques do not require calibration of cameras but involve a search of the camera parameter space. The techniques are proved to be theoretically sound under weak assumptions. They include energy maximization of unfiltered, low-pass-filtered, high-pass-filtered, and bandpass-filtered images. It is shown

Murali Subbarao; Tae S. Choi; Arman Nikzad



Indications of pediatric tonsillectomy.  


Possible indications for tonsillectomy include sleep apnea and other obstructive sleep-related breathing disorders, recurrent tonsillitis, peritonsillar abscess, periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA), and other miscellaneous rare conditions. Over the last century indications have changed, with a decrease in infectious causes and an increase in sleep apnea disorders. Sleep apnea in children is difficult to diagnose short of polysomnography (PSG) which is expensive and disturbing, especially in young children. In sleep apnea confirmed by PSG, tonsillectomy relieves the trouble in close to 80% of patients. What remains unclear is how to diagnose sleep-related breathing disorders without PSG and the efficacy of tonsillectomy in this population. Recurrent tonsillitis is generally poorly documented and randomized studies assessing the efficacy of tonsillectomy are sparse. When frequent infections are present for several years (>7 episodes/1 year, >5/2, >3/3) some benefit from tonsillectomy could be found. If fewer infectious episodes are present, the benefit of tonsillectomy is low. Peritonsillar abscess tends to be treated with quinsy tonsillectomy. Some PFAPA and psoriasis children might benefit from tonsillectomy. Tonsillectomy for other conditions is not warranted. PMID:23978809

Gysin, Claudine



Molecular Models of Indicators  

NSDL National Science Digital Library

The article by Nicholas C. Thomas and Stephen Faulk on "Colorful Chemical Fountains" (1) reminds us that color—the colors of acid–base indicators or of metal complexes—is responsible for many of us developing an interest in chemistry. The featured molecules this month are the acid and base forms of three common indicators–phenolphthalein, methyl orange, and methyl red. These three substances display interesting structural features as the pH-induced transformation from one form to another takes place in three different ways. In the case of phenolphthalein, the lactam ring is cleaved on deprotonation to produce a carboxyl group with the concomitant removal of a proton from a phenolic group. In methyl orange, one of the nitrogen atoms is protonated in the acid form, and that proton is lost in the base form. In methyl red, a carboxylic acid function is deprotonated. There are many other interesting aspects of acid–base indicators. Since most plants and fruits contain pigments that show a color change in some pH range, it is difficult to state with any degree of certainty when these changes were first put to use in a systematic fashion. The Spanish alchemist Arnaldus de Villa Nova (Arnold of Villanova) is purported to have used litmus in the early 14th century. In general systematic use of indicators is traced to the latter half of the nineteenth century with the development of the three synthetic indicators described above. Many students will be familiar with the use of phenolphthalein to identify blood—often shown on the various forensic chemistry TV dramas by dropping some solution on a cotton swab that has been used to pick up some of the sample in question. If the swab turns red we frequently hear "It's blood". The reality of using phenolphthalein in this way is more complicated. The test is presumptive for the presence of blood, but not conclusive. It is not an acid–base reaction but rather, in the presence of hydrogen peroxide, relies on hemoglobin to catalyze the oxidation of phenolphthalein. An interesting assignment for students in a high-school or non-majors course would be to have them explore the details of this Kastle–Meyers test to see just what is involved in the correct application of the test, and what factors complicate the process. For example, would tomato juice infused with asparagus juice give a positive Kastle–Meyers test? Historically phenolphthalein was used in a variety of laxatives. Recently that usage has been discontinued due to concern about the carcinogenic nature of the substance. A review of the history of the controversy surrounding the use of phenolphthalein in laxatives would make a good research paper at the high-school level. Lastly, students with some practice building structures and performing calculations might wish to explore the structures of two other forms of phenolphthalein—one found in very acidic solutions, having an orange color, and one found in very basic solutions that is colorless.


[Indications for IMSI].  


ICSI failures (essentially fertilization and implantation failures) can be due to the quality of the oocytes, the spermatozoon injected and its manipulation, uterine factors and paternal factors, such as DNA fragmentation of the spermatozoa. Pre-selection of the spermatozoon is the crucial phase for ensuring successful ICSI. The characteristics of the sperm must be checked under the microscope at a magnification of x 6600 as certain abnormalities, in particular nuclear vacuoles, cannot be seen at x 300. In our centre, we conducted a study on 72 patients which showed that with more than 30% of fragmented DNA, neither implantation or birth was achieved using ICSI. Performing IMSI on the same patients allowed us to obtain implantation rates of 17.4% with 30 to 40 % of fragmented DNA and of 33.3% above 40%. Births were achieved in 17.4% and 28.6% of cases respectively. IMSI has the advantage of allowing extremely careful selection of the spermatozoon microinjected, so that it is of normal shape, with the least vacuoles possible and a low DNA fragmentation rate. It is, however, a complicated technique that cannot be routinely performed. PMID:18279728

Cohen-Bacrie, P; Dumont, M; Junca, A M; Belloc, S; Hazout, A



Indications for fiberoptic colonscopy.  


In certain clinical situations, fiberoptic colonoscopy has proved most useful and effective as a diagnostic and therapeutic tool. Colonscopy is indicated to remove polyps when feasible and to rule out the presence of toher polyps or tumors undetected by barium enema. Patients with cancer of the colon should have preoperative colonoscopy to rule out the presence of undetected polyps or metachronous cancer. Follow-up examinations are important to insure against residual cancer or recurrence after colonscopic removal of sessile, premalianant, or malignant polypoid lesions, and to evaluate certain patients who have increased risk of polyp or tumor formation. Colonscopy usually can explain persistent, localized abnormalities detected by barium enema (ie, "filling defects") and provide a definitive diagnosis in cases of unexplained rectal bleeding or diarrhea despite negative sigmoidoscopic and barium studies. In experienced hands, this technic is safe, confortable, and effective in avoiding laparotomy to remove clinically significant polyps and in providing definitive diagnosis in many clinical situations. PMID:1098159

Christie, J P; Shinya, H



Teriparatide - Indications beyond osteoporosis  

PubMed Central

Osteoporosis is a condition of impaired bone strength that results in an increased risk of fracture. The current and most popular pharmacological options for the treatment of osteoporosis include antiresorptive therapy, in particular, oral bisphosphonates (alendronate, risedronate, ibandronate). Anabolic agents like teriparatide have widened our therapeutic options. They act by directly stimulating bone formation and improving bone mass quantity and quality. Two forms of recombinant human parathyroid hormone (PTH) are available : full-length PTH (PTH 1–84; approved in the EU only) and the 1–34 N-terminal active fragment of PTH (teriparatide, US FDA approved). This review aims to discuss the benefits of teriparatide beyond the currently licensed indications like fracture healing, dental stability, osteonecrosis of jaw, hypoparathyroidism, and hypocalcemia.

Cheng, Marilyn Lee; Gupta, Vishal



Trust in performance indicators?  

PubMed Central

The 1980s and 90s have seen the proliferation of all forms of performance indicators as part of attempts to command and control health services. The latest area to receive attention is health outcomes. Published league tables of mortality and other health outcomes have been available in the United States for some time and in Scotland since the early 1990s; they have now been developed for England and Wales. Publication of these data has proceeded despite warnings as to their limited meaningfulness and usefulness. The time has come to ask whether the remedy is worse than the malady: are published health outcomes contributing to quality efforts or subverting more constructive approaches? This paper argues that attempts to force improvements through publishing health outcomes can be counterproductive, and outlines an alternative approach which involves fostering greater trust in professionalism as a basis for quality enhancements.

Davies, H. T.; Lampel, J.



[Comparison of pneumatic compression device and sand bag with respect to peripheral vascular complications in elective cardiac catheterization and percutaneous femoral artery interventions].  


Objectives: After coronary angiography and percutaneous coronary intervention (PCI), the classic sand bag method and compression devices are widely used for control of bleeding and prevention of vascular complications. The purpose of our study was to assess the major peripheral vascular complications and to compare the sand bag and a pneumatic compression device ("Close Pad") in terms of major peripheral vascular complications after coronary interventions. Study design: Between June 2011 and November 2011, a total of 434 patients who admitted to the Department of Cardiology of Uludag University Faculty of Medicine were included in the study. 396 patients underwent coronary angiography and 38 patients underwent PCI. Sand bag was applied in 209 patients. Bleeding requiring transfusion, hematoma larger than 10 cm(2), pseudoaneurysm, and arteriovenous (AV) fistula were defined as the major local complications. Logistic regression analysis were used to evaluate the datas. Results: Major vascular complications occurred in 2% of diagnostic angiography and in 13.2% of PCI patients (p=0.003). The major vascular complications were significantly higher with the Close Pad device compared with sand bag (5.3% vs. 0.5%, p=0.007). Smoking, PCI, Close Pad, clopidogrel, and anticoagulants were observed to have increased risk of major local complications. In the logistic regression analysis, only smoking and Close Pad usage were evaluated as independent variables that increased the risk of major vascular complications (p<0.05). Conclusion: Close Pad usage demonstrated increased risk of vascular complications when compared with the sand bag in patients undergoing cardiac catheterizations. After the PCI, patients should be selected carefully for application of the Close Pad. PMID:24104971

Be?li, Feyzullah; Ali?ir, Mehmet Fethi; Keçeba?, Mesut; Serdar, Osman Ak?n; Güngören, Fatih



Meteorological Techniques.  

National Technical Information Service (NTIS)

Contains weather forecasting techniques of interest to military meteorologists, in three sections: surface weather elements, flight weather elements, and severe weather. Includes both general and geographically specific rules of thumb, results of research...

F. Hosein G. Williams J. Piasecki M. Reymann S. Larabee



Endovascular extraction techniques  

PubMed Central

The use of lead extraction is expanding with the introduction of new endovascular extraction techniques. Indications for extraction of chronically implanted pacemaker leads have been classified as mandatory, necessary or discretionary, but their rationale is often based on clinical judgement without corresponding support from the literature. We reviewed the literature of pacemaker lead-related complications as a starting point for discussing the indications for lead extraction. ImagesFigure 1Figure 2Figure 3

Bracke, F.A.; Meijer, A.; van Gelder, B.




EPA Science Inventory

Combined sewer overflow (CSO) and wastewater disinfection effectiveness are evaluated by measuring microbial indicator concentrations before and after disinfection. The standard techniques for quantifying indicators are membrane filtration and multiple-tube fermentation/most pro...


"Wire-Target" Technique for Precise Vascular Access  

PubMed Central

Herein, we describe a technique that facilitates percutaneous vascular access when the traditional method of achieving access is unsuccessful. For multiple reasons, gaining access to small vessels in pediatric patients is sometimes difficult. In instances of atrial, ventricular, or great arterial communications, a wire can be positioned from a vein or artery across the communications into an artery or vein to which access needs to be gained. This wire then serves as a target for vascular access. All pediatric patients who underwent cardiac catheterization at Mattel Children's Hospital from July 2003 through June 2006, and at Rady Children's Hospital from July through December 2006, were considered for the wire-target technique when access could not be achieved in vessels of interest via traditional methods. Fifteen wire-target procedures were undertaken in 14 patients (ages, 4 d–11 yr). By use of a directional catheter, a Wholey or 0.014-inch coronary wire was positioned in a vessel to which access was desired. Anterior–posterior and lateral fluoroscopic views were used to target the wire and attain vascular access. The patients' diagnoses, ages, vessels to which access was gained via traditional methods and via the wire-target technique, and wire routes were retrospectively recorded, and outcomes were noted. In all instances, the technique was performed successfully and without complications. In selected pediatric patients in whom percutaneous vascular access is difficult, the wire-target technique may be used safely and effectively to establish arterial, venous, or transhepatic access.

Hamzeh, Rabih K.; Danon, Saar; Shah, Sanjay; Levi, Daniel S.; Moore, John W.



Current Status of Gil-Vernet Trigonoplasty Technique  

PubMed Central

Significant controversy exists regarding vesicoureteral reflux (VUR) management, due to lack of sufficient prospective studies. The rationale for surgical management is that VUR can cause recurrent episodes of pyelonephritis and long-term renal damage. Several surgical techniques have been introduced during the past decades. Open anti-reflux operations have high success rate, exceeding 95%, and long durability. The goal of this article is to review the Gil-Vernet trigonoplasty technique, which is a simple and highly successful technique but has not gained the attention it deserves. The mainstay of this technique is approximation of medial aspects of ureteral orifices to midline by one mattress suture. A unique advantage of Gil-Vernet trigonoplasty is its bilateral nature, which results in prevention from contralateral new reflux. Regarding not altering the normal course of the ureter in Gil-Vernet procedure, later catheterization of and retrograde access to the ureter can be performed normally. There is no report of ureterovesical junction obstruction following Gil-Vernet procedure. Gil-Vernet trigonoplasty can be performed without inserting a bladder catheter and drain on an outpatient setting. Several exclusive advantages of Gil-Vernet trigonoplasty make it necessary to reconsider the technique role in VUR management.

Simforoosh, Nasser; Radfar, Mohammad H.



Moving Target Indication Using the Snapshot Algorithm.  

National Technical Information Service (NTIS)

This document is the first in a series of three describing the digital real-time 'snapshot' moving target indication (MTI) technique developed for the GEODSS project in FY75. GEODSS is a Ground-based Electro-Optical Deep Space Surveillance system for the ...

J. E. Barry



Treatment of High-Flow Vascular Malformations by Venous Embolization Aided by Flow Occlusion Techniques  

SciTech Connect

Purpose: Transvenous embolization techniques may be helpful as alternatives to the arterial route when treating high-flow vascular malformations. We present our experience using these techniques in four patients. Methods: In one patient the venous portion of the arteriovenous malformation (AVM) was punctured directly; in the other three patients it was catheterized via a retrograde venous approach. Flow occlusion techniques were utilized in all patients during embolization, which was performed with absolute alcohol or N-butyl-2-cyanoacrylate.Results: Excellent clinical and angiographic results were obtained, with obliteration of arteriovenous shunting in all patients. There were no complications.Conclusion: The embolization of certain AVMs using a venous approach is a safe and effective treatment.

Jackson, James E. [Department of Diagnostic Radiology, Royal Postgraduate Medical School, Hammersmith Hospital, Du Cane Road, London W12 OHS (United Kingdom); Mansfield, Averil O. [Department of Surgery, St. Mary's Hospital, Praed Street, London W2 (United Kingdom); Allison, David J. [Department of Diagnostic Radiology, Royal Postgraduate Medical School, Hammersmith Hospital, Du Cane Road, London W12 OHS (United Kingdom)



Percutaneous Nephrostomy: Technical Aspects and Indications  

PubMed Central

First described in 1955 by Goodwin et al as a minimally invasive treatment for urinary obstruction causing marked hydronephrosis, percutaneous nephrostomy (PCN) placement quickly found use in a wide variety of clinical indications in both dilated and nondilated systems. Although the advancement of modern endourological techniques has led to a decline in the indications for primary nephrostomy placement, PCNs still play an important role in the treatment of multiple urologic conditions. In this article, the indications, placement, and postprocedure management of percutaneous nephrostomy drainage are described.

Dagli, Mandeep; Ramchandani, Parvati



Aseptic Technique  

NSDL National Science Digital Library

The North Carolina Community College System BioNetwork's interactive eLearning tools (IETs) are reusable chunks of training that can be deployed in a variety of courses or training programs. IETs are designed to enhance, not replace hands-on training. Learners are able to enter a hands-on lab experience better prepared and more confident. This particular IET delves into aseptic technique and how to work under a laminar airflow hood. Using animations, quizzes, games, and a final evaluation, this interactive lesson will help students understand the lab and important techniques for biology technicians.



Effects & techniques  

Microsoft Academic Search

In this chapter we present the techniques and algorithms used for compelling storytelling in the context of the StarCraft II© real-time strategy game. We will go over some of the design goals for the technology used to empower our artists for both in- game and \\

Dominic Filion; Rob McNaughton



Topical nitroglycerin and lidocaine to dilate the radial artery prior to transradial cardiac catheterization: A randomized, placebo-controlled, double-blind clinical trial: The PRE-DILATE Study.  


BACKGROUND/OBJECTIVES: Transradial access (TRA) is being increasingly used for both diagnostic and interventional cardiac procedures. Use of TRA offers many advantages: decreased bleeding, vascular complications, reduced length of hospital stay, and reduced cost. However, the small size of the radial artery limits the size of the equipment that can be used via this approach. We sought to determine whether pre-procedural administration of topical nitroglycerin and lidocaine increases the size of the radial artery. METHODS: Patients undergoing transradial cardiac catheterization were randomized in a double-blind fashion to a topical combination of nitroglycerin+lidocaine or placebo ointment. The primary endpoint was change in radial artery size. Secondary endpoints included radial artery spasm and radial artery patency. RESULTS: 86 patients were enrolled (43 allocated to treatment group and 43 to placebo group). Patients underwent ultrasound of the radial artery at baseline and before the catheterization. Complications were rare: one hematoma (placebo group) and one radial artery occlusion (placebo group). Baseline demographic and clinical characteristics were similar. The baseline radial artery cross-sectional area (CSA) was similar in both groups (4.95±0.24mm(2) in placebo group and 5.14±0.34mm(2) in the treatment group). However, the final CSA decreased to 4.66±0.25mm(2) in the placebo group and increased to 5.78±0.38mm(2) in the treatment group (p=0.02), which corresponded to a decrease in CSA by -5.6±2.1% and an increase in CSA by 16.5±4.2% (p<0.0001), respectively. CONCLUSIONS: Pre-procedural administration of topical mixture of nitroglycerin+lidocaine increases the size of the radial artery in patients undergoing transradial cardiac catheterization. CLINICALTRIALS.GOV IDENTIFIER: NCT01155167. PMID:23582415

Beyer, Anna T; Ng, Ramford; Singh, Amardeep; Zimmet, Jeffrey; Shunk, Kendrick; Yeghiazarians, Yerem; Ports, Thomas A; Boyle, Andrew J



Electrochemical Techniques  

SciTech Connect

Sensitive and selective detection techniques are of crucial importance for capillary electrophoresis (CE), microfluidic chips, and other microfluidic systems. Electrochemical detectors have attracted considerable interest for microfluidic systems with features that include high sensitivity, inherent miniaturization of both the detection and control instrumentation, low cost and power demands, and high compatibility with microfabrication technology. The commonly used electrochemical detectors can be classified into three general modes: conductimetry, potentiometry, and amperometry.

Chen, Gang; Lin, Yuehe



Nanofabrication Techniques  

NSDL National Science Digital Library

This page from Foothill-De Anza Community College describes a course on nanoscience for those who need an introduction to the subject. This course is the fifth in a five course series that leads to a certificate in nanoscience, nanotechnology, and nanomaterials engineering. Students will obtain a survey of fabrication techniques as well as "hands-on experience creating thin film materials, and quality control 'shadowing' in a clean energy technology fabrication facility." The projects required by the class are also described.



Measurement techniques  

SciTech Connect

The discussion will be restricted to measurements of voltage and current. Also, although the measurements themselves should be as quantitative as possible, the discussion is rather nonquantitative. Emphasis is on types of instruments, how they may be used, and the inherent advantages and limitations of a given technique. A great deal of information can be obtained from good, clean voltage and current data. Power and impedance are obviously inherent if the proper time relationships are preserved. Often an associated, difficult-to-determine, physical event can be evaluated from the V-I data, such as a time-varying load characteristic, or the time of light emission, etc. The lack of active high voltage devices, such as 50-kV operational amplifiers, restricts measurement devices to passive elements, primarily R and C. There are a few more exotic techniques that are still passive in nature. There are several well-developed techniques for voltage measurements. These include: spark gaps; electrostatic meters; capacitive dividers; mixed RC dividers; and the electro-optic effect. Current is measured by either direct measurement of charge flow or by measuring the resulting magnetic field.

Willis, W.L.



[Presbyopia surgery: principles and current indications].  


Presbyopia surgery is not yet a corrective option that can restore effective accommodation, but a compensation option which aims at creating depth of field. Monovision preserves a good close-vision quality for myopes. Multifocality is well tolerated by hyperopes if it is compatible with good far-vision quality. Monovision and multifocality can be applied to surgery by using corneal or intraocular implantation techniques. Presby LASIK and Presbyopic Lens Exchange (PRELEX) are the most effective techniques but they are still controversial. Indications depend on preoperative ametropia and patient age. PMID:17568351

Saragoussi, J-J



The transpulmonary thermodilution technique.  


The transpulmonary thermodilution technique (TPTD) is a safe, multi-parametric advanced cardiopulmonary monitoring technique that provides important parameters required for making decisions in critically ill patients. The TPTD provides more reliable indicators of preload than filling pressures, the unique measurement of extravascular lung water (EVLW) and comparable accuracy in measuring cardiac output (CO). Intermittent measurement of the CO by TPTD when coupled with pulse contour analysis, offer automatic calibration of continuous CO, as well as accurate assessment of volumetric preload, fluid responsiveness and EVLW. TPTD-guided algorithms have been shown to improve the management of high-risk surgical and critically ill patients. PMID:22806214

Sakka, Samir G; Reuter, Daniel A; Perel, Azriel



Magnetotelluric technique  

NASA Astrophysics Data System (ADS)

Over the last three decades, Magnetotelluric technique has become one of the most viable survey tool and many groups worldover adopted this technique for exploration studies. The theoretical and experimental advances have established the efficacy of MT as an inexpensive technbique for the structural studies. MT studies in the Indian Institute of Geomagnetism (IIG) were initiated with Short Period MT system (upto 100 Hz) and long period (2-4096 s) system. With the procurement of a wide band Phoenix V-5 magnetotelluric system (frequency range 320-0.0005 Hz), MT studies have been effectively carried out in the Killari Earthquake affected regions, wherein two conductive bodies at depths of 1.5-14 km were delineated on the SW and NE of the regions of epicenters between Killari and Talni. We established that the damage due to the earthquake was most in the areas where Deccan Traps are thin. In Southeast Rajasthan, the Great Boundary Fault could be delineated as the demarcating line between the Hindoli sequences and the Vindhyan sediments. The studies also showed the presence of upper and lower Vindhyan sedimentary sequences, the Mangalwar complexes and the Hindoli and Jahazpur sequences. MT studies in the seismically active Rohtak region have delineated a 5 km wide, 100 km long N-S aligned conductive feature extending in depth from 25 m to more than 18 km. The granitic upper crust was delineated at a depth of 3-4.5 km. Though the case histories presented here are very fascinating, nevertheless we need quantitative interpretational skills, viz. 3-D modelling techniques, to make the interpretation unique. In a nutshell, MT studies of the interior of the earth holds the clue for earthquake prediction and offers a great promise and challenge for the future.

Singh, B. P.; Gokarn, S. G.


The attribute measurement technique  

SciTech Connect

Any verification measurement performed on potentially classified nuclear material must satisfy two seemingly contradictory constraints. First and foremost, no classified information can be released. At the same time, the monitoring party must have confidence in the veracity of the measurement. An information barrier (IB) is included in the measurement system to protect the potentially classified information while allowing sufficient information transfer to occur for the monitoring party to gain confidence that the material being measured is consistent with the host's declarations, concerning that material. The attribute measurement technique incorporates an IB and addresses both concerns by measuring several attributes of the nuclear material and displaying unclassified results through green (indicating that the material does possess the specified attribute) and red (indicating that the material does not possess the specified attribute) lights. The attribute measurement technique has been implemented in the AVNG, an attribute measuring system described in other presentations at this conference. In this presentation, we will discuss four techniques used in the AVNG: (1) the 1B, (2) the attribute measurement technique, (3) the use of open and secure modes to increase confidence in the displayed results, and (4) the joint design as a method for addressing both host and monitor needs.

Macarthur, Duncan W [Los Alamos National Laboratory; Langner, Diana [Los Alamos National Laboratory; Smith, Morag [Los Alamos National Laboratory; Thron, Jonathan [Los Alamos National Laboratory; Razinkov, Sergey [RFNC-VNIIEF; Livke, Alexander [RFNC-VNIIEF



Edible Acid-Base Indicators.  

ERIC Educational Resources Information Center

Reports on the colors observed during titrations of 15 natural indicators obtained from common fruits and vegetables. These edible indicators can be used for a variety of teacher demonstrations or for simple student experiments. (JN)

Mebane, Robert C.; Rybolt, Thomas R.



Gestures for Mineralogy: Miller Indices  

NSDL National Science Digital Library

In this exercise, students use one hand to gesture crystallographic axes and the other hand to represent planes designated by Miller Indices. This uses embodied learning to reinforce how Miller Indices are used to convey spatial information.

Dutrow, Barb


Social Indicators and Social Forecasting.  

ERIC Educational Resources Information Center

|The paper identifies major types of social indicators and explains how they can be used in social forecasting. Social indicators are defined as statistical measures relating to major areas of social concern and/or individual well being. Examples of social indicators are projections, forecasts, outlook statements, time-series statistics, and…

Johnston, Denis F.


Immune Globulin Intravenous (IGIV) Indications  

Center for Biologics Evaluation and Research (CBER)

... Immune Globulins. -. Immune Globulin Intravenous (IGIV) Indications. ... B-cell Chronic Lymphocytic Leukemia; Immune Thrombocytopenic Purpura; ... More results from


The Perception of Tactical Intelligence Indications: A Replication.  

National Technical Information Service (NTIS)

As part of an effort to provide improved techniques and methods for planning the collection and analysis of intelligence information, an experiment was replicated which showed that tactical intelligence indications, as currently used, are of doubtful effe...

E. M. Johnson



Lean indicators and manufacturing strategies  

Microsoft Academic Search

Develops and tests an integrated check-list to assess manufacturing changes towards lean production. Using the results from a survey to manufacturing plants located in the Spanish region of Aragon, analyzes which lean production indicators are more used to assess the company’s improvements in their production systems, and the determinants on the use of these indicators.

Angel Martínez Sánchez; Manuela Pérez Pérez



Mapping by simple indicator kriging  

Microsoft Academic Search

The problem of predicting the type of an unsampled point in a two-type map is addressed using a procedure called simple indicator kriging. This procedure estimates the conditional probability that the point is of one type or the other given the types of sample points. Simple indicator kriging is applied to examples of certain map models. It is shown to

Andrew R. Solow



Science Indicators and Science Priorities.  

ERIC Educational Resources Information Center

|Discusses science/society interface and difficulties involved in developing realistic science indicators. Topics include: intrinsic vs. extrinsic indicators; four problems society faces as a result of technological activities (toxic chemicals, radioactive wastes, auto safety, cancer); research and development (R&D) priorities; international…

Brooks, Harvey



Sustainability Indicators: A Scientific Assessment  

Technology Transfer Automated Retrieval System (TEKTRAN)

The book entitled "Sustainability Indicators: A Scientific Assessment," which was a product of a multi-location research effort and workshoip held in Prague Czech Republic, is reviewed for readers of the Journal of Enviromental Quality (JEQ). The overview and chapters on biodiversity indicators and ...


Abnormal hematological indices in cirrhosis  

PubMed Central

Abnormalities in hematological indices are frequently encountered in cirrhosis. Multiple causes contribute to the occurrence of hematological abnormalities. Recent studies suggest that the presence of hematological cytopenias is associated with a poor prognosis in cirrhosis. The present article reviews the pathogenesis, incidence, prevalence, clinical significance and treatment of abnormal hematological indices in cirrhosis.

Qamar, Amir A; Grace, Norman D



Manager's Guide to Indicator Selection.  

National Technical Information Service (NTIS)

This publication describes a framework developed by the ASC to guide managers in selecting ASC indicators and benchmarks with which indicator values can be compared. In essence, the framework is a question-and-answer process that defines the parameters of...



Self Indicating Radiation Alert Dosimeter.  

National Technical Information Service (NTIS)

Described as a self-indicating instant radiation dosimeter for monitoring high energy radiations, such as X-ray. The dosimeter contains a radiation sensitive, color changing, indicating composition, e.g., a diacetylene (R--C=C--C=C--R', where R and R' are...

G. N. Patel



Energy Efficiency Indicators Methodology Booklet  

Microsoft Academic Search

This Methodology Booklet provides a comprehensive review and methodology guiding principles for constructing energy efficiency indicators, with illustrative examples of application to individual countries. It reviews work done by international agencies and national government in constructing meaningful energy efficiency indicators that help policy makers to assess changes in energy efficiency over time. Building on past OECD experience and best practices,

Jayant Sathaye; Lynn Price; Michael McNeil



Indices for soil management decisions  

Technology Transfer Automated Retrieval System (TEKTRAN)

Indices are needed for periodic assessments of soil resource condition at all scales – within a lawn, field, farm, watershed, county, state, nation, or the world. There are several types of indices including scorecards, simulation models, decision aides, and assessment frameworks. This chapter exami...


Leading Indicators of Currency Crises  

Microsoft Academic Search

This paper examines the empirical evidence on currency crises and proposes a specific early warning system. This system involves monitoring the evolution of several indicators that tend to exhibit an unusual behavior in the periods preceding a crisis. When an indicator exceeds a certain threshold value, this is interpreted as a warning \\

Graciela Kaminsky; Carmen M. Reinhart



Measuring social behaviour as an indicator of experience  

Microsoft Academic Search

This paper explores and evaluates two techniques that measure aspects of social behaviour as an indicator of experience. The rationale driving the work is the idea that experience is entwined with social interaction and so, while experience itself is difficult to quantify, we might tap into it by measuring aspects of conversation that are related to it. Two techniques are

Siân E. Lindley; Andrew F. Monk



Microbiological indicators of subsurface hydrocarbon accumulations  

SciTech Connect

The measurement of toxin tolerance in the microbial communities present in stream sediments has been demonstrated to be an effective exploration tool. The technique relies on the fact that metals of, or associated with, ore deposits often represent toxins to microbial communities. The microbes adapt to the presence of these toxins by genetic mutation of replicon structures called plasmids that then carry the coding that allows survival in their presence. The level of tolerance developed is proportional to the concentration of toxin present and shows measurable, statistically meaningful variance at levels normally below the detection thresholds of standard inorganic techniques. Hydrocarbons reaching the surface by macro- and microseepage, the metals adsorbed to them, and the geochemical changes they bring about in the near-surface environment also represent toxins or stresses to microbial communities that they must adapt to. Adaptation is again accomplished by genetic mutation and is measured by collecting a sediment sample, separating the microbial population from it, and exposing splits of the sample to several discrete concentrations of the hydrocarbon or metal being used as a seepage indicator. Tolerance to higher levels of toxin is interpreted to be indicative of the strength or volume of hydrocarbon seepage. The authors have undertaken this work using marine samples from the Gulf of Mexico because that setting has fewer surface geochemical variables than subaerial settings. Both gas and oil accumulations can be measured by this technique, and evidence for both macro- and microseepage has been found. Examples from the Mississippi Canyon area will be used to illustrate the efficacy of the technique.

Riese, W.C. (ARCO Oil and Gas Co., Bakersfield, CA (United States)); Michaels, G.B. (Western State College, Gunnison, CO (United States))



Cancer rehabilitation indicators for Europe.  


Little is known of cancer rehabilitation needs in Europe. EUROCHIP-3 organised a group of experts to propose a list of population-based indicators used for describing cancer rehabilitation across Europe. The aim of this study is to present and discuss these indicators. A EUROCHIP-3 expert panel reached agreement on two types of indicators. (a) Cancer prevalence indicators. These were proposed as a means of characterising the burden of cancer rehabilitation needs by time from diagnosis and patient health status. These indicators can be estimated from cancer registry data or by collecting data on follow-up and treatments for samples of cases archived in cancer registries. (b) Indicators of rehabilitation success. These include: return to work, quality of life, and satisfaction of specific rehabilitation needs. Studies can be performed to estimate these indicators in individual countries, but to obtain comparable data across European countries it will be necessary to administer a questionnaire to randomly selected samples of patients from population-based cancer registry databases. However, three factors complicate questionnaire studies: patients may not be aware that they have cancer; incomplete participation in surveys could lead to bias; and national confidentiality laws in some cases prohibit cancer registries from approaching patients. Although these studies are expensive and difficult to perform, but as the number of cancer survivors increases, it is important to document their needs in order to provide information on cancer control. PMID:23237740

Baili, Paolo; Hoekstra-Weebers, Josette; Van Hoof, Elke; Bartsch, Hans Helge; Travado, Luzia; Garami, Miklos; Di Salvo, Francesca; Micheli, Andrea; Veerus, Piret



Hysterectomies. Where are the indications?  


This article reviews the major reasons for hysterectomies and critiques some of the alternative practices, such as medical therapy to shrink fibroids, and new surgical techniques, such as laparoscopic-assisted hysterectomies. Perhaps in response to the increased attention and the new procedures and drugs that allow more conservative management, the rate of hysterectomies has actually decreased. PMID:7936552

Ravnikar, V A; Chen, E




Microsoft Academic Search

Sacroiliac joint fusion remains a useful piece of the surgical armamentarium. Newer percutaneous techniques for fusion supplement the older established procedures. The sacroiliac joint functions in the transmission of forces from the spine to the lower extremities and vice versa. It is a diarthrodial synovial joint that connects the sacrum to the ilium. The sacroiliac joint is unusual in that

Christopher A. Iobst; John A. Glaser


Physiologic and Clinical Principles behind Noninvasive Resuscitation Techniques and Cardiac Output Monitoring.  


Clinical assessment and vital signs are poor predictors of the overall hemodynamic state. Optimal measurement of the response to fluid resuscitation and hemodynamics has previously required invasive measurement with radial and pulmonary artery catheterization. Newer noninvasive resuscitation technology offers the hope of more accurately and safely monitoring a broader range of critically ill patients while using fewer resources. Fluid responsiveness, the cardiac response to volume loading, represents a dynamic method of improving upon the assessment of preload when compared to static measures like central venous pressure. Multiple new hemodynamic monitors now exist that can noninvasively report cardiac output and oxygen delivery in a continuous manner. Proper assessment of the potential future role of these techniques in resuscitation requires understanding the underlying physiologic and clinical principles, reviewing the most recent literature examining their clinical validity, and evaluating their respective advantages and limitations. PMID:21860802

Napoli, Anthony M



Linear Gas-Discharge Indicators.  

National Technical Information Service (NTIS)

New information display units are examined in this article -- linear gas-discharge indicators (LGI), permitting continuous visual monitoring of parametric variations. Owing to their small dimensions and simplicity of regulation, the LGI can markedly reduc...

D. I. Ageikin V. V. Pechnikov A. B. Pokryvailo V. A. Torgonenko



Refinement of microwave vegetation indices  

Technology Transfer Automated Retrieval System (TEKTRAN)

Previous investigations have established the basis for a new type of vegetation index based on passive microwave satellite observations. These microwave vegetation indices (MVIs) have been qualitatively evaluated by examining global spatial and seasonal temporal features. Limited quantitative studie...


Investigation of Some Metallochromic Indicators.  

ERIC Educational Resources Information Center

Presents some introductory experiments involving the reaction between EDTA and several metal ions using metallochromic indicators. The experiments represent familiar reactions and are followed by suggestions for extension into areas of discovery work by students. (Author/SA)

Jones, A. V.; Nelson, M.



Global Climate Change Key Indicators  

NSDL National Science Digital Library

This website charts measurement of key indicators of global climate change. Simple explanations and "What Does This Mean?" sections accompany each area of sea level, carbon dioxide concentration, global surface temperature, Arctic sea ice and land ice.



EPA Science Inventory

This document presents fifteen technical guidelines to evaluate the suitability of an ecological indicator for a particular monitoring program. The guidelines are organized within four evaluation phrases: conceptual relevance, feasibility of implementation, response variability...


Index of Watershed Indicators (IWI)  

NSDL National Science Digital Library

Users can view national maps of watershed indicators or locate and learn about their own watershed at the US Environmental Protection Agency's new web site, Index of Watershed Indicators, part of Surf Your Watershed. National Maps loads with a map indicating the quality of all US watersheds. From here, users can view the map with respect to fifteen categories of watershed indicators, including fish and wildlife consumption advisories, drinking water conditions, wetland losses, and agricultural runoff. Locate your Watershed allows users to search for their watershed via state maps, keywords, places, or National Watershed Network. Information available includes local watershed groups, water use statistics provided by the US Geological Survey, population in the watershed, river and stream miles, and land characteristics.

Agency., United S.



Critical Appraisal of Social Indicators.  

ERIC Educational Resources Information Center

By drawing analogies to the history of mental testing, the author concludes that the responsibility for critical evaluation and beneficial use of social indicators rests with social scientists. Future directions of critical inquiry are suggested. (Author/MH)

Sieber, Joan E.



Superselective neck dissection: rationale, indications, and results.  


It has been established that an appropriately indicated selective neck dissection can achieve the same oncologic results as more extensive dissections. An even more modified selective neck dissection, termed superselective neck dissection, involves the compartmental removal of the fibrofatty tissue contents within the defined boundaries of two or fewer contiguous neck levels. Evidence from retrospective studies suggests that superselective neck dissection (SSND) is oncologically sound for two indications: elective treatment of the clinically N0 neck and salvage treatment of persistent lymph node disease after chemoradiotherapy. While there is broader support for the former scenario, evidence that SSND may constitute optimal treatment in the latter is in conformity with the trend toward developing surgical techniques that provide better functional outcomes without compromising efficacy. PMID:23321797

Suárez, Carlos; Rodrigo, Juan P; Robbins, K Thomas; Paleri, Vinidh; Silver, Carl E; Rinaldo, Alessandra; Medina, Jesus E; Hamoir, Marc; Sanabria, Alvaro; Mondin, Vanni; Takes, Robert P; Ferlito, Alfio



Facet Problems: A Surgical Indication?  

Microsoft Academic Search

\\u000a The apophyseal facet joints of the spine are typical diarthrodial joints located in the posterior aspect of the functional\\u000a spinal unit or “three-joint complex”. They provide motion and stability and protect the neural structures. Indeed, facet problems\\u000a are a surgical indication, mainly after acute trauma with facet dislocation. However, in the absence of “red flags”, surgical\\u000a indications are less clear.

F. Pellisé


Energy Efficiency Indicators Methodology Booklet  

SciTech Connect

This Methodology Booklet provides a comprehensive review and methodology guiding principles for constructing energy efficiency indicators, with illustrative examples of application to individual countries. It reviews work done by international agencies and national government in constructing meaningful energy efficiency indicators that help policy makers to assess changes in energy efficiency over time. Building on past OECD experience and best practices, and the knowledge of these countries' institutions, relevant sources of information to construct an energy indicator database are identified. A framework based on levels of hierarchy of indicators -- spanning from aggregate, macro level to disaggregated end-use level metrics -- is presented to help shape the understanding of assessing energy efficiency. In each sector of activity: industry, commercial, residential, agriculture and transport, indicators are presented and recommendations to distinguish the different factors affecting energy use are highlighted. The methodology booklet addresses specifically issues that are relevant to developing indicators where activity is a major factor driving energy demand. A companion spreadsheet tool is available upon request.

Sathaye, Jayant; Price, Lynn; McNeil, Michael; de la rue du Can, Stephane



Computer Programming Techniques for.  

National Technical Information Service (NTIS)

Contents: statistical prediction, discrimination, and classification technique; integrated computer-oriented information retrieval techniques; multi-programming techniques for intelligence information processing; computer console input and display (textua...



Indicating the Attitudes of High School Students to Environment  

ERIC Educational Resources Information Center

|Within this work in which it has been aimed to indicate the attitudes of High School Students to environment, indication of the attitudes of high school students in Nigde has been regarded as the problem matter. This analysis has the qualification of survey model and techniques of questionnaire and observation have been used. The investigation…

Ozkan, Recep



Peritoneal dialysate volume determined by indicator dilution measurements  

Microsoft Academic Search

Peritoneal dialysate volume determined by indicator dilution measurements. Dialysate volume was simultaneously determined by two different indicator dilution techniques as a function of dwell time in a rabbit model of peritoneal dialysis using isotonic, hypertonic and hypotonic solutions. After a single injection of a large molecular weight index solute (SIIS) to the dialysis solution at a known concentration, the first

Andreas H Pust; John K Leypoldt; Ronald P Frigon; Lee W Henderson





An indicator is presented for measuring the lowspeed velocity of an object in one direction where the object returns in the opposite direction at a high speed. The indicator comprises a drum having its axis of rotation transverse to the linear movement of the object and a tape wound upon the drum with its free end extending therefrom and adapted to be connected to the object. A constant torque is applied to the drum in a direction to wind the tape on the drum. The speed of the tape in the unwinding direction is indicated on a tachometer which is coupled through a shaft and clutch means to the drum only when the tape is unwinding.

Digney, F.J. Jr.; Bevilacqua, F.



Childhood indicators of male homosexuality.  


Questionnaires were administered to 206 male homosexuals and 78 male heterosexuals. The most important aspects of the questionnaire dealt with six "childhood indicators" of later adult homosexuality: (1) interest in dolls, (2) cross-dressing, (3) preference for company of girls rather than boys in childhood games, (4) preference for company of older women rather than older men, (5) being regarded by other boys as a sissy, (6) sexual interest in other boys rather than girls in childhood sex play. Significant differences were found between homosexuals and heterosexuals with respect to all six indicators. Moreover, it was found that the stronger one's homosexual orientation the greater was the number of childhood indicators. It is concluded that there are behavioral aspects related to one's sexual orientation which may begin to emerge early in childhood. PMID:849142

Whitam, F L



Indicators for optical oxygen sensors.  


Continuous monitoring of oxygen concentration is of great importance in many different areas of research which range from medical applications to food packaging. In the last three decades, significant progress has been made in the field of optical sensing technology and this review will highlight the one inherent to the development of oxygen indicators. The first section outlines the bioanalytical fields in which optical oxygen sensors have been applied. The second section gives the reader a comprehensive summary of the existing oxygen indicators with a critical highlight on their photophysical and sensing properties. Altogether, this review is meant to give the potential user a guide to select the most suitable oxygen indicator for the particular application of interest. PMID:23227132

Quaranta, Michela; Borisov, Sergey M; Klimant, Ingo



Novel tamper-indicating protective devices  

SciTech Connect

Several novel tamper-indicating devices, originally developed under DOE auspices for arms control applications, might be useful in nonproliferation. Some devices that have reached the laboratory prototype stage could provide specialized alternatives to established seals. As locks and cables, the following might be useful: (1) a brittle ceramic lock--impervious to toxic, radiation, and thermal extremes--interrogated for identification and continuity by ultrasonic means, (2) a flexible ceramic-fiber seal that also tolerates severe environments, (3) an ultrasonic smart-material strip seal, and (4) an RF-resonant coaxial cable, verified by radio frequency and microwave signals. To validate the identity of secured surfaces, joints, welds, and fasteners--two techniques are applicable: (1) the scanning electron microscope, which examines three- dimensional micron-level topography, and (2) the plastic-casting fingerprint, a simple low-cost technique, analogous to human fingerprinting. The techniques mentioned above have one or more of the potential advantages of low cost, immediate availability, security for large-area enclosures, application to hazardous environments, usability in the FSU, or suitability for covert use.

DeVolpi, A.



Science and Engineering Indicators, 2010.  

National Technical Information Service (NTIS)

Science and Engineering Indicators (SEI) is first and foremost a volume of record comprising the major high-quality quantitative data on the U.S. and international science and engineering enterprise. SEI is factual and policy neutral. It does not offer po...



Multimetric indices: How many metrics?  

EPA Science Inventory

Multimetric indices (MMIâ??s) often include 5 to 15 metrics, each representing a different attribute of assemblage condition, such as species diversity, tolerant taxa, and nonnative taxa. Is there an optimal number of metrics for MMIs? To explore this question, I created 1000 9-met...


Crosswind Landing Gear Position Indicator.  

National Technical Information Service (NTIS)

An instrument for use on an aircraft equipped with a cross wind landing gear system is described. The instrument indicates on the pilot's display panel of the aircraft the alinement or misalinement of the wheels of the aircraft relative to the runway and ...

R. A. Champine



Track Quality Indicator with Hysteresis.  

National Technical Information Service (NTIS)

A first object of the present invention is providing a method for indicating the quality of tracks in a passive sonar system. Another object of the invention is providing such a method that is not overly sensitive to track status changes. Accordingly, the...

W. R. Lane



Geochemical indicators of intrinsic bioremediation  

Microsoft Academic Search

A detailed field investigation has been completed at a gasoline-contaminated aquifer near Rocky Point, NC, to examine possible indicators of intrinsic bioremediation and identify factors that may significantly influence the rae and extent of bioremediation. The dissolved plume of benzene, toluene, ethylbenzene, and xylene (BTEX) in ground water is naturally degrading. Toluene and o-xylene are most rapidly degraded followed by

Robert C. Borden; Carlos A. Gomez; Mark T. Becker



Coincident Indicators of Capital Flows  

Microsoft Academic Search

Capital flows data from Balance of Payments statistics often lag 3-6 months, which renders timely surveillance and policy deliberation difficult. To address the tension, we propose two coincident composite indicators for capital flows that improve upon existing proxies. We find that the most widely used proxy, the capital tracker, often overpredicts net flows by 30 percent. We augment the tracker

Yanliang Miao; Malika Pant



The hydrological indicators of desertification  

Microsoft Academic Search

The lack of, development of, and mismanagement of water are the basic causes of environmental degradation and desertification in many arid regions. The signs, magnitude and severity of desertification can be established through such hydrological indicators as reduced area of water bodies, increased runoff and consequently decreased rainwater infiltration, accelerated soil erosion and sedimentation, and deteriorated ground-water resources. Case studies

K. D. Sharma



Quality Indicators of Online Programs  

ERIC Educational Resources Information Center

|The continued growth of online programs in higher education has resulted in concerns about how institutions monitor the quality of their online programs. These concerns indicate a need for a process by which online programs may be evaluated and compared. They provided the impetus for this study, the goals of which were to identify quality…

Hirner, Leo; Kochtanek, Thomas



Quantitative indicator for semiquantum chaos  

NASA Astrophysics Data System (ADS)

By generalizing to a mixed-state environment the treatment recently given to a model advanced by Cooper et al. [Phys. Rev. Lett. 72, 1337 (1994)], we show that some characteristics of the so-called semiquantum chaos can be described by recourse to a special motion invariant of the problem, that thus becomes a chaos indicator.

Kowalski, A. M.; Martin, M. T.; Nuñez, J.; Plastino, A.; Proto, A. N.



Pancreas Transplantation: Indications and Consequences  

Microsoft Academic Search

Pancreas transplantation continues to evolve as a strategy in the management of diabetes mellitus. The first combined pan- creas-kidney transplant was reported in 1967, but pancreas transplant now represents a number of procedures, each with different indications, risks, benefits, and outcomes. This re- view will summarize these procedures, including their risks and outcomes in comparison to kidney transplantation alone, and