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Sample records for catheterization indications techniques

  1. Superselective catheterization technique in hepatic angiography

    SciTech Connect

    Chuang, V.P.; Soo, C.S.; Carrasco, C.H.; Wallace, S.

    1983-10-01

    The techniques for superselective catheterization of hepatic artery are described. The catheters have five major configurations in various sizes: (1) simple curve, (2) reverse curve, (3) double curve, (4) modified double curve, and (5) hepatic and splenic curves. Since the celiac artery may be directed caudad, horizontally, or cephalad, the techniques vary accordingly. The basic approach of the system described is to tailor the catheter to fit the vascular anatomy. These various techniques have produced a 95% success rate in the hepatic artery catheterization of 1000 patients.

  2. Catheterization.

    ERIC Educational Resources Information Center

    Lewis, Mary Bell; Moseley, James L.

    This module is designed to teach the fundamentals of clean intermittent urinary catheterization for the disabled child, particularly in the school setting. The text includes information on proper hand washing techniques, the supplies needed, suggested settings, and the preparations required before and after the catheter is inserted into the…

  3. Basic Surgical Techniques in the Göttingen Minipig: Intubation, Bladder Catheterization, Femoral Vessel Catheterization, and Transcardial Perfusion

    PubMed Central

    Ettrup, Kaare S.; Glud, Andreas N.; Orlowski, Dariusz; Fitting, Lise M.; Meier, Kaare; Soerensen, Jens Christian; Bjarkam, Carsten R.; Alstrup, Aage K. Olsen

    2011-01-01

    The emergence of the Göttingen minipig in research of topics such as neuroscience, toxicology, diabetes, obesity, and experimental surgery reflects the close resemblance of these animals to human anatomy and physiology 1-6.The size of the Göttingen minipig permits the use of surgical equipment and advanced imaging modalities similar to those used in humans 6-8. The aim of this instructional video is to increase the awareness on the value of minipigs in biomedical research, by demonstrating how to perform tracheal intubation, transurethral bladder catheterization, femoral artery and vein catheterization, as well as transcardial perfusion. Endotracheal Intubation should be performed whenever a minipig undergoes general anesthesia, because it maintains a patent airway, permits assisted ventilation and protects the airways from aspirates. Transurethral bladder catheterization can provide useful information about about hydration state as well as renal and cardiovascular function during long surgical procedures. Furthermore, urinary catheterization can prevent contamination of delicate medico-technical equipment and painful bladder extension which may harm the animal and unnecessarily influence the experiment due to increased vagal tone and altered physiological parameters. Arterial and venous catheterization is useful for obtaining repeated blood samples and monitoring various physiological parameters. Catheterization of femoral vessels is preferable to catheterization of the neck vessels for ease of access, when performing experiments involving frame-based stereotaxic neurosurgery and brain imaging. When performing vessel catheterization in survival studies, strict aseptic technique must be employed to avoid infections6. Transcardial perfusion is the most effective fixation method, and yields preeminent results when preparing minipig organs for histology and histochemistry2,9. For more information about anesthesia, surgery and experimental techniques in swine in general we refer to Swindle 2007. Supplementary information about premedication and induction of anesthesia, assisted ventilation, analgesia, pre- and postoperative care of Göttingen minipigs are available via the internet at http://www.minipigs.com10. For extensive information about porcine anatomy we refer to Nickel et al. Vol. 1-511. PMID:21730947

  4. Urinary Catheterization of Male Rabbits: A New Technique and a Review of Urogenital Anatomy

    PubMed Central

    Uthamanthil, Rajesh K; Hachem, Ray Y; Gagea, Mihai; Reitzel, Ruth A; Borne, Agatha T; Tinkey, Peggy T

    2013-01-01

    Rabbits are widely used as an animal model for urologic research studies in which urinary bladder catheterization is required. However, standard manual retrograde urinary catheterization proved to be difficult to perform on anesthetized male rabbits in a research study, with frequent misplacement of the catheter into the vesicular gland. Attempts to reposition the catheter into the bladder after initial entry into the vesicular gland frequently failed and resulted in exclusion of the animal from the study. We assessed the normal anatomy of the lower urinary tract of male rabbits to determine the cause of catheterization misdirection into the vesicular gland and to develop a more reliable technique for urinary bladder catheterization. A modified ‘digital (finger) pressure’ catheterization technique was developed for successful urinary catheterization of male rabbits. Retrospective statistical analysis of 45 rabbits used for urinary catheterization studies showed improvement in the success rate of catheterization by using the digital pressure technique over the standard method of retrograde urinary catheter insertion. In addition, we here review the relevant gross and histologic anatomy of the urogenital tract of male rabbits. PMID:23562102

  5. Pediatric Catheterization Protocol.

    PubMed

    Sheikh, N

    2015-07-01

    During the last decade, significant technological progress has taken place in the pediatric cardiac catheterization laboratory. Improved noninvasive diagnostic techniques have narrowed down the indications for diagnostic cardiac catheterization, and these techniques are now increasingly being applied to therapeutic procedures. Recently, concern has been raised about the appropriateness of some these applications in pediatric therapeutic cardiac catheterization because of sheer increase in number of techniques being applied, the increase in the number of persons and centers using these techniques, and the increase in the number of lesion types thought to be amenable to catheter therapy. In comparison to diagnostic cardiac catheterization, therapeutic catheterization require more time and resources, involve higher cost and risk, and demand more technical competence and expertise. Higher level of skill and competency is requirement for the operator who performs the various therapeutic catheterization techniques. These procedures should only be performed in institutions equipped with appropriate facilities, personnel, and programs. These considerations, combined with the rapid increase in the number of laboratories and cardiologists performing therapeutic catheterization procedures, raises concern about the safety of patients and human subjects as well as credentials of hospital and level of training and skill of physician involved. Therapeutic catheterization training programs vary in type, extent, and quality. Due to the complexity and potential risks of these procedures, specific skill and competency benchmark should be developed for personnel undergoing training in therapeutic catheterization as well as for those who continue to perform various procedures. Competency in therapeutic catheterization in children requires specific training. Pediatric cardiology fellows should receive therapeutic catheterization training in one or more centers that specializes in angioplasties, valvuloplasties, and/or vascular occlusion procedures. Before performing a therapeutic catheterization as the primary operator, the fellow or practicing pediatric cardiologist should be required to receive procedure-specific training under the supervision of a qualified individual. Credential should be procedure specific. To maintain his or her credentials and skills, the cardiologist should perform or supervise an adequate number of cases annually, and the results must compare favorably with national experience. The cardiologist must keep himself up to date of new trends and progress in the field through scientific reading and attendance of meetings. Interventional pediatric cardiology has grown remarkably over the last two decades. Catheter based interventional procedures have become the treatment of choice for many cardiac lesions, and these procedures serve as alternatives or adjuncts to surgical treatment for many other relevant conditions. Keeping with the pace of development worldwide, catheter based interventional procedures are making good progress in Bangladesh as well. PMID:26329970

  6. Paraplegia following cervical epidural catheterization using loss of resistance technique with air: a case report.

    PubMed

    Chae, Yun Jeong; Han, Kyung Ream; Park, Hyung Bae; Kim, Chan; Nam, Si Gweon

    2016-02-01

    We report a case of paraplegia without neurologic deficit of upper extremities following cervical epidural catheterization using air during the loss of resistance technique. A 41-year-old woman diagnosed with complex regional pain syndrome had upper and lower extremity pain. A thoracic epidural lead was inserted for a trial spinal cord stimulation for treating lower extremity pain and cervical epidural catheterization was performed for treating upper extremity pain. Rapidly progressive paraplegia developed six hours after cervical epidural catheterization. Spine CT revealed air entrapment in multiple thoracic intervertebral foraminal spaces and surrounding epidural space without obvious spinal cord compression before the decompressive operation, which disappeared one day after the decompressive operation. Her paraplegia symptoms were normalized immediately after the operation. The presumed cause of paraplegia was transient interruption of blood supply to the spinal cord through the segmental radiculomedullary arteries feeding the spinal cord at the thoracic level of the intervertebral foramen caused by the air. PMID:26885305

  7. Paraplegia following cervical epidural catheterization using loss of resistance technique with air: a case report

    PubMed Central

    Chae, Yun Jeong; Park, Hyung Bae; Kim, Chan; Nam, Si Gweon

    2016-01-01

    We report a case of paraplegia without neurologic deficit of upper extremities following cervical epidural catheterization using air during the loss of resistance technique. A 41-year-old woman diagnosed with complex regional pain syndrome had upper and lower extremity pain. A thoracic epidural lead was inserted for a trial spinal cord stimulation for treating lower extremity pain and cervical epidural catheterization was performed for treating upper extremity pain. Rapidly progressive paraplegia developed six hours after cervical epidural catheterization. Spine CT revealed air entrapment in multiple thoracic intervertebral foraminal spaces and surrounding epidural space without obvious spinal cord compression before the decompressive operation, which disappeared one day after the decompressive operation. Her paraplegia symptoms were normalized immediately after the operation. The presumed cause of paraplegia was transient interruption of blood supply to the spinal cord through the segmental radiculomedullary arteries feeding the spinal cord at the thoracic level of the intervertebral foramen caused by the air. PMID:26885305

  8. Catheterization (image)

    MedlinePLUS

    Clean intermittent 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 ...

  9. Rhinoplasty – indications and techniques

    PubMed Central

    Tasman, Abel-Jan

    2008-01-01

    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. PMID:22073085

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

    PubMed

    Ragosta, Michael

    2011-08-01

    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

  11. Augmentation cystoplasty: Contemporary indications, techniques and complications.

    PubMed

    Veeratterapillay, Rajan; Thorpe, Andrew C; Harding, Chris

    2013-10-01

    Augmentation cystoplasty (AC) has traditionally been used in the treatment of the low capacity, poorly compliant or refractory overactive bladder (OAB). The use of intravesical botulinum toxin and sacral neuromodulation in detrusor overactivity has reduced the number of AC performed for this indication. However, AC remains important in the pediatric and renal transplant setting and still remains a viable option for refractory OAB. Advances in surgical technique have seen the development of both laparoscopic and robotic augmentation cystoplasty. A variety of intestinal segments can be used although ileocystoplasty remains the most common performed procedure. Early complications include thromboembolism and mortality, whereas long-term problems include metabolic disturbance, bacteriuria, urinary tract stones, incontinence, perforation, the need for intermittent self-catheterization and carcinoma. This article examines the contemporary indications, published results and possible future directions for augmentation cystoplasty. PMID:24235795

  12. Cardiac Catheterization

    MedlinePLUS

    ... done during a cardiac catheterization include: closing small holes inside the heart repairing leaky or narrow heart ... bandage. It's normal for the site to be black and blue, red, or slightly swollen for a ...

  13. Cardiac Catheterization

    MedlinePLUS

    ... where the catheter was inserted. Cardiac catheterization rarely causes serious complications. Rate This Content: NEXT >> Updated: January 30, 2012 Twitter Facebook YouTube Google+ SITE INDEX ACCESSIBILITY PRIVACY STATEMENT FOIA ...

  14. Viscosupplementation: techniques, indications, results.

    PubMed

    Legré-Boyer, V

    2015-02-01

    Viscosupplementation by hyaluronic acid (HA) injections is frequently used for local treatment of osteoarthritis (OA), due to ease of use and good tolerance. A profusion of linear or reticulated HA derivates are marketed, with varied characters and levels of evidence. Viscosupplementation has demonstrated moderate but significant efficacy (20%) versus placebo in terms of pain and function, with a high rate of responders (60-70%) in knee osteoarthritis. It allows reduced administration of opioid analgesics and NSAIDs, with improved risk/benefit ratio, and may delay joint replacement. Cartilage protection remains to be proven. Clinical efficacy shows 1-4 weeks' later onset than corticosteroids, but is maintained for 6 or even 12 months. Systematic association of corticosteroid and HA injection is not justified, and an interval has to be left before undertaking arthroplasty. Intra-articular injection of HA requires a skilled specialist, and may be difficult in a non-swollen joint; some tips and tricks may be helpful. In other joints than the knee, radiologic or ultrasound guidance is recommended. The efficacy of viscosupplementation is a matter of ongoing debate, after discordant findings in some meta-analyses. Some poor results may be due to inappropriate use of HA injections, poorly adapted to the patient's OA phenotype. Viscosupplementation is a treatment for chronic moderate symptomatic OA, and not for flares with joint swelling. Application in sport-related chondropathy has yet to be properly assessed. The optimal response profile remains to be determined. The ideal indication in the knee seems to be moderate femorotibial OA without swelling. Results have been generally disappointing in hip osteoarthritis but promising in OA of the ankle and shoulder (with and without rotator cuff tear). Further studies are needed to determine response profile and optimal treatment schedule, according to the joint. PMID:25596987

  15. Knowledge and attitude of doctors and nurses regarding indication for catheterization and prevention of catheter-associated urinary tract infection in a tertiary care hospital

    PubMed Central

    Jain, Manisha; Dogra, Vinita; Mishra, Bibhabati; Thakur, Archana; Loomba, Poonam Sood

    2015-01-01

    Background and Aims: Catheter-associated urinary tract infection (CAUTI) is one of the most common health care acquired infection encountered in clinical practice. The present study was planned to assess the knowledge and attitude of health care providers regarding the indications for catheterization and methods of preventing CAUTI. Methods: A prospective questionnaire-based survey was done from March 2011 to August 2011. A structured questionnaire comprising of 41 items related to demographic details of the respondents, their knowledge regarding indications for catheterization and methods of preventing CAUTI was given to 54 doctors and 105 nurses. The response was evaluated for statistical correlation using a computer software. Results: The mean years of experience of the respondents in the health care setup was 6.8 years. Only 57% of the respondents could identify all the measures for prevention of CAUTI. The knowledge regarding the indication for catheterization though suboptimal was significantly better amongst the doctors as compared to nurses. Conclusion: The knowledge regarding indication and preventive measures was suboptimal in our study group. There is a tremendous scope of improvement in catheterization practices in our hospital and education induced intervention would be the most appropriate effort toward reducing the incidence of CAUTI. PMID:25722548

  16. Urine culture - catheterized specimen

    MedlinePLUS

    Culture - urine - catheterized specimen; Urine culture - catheterization; Catheterized urine specimen culture ... urinary tract infections may be found in the culture. This is called a contaminant. You may not ...

  17. Cardiac catheterization and angiography. Third edition

    SciTech Connect

    Grossman, W.

    1986-01-01

    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.

  18. A simple sheath removal after open trans-femoral catheterization procedure: the ZIP technique.

    PubMed

    Du Cailar, Claude; Gandet, Thomas; Du Cailar, Marie; Albat, Bernard

    2014-04-01

    The ZIP technique, a surgical equivalent of the 'Preclose' technique, useful for transcatheter aortic valve implantation or endovascular aortic aneurysm repair is described. While percutaneous closure devices are expensive, need a long learning curve and are associated with primary failure, the ZIP technique is easy and allows a quick, safe and anatomical closure of the artery. This procedure avoids arterial cross-clamping and no purse-string effect was demonstrated using Doppler ultrasound examination. PMID:23886993

  19. Anesthesia for cardiac catheterization procedures.

    PubMed

    Hamid, A

    2014-01-01

    Anesthesiologist's involvement for the purpose of diagnostic and interventional procedures in cardiac catheterization laboratory has been evolving particularly since last two decades. Catheterization laboratory environment poses certain challenges for the anesthesiologist including unfamiliar remote location, exposure to radiation, limited help from colleagues and communication with cardiologists. Anesthesiologists working in catheterization laboratory are required to have adequate knowledge of the environment, personnel, fluoroscope, echocardiography and type of radio contrast dye during the procedure. Anyone who is exposed to radiation environment is expected to protect himself from the exposure and must also wear a dosimeter for cumulative exposure tracing. There is no ideal anesthetic technique and the decision about sedation, general anesthesia or regional anesthesia for the procedure has to be made by attending anesthesiologists in consultation with cardiologists. Anesthesiologists should always try to minimize the effects of anesthesia on cardiovascular system. In addition, oxygenation and ventilatory management should be done according to the diagnostic procedure as it can also influence the diagnosis particularly in pediatric cath procedures. Since more complex procedures are being done in cardiac catheterization laboratory,  it is the responsibility of anesthesia department to train and assign dedicated anesthesiologists for new challenges. Role of anesthetist should be well defined so that there is no confrontation during patient management. Sedation in cardiac catheterization laboratory by non-anesthetists is also an issue, which can be sorted out by making policies and protocol in consultation with cardiologists. PMID:25436204

  20. Suprachoroidal buckling: technique and indications.

    PubMed

    El Rayes, Ehab N; Elborgy, Ebrahim

    2013-10-01

    The authors herein report the feasibility of suprachoroidal buckling (SCB) procedure as a new approach for treating different forms of retinal detachment (RD) by creating suprachoroidal indentation (buckling effect). With this technique, specially designed devices, i.e. a catheter or cannula, are guided in the suprachoroidal space to reach the target area. Then, a suprachoroidal filler (long lasting hyaluronic acid) is injected to indent the choroid creating SCB, thereby closing retinal tears and supporting the overlying retina. This procedure was performed to treat both myopic tractional maculopathy (MTM), including myopic macular holes, as well as peripheral retinal breaks. SCB may be used alone or in conjunction with vitrectomy. In myopic patients, restoration of retinal layers was achieved in all eyes with myopic foveoschisis. Most eyes with macular hole detachments demonstrated closure of the holes. All peripheral retinal breaks were adequately buckled and closed in a single procedure. The buckling effect was long enough in duration to seal the tears and promote adequate chorioretinal scarring. The procedure was safe and relatively simple in terms of reaching the treatment area and injecting the filler. SCB adds to our surgical options for treating selected cases of peripheral retinal tears and rhegmatogenous RD, and avoids potential problems of episcleral buckles. Moreover it may avoid vitrectomy in selected cases of rhegmatogenous RD. PMID:24653830

  1. The history of cardiac catheterization.

    PubMed

    Bourassa, Martial G

    2005-10-01

    The evolution of cardiac catheterization has occurred over at least four centuries. One of the first major steps was the description of the circulation of the blood by William Harvey in 1628. The next milestone was the measurement of arterial pressure by Stephen Hales, one century later. However, the 19th century represented the golden age of cardiovascular physiology, highlighted by the achievements of Carl Ludwig, Etienne-Jules Marey and Claude Bernard, among others. Human cardiac catheterization developed during the 20th century. The first right heart catheterization in a human was performed by Werner Forssmann on himself in 1929. Diagnostic cardiac catheterization was introduced by André Cournand and Dickinson Richards in the early 1940s, and selective coronary angiography was described by Mason Sones in the early 1960s. More recently, with the advent of catheter-based interventions, pioneered by Andreas Gruentzig in the late 1970s, there has been considerable progress in the refinement and expansion of these techniques. Currently, the Sones technique is used only infrequently, and coronary angiography and percutaneous coronary intervention rely mainly on percutaneous femoral and percutaneous radial artery approaches. On the occasion of the 50th anniversary of the Montreal Heart Institute, it seems appropriate to highlight the contribution of this institution in these two areas. PMID:16234881

  2. Left heart catheterization

    MedlinePLUS

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye will be injected into your ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  3. Bladder catheterization, male (image)

    MedlinePLUS

    ... kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration of time. Catheterization in males is slightly more difficult and uncomfortable than in females because of the longer urethra.

  4. Cardiac catheterization and angiography, 3d Ed

    SciTech Connect

    Grossman, W.

    1986-01-01

    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.

  5. HRCT in children: technique and indications.

    PubMed

    Garcia-Peña, Pilar; Lucaya, Javier

    2004-03-01

    High-resolution computed tomography (HRCT) is a very important diagnostic tool, which improves our understanding of many lung diseases in children. However, the technique requires great care in managing the child and attention in using the lowest radiation dose possible. HRCT provides important diagnostic information on pediatric lung disorders for both airway and interstitial lung diseases. In this review we describe in detail the most appropriate technique to be used on children including patient preparation and sedation, discuss indications, and analyze the HRCT appearance of a variety of diseases. PMID:14762683

  6. Changing techniques and indications for lamellar keratoplasty.

    PubMed

    Facskó, A; Nagy, A; Balázs, K; Berta, A

    1997-01-01

    In recent decades, the number of lamellar keratoplasties (LKs) being performed worldwide has been gradually decreasing. However, new technical procedures have been developed and microsurgeons must consider modified indications for lamellar grafting. In the period 1946-1995, in the Department of Ophthalmology University Medical School of Debrecen, Hungary 3889 consecutive keratoplasties were performed of which 608 were LKs. In the period 1946-1960 special surgical material (biosutures) was used without operating microscopes and the leading indication for LK was corneal scar (leukomas). Between 1961 and 1979 with the development of microsurgical procedures (10/0 nylon sutures, operating microscope), the LK technique became more advanced. In the period 1979-1995 precision lamellar grafting could be performed with the widely available improved modern techniques. Changing indications for LK were noted in the second period and this tendency has subsequently continued. Currently the main indications for LK are "immediate" keratoplasty after chemical burns, and sclerokeratoplasty against recurrent pterygia. Their observations lead the authors to conclude that the possible reasons for the changing indications of LK are the new technical procedures, the increasing knowledge, the better immunological tests and the improved postoperative therapy. PMID:9408295

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

    SciTech Connect

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

    1984-08-01

    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)

  8. Oncoplastic breast surgery: indications, techniques and perspectives

    PubMed Central

    Montag, Eduardo; Gemperli, Rolf

    2013-01-01

    Breast-conservation surgery (BCS) is established as a safe option for most women with early breast cancer. Recently, advances in oncoplastic techniques have reduced surgical trauma and thus are capable of preserving the breast form and quality of life. In spite of the most BCS defects can be managed with primary closure, the aesthetic outcome may be unpredictable. Oncoplastic reconstruction may begin at the time of BCS (immediate), weeks (delayed-immediate) or months to years afterwards (delayed). With immediate reconstruction, the surgical process is smooth, since both procedures can be associated in one operative setting. Additionally, it permits wider excision of the tumor, with a superior mean volume of the specimen and potentially reducing the incidence of margin involvement. The oncoplastic techniques are related to volume displacement or replacement procedures including local flaps, latissimus dorsi myocutaneous flap and reduction mammaplasty/masthopexy. Regardless of the fact that there is no consensus concerning the best approach, the criteria are determined by the surgeon’s experience and the size of the defect in relation to the size of the remaining breast. On the basis of our 15-year experience, it is possible to identify trends in types of breast defects and to develop an algorithm for immediate BCS reconstruction on the basis of the initial breast volume, the extent/location of glandular tissue ressection and the remaining available breast tissue. The main advantages of the technique utilized should include reproducibility, low interference with the oncologic treatment and long-term results. Surgical planning should include the patients’s preferences, and chiefly addressing individual reconstructive requirements, enabling each patient to receive an individual “custom-made” reconstruction. PMID:25083476

  9. Acute urinary retention and the difficult catheterization: current emergency management.

    PubMed

    Sliwinski, Ania; D'Arcy, Frank T; Sultana, Ron; Lawrentschuk, Nathan

    2016-04-01

    Acute urinary retention (AUR) is a common presentation to emergency departments. This article updates the reader on the appropriate management, investigations and guidelines for AUR. It looks at the mechanism of normal micturition and describes the theories of AUR. It outlines urethral catheterization techniques for difficult cases, reviews suprapubic catheterization procedures and describes the management of AUR in polytrauma. Although emergency management is by bladder drainage, key points in the history and examination may expose significant, latent pathologies. PMID:26479738

  10. Doppler-guided retrograde catheterization system

    NASA Astrophysics Data System (ADS)

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

    1991-05-01

    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.

  11. Mandibular distraction in neonates: indications, technique, results

    PubMed Central

    2012-01-01

    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. PMID:22300418

  12. Radiation Dose Estimation for Pediatric Patients Undergoing Cardiac Catheterization

    NASA Astrophysics Data System (ADS)

    Wang, Chu

    Patients undergoing cardiac catheterization are potentially at risk of radiation-induced health effects from the interventional fluoroscopic X-ray imaging used throughout the clinical procedure. The amount of radiation exposure is highly dependent on the complexity of the procedure and the level of optimization in imaging parameters applied by the clinician. For cardiac catheterization, patient radiation dosimetry, for key organs as well as whole-body effective, is challenging due to the lack of fixed imaging protocols, unlike other common X-ray based imaging modalities. Pediatric patients are at a greater risk compared to adults due to their greater cellular radio-sensitivities as well as longer remaining life-expectancy following the radiation exposure. In terms of radiation dosimetry, they are often more challenging due to greater variation in body size, which often triggers a wider range of imaging parameters in modern imaging systems with automatic dose rate modulation. The overall objective of this dissertation was to develop a comprehensive method of radiation dose estimation for pediatric patients undergoing cardiac catheterization. In this dissertation, the research is divided into two main parts: the Physics Component and the Clinical Component. A proof-of-principle study focused on two patient age groups (Newborn and Five-year-old), one popular biplane imaging system, and the clinical practice of two pediatric cardiologists at one large academic medical center. The Physics Component includes experiments relevant to the physical measurement of patient organ dose using high-sensitivity MOSFET dosimeters placed in anthropomorphic pediatric phantoms. First, the three-dimensional angular dependence of MOSFET detectors in scatter medium under fluoroscopic irradiation was characterized. A custom-made spherical scatter phantom was used to measure response variations in three-dimensional angular orientations. The results were to be used as angular dependence correction factors for the MOSFET organ dose measurements in the following studies. Minor angular dependence (< +/-20% at all angles tested, < +/-10% at clinically relevant angles in cardiac catheterization) was observed. Second, the cardiac dose for common fluoroscopic imaging techniques for pediatric patients in the two age groups was measured. Imaging technique settings with variations of individual key imaging parameters were tested to observe the quantitative effect of imaging optimization or lack thereof. Along with each measurement, the two standard system output indices, the Air Kerma (AK) and Dose-Area Product (DAP), were also recorded and compared to the measured cardiac and skin doses -- the lack of correlation between the indices and the organ doses shed light to the substantial limitation of the indices in representing patient radiation dose, at least within the scope of this dissertation. Third, the effective dose (ED) for Posterior-Anterior and Lateral fluoroscopic imaging techniques for pediatric patients in the two age groups was determined. In addition, the dosimetric effect of removing the anti-scatter grid was studied, for which a factor-of-two ED rate reduction was observed for the imaging techniques. The Clinical Component involved analytical research to develop a validated retrospective cardiac dose reconstruction formulation and to propose the new Optimization Index which evaluates the level of optimization of the clinician's imaging usage during a procedure; and small sample group of actual procedures were used to demonstrate applicability of these formulations. In its entirety, the research represents a first-of-its-kind comprehensive approach in radiation dosimetry for pediatric cardiac catheterization; and separately, it is also modular enough that each individual section can serve as study templates for small-scale dosimetric studies of similar purposes. The data collected and algorithmic formulations developed can be of use in areas of personalized patient dosimetry, clinician training, image quality studies and radiation-associated health effect research.

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

    SciTech Connect

    Li Xiao; Wang Yixiang, J.; Zhou Xiangping Guan Yongsong; Tang Chengwei

    2006-12-15

    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.

  14. The effect of anesthetization and urinary bladder catheterization on renal function of rainbow trout

    USGS Publications Warehouse

    Hunn, J.B.; Willford, W.A.

    1970-01-01

    1. Rainbow trout were anesthetized with MS-222 (Sandoz) or methylpentynol and catheterized. Urine was collected at selected intervals up to 48 hr. 2. Effects of MS-222 anesthesia on urine flow and composition were isolated from the stress of catheterization by re-anesthetizing the fish 18 to 20 hr post catheterization. 3. Urine output patterns were similar following MS-222 or methylpentynol anesthesia and catheterization. Highest urine flows were measured 4 to 8 hr post treatment. The highest urine output after re-anesthetization with MS-222 was observed 2 to 4 hr post-anesthesia. 4. Highest concentrations of Na2+, K+, Ca2+, Cl- and inorganic PO4 in the urine were measured in the first 2 hr after anesthesia and catheterization. 5. Flow rates and chemical composition of urine indicate that "normal" renal function is re-established 12 to 24 hr post-treatment.

  15. Clean intermittent catheterization in the school setting.

    PubMed

    Katrancha, Elizabeth D

    2008-08-01

    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, helps build self-esteem, and allows the student greater independence. The school nurse assists the student with SB with CIC in the school setting and reinforces the importance of correct technique with the student, family, and other personnel caring for the student. The success of a continence management program at school is dependent on all these individuals working together with the common goal of maintaining normal renal function, gaining urinary continence, and promoting independence of the student. PMID:18757352

  16. Venous catheterization with ultrasound navigation

    NASA Astrophysics Data System (ADS)

    Kasatkin, A. A.; Urakov, A. L.; Nigmatullina, A. R.

    2015-11-01

    By ultrasound scanning it was determined that respiratory movements made by chest of healthy and sick person are accompanied by respiratory chest rise of internal jugular veins. During the exhalation of an individual diameter of his veins increases and during the breath it decreases down to the complete disappearing if their lumen. Change of the diameter of internal jugular veins in different phases can influence significantly the results of vein puncture and cauterization in patients. The purpose of this research is development of the method increasing the efficiency and safety of cannulation of internal jugular veins by the ultrasound visualization. We suggested the method of catheterization of internal jugular veins by the ultrasound navigation during the execution of which the puncture of venous wall by puncture needle and the following conduction of J-guide is carried out at the moment of patient's exhalation. This method decreases the risk of complications development during catheterization of internal jugular vein due to exclusion of perforating wound of vein and subjacent tissues and anatomical structures.

  17. Full Endoscopic Spinal Surgery Techniques: Advancements, Indications, and Outcomes

    PubMed Central

    Yue, James J.; Long, William

    2015-01-01

    Advancements in both surgical instrumentation and full endoscopic spine techniques have resulted in positive clinical outcomes in the treatment of cervical, thoracic, and lumbar spine pathologies. Endoscopic techniques impart minimal approach related disruption of non-pathologic spinal anatomy and function while concurrently maximizing functional visualization and correction of pathological tissues. An advanced understanding of the applicable functional neuroanatomy, in particular the neuroforamen, is essential for successful outcomes. Additionally, an understanding of the varying types of disc prolapse pathology in relation to the neuroforamen will result in more optimal surgical outcomes. Indications for lumbar endoscopic spine surgery include disc herniations, spinal stenosis, infections, medial branch rhizotomy, and interbody fusion. Limitations are based on both non spine and spine related findings. A high riding iliac wing, a more posteriorly located retroperitoneal cavity, an overly distal or proximally migrated herniated disc are all relative contra-indications to lumbar endoscopic spinal surgery techniques. Modifications in scope size and visual field of view angulation have enabled both anterior and posterior cervical decompression. Endoscopic burrs, electrocautery, and focused laser technology allow for the least invasive spinal surgical techniques in all age groups and across varying body habitus. Complications include among others, dural tears, dysesthsia, nerve injury, and infection. PMID:26114086

  18. Identifying indicators through modified Delphi technique in polytechnics system

    NASA Astrophysics Data System (ADS)

    Nashir, Irdayanti Mat; Mustapha, Ramlee; Yusoff, Abdullah

    2015-02-01

    This study aims to examine how the panel has been selected as experts in assessing indicators of innovative instructional leadership (IIL) administrator in polytechnics based on 222 items were obtained through previous studies. A total of eleven people were selected as the expert panels in a study where expert selection criteria based on their background in the leadership. Experts were interviewed separately. Interviews were carried out for a half hour in their offices. The data obtained were analyzed using Atlas Ti. Overall findings indicate experts agree that a total of 188 items and 14 indicators should be maintained in this innovative instructional leadership instruments and next by using Modified Delphi Technique. The instrument will then be analyzed to obtain findings on the perception of lecturers on every administrator innovative instructional leadership in their respective polytechnics.

  19. Complications of Cardiac Catheterization in Structural Heart Disease

    PubMed Central

    Lee, Ko Eun; Seo, Yeon Jeong; An, Hyo Soon; Song, Young Hwan; Kwon, Bo Sang; Bae, Eun Jung; Noh, Chung Il

    2016-01-01

    Background and Objectives Cardiac catheterization is used to diagnose structural heart disease (SHD) and perform transcatheter treatment. This study aimed to evaluate complications of cardiac catheterization and the associated risk factors in a tertiary center over 10 years. Subjects and Methods Total 2071 cardiac catheterizations performed at the Seoul National University Children's Hospital from January 2004 to December 2013 were included in this retrospective study. Results The overall complication, severe complication, and mortality rates were 16.2%, 1.15%, and 0.19%, respectively. The factors that significantly increased the risk of overall and severe complications were anticoagulant use before procedure (odds ratio [OR] 1.83, p=0.012 and OR 6.45, p<0.001, respectively), prothrombin time (OR 2.30, p<0.001 and OR 5.99, p<0.001, respectively), general anesthesia use during procedure (OR 1.84, p=0.014 and OR 5.31, p=0.015, respectively), and total procedure time (OR 1.01, p<0.001 and OR 1.02, p<0.001, respectively). Low body weight (OR 0.99, p=0.003), severe SHD (OR 1.37, p=0.012), repetitive procedures (OR 1.7, p=0.009), and total fluoroscopy time (OR 1.01, p=0.005) significantly increased the overall complication risk. High activated partial thromboplastin time (OR 1.04, p=0.001), intensive care unit admission state (OR 14.03, p<0.001), and concomitant electrophysiological study during procedure (OR 3.41, p=0.016) significantly increased severe complication risk. Conclusion Currently, the use of cardiac catheterization in SHD is increasing and becoming more complex; this could cause complications despite the preventive efforts. Careful patient selection for therapeutic catheterization and improved technique and management during the peri-procedural period are required to reduce complications. PMID:27014356

  20. Propeller flaps: a review of indications, technique, and results.

    PubMed

    D'Arpa, Salvatore; Toia, Francesca; Pirrello, Roberto; Moschella, Francesco; Cordova, Adriana

    2014-01-01

    In the last years, propeller flaps have become an appealing option for coverage of a large range of defects. Besides having a more reliable vascular pedicle than traditional flap, propeller flaps allow for great freedom in design and for wide mobilization that extend the possibility of reconstructing difficult wounds with local tissues and minimal donor-site morbidity. They also allow one-stage reconstruction of defects that usually require multiple procedures. Harvesting of a propeller flap requires accurate patient selection, preoperative planning, and dissection technique. Complication rate can be kept low, provided that potential problems are prevented, promptly recognized, and adequately treated. This paper reviews current knowledge on propeller flaps. Definition, classification, and indications in the different body regions are discussed based on a review of the literature and on the authors' experience. Details about surgical technique are provided, together with tips to avoid and manage complications. PMID:24971367

  1. Propeller Flaps: A Review of Indications, Technique, and Results

    PubMed Central

    D'Arpa, Salvatore; Toia, Francesca; Pirrello, Roberto; Moschella, Francesco; Cordova, Adriana

    2014-01-01

    In the last years, propeller flaps have become an appealing option for coverage of a large range of defects. Besides having a more reliable vascular pedicle than traditional flap, propeller flaps allow for great freedom in design and for wide mobilization that extend the possibility of reconstructing difficult wounds with local tissues and minimal donor-site morbidity. They also allow one-stage reconstruction of defects that usually require multiple procedures. Harvesting of a propeller flap requires accurate patient selection, preoperative planning, and dissection technique. Complication rate can be kept low, provided that potential problems are prevented, promptly recognized, and adequately treated. This paper reviews current knowledge on propeller flaps. Definition, classification, and indications in the different body regions are discussed based on a review of the literature and on the authors' experience. Details about surgical technique are provided, together with tips to avoid and manage complications. PMID:24971367

  2. Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications.

    PubMed

    Halpern, Joshua; Mittal, Sameer; Pereira, Keith; Bhatia, Shivank; Ramasamy, Ranjith

    2016-01-01

    There are several options for the treatment of varicocele, including surgical repair either by open or microsurgical approach, laparoscopy, or through percutaneous embolization of the internal spermatic vein. The ultimate goal of varicocele treatment relies on the occlusion of the dilated veins that drain the testis. Percutaneous embolization offers a rapid recovery and can be successfully accomplished in approximately 90% of attempts. However, the technique demands interventional radiologic expertise and has potential serious complications, including vascular perforation, coil migration, and thrombosis of pampiniform plexus. This review discusses the common indications, relative contraindications, technical details, and risks associated with percutaneous embolization of varicocele. PMID:26658060

  3. Transconjunctival Inferior Orbitotomy: Indications, Surgical Technique, and Complications

    PubMed Central

    Davies, Brett W.; Hink, Eric M.; Durairaj, Vikram D.

    2014-01-01

    Surgical access to the inferior orbit can be accomplished through either a transcutaneous or transconjunctival incision. The preferred approach should provide adequate surgical exposure with the fewest adverse effects. The purpose of this article is to review the literature on the transconjunctival incision and to discuss the indications and complications of the approach. The authors also discuss their preferred technique and provide a step-by-step instruction. The transconjunctival approach provides good surgical access with a low incidence of complications and a better aesthetic outcome than transcutaneous approaches. PMID:25136405

  4. Simple Enucleation for Renal Tumors: Indications, Techniques, and Results.

    PubMed

    García, Adolfo García; León, Tania González

    2016-01-01

    Kidney cancer is the 13th most common malignancy worldwide with significant increase in Stage I renal cell cancer (RCC). Surgical excision by nephron sparing surgery (NSS) remains the treatment of choice for small renal masses (SRMs). One of the variants of partial nephrectomy is simple enucleation (SE) or tumor enucleation (TE). The present review comments on the indications and technical aspects of SE as well as its outcomes. SE/TE has shown both perioperative and oncologic satisfactory results, comparable to partial nephrectomy (PN). It is a valid technique for SRMs and achieves maximum renal parenchymal preservation with an insignificant impact on renal function. PMID:26728315

  5. Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications

    PubMed Central

    Halpern, Joshua; Mittal, Sameer; Pereira, Keith; Bhatia, Shivank; Ramasamy, Ranjith

    2016-01-01

    There are several options for the treatment of varicocele, including surgical repair either by open or microsurgical approach, laparoscopy, or through percutaneous embolization of the internal spermatic vein. The ultimate goal of varicocele treatment relies on the occlusion of the dilated veins that drain the testis. Percutaneous embolization offers a rapid recovery and can be successfully accomplished in approximately 90% of attempts. However, the technique demands interventional radiologic expertise and has potential serious complications, including vascular perforation, coil migration, and thrombosis of pampiniform plexus. This review discusses the common indications, relative contraindications, technical details, and risks associated with percutaneous embolization of varicocele. PMID:26658060

  6. The AO Ulnar Shortening Osteotomy System Indications and Surgical Technique

    PubMed Central

    Nagy, Ladislav; Jungwirth-Weinberger, Anna; Campbell, Douglas; Pino, Juan González del

    2014-01-01

    Ulnar shortening osteotomy is an established and frequently performed surgical procedure in wrist surgery. The technical aspects of the procedure have continued to develop in recent years, with instruments and implants being developed specifically for this purpose. Ulnar shortening osteotomy is required for different clinical indications and situations. These varying indications demand different amounts of shortening, but all must be precise and accurate. Controversy exists as to how this can best be achieved in terms of the location for osteotomy, the surgical approach and geometry of the osteotomy, as well as which implant to use to provide optimal stability. The goal of all techniques (besides successfully resolving the underlying problem) is to achieve reliable and rapid bone union without compromising early functional rehabilitation and also to avoid hardware complications. The AO Hand Expert Group has developed a specialized instrumentation system with dedicated and specifically designed implants to ensure exact and accurate cutting with precise and rigid stabilization of the ulna. The matched drill guides and double-blade saws allow accurate completion of the planned amount of shortening together with precise coaptation of the osteotomy fragments. The specific ulnar osteotomy LCP (locking compression plate) combines maximum stability with minimum bulk and soft tissue irritation. The features of the implant, its surgical technique, and early results are described. PMID:25077046

  7. [Aseptic precautions in epidural catheterization for surgery].

    PubMed

    Haraga, Isao; Shono, Shinjiro; Abe, Shintarou; Higa, Kazuo

    2010-05-01

    We describe aseptic precautions in epidural catheterization for surgery. Every patient has to be checked for immunodeficiency, atopic dermatitis, preoperative use of antibiotics, and local infection of the epidural puncture site. Physicians who perform epidural catheterization should wear a mask and a cap and take off a wrist watch and rings on the fingers before an epidural kit is opened. Fingers and hands should be disinfected before wearing surgical gloves. The skin for epidural puncture site should be disinfected with 0.5% chlorhexidine in 80% ethanol. A micropore filter should be used when epidural catheterization is expected to remain over 24 hours. PMID:20486569

  8. Percutaneous endoscopic gastrostomy: Indications, technique, complications and management

    PubMed Central

    Rahnemai-Azar, Ata A; Rahnemaiazar, Amir A; Naghshizadian, Rozhin; Kurtz, Amparo; Farkas, Daniel T

    2014-01-01

    Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known advantages over parenteral nutrition, PEG offers superior access to the gastrointestinal system over surgical methods. Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide, knowing its indications and contraindications is of paramount importance in current medicine. PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish. Broadly, the two main indications of PEG tube placement are enteral feeding and stomach decompression. On the other hand, distal enteral obstruction, severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients. Although generally considered to be a safe procedure, there is the potential for both minor and major complications. Awareness of these potential complications, as well as understanding routine aftercare of the catheter, can improve the quality of care for patients with a PEG tube. These complications can generally be classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use and wound care. In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance. Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the “pull” technique being the most common method. In the last section of this review, the reader is presented with a brief discussion of these procedures, techniques and related issues. Despite the mentioned PEG tube placement complications, this procedure has gained worldwide popularity as a safe enteral access for nutrition in patients with a functional gastrointestinal system. PMID:24976711

  9. [Glenoid replacement for omarthritis : indications, technique, results and new developments].

    PubMed

    Pfahler, M

    2013-07-01

    In anatomical shoulder arthroplasty glenoid replacement is a critical point. Although total shoulder arthroplasty (TSA) provides better functional and pain results than hemi shoulder arthroplasty (HSA) there is great reluctance to implant a glenoid. For successful glenoid replacement it is necessary to preoperatively evaluate clear indications for glenoid replacement. Planning is a crucial point and has to be done thoroughly. The gold standard is an all polyethylene cemented glenoid. The implantation technique is most important to obtain an excellent and long-term result without complications. Significant key factors are preservation of the subchondral bone and an anatomical reconstruction of the glenoid. It seems that after a period of 10 years the loosening rate of glenoids increases and revisions rates rise. Therefore there is a high demand to develop new implants and a need for improved and convertible glenoids with better modularity and alternative options for fixation. PMID:23793843

  10. Ray Resections of the Fingers: Indications, Techniques, and Outcomes.

    PubMed

    Blazar, Philip E; Garon, Mark T

    2015-08-01

    Ray resection, which was pioneered by Bunnell in the 1920s, was initially performed as a salvage procedure for dysfunction of the proximal interphalangeal joint. Successful ray resection with or without an adjacent ray transfer can be useful for treating vascular insufficiency, tumors, infection, trauma, recurrent Dupuytren contracture, and congenital abnormalities of the hand. Indications, techniques, and outcomes vary based on the digit and the number of digits resected. Compared with amputation at the proximal phalangeal level, a single ray resection has better cosmesis and similar function, resulting in improved patient satisfaction. However, a 15% to 30% loss in grip and pinch strength has been reported. Today, ray resection results in good cosmetic and functional outcomes when preservation of a functional digit is unattainable or when the presence of an abnormal, unreconstructable digit interferes with the overall hand function. PMID:26209144

  11. Swan-Ganz - right heart catheterization

    MedlinePLUS

    ... you are in bed in an intensive care unit (ICU) of a hospital or in special procedure areas such as a cardiac catheterization laboratory. Before the test starts, you may be given medicine (sedative) to ...

  12. Radar techniques for indicating internal erosion in embankment dams

    NASA Astrophysics Data System (ADS)

    Carlsten, Seje; Johansson, Sam; Wörman, Anders

    1995-01-01

    For improved dam safety in Sweden, radar techniques have been tested for detecting anomalous zones in the central core of embankment dams and the level of the core crest. Anomalies in the core may indicate a continuing process and a greater risk of internal erosion. The level of the core crest is an essential parameter since temporary overtopping of the core has been discussed in Scandinavia as a possible way of coping with extreme floods. Detection methods of the time rate of change in soil characteristics and the exact location of the core crest and its variability would be valuable for analyses of the risk of internal erosion and planning of remedial measures. A system based on ground penetrating radar with multiple antennas has been developed partly to detect the core crest. The system operates with an accuracy significantly higher than single-antenna systems. Crosshole electromagnetic tomography supplies information on the porosity variation in the plane analyzed. In particular, time changes in porosity indicate that internal erosion is a serious problem.

  13. Ebstein's anomaly: Indications for repair and surgical technique.

    PubMed

    Di Russo, Gregory B.; Gaynor, J. William

    1999-01-01

    Ebstein's anomaly of the tricuspid valve is characterized by a regurgitant tricuspid valve with a large anterior leaflet and septal and tricuspid leaflets displaced into the right ventricle. Associated anomalies are common, especially atrial septal communication and right ventricular outflow tract obstruction. Clinical presentation includes a spectrum from minimal hemodynamic derangement and mild exercise intolerance to severe cardiopulmonary abnormalities and grave illness. The natural history of the disease is extremely variable; the worst prognosis is in the youngest patients, who often have associated cardiac abnormalities. Operative procedures range from ligation of a patent ductus arteriosus to cardiac transplantation. Tricuspid valvuloplasty has been advanced by several investigators and can be considered in nearly all cases. Repairs are based on the creation of a monocuspid or bicuspid valve with reduction of the enlarged annulus. While tricuspid valve repair or replacement is indicated for symptomatic children and adults, the management of the symptomatic neonate is difficult. Patients are stratified according to clinical status and morphology, then treated with observation, valve repair, conversion to single ventricle, or transplantation. We review the anatomy and pathophysiology of Ebstein's anomaly, the indications for surgery, and the appropriate timing of surgical intervention. Current techniques of tricuspid valvuloplasty are described and unresolved issues are discussed, including the role for superior cavopulmonary anastomosis, the management of symptomatic infants, and the necessity of ventricular plication in valve repair. Copyright 1999 by W.B. Saunders Company PMID:11486224

  14. Surgical ablation for atrial fibrillation: techniques, indications, and results

    PubMed Central

    Lawrance, Christopher P.; Henn, Matthew C.; Damiano, Ralph J.

    2015-01-01

    Purpose of review The aim of this review is to focus specifically on the indications, evolution of technique, and results of surgical ablation for atrial fibrillation. Recent findings With the introduction of the Cox-Maze IV procedure utilizing bipolar radiofrequency ablation and cryoablation, long-term studies have demonstrated a significant decrease in aortic cross-clamp times and major complications with a comparable rate of restoration of sinus rhythm. New hybrid approaches utilizing both catheter-based ablation and minimally invasive surgical approaches have been developed, but have not been standardized. Early studies have demonstrated reasonable success rates of hybrid procedures, with advantages that include confirmation of conduction block, decreased surgical morbidity, and possibly reduced morbidity. However, hybrid approaches have the disadvantage of significantly increased operative times. Summary The Cox-Maze IV is currently the gold standard for surgical treatment of atrial fibrillation. New hybrid approaches have potential advantages with promising early results, but a standard lesion set, improvement in operative times, and long-term results still need to be evaluated. PMID:25389650

  15. [External patello-tibial transfixation. I: Indications and technique].

    PubMed

    Gotzen, L; Ishaque, B; Morgenthal, F; Petermann, J

    1997-01-01

    Patello-tibial transfixation using the MPT-fixator is a new kind of external fixation. The device works biomechanically transferring the quadriceps tension forces from the patella to the lower leg and converting them into extension of the knee. The fixator can be applied in two different configurations. When performing configuration A, a Steinmann pin with a central thread is transversely placed through the patella and proximal tibia. Both pins are joined to connecting rods. Configuration B differs from type A in that a Schanz screw is inserted from anterior to posterior through the proximal tibia. The frame construction is achieved by fastening the tibial-sided Steinmann pin with a special clamp at the Schanz screw. Patello-tibial transfixation is indicated in the repair of fresh extensor mechanism disruption and reconstruction of neglected rupture of the patellar tendon. The technique provides a secure protection of the repair and reconstruction against mechanical overloading during the healing period. It enables immediate functional after-treatment and mobilization with early full weight bearing. PMID:9132951

  16. Right Cardiac Catheterization Using the Antecubital Fossa Vein in Korean Patients

    PubMed Central

    Lee, Sang Hyun; Lee, Dae Sung; Lee, Soo Yong; Hwang, Jongmin; Chon, Min Ku; Hwang, Ki Won; Kim, Jeong Su; Park, Yong Huyn; Kim, June Hong

    2016-01-01

    Background and Objectives Right heart catheterization is traditionally performed using a femoral vein approach that involves admission, bed rest, and risks of bleeding and hematoma. Recent studies have confirmed safety of the use of forearm vein for right cardiac catheterization. In the present study, we evaluated the feasibility of right cardiac catheterization via the antecubital fossa vein in Korean patients. Subjects and Methods The medical records of all patients who underwent right heart catheterization at our hospital between January 2003 and December 2014 were reviewed retrospectively. Right cardiac catheterizations via the antecubital fossa vein and the femoral vein were compared in terms of demographic data (age, sex, weight, height, and body mass index), indications for right cardiac catheterization, and procedural and outcome data (initial success rate, procedure time, compression to ambulation time, and complications). Results We reviewed 132 cases (antecubital fossa vein approach, n=37; femoral vein approach, n=95). The demographic data, initial success rate (100% vs. 100%) and procedure time (21.6±16.8 min vs. 25.6±12.6 min, p=0.14) were similar in both groups. The antecubital fossa vein group had a shorter mean compression to ambulation time than the femoral vein group (0.0 min vs. 201.2±48.1 min, p<0.01). No complications were observed in either group. Conclusion Our study indicated the ease of performance of right cardiac catheterization via the antecubital fossa vein. Thus, the antecubital fossa vein can be an alternative access site for right cardiac catheterization in Korean patients. PMID:27014351

  17. Radiation dosage during pediatric diagnostic or interventional cardiac catheterizations using the “air gap technique” and an aggressive “as low as reasonably achievable” radiation reduction protocol in patients weighing <20 kg

    PubMed Central

    Osei, Frank A; Hayman, Joshua; Sutton, Nicole J; Pass, Robert H

    2016-01-01

    Background: Cardiac catheterizations expose both the patient and staff to the risks of ionizing radiation. Studies using the “air gap” technique (AGT) in various radiological procedures indicate that its use leads to reduction in radiation exposure but there are no data on its use for pediatric cardiac catheterization. The aim of this study was to retrospectively review the radiation exposure data for children weighing <20 kg during cardiac catheterizations using AGT and an “as low as reasonably achievable (ALARA)” radiation reduction protocol. Patients and Methods: All patients weighing <20 kg who underwent cardiac catheterization at the Children's Hospital at Montefiore (CHAM), New York, the United States from 05/2011 to 10/2013 were included. Transplant patients who underwent routine endomyocardial biopsy and those who had surgical procedures at the time of the catheterizations were excluded. The ALARA protocol was used in concert with AGT with the flat panel detector positioned 110 cm from the patient. Demographics, procedural data, and patient radiation exposure levels were collected and analyzed. Results: One-hundred and twenty-seven patients underwent 151 procedures within the study period. The median age was 1.2 years (range: 1 day to 7.9 years) and median weight was 8.8 kg (range: 1.9-19.7). Eighty-nine (59%) of the procedures were interventional. The median total fluoro time was 13 min [interquartile range (IQR) 7.3-21.8]. The median total air Kerma (K) product was 55.6 mGy (IQR 17.6-94.2) and dose area product (DAP) was 189 Gym2 (IQR 62.6-425.5). Conclusion: Use of a novel ALARA and AGT protocol for cardiac catheterizations in children markedly reduced radiation exposure to levels far below recently reported values. Abbreviations: AGT: Air gap technique, ALARA: As low as reasonably achievable. PMID:27011686

  18. Idiopathic unilateral hypoplasia of internal jugular vein and coagulopathy: Unusual case for central venous catheterization

    PubMed Central

    Nama, Rajnish K.; Bhosale, Guruprasad P.; Shah, Veena R.

    2015-01-01

    Central venous catheterization (CVC) is routinely done procedure in ICU or during surgery for various indications. Right Internal jugular vein (IJV) is preferred vessel among different routes for CVC. Anatomic variations of neck vessels are not uncommon and may increase the complication rate especially in patients with altered coagulation profile. Anatomic landmark technique is commonly used for CVC but not without possibility of complications. Ultrasound (US) guided IJV Cannulation provides high success rate, less access time and lesser complications. Superiority of US over anatomic landmark technique has been established, but use of US in clinical practice is still limited. We report a case of idiopathic unilateral hypoplastic IJV in a patient with altered coagulation profile who required CVC, we also tried to find out the barriers for limited use of US. PMID:26712993

  19. La réparation sphinctérienne directe: points techniques, indications et résultats

    PubMed Central

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

    2013-01-01

    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. PMID:23504542

  20. Pediatric Thoracic Organ Transplantation: Current Indications, Techniques, and Imaging Findings.

    PubMed

    Chang, Patricia T; Frost, Jamie; Stanescu, A Luana; Phillips, Grace S; Lee, Edward Y

    2016-03-01

    In the past decade, with improved surgical technique and knowledge of immunosuppression, pediatric lung and heart transplantation have been established as viable therapeutic interventions for pediatric patients with end-stage cardiopulmonary disease from various underlying congenital and acquired disorders. Although outcomes for pediatric patients are similar to those for adult patients, thoracic organ transplantation in this special age group carries unique challenges for preoperative and postoperative imaging evaluation. The article provides an up-to-date review of the postoperative transplant anatomy, imaging techniques, and complications of pediatric lung and heart transplantation. PMID:26896227

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

    SciTech Connect

    Gottwalles, Yannick; Wunschel-Joseph, Marie-Eve; Hanssen, Michel

    2000-11-15

    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.

  2. Allograft anterior cruciate ligament reconstruction: indications, techniques, and outcomes.

    PubMed

    Vyas, Dharmesh; Rabuck, Stephen J; Harner, Christopher D

    2012-03-01

    The anterior cruciate ligament (ACL) is an important stabilizer of the knee against translational and rotational forces. The goal of anatomic reconstruction of the ACL-deficient knee is to re-create a stable knee that will allow for return to sport and prevent recurrent injury. Multiple graft options exist for ACL reconstruction, and each option has unique advantages and disadvantages. With appropriate patient selection, each graft can be utilized to optimize patient outcomes. Allograft options limit morbidity following ACL reconstruction, but care must be taken with surgical technique and postoperative rehabilitation to allow for graft incorporation. An understanding of the surgical technique and differences between graft options will allow the patient, surgeon, and physical therapist to maximize outcomes following ACL reconstruction. PMID:22282347

  3. Frontofacial Surgery in Children and Adolescents: Techniques, Indications, Outcomes

    PubMed Central

    Britto, J.A.; Greig, A.; Abela, C.; Hearst, D.; Dunaway, D.J.; Evans, R.D.

    2014-01-01

    The techniques of frontofacial surgery are most valuable in the clinical management of complex craniofacial deformity to achieve a range of functional and aesthetic gains in children from infancy to maturity. A variety of complex craniofacial osteotomies that can be used to separate the orbits from the skull base have been described. In addition, the combination of circumorbital release and pterygomaxillary disjunction allows advancement of the orbitomaxillary segment for powerful clinical benefit. For the purpose of this article, the principal frontofacial strategies include the monobloc frontofacial advancement by distraction (MBD), frontofacial bipartition advancement by distraction (BpD), orbital box osteotomy (FFBx), and frontofacial bipartition (FFBp). These techniques are broadly used for two purposes: to allow for the translocation of one or both orbits to correct orbitofacial disproportion (hypertelorism, vertical orbital dystopia, or a combination of both), or to advance the orbitomaxillary segment for orbital volume expansion and protection of the eye in syndromes featuring severe exorbitism (oculo-orbital disproportion). Here we describe aspects of our experience of frontofacial surgery in the Craniofacial Centre at Great Ormond Street Hospital for Children, London, with reference to the principles underpinning frontofacial surgical techniques, their challenges, and their impact on function and aesthetics. PMID:25210505

  4. Clean Intermittent Catheterization in the School Setting

    ERIC Educational Resources Information Center

    Katrancha, Elizabeth D.

    2008-01-01

    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,…

  5. Elective Surgery for Sigmoid Diverticulitis - Indications, Techniques, and Results.

    PubMed

    Jurowich, Christian F; Germer, Christoph T

    2015-04-01

    Diverticulitis is one of the leading indications for elective colonic resections although there is an ongoing controversial discussion about classification, stage-dependent therapeutic options, and therapy settings. As there is a rising trend towards conservative therapy for diverticular disease even in patients with a complicated form of diverticulitis, we provide a compact overview of current surgical therapy principles and the remaining questions to be answered. PMID:26989381

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

    SciTech Connect

    Walser, Eric M.

    2012-08-15

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

  7. Microsurgical epididymal sperm aspiration: indications, techniques and outcomes.

    PubMed

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

    2013-01-01

    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. PMID:23160264

  8. [Indications, technique and risks in bone marrow transplantation in adulthood].

    PubMed

    Heyll, A; Söhngen, D; Minning, H; Meckenstock, G; Aul, C; Schneider, W

    1996-03-19

    The option of bone marrow transplantation (BMT) significantly improved prognosis of adult patients with hematologic malignancies aged less than 50 years. Allogeneic BMT using the marrow of an HLA-identical family member still provides the most effective method of BMT. Conventional indications for this form of BMT are chronic myeloid leukemia (CML), acute leukemias presenting with adverse risk factors, myelodysplastic syndromes and severe aplastic anemia. If performed early in the disease course (e.g. during the chronic phase of CML or first remission of acute leukemia and MDS) allogeneic BMT cures 50 to 60% of patients. About 20% die of therapy related complications, e.g. graft versus host disease (GvHD), fatal infections or venoocclusive disease of the liver (VOD) and about 20% of patients succumb to relapse of their hematologic disorder. 80% presenting with severe aplastic anemia can be cured, if allogeneic BMT is performed soon after diagnosis without previous immunosuppressive therapy and blood transfusions. BMT with the marrow of a matched unrelated donor or autologous BMT are increasingly used as alternative procedures. A rate of lethal complications as high as 50% hinders rapid extension of BMT with unrelated donors. Therefore, this form of BMT should be restricted to young patients with leukemias, who cannot achieve long-term remission with conventional chemotherapy (in case of acute leukemias) or alpha-interferon (in case of CML). Reconstitution of hematopoiesis is more rapid after peripheral blood stem cell transplantation (PBSCT) compared with autologous BMT. Therefore, PBSCT will replace autologous BMT in most cases. Most favourable results of PBSCT have been reported in patients with malignant lymphomas after relapse or inferior response to primary induction therapy. Due to the higher relapse rate autologous BMT is inferior to allogeneic BMT in leukemia patients. Trials are required to clarify the potential role of myeloablative therapy with stem cell support in the treatment of patients with solid tumors. Many of the preliminary results already published are unsatisfactory and data of larger trials are still lacking. Therefore, BMT or PBSCT cannot be recommended generally for the therapy of patients with solid tumors. PMID:8643901

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

    SciTech Connect

    Bolia, Amman; Nasim, Akhtar; Bell, Peter R.F.

    1996-05-15

    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.

  10. Complete guidewire retention after femoral vein catheterization.

    PubMed

    Cat, Bahar Gulcay; Guler, Sertac; Soyuduru, Murat; Guven, Ibrahim; Ramadan, Hayri

    2015-01-01

    Central venous catheters (CVCs) are often used for various purposes in the emergency departments (ED). The main uses of CVCs in the EDs are emergent hemodialysis, in situations where peripheral vein catheterization cannot be achieved, and continuous invasive hemodynamic monitoring. The complications related to CVC insertion are usually mechanical and observed in the near term after the procedure. Retained CVC guidewire after catheterization is a rare complication in the published reports and usually related with intra- or postoperative settings and jugular or subclavian vein. The present study reported a young female patient who underwent left femoral vein catheterization 6 months earlier in an intensive care unit of another hospital and was diagnosed with complete guidewire retention in the ED. To the best of the authors' knowledge, this is the first case in published reports with a diagnosis of retained CVC guidewire with retrograde migration into the femoral vein. Surprisingly, the patient developed no thrombotic or embolic complication during this 6-month period. PMID:26657235

  11. In vivo measurement of myocardial protein turnover using an indicator dilution technique

    SciTech Connect

    Revkin, J.H.; Young, L.H.; Stirewalt, W.S.; Dahl, D.M.; Gelfand, R.A.; Zaret, B.L.; Barrett, E.J. )

    1990-10-01

    We applied a nondestructive tracer technique, previously developed for measuring skeletal muscle protein turnover, to the measurement of myocardial protein turnover in vivo. During a continuous infusion of L-(ring-2,6-3H)phenylalanine to anesthetized, overnight-fasted dogs, we measured the uptake of radiolabeled phenylalanine from plasma and the release of unlabeled phenylalanine from myocardial proteolysis using arterial and coronary sinus catheterization and analytic methods previously applied to skeletal muscle. Using these measurements, together with a model of myocardial protein synthesis that assumes rapid equilibration of tracer specific activity between myocardial phenylalanyl-tRNA and circulating phenylalanine, we estimated the rates of heart protein synthesis and degradation. The rate of heart protein synthesis was also estimated directly from the incorporation of labeled phenylalanine into tissue protein. The use of (3H)phenylalanine was compared with L-(1-14C)leucine in the measurement of heart protein turnover in dogs given simultaneous infusion of both tracers. Leucine uptake and release by the myocardium exceeded that of phenylalanine by 3.1 +/- 0.4- and 1.7 +/- 0.3-fold, respectively, consistent with leucine's 2.4-fold greater abundance in heart protein and its metabolism via other pathways. Phenylalanine is the preferred tracer for use with this method because of its limited metabolic fate in muscle. One theoretical limitation to the method, slow equilibration of circulating labeled phenylalanine with myocardial phenylalanyl-tRNA, was resolved by comparison of these specific activities after a 30-minute infusion of labeled phenylalanine in the rat. A second, empirical limitation involves precision in the measurement of the small decrements in phenylalanine specific activity that occur with each pass of blood through the coronary circulation.

  12. Transcervical catheterization and cervical patency during the oestrous cycle in domestic cats.

    PubMed

    Chatdarong, K; Lohachit, C; Ponglowhapan, S; Linde-Forsberg, C

    2001-01-01

    The aims of the present study were to develop a device for vaginal and transcervical catheterization in domestic cats, and to study cervical patency during the various stages of the oestrous cycle. Seventeen queens submitted for routine spaying were included in the study. A vaginal catheter was designed from a urinary catheter for dogs, to fit into the ventral vaginal fornix, and a 3.5 French tomcat catheter was used as an inner transcervical catheter. Cervical patency was studied by infusing 0.5 ml Urografin into the cranial vagina and taking X-rays of the queens after 5 min. The Urografin did not enter the uterus, even in the oestrous queens. Transcervical catheterization was then attempted. The correct placement of the intrauterine catheter was confirmed by injecting green food colour mixed with penicillin G and observing the presence of stain in the uterine horns during surgery. Catheterization was successful in 13 of 17 queens: six of nine in interoestrus, three of three in oestrus, one of two in metoestrus and three of three in the postpartum period. Transcervical catheterization is a non-invasive technique that is likely to improve the success rate of assisted feline reproduction, and is potentially a useful non-surgical technique for diagnosis and therapy of uterine diseases. PMID:11787175

  13. Catheterization of the urethra in female pigs.

    PubMed

    Musk, G C; Zwierzchoniewska, M; He, B

    2015-10-01

    Female pigs are commonly utilized as an animal model for biomedical research and require urethral catheterization. Sixteen pigs were anaesthetized for research purposes and required the placement of a urethral catheter. Post-mortem examination of the vaginas revealed the urethral opening to be consistently halfway from the mucocutaneous junction of the vulva to the cervix. A shallow diverticulum was also observed on the ventral floor of the urethral opening. To optimize conditions for success the pig should be carefully positioned supine, a vaginal speculum and light source should be used, the pig should be adequately anaesthetized, and the anatomy of the vagina should be reviewed. PMID:25977261

  14. Myocardial blood flow: Roentgen videodensitometry techniques

    NASA Technical Reports Server (NTRS)

    Smith, H. C.; Robb, R. A.; Wood, E. H.

    1975-01-01

    The current status of roentgen videodensitometric techniques that provide an objective assessment of blood flow at selected sites within the coronary circulation were described. Roentgen videodensitometry employs conventional radiopaque indicators, radiological equipment and coronary angiographic techniques. Roentgen videodensitometry techniques developed in the laboratory during the past nine years, and for the past three years were applied to analysis of angiograms in the clinical cardiac catheterization laboratory.

  15. A unique complication of urethral catheterization: pubic hair associated with struvite bladder calculi.

    PubMed

    Perz, Sarah; Ellimoottil, Chandy; Rao, Manoj; Bresler, Larissa

    2013-01-01

    Bladder stones account for 5% of all urinary stone disease and can develop on a foreign body, such as a misplaced suture, eroded surgical mesh, or ureteral stent. In this case study, the authors present a patient with bladder stones associated with pubic hairs introduced during a monthly indwelling Foley catheter change. Clinicians have an important role in instructing patients on the use of proper technique and hygiene practices during urethral catheterization to minimize the potential for urinary complications. PMID:24354112

  16. Indications, technique and results of caudal epidural injection for lumbar disc retropulsion.

    PubMed Central

    Sharma, P. K.

    1977-01-01

    The indications, contra-indications and technique of caudal epidural injections in the treatment of low back pain and sciatica are described. Of 201 patients treated by epidural injection, about 56% had favourable results. Images Fig. 1 Fig. 3 Fig. 5 PMID:141659

  17. Use of structured personality survey techniques to indicate operator response to stressful situations

    SciTech Connect

    Waller, M.A.

    1990-01-01

    Under given circumstances, a person will tend to operate in one of four dominant orientations: (1) to perform tasks; (2) to achieve consensus; (3) to achieve understanding, or (4) to maintain structure. Historically, personality survey techniques, such as the Myers-Briggs type indicator, have been used to determine these tendencies. While these techniques can accurately reflect a person's orientation under normal social situations, under different sets of conditions, the same person may exhibit other tendencies, displaying a similar or entirely different orientation. While most do not exhibit extreme tendencies or changes of orientation, the shift in personality from normal to stressful conditions can be rather dramatic, depending on the individual. Structured personality survey techniques have been used to indicate operator response to stressful situations. These techniques have been extended to indicate the balance between orientations that the control room team has through the various levels of cognizance.

  18. Clean, intermittent catheterization of infants with neurogenic bladder.

    PubMed

    Joseph, D B; Bauer, S B; Colodny, A H; Mandell, J; Retik, A B

    1989-07-01

    Clean, intermittent catheterization was instituted in 38 babies with myelodysplasia who were thought to be at risk for upper urinary tract deterioration because of neurogenic bladder dysfunction. There were 19 patients 2 weeks to 12 months of age, 11 were 1 to 2 years of age, and 8 were older than 2 years. Effectiveness of clean, intermittent catheterization was determined by maintenance of upper urinary tract stability. Upper urinary tracts improved or remained stable in 13 of 16 infants (81%) with reflux and 16 of 18 infants (89%) with detrusor-sphincter dyssynergia. Bacteriuria was present in 16 (42%), with only 2 infants (5%) having a febrile episode; no infant required hospitalization because of urinary tract infections. No further complications were identified in infants who were cleanly and intermittently catheterized. Most families found clean, intermittent catheterization of their infants easy to master and not stressful, and their children adjusted to it at an early age. PMID:2740179

  19. Filmless multimedia display following cardiac catheterization.

    PubMed

    Mathewson, J W

    1997-08-01

    In traditional cardiac catheterization laboratories, anatomic images are acquired onto 35-mm cine film and presented in series with related information days, weeks, or months later to an audience of decision-makers. These data are projected onto a convenient light-colored wall or silver screen, while echocardiograms and electrophysiologic data are displayed using small single-user computer monitors. This presentation format is not ideal, because full audience participation is not fostered, image quality may be degraded, and small computer screens can be adequataly visualized only by those individuals immediately in front of them. Modern video multimedia systems now make an ideal data presentation format practical, in which all types of media including digitally acquired angiograms can be displayed in parallel with full annotation, using large diagonal multisync color monitors. This communication discusses how to design a multimedia conference center in which remotely acquired filmless digital images can be displayed and processed together with all other pertinent cardiac multimedia to a large audience. PMID:9258498

  20. Paediatric cardiac catheterization: an information sheet.

    PubMed

    Bonnet, Caroline; Greffier, Angelique

    2013-04-01

    The need to inform patients using validated scientific data is acknowledged internationally. The obligation to inform patients is based on a fundamental principle of French law: the principle of the unavailability of the human body. Before engaging in diagnostic or therapeutic strategies such as paediatric cardiac catheterization, the healthcare professional must explain the disease, the advantages and drawbacks of each treatment strategy and their foreseeable benefit/risk ratio in order to help older children and their parents come to a decision. To obtain this required consent and before the care is provided, the infant and their legal representative must have received clear, accurate and understandable information. An information sheet cannot substitute for verbal information. Guidelines for good practices on the delivery of information have been established by the Health Authorities and officially recognized in a decree from the Ministry of Health. These documents allow professionals to draft a written information document for patients and healthcare users. This document must help the patient to take part in decisions that concern them. The law of 4th March 2002 regarding the rights of patients and the quality of the healthcare system states that 'in cases of litigation, it is the responsibility of the professional or the healthcare establishment to provide proof that the information was given to the person concerned in the conditions set out in the present article. This proof can be brought by any means'. PMID:23706369

  1. Removal of gallstone from mesorectum after laparoscopic cholecystectomy – new indication for transanal endoscopic microsurgery technique

    PubMed Central

    Przywózka, Alicja; Zieliński, Tomasz

    2015-01-01

    Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for local excision of benign and malignant neoplasms in the rectum. Indications for this technique are constantly changing and extending. The aim of this study is to describe a case of a unique and innovative application of this surgical technique. A 72-year-old patient was admitted to the Clinical Department of General and Colorectal Surgery for elective resection of a tumor located in the perianal area using the TEM surgical technique. In August 2005 the patient underwent laparoscopic cholecystectomy due to symptomatic cholecystitis. From March 2011 the patient complained about ongoing sharp pain in the perianal and presacral area. Computed tomography revealed two oval areas approximately 30 mm in size to the right of the sigmoido-rectal region communicating with the colon lumen. Subsequently diverticulitis was diagnosed. The TEM technique was uniquely used to successfully remove the gallstone from the 72-year-old patient's presacral area. PMID:26865896

  2. Removal of gallstone from mesorectum after laparoscopic cholecystectomy - new indication for transanal endoscopic microsurgery technique.

    PubMed

    Szczepkowski, Marek; Przywózka, Alicja; Zieliński, Tomasz

    2016-01-01

    Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for local excision of benign and malignant neoplasms in the rectum. Indications for this technique are constantly changing and extending. The aim of this study is to describe a case of a unique and innovative application of this surgical technique. A 72-year-old patient was admitted to the Clinical Department of General and Colorectal Surgery for elective resection of a tumor located in the perianal area using the TEM surgical technique. In August 2005 the patient underwent laparoscopic cholecystectomy due to symptomatic cholecystitis. From March 2011 the patient complained about ongoing sharp pain in the perianal and presacral area. Computed tomography revealed two oval areas approximately 30 mm in size to the right of the sigmoido-rectal region communicating with the colon lumen. Subsequently diverticulitis was diagnosed. The TEM technique was uniquely used to successfully remove the gallstone from the 72-year-old patient's presacral area. PMID:26865896

  3. Lung radiofrequency and microwave ablation: a review of indications, techniques and post-procedural imaging appearances

    PubMed Central

    Jennings, P E

    2015-01-01

    Lung ablation can be used to treat both primary and secondary thoracic malignancies. Evidence to support its use, particularly for metastases from colonic primary tumours, is now strong, with survival data in selected cases approaching that seen after surgery. Because of this, the use of ablative techniques (particularly thermal ablation) is growing and the Royal College of Radiologists predict that the number of patients who could benefit from such treatment may reach in excess of 5000 per year in the UK. Treatment is often limited to larger regional centres, and general radiologists often have limited awareness of the current indications and the techniques involved. Furthermore, radiologists without any prior experience are frequently expected to interpret post-treatment imaging, often performed in the context of acute complications, which have occurred after discharge. This review aims to provide an overview of the current indications for pulmonary ablation, together with the techniques involved and the range of post-procedural appearances. PMID:25465192

  4. Development of Needle Insertion Manipulator for Central Venous Catheterization

    NASA Astrophysics Data System (ADS)

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

    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.

  5. Compliance With Guideline Statements for Urethral Catheterization in an Iranian Teaching Hospital

    PubMed Central

    Taleschian-Tabrizi, Negar; Farhadi, Fereshteh; Madani, Neda; Mokhtarkhani, Mohaddeseh; Kolahdouzan, Kasra; Hajebrahimi, Sakineh

    2015-01-01

    Background: It is believed that healthcare staff play an important role in minimizing complications related to urethral catheterization. The purpose of this study was to determine whether or not healthcare staff complied with the standards for urethral catheterization. Methods: This study was conducted in Imam Reza teaching hospital, Tabriz, Iran, from July to September 2013. A total of 109 catheterized patients were selected randomly from surgical and medical wards and intensive care units (ICUs). A questionnaire was completed by healthcare staff for each patient to assess quality of care provided for catheter insertion, while catheter in situ, draining and changing catheter bags. Items of the questionnaire were obtained from guidelines for the prevention of infection. Data analysis was performed with SPSS 16. Results: The mean age of the patients was 50.54 ± 22.13. Of the 109 patients, 56.88% were admitted to ICUs. The mean duration of catheter use was 15.86 days. Among the 25 patients who had a urinalysis test documented in their hospital records, 11 were positive for urinary tract infection (UTI). The lowest rate of hand-washing was reported before bag drainage (49.52%). The closed drainage catheter system was not available at all. Among the cases who had a daily genital area cleansing, in 27.63% cases, the patients or their family members performed the washing. In 66.35% of cases, multiple-use lubricant gel was applied; single-use gel was not available. The rate of documentation for bag change was 79%. Conclusion: The majority of the guideline statements was adhered to; however, some essential issues, such as hand hygiene were neglected. And some patients were catheterized routinely without proper indication. Limiting catheter use to mandatory situations and encouraging compliance with guidelines are recommended. PMID:26673464

  6. Endovascular Aortic Aneurysm Repair with Chimney and Snorkel Grafts: Indications, Techniques and Results

    SciTech Connect

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

    2013-12-15

    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.

  7. Indwelling Catheterization in Caesarean Section: Time To Retire It!

    PubMed Central

    Mehta, Sumita; Grover, Anshul; Goel, Neerja

    2015-01-01

    Background Routine placement of indwelling catheter preoperatively in Caesarean Section is being practiced without justified scientific evidence. Aim To evaluate the effect of routine indwelling catheterization on the postoperative ambulation, morbidity and hospital stay in women undergoing Caesarean section. Settings and Design Case-Control study carried in a tertiary teaching hospital. Materials and Methods This study was carried over 150 women undergoing primary Caesarean section without any medical complication or pre-existing Urinary Tract Infections (UTI). The subjects were randomly allocated to 2 groups i.e. Group 1(Non-Catheterized; NC) and Group 2 (Catheterized for 24 hours postoperatively; C). Parameters noted were; duration of surgery, time of ambulation, postoperative voiding discomfort {graded as - no, mild, moderate-severe, by Visual Analog Scoring (VAS)}, incidence of UTI, postoperative urinary retention, need of postoperative antibiotics and duration of hospital stay. Statistical Analysis Results were analysed using unpaired t-test. Results There was no significant difference in duration of surgery and postoperative urinary retention in both groups. However, it was seen that non-catheterized patients had significantly earlier ambulation, shorter hospital stay, took less time for first voiding, lesser voiding discomfort, less incidence of UTI and lesser use of postoperative antibiotics. Conclusion The routine use of indwelling catheter in Caesarean section is unscientific and unnecessary. There should be selective rather than routine catheterization. PMID:26500959

  8. [One-step reconstruction of penile urethral strictures. Indications and techniques].

    PubMed

    Alvarez-Vijande, Ricardo

    2014-01-01

    Penile urethra stenoses generally appear as a sequel after acute (sexually transmitted diseases) or chronic urethritis processes, associated with diseases such as lichen sclerosus or as a consequence of traumatism, iatrogeny and forced distention of the urethral lumen. One third of these lesions may be congenital and they usually present in the youngest patients. When there is indication for surgical urethral reconstruction there are multiple surgical techniques and different tissues. The selection of the best technique depends on the availability of different tissue sources, the knowledge of the various technical options, and being familiar or having personal experience with the surgical techniques. This chapter aims to review the various technical options of more frequent use for urethral lumen reconstruction, to offer the greatest number of resources to solve a medical problem of complex solution. PMID:24531670

  9. Combined Hip Arthroscopy and Periacetabular Osteotomy: Indications, Advantages, Technique, and Complications

    PubMed Central

    Domb, Benjamin; LaReau, Justin; Redmond, John M.

    2014-01-01

    Evaluation and treatment of concomitant intra-articular pathology may be beneficial before periacetabular osteotomy (PAO) is performed. Hip arthroscopy before PAO allows the surgeon to perform full inspection of the hip joint and can be used to treat hip pathology before osteotomy. The indications for hip arthroscopy before PAO are presented in this article. The combined surgical procedure is described, along with potential complications. The advantages and disadvantages of this technique are outlined. PMID:24843847

  10. Pelvic Fixation in Adult and Pediatric Spine Surgery: Historical Perspective, Indications, and Techniques: AAOS Exhibit Selection.

    PubMed

    Jain, Amit; Hassanzadeh, Hamid; Strike, Sophia A; Menga, Emmanuel N; Sponseller, Paul D; Kebaish, Khaled M

    2015-09-16

    Achieving solid osseous fusion across the lumbosacral junction has historically been, and continues to be, a challenge in spine surgery. Robust pelvic fixation plays an integral role in achieving this goal. The goals of this review are to describe the history of and indications for spinopelvic fixation, examine conventional spinopelvic fixation techniques, and review the newer S2-alar-iliac technique and its outcomes in adult and pediatric patients with spinal deformity. Since the introduction of Harrington rods in the 1960s, spinal instrumentation has evolved substantially. Indications for spinopelvic fixation as a means to achieve lumbosacral arthrodesis include a long arthrodesis (five or more vertebral levels) or use of three-column osteotomies in the lower thoracic or lumbar spine, surgical treatment of high-grade spondylolisthesis, and correction of lumbar deformity and pelvic obliquity. A variety of techniques have been described over the years, including Galveston iliac rods, Jackson intrasacral rods, the Kostuik transiliac bar, iliac screws, and S2-alar-iliac screws. Modern iliac screws and S2-alar-iliac screws are associated with relatively low rates of pseudarthrosis. S2-alar-iliac screws have the advantages of less implant prominence and inline placement with proximal spinal anchors. Collectively, these techniques provide powerful methods for obtaining control of the pelvis in facilitating lumbosacral arthrodesis. PMID:26378268

  11. A new technique for determining Substorm Onsets and Phases from Indices of the Electrojet (SOPHIE)

    NASA Astrophysics Data System (ADS)

    Forsyth, C.; Rae, I. J.; Coxon, J. C.; Freeman, M. P.; Jackman, C. M.; Gjerloev, J.; Fazakerley, A. N.

    2015-12-01

    We present a new quantitative technique that determines the times and durations of substorm expansion and recovery phases and possible growth phases based on percentiles of the rate of change of auroral electrojet indices. By being able to prescribe different percentile values, we can determine the onset and duration of substorm phases for smaller or larger variations of the auroral index or indeed any auroral zone ground-based magnetometer data. We apply this technique to the SuperMAG AL (SML) index and compare our expansion phase onset times with previous lists of substorm onsets. We find that more than 50% of events in previous lists occur within 20 min of our identified onsets. We also present a comparison of superposed epoch analyses of SML based on our onsets identified by our technique and existing onset lists and find that the general characteristics of the substorm bay are comparable. By prescribing user-defined thresholds, this automated, quantitative technique represents an improvement over any visual identification of substorm onsets or indeed any fixed threshold method.

  12. [Difficult catheterization of the radial artery. Comparison of a new arterial catheter and Seldinger's technic].

    PubMed

    Videcoq, M; Desmonts, J M

    1989-01-01

    Sixty difficult radial artery cannulations were carried out using either the Seldinger technique (Seldicath Plastimed, FG 3, 80 mm long; group S; n = 30) or a new arterial catheter (Arrow, Critikon, gauge 20, 44 mm long; group A; n = 30) in patients scheduled for coronary arterial surgery or cardiac valve replacement (age: 54.8 +/- 11.8 yr). The technique was chosen at random after failure of radial artery catheterization with a short intravenous catheter (Quick-Cath Travenol, gauge 20, 31 or 51 mm long, or Insite W Beckton-Dickinson, gauge, 20, 30 mm long). The second attempt was carried out on the same artery, a few centimeters higher up than the first one. Heparinized normal saline was infused through this arterial line. All the catheters were removed after extubation. There was no arterial thrombosis, nor any displacement of the catheter with loss of the arterial pressure curve. No difference was found between the two techniques regarding the number of catheterization failures, the duration of cannulation, and the quality of the blood pressure curve. For difficult radial artery cannulations, the arterial catheter Arrow associated the advantages of the Seldinger technique with those of short intravenous catheters. PMID:2782692

  13. Screening children with myelodysplasia for readiness to learn self-catheterization.

    PubMed

    Brown, J P; Reichenbach, M B

    1989-01-01

    The purpose of this research study was to develop and test a screening tool to determine the readiness of children with myelodysplasia to self-catheterize. The tool was developed after identifying requisite skills for self-catheterization. Twenty-five clients with myelodysplasia who required intermittent catheterization for bladder management--all under 18 years of age--were screened using the tool. Based on their previously demonstrated ability to self-catheterize, the children were divided into two groups: those who did self-catheterize and those who did not. The 18 children who self-catheterized all passed each item on the screening tool. The 7 children who did not self-catheterize failed one or more items on the screening tool. Based on this small sample, the tool offers a simple, safe way to judge readiness to learn self-catheterization. PMID:2813951

  14. The management of femoral bone stock in THA revision: indications and techniques.

    PubMed

    Bianchi, Luca; Galante, Claudio; Zagra, Luigi

    2014-01-01

    Following the increasing number of total hip arthroplasties, the amount of hip revision procedures continue to rise. Careful patient selection and bone loss evaluation is crucial for a correct management of femoral revision procedures. The key point in femoral revision is to obtain a reliable primary stability of the stem, with the least invasive implant as possible, to preserve and if possible to restore the bone stock. In this article we present the indications and the techniques for the femoral revisions most commonly used in Europe, referring to the evidence in the literature and our personal experiences. PMID:24970033

  15. 21 CFR 870.1310 - Vessel dilator for percutaneous catheterization.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Vessel dilator for percutaneous catheterization. 870.1310 Section 870.1310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices §...

  16. 21 CFR 870.1310 - Vessel dilator for percutaneous catheterization.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Vessel dilator for percutaneous catheterization. 870.1310 Section 870.1310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices §...

  17. 21 CFR 870.1310 - Vessel dilator for percutaneous catheterization.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Vessel dilator for percutaneous catheterization. 870.1310 Section 870.1310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices §...

  18. 21 CFR 870.1310 - Vessel dilator for percutaneous catheterization.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Vessel dilator for percutaneous catheterization. 870.1310 Section 870.1310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices §...

  19. 21 CFR 870.1310 - Vessel dilator for percutaneous catheterization.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vessel dilator for percutaneous catheterization. 870.1310 Section 870.1310 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices §...

  20. Diagnostic aspiration of an iatrogenic hydrothorax following subclavian catheterization.

    PubMed Central

    Steiger, M. J.; Morgan, A. G.

    1990-01-01

    Central venous catheterization is not without hazard. Inadvertent placement in the pleural space can occur without the development of a pneumothorax and pressure measurements may appear misleadingly normal. This case report illustrates an effective method of diagnosing and draining an iatrogenic hydrothorax which resulted in this way. Images Figure 1 Figure 2 PMID:2217040

  1. Patient Decision Control and the Use of Cardiac Catheterization

    PubMed Central

    Paasche-Orlow, Michael K.; Orner, Michelle B.; Stewart, Sabrina K.; Kressin, Nancy R.

    2015-01-01

    Background: Shared decision-making is a key determinant of patient-centered care. A lack of patient involvement in treatment decisions may explain persistent racial disparities in rates of cardiac catheterization (CCATH). To date, limited evidence exists to demonstrate whether patients who engage in shared decision-makingare more or less likely to undergo non-emergency CCATH. Objective: To assess the relationship between participation in the decision to undergo a CCATH and the use of CCATH. We also examined whether preference for or actual engagement in decision-making varied by patient race. Methods: We analyzed data from 826 male Veterans Administration patients for whom CCATH was indicated and who participated in the Cardiac Decision Making Study. Results: After controlling for confounders, patients reporting any degree of decision control were more likely to receive CCATH compared with those reporting no control (doctor made decision without patient input) (54% vs 39%, P<.0001). Across racial groups, patients were equally likely to report a preference for control over decision-making (P=.53) as well as to experience discordance between their preference for control and their perception of the actual decision-making process (P=.59). Therefore, these factors did not mediate racial disparities in rates of CCATH use. Conclusion: Shared decision-making is an essential feature of whole-person care. While participation in decision-making may not explain disparities in CCATH rates, further work is required to identify strategies to improve congruence between patients' desire for and actual control over decision-making to actualize patient-centered care. PMID:26331101

  2. Indwelling versus Intermittent Urinary Catheterization following Total Joint Arthroplasty: A Systematic Review and Meta-Analysis

    PubMed Central

    Xue, Deting; Li, Chao; Zhang, Kai; Ma, Honghai; Yan, Shigui; Pan, Zhijun

    2015-01-01

    Objective The purpose of this study is to compare the rates of urinary tract infection (UTI) and postoperative urinary retention (POUR) in patients undergoing lower limb arthroplasty after either indwelling urinary catheterization or intermittent urinary catheterization. Methods We conducted a meta-analysis of relevant randomized controlled trials (RCT) to compare the rates of UTI and POUR in patients undergoing total joint arthroplasty after either indwelling urinary catheterization or intermittent urinary catheterization. A comprehensive search was carried out to identify RCTs. Study-specific risk ratios (RR) with 95% confidence intervals (CI) were pooled. Additionally, a meta-regression analysis, as well as a sensitivity analysis, was performed to evaluate the heterogeneity. Results Nine RCTs with 1771 patients were included in this meta-analysis. The results showed that there was no significant difference in the rate of UTIs between indwelling catheterization and intermittent catheterization groups (P>0.05). Moreover, indwelling catheterization reduced the risk of POUR, versus intermittent catheterization, in total joint surgery (P<0.01). Conclusions Based on the results of the meta-analysis, indwelling urinary catheterization, removed 24-48 h postoperatively, was superior to intermittent catheterization in preventing POUR. Furthermore, indwelling urinary catheterization with removal 24 to 48 hours postoperatively did not increase the risk of UTI. In patients with multiple risk factors for POUR undergoing total joint arthroplasty of lower limb, the preferred option should be indwelling urinary catheterization removed 24-48 h postoperatively. Level of Evidence Level I. PMID:26146830

  3. Teaching Self-Catheterization Skills to a Child with Myelomeningocele in a Preschool Setting.

    ERIC Educational Resources Information Center

    Robertson, Jo; And Others

    1992-01-01

    Simulation training and a prompt hierarchy were found to facilitate acquisition of clean intermittent self-catheterization skills by a four-year-old male with myelomeningocele. The child was first taught to perform catheterization on a doll, then on himself. Skills were clustered into three tasks of diapering, cleansing, and catheterization.…

  4. Teaching Self-Catheterization Skills to a Child with Myelomeningocele in a Preschool Setting.

    ERIC Educational Resources Information Center

    Robertson, Jo; And Others

    1992-01-01

    Simulation training and a prompt hierarchy were found to facilitate acquisition of clean intermittent self-catheterization skills by a four-year-old male with myelomeningocele. The child was first taught to perform catheterization on a doll, then on himself. Skills were clustered into three tasks of diapering, cleansing, and catheterization

  5. An effective ostrich oil bleaching technique using peroxide value as an indicator.

    PubMed

    Palanisamy, Uma Devi; Sivanathan, Muniswaran; Radhakrishnan, Ammu Kutty; Haleagrahara, Nagaraja; Subramaniam, Thavamanithevi; Chiew, Gan Seng

    2011-01-01

    Ostrich oil has been used extensively in the cosmetic and pharmaceutical industries. However, rancidity causes undesirable chemical changes in flavour, colour, odour and nutritional value. Bleaching is an important process in refining ostrich oil. Bleaching refers to the removal of certain minor constituents (colour pigments, free fatty acid, peroxides, odour and non-fatty materials) from crude fats and oils to yield purified glycerides. There is a need to optimize the bleaching process of crude ostrich oil prior to its use for therapeutic purposes. The objective of our study was to establish an effective method to bleach ostrich oil using peroxide value as an indicator of refinement. In our study, we showed that natural earth clay was better than bentonite and acid-activated clay to bleach ostrich oil. It was also found that 1 hour incubation at a 150 °C was suitable to lower peroxide value by 90%. In addition, the nitrogen trap technique in the bleaching process was as effective as the continuous nitrogen flow technique and as such would be the recommended technique due to its cost effectiveness. PMID:21730920

  6. Reflections of six years of lead extraction: influence on indications and technique

    PubMed Central

    Bracke, F.A.; Meijer, A.; van Gelder, B.

    2004-01-01

    Background Endovascular techniques have become the standard approach for extraction of pacemaker and ICD leads. However, with experience, the indications and technical approach have evolved. Indications In a population referred for lead extraction, we could not found a relation between the number of leads implanted and the incidence of occlusion of the access vein. Moreover, there is evidence that the lead extraction itself is accompanied with an increased risk of post-procedural venous occlusion. Electrical interference can be avoided in most cases, even in ICD patients. As complications of extraction have to be taken into account as well, it is therefore not in the patient's interest to extract chronically implanted non-functional superfluous leads. In contrast, lead extraction is a most effective way to cure pacemaker or ICD related infections, even if previous conservative therapy has failed. However, in patients at high risk, extraction might be deferred to attempt device saving therapy first. Technique Although leads can be removed with traction for almost all implant times, after six months additional tools are increasingly necessary to safely and completely extract them. No single technique suffices for all procedures: powered sheaths — as the laser sheath — and a femoral workstation with retrievers should be available when extraction is attempted. Complications Venous or myocardial perforation is a life-threatening complication of lead extraction. In these circumstances, time lacks to safely transfer a patient for emergency surgery and therefore the only safe environment to perform lead extraction is the operating theatre with cardiosurgical standby. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9 PMID:25696305

  7. Specialized service offerings and patients' choice of hospital: the case of cardiac catheterization.

    PubMed

    Hodgkin, D

    1996-06-01

    Patients' choice of hospital is modeled as a function of their expectation of needing a specialized service (option demand). The estimation tests whether cardiac patients' choice of hospital responds to changes over time in the availability of a specialized cardiac service. Results suggest that availability of cardiac catheterization has a strong, significant effect on the choice of hospital, even after controlling for other quality characteristics. However, the effect appears confined to those patients whose diagnosis indicates some probability of needing the service. Patients with no 'option demand' do not appear to use specialized services as a signal of quality. PMID:10159444

  8. Preoperative portal vein embolization in liver cancer: indications, techniques and outcomes.

    PubMed

    Loffroy, Romaric; Favelier, Sylvain; Chevallier, Olivier; Estivalet, Louis; Genson, Pierre-Yves; Pottecher, Pierre; Gehin, Sophie; Krausé, Denis; Cercueil, Jean-Pierre

    2015-10-01

    Postoperative liver failure is a severe complication of major hepatectomies, in particular in patients with a chronic underlying liver disease. Portal vein embolization (PVE) is an approach that is gaining increasing acceptance in the preoperative treatment of selected patients prior to major hepatic resection. Induction of selective hypertrophy of the non-diseased portion of the liver with PVE in patients with either primary or secondary hepatobiliary, malignancy with small estimated future liver remnants (FLR) may result in fewer complications and shorter hospital stays following resection. Additionally, PVE performed in patients initially considered unsuitable for resection due to lack of sufficient remaining normal parenchyma may add to the pool of candidates for surgical treatment. A thorough knowledge of hepatic segmentation and portal venous anatomy is essential before performing PVE. In addition, the indications and contraindications for PVE, the methods for assessing hepatic lobar hypertrophy, the means of determining optimal timing of resection, and the possible complications of PVE need to be fully understood before undertaking the procedure. Technique may vary among operators, but cyanoacrylate glue seems to be the best embolic agent with the highest expected rate of liver regeneration for PVE. The procedure is usually indicated when the remnant liver accounts for less than 25-40% of the total liver volume. Compensatory hypertrophy of the non-embolized segments is maximal during the first 2 weeks and persists, although to a lesser extent during approximately 6 weeks. Liver resection is performed 2 to 6 weeks after embolization. The goal of this article is to discuss the rationale, indications, techniques and outcomes of PVE before major hepatectomy. PMID:26682142

  9. Preoperative portal vein embolization in liver cancer: indications, techniques and outcomes

    PubMed Central

    Favelier, Sylvain; Chevallier, Olivier; Estivalet, Louis; Genson, Pierre-Yves; Pottecher, Pierre; Gehin, Sophie; Krausé, Denis; Cercueil, Jean-Pierre

    2015-01-01

    Postoperative liver failure is a severe complication of major hepatectomies, in particular in patients with a chronic underlying liver disease. Portal vein embolization (PVE) is an approach that is gaining increasing acceptance in the preoperative treatment of selected patients prior to major hepatic resection. Induction of selective hypertrophy of the non-diseased portion of the liver with PVE in patients with either primary or secondary hepatobiliary, malignancy with small estimated future liver remnants (FLR) may result in fewer complications and shorter hospital stays following resection. Additionally, PVE performed in patients initially considered unsuitable for resection due to lack of sufficient remaining normal parenchyma may add to the pool of candidates for surgical treatment. A thorough knowledge of hepatic segmentation and portal venous anatomy is essential before performing PVE. In addition, the indications and contraindications for PVE, the methods for assessing hepatic lobar hypertrophy, the means of determining optimal timing of resection, and the possible complications of PVE need to be fully understood before undertaking the procedure. Technique may vary among operators, but cyanoacrylate glue seems to be the best embolic agent with the highest expected rate of liver regeneration for PVE. The procedure is usually indicated when the remnant liver accounts for less than 25-40% of the total liver volume. Compensatory hypertrophy of the non-embolized segments is maximal during the first 2 weeks and persists, although to a lesser extent during approximately 6 weeks. Liver resection is performed 2 to 6 weeks after embolization. The goal of this article is to discuss the rationale, indications, techniques and outcomes of PVE before major hepatectomy. PMID:26682142

  10. Zygomatic implants: indications, techniques and outcomes, and the zygomatic success code.

    PubMed

    Aparicio, Carlos; Manresa, Carolina; Francisco, Karen; Claros, Pedro; Alández, Javier; González-Martín, Oscar; Albrektsson, Tomas

    2014-10-01

    The zygoma implant has been an effective option in the management of the atrophic edentulous maxilla as well as for maxillectomy defects. Brånemark introduced the zygoma implant not only as a solution to obtain posterior maxillary anchorage but also to expedite the rehabilitation process. The zygoma implant is a therapeutic option that deserves consideration in the treatment-planting process. This paper reviews the indications for zygoma implants and the surgical and prosthetic techniques (including new developments) and also reports on the clinical outcome of the zygomatic anatomy-guided approach. An overview of conventional grafting procedures is also included. Finally, a Zygoma Success Code, describing specific criteria to score the success of rehabilitation anchored on zygomatic implants, is proposed. PMID:25123760

  11. Computed tomography colonography in 2014: An update on technique and indications

    PubMed Central

    Laghi, Andrea

    2014-01-01

    Twenty years after its introduction, computed tomographic colonography (CTC) has reached its maturity, and it can reasonably be considered the best radiological diagnostic test for imaging colorectal cancer (CRC) and polyps. This examination technique is less invasive than colonoscopy (CS), easy to perform, and standardized. Reduced bowel preparation and colonic distention using carbon dioxide favor patient compliance. Widespread implementation of a new image reconstruction algorithm has minimized radiation exposure, and the use of dedicated software with enhanced views has enabled easier image interpretation. Integration in the routine workflow of a computer-aided detection algorithm reduces perceptual errors, particularly for small polyps. Consolidated evidence from the literature shows that the diagnostic performances for the detection of CRC and large polyps in symptomatic and asymptomatic individuals are similar to CS and are largely superior to barium enema, the latter of which should be strongly discouraged. Favorable data regarding CTC performance open the possibility for many different indications, some of which are already supported by evidence-based data: incomplete, failed, or unfeasible CS; symptomatic, elderly, and frail patients; and investigation of diverticular disease. Other indications are still being debated and, thus, are recommended only if CS is unfeasible: the use of CTC in CRC screening and in surveillance after surgery for CRC or polypectomy. In order for CTC to be used appropriately, contraindications such as acute abdominal conditions (diverticulitis or the acute phase of inflammatory bowel diseases) and surveillance in patients with a long-standing history of ulcerative colitis or Crohn’s disease and in those with hereditary colonic syndromes should not be overlooked. This will maximize the benefits of the technique and minimize potential sources of frustration or disappointment for both referring clinicians and patients. PMID:25492999

  12. Computed tomography colonography in 2014: an update on technique and indications.

    PubMed

    Laghi, Andrea

    2014-12-01

    Twenty years after its introduction, computed tomographic colonography (CTC) has reached its maturity, and it can reasonably be considered the best radiological diagnostic test for imaging colorectal cancer (CRC) and polyps. This examination technique is less invasive than colonoscopy (CS), easy to perform, and standardized. Reduced bowel preparation and colonic distention using carbon dioxide favor patient compliance. Widespread implementation of a new image reconstruction algorithm has minimized radiation exposure, and the use of dedicated software with enhanced views has enabled easier image interpretation. Integration in the routine workflow of a computer-aided detection algorithm reduces perceptual errors, particularly for small polyps. Consolidated evidence from the literature shows that the diagnostic performances for the detection of CRC and large polyps in symptomatic and asymptomatic individuals are similar to CS and are largely superior to barium enema, the latter of which should be strongly discouraged. Favorable data regarding CTC performance open the possibility for many different indications, some of which are already supported by evidence-based data: incomplete, failed, or unfeasible CS; symptomatic, elderly, and frail patients; and investigation of diverticular disease. Other indications are still being debated and, thus, are recommended only if CS is unfeasible: the use of CTC in CRC screening and in surveillance after surgery for CRC or polypectomy. In order for CTC to be used appropriately, contraindications such as acute abdominal conditions (diverticulitis or the acute phase of inflammatory bowel diseases) and surveillance in patients with a long-standing history of ulcerative colitis or Crohn's disease and in those with hereditary colonic syndromes should not be overlooked. This will maximize the benefits of the technique and minimize potential sources of frustration or disappointment for both referring clinicians and patients. PMID:25492999

  13. [Methods of resolution for haptic assistance during catheterization].

    PubMed

    Kern, T A; Herrmann, J; Klages, S; Meiss, T; Werthschützky, R

    2005-01-01

    During catheterization navigation within the patient is mainly dependent on a live x-ray image on the screen. Although methods for 3D visualisation and remote navigation of the catheter are discussed and tested still precise positioning is merely the result of intense training and a high skill and level of training of the performing surgeon. This article refers to a system which can be considered as an add-on for existing procedures of catheterization. It compromises of a miniaturised force sensor located at the tip of guide-wires whose prototype is shown here. The measured forces will be presented to the surgeon amplified by an external actuator described in this article. As a result a haptic perception of the forces between the tip of the guide-wire and the vessels walls will be available and enable the surgeon to gain an impression which is comparable to palpation of living vessels from the inside PMID:15792195

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

    PubMed Central

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

    2013-01-01

    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. PMID:24147263

  15. Ensuring patient adherence to clean intermittent self-catheterization

    PubMed Central

    Seth, Jai H; Haslam, Collette; Panicker, Jalesh N

    2014-01-01

    Patient performance of clean intermittent self-catheterization is a crucial component of the management of incomplete bladder emptying, which can arise from a variety of conditions. This allows patients to have more control over their bladder emptying, and avoids the inconveniences that come with an indwelling urethral catheter. There are, however, barriers that patients face when performing this task which may ultimately limit adherence. In this article, these barriers are discussed in more detail with potential solutions to counter them. PMID:24611001

  16. Jugular Venous Catheterization: A Case of Knotting

    PubMed Central

    Erk?l?ç, E.; Aksoy, M.; Gümü?, T.; Sar?, S.; Kesimci, E.

    2015-01-01

    A 79-year-old woman, diagnosed for cancer of the ovary, had a central catheter that was placed with difficulty through the right internal jugular vein intraoperatively. After oophorectomy, it was realized that the catheter was knotted. Thus, the central venous catheter was removed successfully using a traction technique in the operating room. Central venous catheter use may result in various complications, although it has been used as an invasive method for hemodynamic monitoring and fluid and drug infusion. Here, we present catheter knotting in a case with solutions for this complication, under literature review. PMID:26633975

  17. Caffeine clearance by enzyme multiplied immunoassay technique: a simple, inexpensive, and useful indicator of liver function.

    PubMed Central

    McDonagh, J E; Nathan, V V; Bonavia, I C; Moyle, G R; Tanner, A R

    1991-01-01

    The clinical value and sensitivity of serum caffeine clearance measurement has been evaluated as an indicator of hepatic disease. After a 17 hour caffeine exclusion period, 300 mg of caffeine citrate was administered orally to the study subjects. Serum samples were taken four and 16 hours later. Serum caffeine concentrations were measured using an enzyme multiplied immunoassay technique (EMIT) and a clearance value derived. Conventional liver function tests were measured at the same time. A total of 103 subjects attending the medical unit in a district general hospital were studied. Twenty one had alcoholic liver disease, 11 non-alcoholic cirrhosis, nine non-cirrhotic liver disease, 21 suspected liver disease, six hepatic tumours, and 35 were hospital and normal control subjects. Caffeine clearance values were lowest in subjects with alcoholic liver disease (median 0.19 ml/min/kg, range 0.04-0.61 ml/min/kg) and significantly reduced in all subjects with liver disease (median 0.32 ml/min/kg, range 0.04-2.68 ml/min/kg) compared with control subjects (median 1.27 ml/min/kg, p less than 0.001). In subjects with suspected liver disease subsequently shown to have another explanation for abnormal liver function test results, caffeine clearance values were normal (median 1.31 ml/min/kg, range 0.23-2.64 ml/min/kg) and significantly different, p less than 0.001, from those of subjects with liver disease. Serum albumen values were not different for these latter two groups. Using a cut off value of 0.86 ml/min/kg, caffeine clearance measurement was 100% sensitive for alcoholic liver disease and 89% sensitive for all liver disease. The respective sensitivities for conventional liver function test measurement were 76% and 83%. In the suspected liver disease group, caffeine clearance was abnormal in only 24%, conventional liver function tests were abnormal in 95%. The respective specificities for caffeine clearance and liver function test measurement in control subjects were 93% and 100%. Caffeine clearance determined by EMIT is a simple inexpensive hepatic metabolic function test. This study indicates that it is a more sensitive indicator of structural liver disease than conventional liver function tests, especially for alcoholic liver disease. The test could be widely introduced as a useful, repeatable assessment of hepatic function. PMID:2060878

  18. Caffeine clearance by enzyme multiplied immunoassay technique: a simple, inexpensive, and useful indicator of liver function.

    PubMed

    McDonagh, J E; Nathan, V V; Bonavia, I C; Moyle, G R; Tanner, A R

    1991-06-01

    The clinical value and sensitivity of serum caffeine clearance measurement has been evaluated as an indicator of hepatic disease. After a 17 hour caffeine exclusion period, 300 mg of caffeine citrate was administered orally to the study subjects. Serum samples were taken four and 16 hours later. Serum caffeine concentrations were measured using an enzyme multiplied immunoassay technique (EMIT) and a clearance value derived. Conventional liver function tests were measured at the same time. A total of 103 subjects attending the medical unit in a district general hospital were studied. Twenty one had alcoholic liver disease, 11 non-alcoholic cirrhosis, nine non-cirrhotic liver disease, 21 suspected liver disease, six hepatic tumours, and 35 were hospital and normal control subjects. Caffeine clearance values were lowest in subjects with alcoholic liver disease (median 0.19 ml/min/kg, range 0.04-0.61 ml/min/kg) and significantly reduced in all subjects with liver disease (median 0.32 ml/min/kg, range 0.04-2.68 ml/min/kg) compared with control subjects (median 1.27 ml/min/kg, p less than 0.001). In subjects with suspected liver disease subsequently shown to have another explanation for abnormal liver function test results, caffeine clearance values were normal (median 1.31 ml/min/kg, range 0.23-2.64 ml/min/kg) and significantly different, p less than 0.001, from those of subjects with liver disease. Serum albumen values were not different for these latter two groups. Using a cut off value of 0.86 ml/min/kg, caffeine clearance measurement was 100% sensitive for alcoholic liver disease and 89% sensitive for all liver disease. The respective sensitivities for conventional liver function test measurement were 76% and 83%. In the suspected liver disease group, caffeine clearance was abnormal in only 24%, conventional liver function tests were abnormal in 95%. The respective specificities for caffeine clearance and liver function test measurement in control subjects were 93% and 100%. Caffeine clearance determined by EMIT is a simple inexpensive hepatic metabolic function test. This study indicates that it is a more sensitive indicator of structural liver disease than conventional liver function tests, especially for alcoholic liver disease. The test could be widely introduced as a useful, repeatable assessment of hepatic function. PMID:2060878

  19. Effect of pulsed progressive fluoroscopy on reduction of radiation dose in the cardiac catheterization laboratory

    SciTech Connect

    Holmes, D.R. Jr.; Wondrow, M.A.; Gray, J.E.; Vetter, R.J.; Fellows, J.L.; Julsrud, P.R. )

    1990-01-01

    The increased application of therapeutic interventional cardiology procedures is associated with increased radiation exposure to physicians, patients and technical personnel. New advances in imaging techniques have the potential for reducing radiation exposure. A progressive scanning video system with a standard vascular phantom has been shown to decrease entrance radiation exposure. The effect of this system on reducing actual radiation exposure to physicians and technicians was assessed from 1984 through 1987. During this time, progressive fluoroscopy was added sequentially to all four adult catheterization laboratories; no changes in shielding procedures were made. During this time, the case load per physician increased by 63% and the number of percutaneous transluminal coronary angioplasty procedures (a high radiation procedure) increased by 244%. Despite these increases in both case load and higher radiation procedures, the average radiation exposure per physician declined by 37%. During the same time, the radiation exposure for technicians decreased by 35%. Pulsed progressive fluoroscopy is effective for reducing radiation exposure to catheterization laboratory physicians and technical staff.

  20. Ultrasound-guided vascular catheterization in loggerhead sea turtles (Caretta caretta).

    PubMed

    Di Bello, Antonio; Valastro, Carmela; Freggi, Daniela; Saponaro, Vittorio; Grimaldi, Domenico

    2010-09-01

    In this study, the authors describe a simple, nontraumatic procedure for ultrasound-guided placement and maintenance ofjugular and cephalic vein catheterization. The ultrasound scans were performed with a GE Logiq 400 machine connected to a multifrequency (7-11 MHz) linear-array transducer. To find the cephalic vein, longitudinal and transverse color-Doppler ultrasonographic scans were made of the dorsal surface of the flipper. To find the jugular vein, scans of the midline of the lateral surface of the neck were performed. Once the vein had been located, a 16- to 22-gauge 51-mm needle catheter was inserted into the skin beneath the ultrasound probe, inclined at 15-25 degrees to the skin surface. The successful insertion of the catheter inside the vein was monitored by ultrasound. The authors believe that the procedure described offers a good option for fashioning a simple, nontraumatic, and durable vascular access in sea turtles compared with previously described techniques. Caretta caretta, cephalic vein, jugular vein, ultrasonography, vascular catheterization. PMID:20945652

  1. Can echocardiographic evaluation of cardiopulmonary hemodynamics decrease right heart catheterizations in end-stage heart failure patients awaiting transplantation?

    PubMed

    Kuppahally, Suman S; Michaels, Andrew D; Tandar, Anwar; Gilbert, Edward M; Litwin, Sheldon E; Bader, Feras M

    2010-12-01

    Candidacy for heart transplantation is influenced by the severity of pulmonary hypertension. In this study, invasive hemodynamics from right-sided cardiac catheterization were compared with values obtained by validated equations from Doppler 2-dimensional transthoracic echocardiography. This prospective study was conducted in 40 patients with end-stage heart failure evaluated for heart transplantation or ventricular assist device implantation. Transthoracic echocardiography and right-sided cardiac catheterization were performed within 4 hours. From continuous-wave Doppler of the tricuspid regurgitation jet, pulmonary artery systolic pressure was calculated as the peak gradient across the tricuspid valve plus right atrial pressure estimated from inferior vena cava filling. Mean pulmonary artery pressure was calculated as (0.61 × pulmonary artery systolic pressure) + 2. Pulmonary vascular resistance (PVR) was calculated as (tricuspid regurgitation velocity/right ventricular outflow tract time-velocity integral × 10) + 0.16. Pulmonary capillary wedge pressure was calculated as 1.91 + (1.24 × E/E'). Pearson's correlation and Bland-Altman analysis of mean differences between echocardiographic and right-sided cardiac catheterization measurements were statistically significant for all hemodynamic parameters (pulmonary artery systolic pressure: r = 0.82, p < 0.05, mean difference 3.1 mm Hg, 95% confidence interval [CI] -0.2 to 6.3; mean pulmonary artery pressure: r = 0.80, p < 0.05, mean difference 2.5 mm Hg, 95% CI 0.3 to 4.6; PVR: r = 0.52, p < 0.05, mean difference 0.8 Wood units, 95% CI 0.3 to 1.4; pulmonary capillary wedge pressure: r = 0.65, p < 0.05, mean difference 2.2 mm Hg, 95% CI 0.1 to 4.3). Compared with right-sided cardiac catheterization, PVR by Doppler echocardiography identified all patients with PVR > 4 Wood units (n = 4), 73% of patients with PVR <2 Wood units (n = 8), and 52% of patients with PVR from 2 to 4 Wood units (n = 10). In conclusion, echocardiographic estimation of cardiopulmonary hemodynamics is reliable in patients with end-stage cardiomyopathy. The noninvasive assessment of hemodynamics by echocardiography may be able to decrease the number of serial right-sided cardiac catheterizations in selected patients awaiting heart transplantation. However, in patients with borderline PVR, right-sided cardiac catheterization is indicated to assess eligibility for transplantation. PMID:21094370

  2. Iliopsoas abscess as a complication of tunneled jugular vein catheterization in a hemodialysis patient.

    PubMed

    Hsiao, Po-Jen; Tsai, Ming-Hsien; Leu, Jyh-Gang; Fang, Yu-Wei

    2015-04-01

    Iliopsoas abscess is a rare complication in hemodialysis patients that is mainly due to adjacent catheterization, local acupuncture, discitis, and bacteremia. Herein, we report a 47-year-old woman undergoing regular hemodialysis via a catheter in the internal jugular vein who presented with low back pain and dyspnea. A heart murmur suggested the presence of catheter-related endocarditis, and this was confirmed by an echocardiogram and a blood culture of methicillin-resistant Staphylococcus aureus. A computed tomography indicated a pulmonary embolism and an incidental finding of iliopsoas abscess. Following surgical intervention and intravenous daptomycin, the patient experienced full recovery and a return to usual activities. This case indicates that an iliopsoas abscess can be related to a jugular vein catheter, which is apparently facilitated by infective endocarditis. The possibility of iliopsoas abscess should be considered when a hemodialysis patient presents with severe low back pain, even when there is no history of adjacent mechanical intervention. PMID:25040197

  3. Ultrasound evaluation of the radial artery for arterial catheterization in healthy anesthetized patients.

    PubMed

    Lee, Dongchul; Kim, Ji Young; Kim, Hong Soon; Lee, Kyung Cheon; Lee, Su Jin; Kwak, Hyun Jeong

    2016-04-01

    The purpose of this study was to assess the anatomy of the radial artery using ultrasound in anesthetized patients, and to correlate its anatomical data with patients' characteristics. The success rate of radial artery cannulation using ultrasound was also evaluated to analyze the relationship between the anatomical data and the success rate. Study 1 One hundred ninety-five patients scheduled for general anesthesia were enrolled. Ultrasound measurements were obtained when the vital signs were stable after anesthesia induction. The wrist joint of patients were extended to 30°. The diameter and depth of the radial artery, and the angle between the radial artery and skin surface were measured using ultrasound. Anatomical data were correlated with patients' characteristics. Study 2 Arterial cannulation was performed in 125 patients using long-axis in-plane technique to evaluate the success rate using ultrasound. Study 1 The diameter of the radial artery was mean value of 2.2 ± 0.4 mm and larger than 0.9 mm in all patients. It had significant correlation with body surface area (BSA) (Pearson correlation 0.292, P < 0.001). The incidence of abnormal angle between the radial artery and skin surface was significantly higher in elderly patients (≥65 years) than young patients (P = 0.017). Study 2 The first attempt success rate of arterial catheterization using ultrasound was 92.5 % using long-axis in-plane technique, regardless of patient's characteristics. For small sized adult patients, a 22G angio-catheter should be used during radial artery cannulation, because the radial artery diameter significantly correlated with BSA in healthy anesthetized patients. In addition, ultrasound-guided catheterization is recommended in elderly patients because the incidence of abnormal angle between the radial artery and skin surface was high. PMID:26013978

  4. INDICATOR OF EUTROPHICATION AND SEDIMENT LOAD: HYPERSPECTRAL TECHNIQUE FOR CONTINUOUS COVERAGE OF DEEP RIVERS

    EPA Science Inventory

    Remote sensing techniques were used to characterize and quantify spatial and temporal variation in water quality of the Great Miami River in Ohio. An initial feasibility study was conducted in the summer of 1999 using a non-imaging hand-held spectroradiometer to ascertain the pr...

  5. HYPERSPECTRAL TECHNIQUE AS AN INDICATOR OF EUTROPHICATION AND SEDIMENT LOAD FOR DEEP RIVERS

    EPA Science Inventory

    Remote sensing techniques were used to characterize and quantify spatial and temporal variation in water quality of the Great Miami River in Ohio. An initial feasibility study was conducted in the summer of 1999 using a non-imaging hand-held spectroradiometer to ascertain the pre...

  6. Anatomic shoulder arthroplasty: an update on indications, technique, results and complication rates

    PubMed Central

    MATTEI, LORENZO; MORTERA, STEFANO; ARRIGONI, CHIARA; CASTOLDI, FILIPPO

    2015-01-01

    A shoulder replacement is indicated in patients affected by glenohumeral arthropathy with severely reduced range of motion, persistent pain, especially at night, and loss of strength. There is much discussion in the scientific community about the prosthetic options for these cases: hemiarthroplasty, anatomic total shoulder arthroplasty, and reverse total shoulder arthroplasty. We analyzed the indications for, results of, and complications associated with this kind of surgery, focusing on anatomic arthroplasty and on the concept of modularity. PMID:26605254

  7. Cardiovascular procedures/diagnostic techniques and therapeutic procedures

    SciTech Connect

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

    1986-01-01

    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.

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

    PubMed

    Nosrati, Kazem

    2013-04-01

    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

  9. IMMUNOLOGICAL AND BIOSENSOR TECHNIQUES FOR DETECTING NON-MICROBIAL INDICATORS OF HUMAN FECAL POLLUTION

    EPA Science Inventory

    Limitations exist in applying the conventional microbial methods to the detection of human fecal contamination in water. Recently, there has been an increased interest in developing supplemental and/or alternate indicators of human contamination to better define water quality an...

  10. Urinary Catheterization May Not Adversely Impact Quality of Life in Multiple Sclerosis Patients

    PubMed Central

    Frasure, Heidi E.; Mahajan, Sangeeta T.

    2014-01-01

    Background. Multiple sclerosis (MS) healthcare providers (HCP) have undergone considerable educational efforts regarding the importance of evaluating and treating pelvic floor disorders, specifically, urinary dysfunction. However, limited data are available to determine the impact of catheterization on patient quality of life (QoL). Objectives. To describe the use of urinary catheterization among MS patients and determine the differences between those who report positive versus negative impact of this treatment on QoL. Methods. Patients were queried as part of the 2010 North American Research Committee On Multiple Sclerosis survey; topics included 1) urinary/bladder, bowel, or sexual problems; 2) current urine leakage; 3) current catheter use; 4) catheterizing and QoL. Results. Respondents with current urine leakage were 5143 (54.7%), of which 1201 reported current catheter use (12.8%). The types of catheters (intermittent self-catheterization and Foley catheter (indwelling and suprapubic)) did not differ significantly. Of the current catheter users, 304 (25.35%) respondents reported catheterization negatively impacting QoL, 629 (52.4%) reported a positive impact on QoL, and 223 (18.6%) reported neutral QoL. Conclusions. A large proportion of catheterized MS patients report negative or positive changes in QoL associated with urinary catheterization. Urinary catheterization does not appear to have a universally negative impact on patient QoL. PMID:25006498

  11. Current Indications, Techniques, and Imaging Findings of Stem Cell Treatment and Bone Marrow Transplant.

    PubMed

    Pandey, Tarun; Thomas, Stephen; Heller, Matthew T

    2016-03-01

    The role of stem cell therapy in the treatment of hematologic and nonhematologic conditions is ever increasing. A thorough knowledge of the applications of stem cells and transplant physiology is essential for understanding the imaging manifestations. Stem cell imaging includes molecular imaging, and diagnostic and interventional radiology. It is possible to make a diagnosis of various complications and diseases associated with stem cell transplant. This article presents a simplified overview of stem cell applications and techniques with focus on hematopoietic stem cell transplant imaging. PMID:26896230

  12. Laser and high-frequency cauthery gingivectomy in nonperiodontal indications: assessment and comparison of techniques

    NASA Astrophysics Data System (ADS)

    Bartak, Petr; Smucler, Roman

    2003-06-01

    The authors have verified the efficiency and safety of laser and high-frequency gingivectomy in non-periodontal indications. Within a prospective, non-selective study, they treated and monitored 357 dental areas in 139 teeth.Out of the total number, 248 areas were treated wtih a diode laser, 980nm; 109 areas with high-frequency electrocautery. The following parameters were monitored: a) regeneration of the marginal gingiva; b) generation of iatrogenic recessions or periodontal pockets; c) bleeding from gingival sulcus during probing; d) changes in tooth vitality; e) patient's subjective evaluation. The authors identified a high degree of safety in both laser and high-frequency gingivectomy, with no significant difference between these two methods. Laser gingivectomy appears to have a wider indication range, while high-frequency gingivectomy requires lower financial expenses.

  13. Survival analysis for the missing censoring indicator model using kernel density estimation techniques.

    PubMed

    Subramanian, Sundarraman

    2006-01-01

    This article concerns asymptotic theory for a new estimator of a survival function in the missing censoring indicator model of random censorship. Specifically, the large sample results for an inverse probability-of-non-missingness weighted estimator of the cumulative hazard function, so far not available, are derived, including an almost sure representation with rate for a remainder term, and uniform strong consistency with rate of convergence. The estimator is based on a kernel estimate for the conditional probability of non-missingness of the censoring indicator. Expressions for its bias and variance, in turn leading to an expression for the mean squared error as a function of the bandwidth, are also obtained. The corresponding estimator of the survival function, whose weak convergence is derived, is asymptotically efficient. A numerical study, comparing the performances of the proposed and two other currently existing efficient estimators, is presented. PMID:18953423

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

    PubMed

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

    2012-08-01

    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

  15. Supporting 64-bit global indices in Epetra and other Trilinos packages : techniques used and lessons learned.

    SciTech Connect

    Jhurani, Chetan; Austin, Travis M.; Heroux, Michael Allen; Willenbring, James Michael

    2013-06-01

    The Trilinos Project is an effort to facilitate the design, development, integration and ongoing support of mathematical software libraries within an object-oriented framework. It is intended for large-scale, complex multiphysics engineering and scientific applications [2, 4, 3]. Epetra is one of its basic packages. It provides serial and parallel linear algebra capabilities. Before Trilinos version 11.0, released in 2012, Epetra used the C++ int data-type for storing global and local indices for degrees of freedom (DOFs). Since int is typically 32-bit, this limited the largest problem size to be smaller than approximately two billion DOFs. This was true even if a distributed memory machine could handle larger problems. We have added optional support for C++ long long data-type, which is at least 64-bit wide, for global indices. To save memory, maintain the speed of memory-bound operations, and reduce further changes to the code, the local indices are still 32-bit. We document the changes required to achieve this feature and how the new functionality can be used. We also report on the lessons learned in modifying a mature and popular package from various perspectives - design goals, backward compatibility, engineering decisions, C++ language features, effects on existing users and other packages, and build integration.

  16. Tubal sterilization by selective catheterization in an animal model.

    PubMed

    Maubon, A; Rouanet, J P; Laurent, A; Joujoux, J M; Cover, S; Courtieu, C; Wassef, M; Godlewski, G; Honiger, J; Lopez, F M

    1994-02-01

    Unilateral selective salpingography was performed in 3 groups of 6 rabbits. 4-6 month old, virgin New Zealand White female rabbits were used with a mean weight of 4.4 kg. The fallopian tubes were embolized with ethanol (group 1); a viscous radiopaque solution which solidifies rapidly after injection to produce a biocompatible and inert hydrogel (group 2); or an occluding emulsion (a radiopaque heterogeneous alcoholic solution of zein, poppy seed oil, propylene glycol, and sodium amidotrizoate from Ethibloc, Laboratoire Princeps, Neuilly sur Seine, France) (group 3). Animals were killed 2 days or 30 days after the procedure, according to randomization; and tubal patency and histologic modifications were evaluated. Selective tubal catheterization was possible in all 18 cases, in 12 cases on the right side (66%), in 6 cases on the left side (33%); in 11 cases with a 5F catheter (61%), in 7 cases with a 2.5F catheter (39%). In group 1, no satisfactory occlusion was obtained; in group 2, 65% of the tubes were occluded with little histologic damage; and in group 3, 80% of the tubes were occluded, but significant inflammation and tissue necrosis were noted. The fallopian tubes were selectively catheterized over variable lengths: over 10 mm in 5 rabbits (28%), between 5 and 10 mm in 4 rabbits (22%), and between 1 and 5 mm in 9 rabbits (50%). Before injection of the occluding materials, all the catheterized tubes were patent. Mean volume of occluding material injected was 0.36 mL in group 1, 0.30 mL in group 2, and 0.83 mL in group 3. The ethanol injected reached the peritoneum in all 6 rabbits. The gel was injected an average length of 11 mm in the tube, while the emulsion opacified all the volume of the tubes with a peritoneal spill of emulsion in 3 of 6 cases. Reflux of occluding material into the uterus was noted in 1 of 6 rabbits in group 1, in 4 of 6 rabbits in group 2, in 3 of 6 rabbits in group 3. Selective salpingography proved a suitable method and allowed selective injection of occluding materials. PMID:8169090

  17. Percutaneous laser disk decompression under CT and fluoroscopic guidance: indications, technique, and clinical experience.

    PubMed

    Gangi, A; Dietemann, J L; Ide, C; Brunner, P; Klinkert, A; Warter, J M

    1996-01-01

    The aim of percutaneous laser disk decompression (PLDD) is to vaporize a small portion of the nucleus pulposus of an intervertebral disk, thereby reducing the volume and pressure of a diseased disk. This minimally invasive technique can be performed in patients who need surgical intervention for disk herniation with leg pain. PLDD is usually performed under fluoroscopic guidance with or without diskoscopy. However, it can also be performed under dual computed tomographic (CT) and fluoroscopic guidance as an outpatient procedure. CT and fluoroscopic guidance increases the safety and accuracy of PLDD, with high precision of instrument guidance, direct visualization of nucleus pulposus vaporization, and reduced risk of complications. Of 119 patients with lumbar disk herniation treated with PLDD under CT and fluoroscopic guidance, 91 (76.5%) had a good or fair response. PLDD performed with CT and fluoroscopic guidance appears to be a safe and effective treatment for herniated intervertebral disks. PMID:10946692

  18. [Pancreas transplantation: a survey on indications, surgical techniques, immunosuppression, complications and outcome].

    PubMed

    Drognitz, O; Hopt, U T

    2003-10-01

    Since its introduction in 1966, pancreas transplantation has undergone considerable progress. Refinements in surgical technique, better organ preservation solutions, and more potent immunosuppressive therapies have improved patient and graft-survival rates dramatically. Survival rates for patient and pancreas at 1 year approach 95 and 83 %, resp., for simultaneous pancreas and kidney transplantation, and 97 and 78 %, resp., for pancreas alone. US pancreas graft and patient survival rates do not significantly differ from the results of the European centers. However, there is still a hesitant acceptance of combined pancreas-kidney transplantation in Germany. Combined pancreas-kidney transplantation is nowadays the treatment of choice in carefully selected patients with type 1 insulin-dependent diabetes mellitus and end-stage renal failure. Many US centers even advocate combined transplantation in diabetic patients at a pre-uremic stage. Pancreas transplantation significantly improves quality of life and provides excellent long-term glycemic control which halts or even ameliorates secondary diabetic complications such as microangiopathy and neuropathy. In addition, there is increasing evidence that successful pancreas transplantation significantly prolongs patient survival mainly by a reduction of cardiovascular-related mortality. Current 10-year patient survival rate after SPK exceeds 70 %. For diabetics with end-stage renal disease there is no alternative treatment available with comparable live expectancy. However, morbidity and mortality after SPK is still higher than for kidney transplantation alone in the first year. Outcome of isolated pancreas transplantation is also improving but this technique is still restricted to non-uremic patients with severe diabetic complications or with brittle diabetes and severe impairment of quality of life. PMID:14628231

  19. Can carotid angiography be performed by vascular surgeons? A critical evaluation of indications, technique, and results.

    PubMed

    Sullivan, Timothy M; Patel, Ajay; Langan, Eugene M; Gray, Bruce H; Mackrell, Peter J; Taylor, Spence M; Carsten, Christopher G; Cull, David L; Snyder, Bruce A; Miskulin, Joseph; Youkey, Jerry

    2004-11-01

    The purpose of this report is to examine the contemporary indications for diagnostic carotid arteriography and evaluate its utility and safety when performed by vascular surgeons. The records of all patients having selective carotid arteriography from September 2000 through March 2002 at our institution were reviewed. One hundred sixty-four consecutive patients had selective arteriography of the extracranial carotid arteries for the following indications: hemispheric symptoms with stenosis <80% by duplex ultrasound (20.6%), suspected brachiocephalic trunk stenosis (15.8%), unclear anatomy by duplex (10.3%), recurrent carotid stenosis (10.3%), symptomatic high-grade (>80% by duplex) internal carotid stenosis (9.8%), ipsilateral internal carotid artery occlusion (7.1%), bilateral high-grade internal carotid artery stenoses (7.1%), vertebral-basilar ischemia (7.0%), contralateral internal carotid occlusion (5.4%), duplex ultrasound from a nonaccredited vascular laboratory (3.3%), and evaluation of nonatherosclerotic carotid disease (3.3%). There were no transient ischemic attacks, strokes, or deaths related to the index procedure. Selective angiography of the extracranial carotid arteries remains an important adjunct in the evaluation of patients with carotid disease. This procedure can be performed safely by vascular surgeons. PMID:15599629

  20. Evaluation of two coated catheters in intermittent self-catheterization.

    PubMed

    Pascoe, G; Clovis, S

    Intermittent self-catheterization (ISC) has addressed the problems of mechanical or functional urological voiding since the 1970s. Patient quality of life is enhanced by the increased independence and security offered by ISC (Lapides et al, 1972). A randomized, comparative crossover study was undertaken in two centres to evaluate the performance of SpeediCath (Coloplast) and Lofric (Astra Tech) catheters. A total of 27 subjects were recruited, all of whom had been performing ISC more than twice a day for longer than 3 months with a coated catheter. Each catheter was used for 1 week to assess catheter performance and acceptability. There were no significant differences recorded for the performance of each catheter. However, SpeediCath demonstrated favourable statistical significance in relation to ease of use, speed of use, and the concept of water as an integral part of the packaging of the catheter. PMID:12170675

  1. Radial artery occlusion after transradial approach to cardiac catheterization.

    PubMed

    Wagener, John F; Rao, Sunil V

    2015-03-01

    Radial artery occlusion (RAO) is the most common complication of the transradial approach (TRA) to cardiac catheterization, with a reported incidence between 0.8 % and 30 %. RAO is likely the result of acute thrombus formation and complicated by neointimal hyperplasia. Most RAO are asymptomatic with rare cases of acute hand or digit ischemia reported in the literature. The role of testing for dual circulation to the hand in determining the safety of TRA as it relates to symptomatic RAO is controversial; however, modifiable risk factors like low sheath-to-artery ratio, adequate anticoagulation, and non-occlusive ("patent") hemostasis are likely to prevent RAO. This review examines the incidence of RAO, potential mechanisms leading to RAO, and strategies to prevent and treat RAO. PMID:25651786

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

    PubMed

    Delaisi de Parseval, G

    2006-09-01

    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

  3. Comparison of remote sensing techniques for measurements of aircraft emissions indices at airports

    NASA Astrophysics Data System (ADS)

    Schaefer, Klaus P.; Jahn, Carsten; Sturm, Peter J.; Lechner, Bernhard; Bacher, Michael; Gostomczyk, Adam; Kabarowska, Barbara; Zalewski, Leszec; Dahl, Guenter

    2004-02-01

    The emission indices of aircraft engine exhausts were measured at airports non-intrusively by FTIR emission spectrometry at the engine nozzle exit as well as by FTIR absorption spectrometry and DOAS (Differential Optical Absorption Spectrometry) behind the aircraft. Two measurement campaigns were performed to compare these different measurement methods. A kerosene powered burner was operated in that way that the different methods were applied for the exhaust gas investigations during the same time and at nearly the same exhaust gas volume. The burner was built with a nozzle exit diameter of 37 cm and a power of about 150 kW. Fresh air was pumped into the burner tube by a fan. Calibration gases as pure CO and NO were added in different amounts to vary the concentration of these gases in the exhaust. The sampling probe of an intrusive measurement system was installed in the centre of the exhaust stream near the exhaust exit for measurements of these gases and CO2 as well as NO2, UHC, SO2 and O2. An APU (GTCP36-300) in a test bed was used in the same way. CO was mixed into the exhausts near the nozzle exit. The passive FTIR instrument was operated in the test bed using special noise and vibration isolation. The open-path instruments were installed at the chimney exit on the roof of the test bed building. The deviations between the different measurement methods were in the order of +/-10 up to +/-20 %.

  4. Shaping Physiological Indices, Swimming Technique, and Their Influence on 200m Breaststroke Race in Young Swimmers

    PubMed Central

    Strzala, Marek; Stanula, Arkadiusz; Głab, Grzegorz; Glodzik, Jacek; Ostrowski, Andrzej; Kaca, Marcin; Nosiadek, Leszek

    2015-01-01

    The aim of this study was to investigate somatic properties and physiological capacity, and analyze kinematic parameters in the 200 m breaststroke swimming race. Twenty-seven male swimmers participated in the study. They were 15.7±1.98 years old. Their average height was 1.80 ± 0.02 m and lean body mass (LBM) was 62.45 ± 8.29 kg. Physiological exercise capacity was measured in two separate 90 sec. all-out tests, one for the arms and second for legs. During the tests total work of arm cranking (TWAR) and cycling (TWLG) as well as peak of VO2 for arm (VO2peakAR) and leg (VO2peakLG) were measured. The underwater swimmers body movements were recorded during the all-out swimming 200m breaststroke speed test using an underwater camera installed on a portable trolley. The swimming kinematic parameters and propulsive or non-propulsive movement phases of the arms and legs as well as average speed (V200), surface speed (V200surface) and swimming speed in turn zones (V200turns) were extracted. V200surface was significantly related to the percentage of leg propulsion and was shown to have large effect on VO2peakLG in the Cohen analysis. V200turns depended significantly on the indicators of physiological performance and body structure: TWAR, VO2peak LG and LBM, LBM, which in turn strongly determined the measured results of TWAR, TWLG, VO2peakAR and VO2peakLG. The V200turns and V200surface were strongly associated with V200, 0.92, p < 0.001 and 0.91, p < 0.001 respectively. In each lap of the 200m swimming there was an increased percentage of propulsion of limb movement observed simultaneously with a reduction in the gliding phase in the breaststroke cycles. Key points This study investigated the influence of the selected indicators of somatic properties and physiological capacity as well kinematic and coordination parameters on breaststroke swimming. In this observations the body’s functional capacity have an important impact on achieving good breaststroke swimming results, the V200 was moderately associated on VO2peakLG, moreover, separate V200turns depended with VO2peakLG and on LBM and TWAR. The speed of surface breaststroke swimming - V200surface similarly as V200turns had a very strong influence on the end result of V200 , 0.91, p<0.001 and 0.92, p<0.001 respectively. The ability to swim fast on the surface (V200surface) was positively and significantly associated with the percentage time of propulsion generation -LP in the breaststroke cycle. PMID:25729298

  5. [Transrectal ultrasound-guided punch biopsies of the prostate. Indication, technique, results, and complications].

    PubMed

    Palisaar, J; Eggert, T; Graefen, M; Haese, A; Huland, H

    2003-09-01

    The golden standard for diagnosis of prostate cancer is transrectal ultrasound-guided systematic biopsy (TRUS-Bx). The optimal number of cylinders, sampling design, and indications for repeat biopsy are still in a state of flux. At the beginning of the 1980s, considerable doubts persisted regarding the benefit of ultrasound-guided punch biopsy for the diagnosis of prostate cancer. The examination on a chair with a fixed ultrasound head caused the patient substantial discomfort. Besides, in the pre-PSA era, most prostate carcinomas were detected by palpation and digitally guided biopsies were easily obtained. Indeed, the DRU procedure alone exhibited low sensitivity. Keetch et al. found that in only 25% of patients with abnormal palpatory findings and PSA between 4 and 20 ng/ml was a carcinoma revealed upon biopsy. On the other hand, patients with suspicious palpatory findings and proven malignancy suffered more frequently from locally advanced and systemic metastasizing tumors. As a result of restaging based on PSA, in most series more than half of the detected carcinomas presented normal palpatory findings. Ultrasound examination made precise imaging of zonal structures possible and thus offered the advantage of precision guidance for tissue biopsy despite lower sensitivity and specificity for diagnosis of suspicious lesions. Furthermore, calculation of prostate volume was possible. At the end of the 1980s, Hodge defined the systematic sextant biopsy as the first golden standard for early detection of prostate cancer. This meant the systematic removal of three punch cylinders from both lateral lobes of the prostate in the parasagittal midline at various levels (apex, middle, and base). PMID:14504751

  6. USING THE DELPHI TECHNIQUE TO DEVELOP EFFECTIVENESS INDICATORS FOR SOCIAL MARKETING COMMUNICATION TO REDUCE HEALTH-RISK BEHAVIORS AMONG YOUTH.

    PubMed

    Vantamay, Nottakrit

    2015-09-01

    This study aimed to develop effectiveness indicators for social marketing communication to reduce health-risk behaviors among Thai youth by using the Delphi technique. The Delphi technique is a research approach used to gain consensus through a series of two or more rounds of questionnaire surveys where information and results are fed back to panel members between each round and it has been extensively used to generate many indicators relevant to health behaviors. The Delphi technique was conducted in 3 rounds by consulting a panel of 15 experts in the field of social marketing communication for public health campaigns in Thailand. We found forty-nine effectiveness indicators in eight core components reached consensus. These components were: 1) attitude about health-risk behavior reduction, 2) subjective norms, 3) perceived behavioral control, 4) intention to reduce health-risk behaviors, 5) practices for reducing health-risk behaviors, 6) knowledge about the dangers and impact of health-risk behaviors, 7) campaign brand equity, and 8) communication networks. These effectiveness indicators could be applied by health promotion organizations for evaluating the effectiveness of social marketing communication to effectively reduce health-risk behaviors among youth. PMID:26863866

  7. [Kirschner wire transfixation of unstable ankle fractures: indication, surgical technique and outcomes].

    PubMed

    Marvan, J; Džupa, V; Bartoška, R; Kachlík, D; Krbec, M; Bá?a, V

    2015-01-01

    PURPOSE OF THE STUDY The aim of the study was to assess treatment outcomes in patients undergoing K-wire transfixation of unstable ankle fractures and compare the results with those of patients in whom it was possible to perform primary one-stage osteosynthesis. MATERIAL AND METHODS Between 2009 and 2012, a total of 358 patients (191 women and 167 men) had surgery for unstable ankle fracture. At 1-year follow-up, their subjective feelings, objective findings and ankle radiographs were evaluated. The fractures were categorised according to the Weber classification. A patient group treated by one-stage osteosynthesis, a group with definitive transfixation and a group of patients in whom temporary transfixation was converted to definitive osteosynthesis were assessed and compared. RESULTS The group treated by one-stage osteosynthesis included 278 patients with an average age of 47 years; the group of 20 patients with definitive transfixation had an average age of 67 years, and the group of 60 patients who had temporary transfixation with subsequent conversion to internal osteosynthesis were 55 years on average. In the group with one-stage osteosynthesis, 223 (80%) ankle fractures on post-injury radiographs were associated with minor joint dislocations and 55 (20%) with major dislocations. On the other hand, the radiographs of the patients treated by temporary transfixation and delayed open reduction with internal fixation showed major dislocations in 38 (63%) and minor dislocations in the rest of the patients (37%); the difference between the two groups was statistically significant (p<0.001). Posterior malleolar fractures were most frequent in the group with temporary transfixation (60%) and least frequent in the group with primary osteosynthesis (44%); also this difference was statistically significant (p=0.032). At one-year follow-up, in the group with one-stage osteosynthesis, 220 patients (79%) had no radiographic signs of posttraumatic ankle osteoarthritis while, in the group with temporary transfixation, no radiographic evidence of ankle osteoarthritis was recorded in 25 (42%) patients. While tibiofibular synostosis was recorded in only few patients (9%) of the group with one-stage osteosynthesis, it showed a high occurrence in the group with temporary transfixation (35%). The patients with one-stage osteosynthesis (188/68%) had a higher proportion of excellent outcomes measured on the Olerund-Molander ankle scoring scale than the other two groups (temporary transfixation, 47%; definitive transfixation,10%); in both cases the difference was significant (p < 0.001 and p = 0.003, respectively). DISCUSSION In this study the morphological and clinical aspects of surgically treated ankle fractures were assessed. The patients with one-stage osteosynthesis were compared with those treated by temporary or definitive transfixation. The majority of patients undergoing temporary transfixation had a fractured posterior margin of the tibia and major ankle joint dislocation, which suggested serious injuries to bone and ligament structures. Generally, the use of only two K-wires inserted through the calcaneus and talus into the distal tibia is recommended. Patients with K-wire transfixation usually require a longer hospital stay because of the serious nature of their injuries. CONCLUSIONS The therapy of choice for unstable ankle fractures is one-stage osteosynthesis. Temporary transfixation is an effective method of primary management when an unstable fracture cannot be treated by definitive osteosynthesis at the early stage due to local or general health conditions of the patient. The temporary transfixation provides good alignment of the ankle joint necessary for successful healing of soft tissues. A higher occurrence of post-traumatic ankle osteoarthritis, ossification and distal tibiotalar synostosis found in the patients treated by temporary transfixation is more related to serious types of ankle fractures the patient had suffered than to the method itself. Key words: unstable ankle fracture, soft tissue condition, indic

  8. A pilot study to compare epidural identification and catheterization using a saline-filled syringe versus a continuous hydrostatic pressure system.

    PubMed

    Samhan, Yasser M; El-Sabae, Hossam H; Khafagy, Hanan F; Maher, Mohamed A

    2013-08-01

    We are introducing a new continuous hydrostatic pressure system for identification and catheterization of epidural space in adults. One hundred and eight patients scheduled for elective endoscopic urological procedures were enrolled in this prospective randomized study. They were assigned to perform loss of resistance epidural technique by either the conventional saline-filled syringe (group C) or the new pressure technique (group P). The latter depends on observing passage of free flow of pressurized normal saline (50 mmHg) connected to epidural needle during its advancement, and then the epidural catheter was inserted to "float" easily while saline was flowing. Ten ml of bupivacaine 0.5 % with 50 ?g fentanyl were injected. Time to identify epidural space, number of attempts, ease of catheterization, sensory and motor block by Bromage scale after 20 min, quality of anesthesia and any side effects were recorded. Significant reduction was found in group P versus group C concerning time to identify epidural space [20 (6-40) vs. 60.5 (23-75) s with p = 0.001], number of attempts [1 (1-2) vs. 1 (1-4) with p = 0.02] and motor block [1 (0-3) vs. 2 (0-2) with p = 0.02], respectively. No significant difference in epidural catheterization, sensory block, quality of anesthesia and incidence of side effects. We concluded that this new technique is an easy way to identify epidural space using available tools in the operating room. PMID:23408046

  9. Determination of the mean cross-sectional area of the thoracic aorta using a double indicator dilution technique.

    PubMed

    Kornet, L; Jansen, J R; Gussenhoven, E J; Versprille, A

    1996-10-01

    A double indicator dilution technique for determining the mean cross-sectional area (CSA) of a blood vessel in vivo is presented. Analogous to the thermodilution method, dilution of hypertonic saline was measured by an electrical conductance technique. Because the change in conductance rather than absolute conductance was used to calculate CSA, pulsatile changes in shear rate of blood and conductance of surrounding tissues had no effect on the data. To calculate CSA from an ion mass balance, cardiac output was needed and estimated from the thermodilution curve using the same "cold" (hypertonic) saline injection. The mean CSA, obtained from this double indicator dilution method (CSAGD), was compared with the CSA obtained from the intravascular ultrasound method (IVUS) in 44 paired observations in six piglets. The regression line is close to the line of identity (CSAGD = -1.83 + 1.06 . CSAIVUS, r = 0.96). The difference between both CSAs was independent of the diameter of the vessel, on average -0.99 mm2 +/- 2.64 mm2 (mean CSAGD = 46.84 +/- 8.21 mm2, mean CSAIVUS = 47.82 +/- 9.08 mm2) and not significant. The results show that the double indicator dilution method is a reliable technique for estimating the CSA of blood vessels in vivo. PMID:8781202

  10. Rare malposition following left jugular vein catheterization: Case reports and a literature review

    PubMed Central

    Wang, Lin; Liu, Zhangsuo; Wang, Changan; Liu, Dongwei; Yuan, Yiqiang

    2015-01-01

    The number of patients requiring chronic hemodialysis via a tunneled cuffed catheter is increasing. The right internal jugular vein (IJV) is generally the preferred site of percutaneous insertion. In certain situations, for example, in patients with a history of multiple access failures, catheterization of the left IJV is an important option. In this report, we present two rare cases of catheter malposition after left IJV catheterization; catheter adjustments, with the help of chest radiographs, resulted in a positive outcome in both cases. These cases exemplify the difficulties associated with left IJV catheterization, of which there are few reports in the published literature. PMID:26770467

  11. [Assessment of insulin sensitivity during exercise training program in obese women. Comparison of simple indices with hyperinsulinemic euglycemic clamp technique].

    PubMed

    Straczkowski, Marek; Stepie?, Angieszka; Kowalska, Irina; Topolska, Jolanta; Kinalska, Ida

    2003-05-01

    Insulin resistance is a key element of metabolic syndrome, which includes disturbances of glucose tolerance, obesity, hypertension, coronary heart disease dyslipidemia and many other defects. An important problem in scientific research is precise measurement of insulin sensitivity. The method considered "the gold standard" is glucose clamp, however, it is difficult to apply this method in large studies. Therefore, simple indices of insulin resistance are proposed. It remains unclear whether those indices are able to reflect changes occurring during insulin-sensitizing intervention. The aim of the present study was to assess the use of indirect indices for the changes in insulin sensitivity during exercise training and to compare those indices with results derived from clamp. Fourteen obese normoglycemic women participated in 12-week exercise training program, which included exercise performed on a bicycle ergometer, 5 days a week for 30 minutes. Insulin sensitivity (M/FFM value) before and after training was measured with hyperinsulinemic euglycemic clamp technique. Simple indices of insulin resistance were also assessed: fasting plasma insulin (INS), logarithm INS (log [INS]), homeostasis model assessment (HOMA), logarithm HOMA (log [HOMA]) and quantitative insulin sensitivity check index (QUICKI). Before training, all those indices were markedly related to M/FFM. After training, an increase in M/FFM was observed. None of the examined indices markedly changed after training. There was no correlations between changes of evaluated indices and in M/FFM during training, and no relationships of those parameters after training. Our study indicates that simple indices are not able to reflect changes occurring during insulin-sensitizing intervention. PMID:14768177

  12. Left atrial appendage closure-indications, techniques, and outcomes: results of the European Heart Rhythm Association Survey.

    PubMed

    Pison, Laurent; Potpara, Tatjana S; Chen, Jian; Larsen, Torben B; Bongiorni, Maria Grazia; Blomström-Lundqvist, Carina

    2015-04-01

    The purpose of this EP Wire was to assess the indications, techniques, and outcomes of left atrial appendage occlusion (LAAO) in Europe. Thirty-three European centres, all members of the European Heart Rhythm Association electrophysiology (EP) research network, responded to this survey by completing the questionnaire. The major indication for LAAO (94%) was the prevention of stroke in patients at high thrombo-embolic risk (CHA2DS2-VASc ? 2) and contraindications to oral anticoagulants (OACs). Twenty-one (64%) of the responding centres perform LAAO in their own institution and 80% implanted 30 or less LAAO devices in 2014. Two-dimensional transoesophageal echocardiography was the preferred imaging technique to visualize LAA before, during, and after LAAO in 79, 58, and 62% of the participating centres, respectively. Following LAAO, 49% of the centres prescribe vitamin K antagonists or novel OACs. Twenty-five per cent of the centres combine LAAO with pulmonary vein isolation. The periprocedural complications included death (range, 0-3%), ischaemic or haemorrhagic stroke (0-25%), tamponade (0-25%), and device embolization (0-20%). In conclusion, this EP Wire has demonstrated that LAAO is most commonly employed in patients at high thrombo-embolic risk in whom OAC is contraindicated. The technique is not yet very widespread and the complication rates remain significant. PMID:25833883

  13. Current and emerging robot-assisted endovascular catheterization technologies: a review.

    PubMed

    Rafii-Tari, Hedyeh; Payne, Christopher J; Yang, Guang-Zhong

    2014-04-01

    Endovascular techniques have been embraced as a minimally-invasive treatment approach within different disciplines of interventional radiology and cardiology. The current practice of endovascular procedures, however, is limited by a number of factors including exposure to high doses of X-ray radiation, limited 3D imaging, and lack of contact force sensing from the endovascular tools and the vascular anatomy. More recently, advances in steerable catheters and development of master/slave robots have aimed to improve these practices by removing the operator from the radiation source and increasing the precision and stability of catheter motion with added degrees-of-freedom. Despite their increased application and a growing research interest in this area, many such systems have been designed without considering the natural manipulation skills and ergonomic preferences of the operators. Existing studies on tool interactions and natural manipulation skills of the operators are limited. In this manuscript, new technical developments in different aspects of robotic endovascular intervention including catheter instrumentation, intra-operative imaging and navigation techniques, as well as master/slave based robotic catheterization platforms are reviewed. We further address emerging trends and new research opportunities towards more widespread clinical acceptance of robotically assisted endovascular technologies. PMID:24281653

  14. Transradial Approach for Cardiac Catheterization: The New Frontier of Coronary Intervention

    MedlinePLUS Videos and Cool Tools

    Transradial approach for cardiac catheterization: The new frontier of coronary intervention Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2016 BroadcastMed, Inc. All rights reserved.

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

    PubMed

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

    1994-01-01

    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

  16. Incidence and Predictors of Radial Artery Occlusion Associated Transradial Catheterization

    PubMed Central

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

    2013-01-01

    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. PMID:24151442

  17. Pharmacotherapy in the cardiac catheterization laboratory: evolution and recent developments

    PubMed Central

    Thind, Guramrinder S; Parida, Raunak; Gupta, Nishant

    2014-01-01

    Many recent innovations have been made in developing new antiplatelet and anticoagulant drugs in the last few years, with a total of nine new antithrombotic drugs approved by the Food and Drug Administration after the year 2000. This has revolutionized the medical therapy given to manage acute coronary syndrome and support cardiac catheterization. The concept of dual antiplatelet therapy has been emphasized, and clopidogrel has emerged as the most-popular second antiplatelet drug after aspirin. Newer P2Y12 inhibitors like prasugrel and ticagrelor have been extensively studied and compared to clopidogrel. The role of glycoprotein (Gp) IIb/IIIa inhibitors is being redefined. Other alternatives to unfractionated heparin have become available, of which enoxaparin and bivalirudin have been studied the most. Apart from these, many more drugs with novel therapeutic targets are being studied and are currently under development. In this review, current evidence on these drugs is presented and analyzed in a way that would facilitate decision making for the clinician. For this analysis, various high-impact clinical trials, pharmacological studies, meta-analyses, and reviews were accessed through the MEDLINE database. Adopting a unique interdisciplinary approach, an attempt has been made to integrate pharmacological and clinical evidence to better understand and appreciate the pros and cons of each of these classes of drugs. PMID:25364258

  18. Real-time MRI-guided right heart catheterization in adults using passive catheters

    PubMed Central

    Ratnayaka, Kanishka; Faranesh, Anthony Z.; Hansen, Michael S.; Stine, Annette M.; Halabi, Majdi; Barbash, Israel M.; Schenke, William H.; Wright, Victor J.; Grant, Laurie P.; Kellman, Peter; Kocaturk, Ozgur; Lederman, Robert J.

    2013-01-01

    Aims Real-time MRI creates images with superb tissue contrast that may enable radiation-free catheterization. Simple procedures are the first step towards novel interventional procedures. We aim to perform comprehensive transfemoral diagnostic right heart catheterization in an unselected cohort of patients entirely using MRI guidance. Methods and results We performed X-ray and MRI-guided transfemoral right heart catheterization in consecutive patients undergoing clinical cardiac catheterization. We sampled both cavae and both pulmonary arteries. We compared success rate, time to perform key steps, and catheter visibility among X-ray and MRI procedures using air-filled or gadolinium-filled balloon-tipped catheters. Sixteen subjects (four with shunt, nine with coronary artery disease, three with other) underwent paired X-ray and MRI catheterization. Complete guidewire-free catheterization was possible in 15 of 16 under both. MRI using gadolinium-filled balloons was at least as successful as X-ray in all procedure steps, more successful than MRI using air-filled balloons, and better than both in entering the left pulmonary artery. Total catheterization time and individual procedure steps required approximately the same amount of time irrespective of image guidance modality. Catheter conspicuity was best under X-ray and next-best using gadolinium-filled MRI balloons. Conclusion In this early experience, comprehensive transfemoral right heart catheterization appears feasible using only MRI for imaging guidance. Gadolinium-filled balloon catheters were more conspicuous than air-filled ones. Further workflow and device enhancement are necessary for clinical adoption. PMID:22855740

  19. Application of the double-indicator technique for measurement of blood-brain barrier permeability in humans.

    PubMed

    Knudsen, G M

    1994-01-01

    This review examines and evaluates the double-indicator technique for utilization in quantitative measurements of the transport of substances across the human blood-brain barrier (BBB). The classic double-indicator method and its limitations are described along with a new approach for correction of capillary heterogeneity and tracer backflux. This approach considers the total course of the venous outflow curves and involves a short-time experiment model that incorporates calculations of parameters for transport from the blood into the brain and from the brain back to the blood, for the uptake of neurons and glia cells, and for the tracer distribution volume. A modification of the double-indicator technique with intravenous instead of intracarotid bolus injection is discussed along with advantages and limitations of this technique. The application of the method is described and examples are given for D-glucose as well as for some large neutral amino acids and flow tracers. On the basis of the model, it is demonstrated that after crossing the BBB, D-glucose distributes in the brain interstitial fluid volume, and already at the peak of the glucose outflow curves, the apparent extraction is significantly influenced by backflux from the brain. For large neutral amino acids, the permeability from the interstitial fluid space back to the blood is approximately 10 times higher than the permeability from the blood into the brain. Such a difference in permeabilities across the BBB can almost entirely be ascribed to the effect of a nonlinear transport system combined with a relatively small brain amino acid metabolism. This high and rapid backflux causes methodological problems when estimating blood-to-brain transfer of amino acids with traditional in vivo methods. The method is also evaluated for high-permeable substances. Water and the two flow tracers ethyl cysteinate dimer and hexamethylpropyleneamine oxime and the obtained values for brain extraction and distribution volume compare well with those obtained by other methods. Finally, ethical aspects and the future role and possibilities of the double-indicator technique are discussed and related to other methods for determination of BBB permeabilities in the living human brain. PMID:8186068

  20. Catheterization of Intestinal Loops in Ruminants Does Not Adversely Affect Loop Function

    PubMed Central

    Inglis, G Douglas; Kastelic, John P; Uwiera, Richard R E

    2010-01-01

    Catheterized intestinal loops may be a valuable model to elucidate key components of the host response to various treatments within the small intestine of ruminants. We examined whether catheterizing ileal loops in sheep affected the overall health of animals and intestinal function, whether a bacterial treatment could be introduced into the loops through the catheters, and whether broad-spectrum antibiotics could sterilize the loops. Escherichia coli cells transformed to express the GFP gene were introduced readily into the loops through the catheters, and GFP E. coli cells were localized within the injected loops. Catheterized loops, interspaces, and intact ileum exhibited no abnormalities in tissue appearance or electrical resistance. Expression of the IFNγ, IL1α, IL4, IL6, IL12p40, IL18, TGFβ1, and TNFα cytokine genes did not differ significantly among the intact ileum, catheterized loops, and interspaces, nor did the expression of the gene for inducible nitric oxide synthase. Broad-spectrum antibiotics administered during surgery did not sterilize the loops or interspaces and did not substantively change the composition of the microbiota. However, antibiotics reduced the overall number of bacterial cells within the loop and the relative abundance of community constituents. We concluded that catheterization of intestinal loops did not adversely affect health or loop function in sheep. Furthermore, allowing animals to recover fully from surgery and to clear pharmaceuticals will remove any confounding effects due to these factors, making catheterized intestinal loops a feasible model for studying host responses in ruminants. PMID:21262134

  1. Single-incision laparoscopy: a review of the indications, techniques and results after more than 700 procedures.

    PubMed

    Dapri, Giovanni

    2014-05-01

    Single-incision laparoscopy (SIL) gained in popularity in the last 5-7 years, as a new philosophy has emerged to reduce the invasiveness of minimally invasive surgery. Various abdominal procedures using fewer and smaller trocars in order to obtain pure SIL have been described. To overcome some known problems of SIL, such as establishing the conventional multiport laparoscopic working triangulation, the non-ergonomic positioning of the surgeon, and the increased cost of each procedure, a particular SIL technique has been developed. The technique involves reusable trocars along with specially designed DAPRI curved reusable instruments introduced through the same incision but laterally to the optical system. Hence, the main principle of conventional multiport laparoscopy--working in an appropriate triangulation while maintaining the scope in the center--is respected. The final scar is 15?mm and the cost of the procedure remains unchanged because reusable materials are used. All the abdominal procedures, including upper and lower gastrointestinal, colorectal, hepatobiliopancreatic, solid organs, gynecologic and abdominal wall hernia repair, are here reported, as are the indications for and the results after 740 procedures. In conclusion, SIL has to be considered as one of the most attractive techniques of the new minimally invasive era. PMID:24641473

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

    SciTech Connect

    Lajoie, W.N. )

    1988-09-01

    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.

  3. Appropriate indication of fronto-orbital advancement by distraction osteogenesis in syndromic craniosynostosis: Beyond the conventional technique.

    PubMed

    Satoh, Kaneshige; Mitsukawa, Nobuyuki; Kubota, Yoshitaka; Akita, Shinsuku

    2015-12-01

    Currently the distraction technique could be very useful for posterior expansion in syndromic craniosynostosis. Even for fronto-orbital advancement (FOA), it is thought that distraction has the definitive advantage over the conventional technique. The authors describe the appropriate indication of distraction for FOA in our series of craniosynostosis patients. Since 1998, FOA by distraction has been used for 61 cases of simple and syndromic craniosynostosis. Among these, seven severe cases were extracted with a conspicuous craniofacial deformity with a multiple honeycomb appearance in 3DCT views. Early surgery for FOA by distraction to the extent possible was performed and a retrospective study was conducted. Seven children were identified. All of them exhibited a severe craniofacial deformity. Pfeiffer syndrome in 5 children and clover-leaf skull in two unidentified children were diagnosed. Mean age at surgery for FOA by distraction ranged 10-18 months. Mean operative time: 3-3.5 h. Blood loss: 230-320 mL. The mean advancement by distraction: 20-27 mm. We conclude FOA by distraction when a large amount of advancement is required for early severe cases as our series can be definitely one of the most appropriate candidates beyond the conventional technique, despite disadvantages. PMID:26463472

  4. Multispectral indices and advanced classification techniques to detect percent residue cover over agricultural crops using Landsat data

    NASA Astrophysics Data System (ADS)

    Pacheco, Anna; McNairn, Heather; Smith, Anne M.

    2006-08-01

    Detecting and quantifying crop residue cover on agricultural fields is essential in identifying conservation tillage practices and estimating carbon sequestration, both of which are important goals within the Agricultural Policy Framework of Agriculture and Agri-Food Canada. Crop residue is traditionally measured using ground survey techniques such as the line-transect method or visual (drive-by) assessment but these techniques are tedious, time-consuming and subjective. With the increased number of advanced earth observation satellites, remote sensing has now become a viable option for mapping agricultural land management practices and percent crop residue cover. A wide variety of indices such as the Normalized Difference Index (NDI) and the Modified Soil Adjusted Crop Residue Index (MSACRI) were developed using multispectral data for this purpose but results have been mixed. Advanced classification techniques including linear spectral mixture analysis (SMA) and spectral angle mapper (SAM) provide an alternative to derive percent crop residue cover. Landsat-7 SLC-Off data were acquired over an agricultural study site in Eastern Ontario on May 25 2005. Simultaneous ground data were collected to characterize residue type, position, direction and percent cover. NDI, MSACRI, SMA and SAM were all computed and used to derive percent crop residue cover information. Preliminary results indicate that the SMA model predicts percent crop residue cover over agricultural fields with the most success, especially over fields of corn residue with an R2 value of 0.85 (RMSE of 12.46 and D of 0.99). However, further investigation is needed where residue models are validated against a larger dataset with greater variability in percent crop residue cover.

  5. Quality and in vitro fertilizing ability of cryopreserved cat spermatozoa obtained by urethral catheterization after medetomidine administration.

    PubMed

    Zambelli, D; Prati, F; Cunto, M; Iacono, E; Merlo, B

    2008-03-01

    Quality and in vitro fertilizing ability of frozen-thawed cat semen collected by urethral catheterization (CT) or electroejaculation (EE) after medetomidine administration were compared. Sperm collection was performed by an urinary tomcat catheter and, 4 days apart, by electroejaculation from each of eight tomcats. Results showed that semen collected by CT was characterized by lower volume (10.5+/-5.3 microL, P<0.05), higher sperm concentration (1868.4+/-999.8 x 10(6)/mL, P<0.05) and lower pH (7.0+/-0.4, P<0.05) than that collected by EE (67.1+/-25.9 microL, 542.9+/-577.9 x 10(6)/mL, and 7.9+/-0.4, respectively). Spermatozoa characteristics after thawing at 0, 3 and 6h did not differ between the two methods of collection. Also cleavage rate and embryo production from oocytes fertilized with frozen-thawed spermatozoa collected by CT or EE showed no significant differences (P>0.05). In conclusion, the results obtained in the present study indicate that good quality freezable semen can be collected from cats by urethral catheterization after medetomidine administration. This new method of semen collection appears very useful in practice and, compared with the electroejaculation protocol, permits to obtain semen samples characterized by a higher concentration of spermatozoa, lower total volume and lower pH. PMID:18082880

  6. Care of the central venous catheterization site: the use of a transparent polyurethane film.

    PubMed

    Vazquez, R M; Jarrard, M M

    1984-01-01

    Studies of care of patients with central venous catheters report a 3-7% incidence of catheter-induced sepsis when sterile gauze and tape are used as an occlusive dressing. The technique requires that the dressing be changed three times each week for catheterization site inspection. From June 1979 to September 1980, a noncomparative evaluation of a transparent, self-adhesive, polyurethane dressing which is permeable to water vapor but not bacteria was performed. This dressing was used for the care of 100 consecutive patients with central venous catheters. Dressing life averaged 5.3 days with silicone rubber catheters and 4.3 days for polyvinyl chloride catheters. One patient developed catheter induced sepsis (incidence 1%). This dressing material: (1) is acceptable for use as a dressing of central venous catheters; (2) continuously permits inspection of the insertion sites; (3) decreases nursing hours; (4) provides a comfortable dressing which secures the catheter to the patient; and (5) is durable even when exposed to high humidity therapy devices, or when possible permits the patient to take showers. PMID:6425522

  7. High attenuation pericardial fluid on CT following cardiac catheterization.

    PubMed

    Avery, Laura L; Jain, Vineet R; Cohen, Hillel W; Scheinfeld, Meir H

    2014-08-01

    High-density pericardial fluid may be seen on noncontrast CT performed following cardiac catheterization (CC), raising the possibility of hemopericardium. Our goal was to determine the clinical course and associations of incidentally discovered high-attenuation pericardial fluid on noncontrast CT performed soon after CC. Hospital database search over a 7.5-year period identified 211 patients who underwent CT of the chest and/or abdomen within 60 h before or after CC, 150 having CC first. Pericardial fluid volume and attenuation as well as relevant laboratory and clinical parameters were recorded. Bivariate associations with average pericardial fluid attenuation (HUavg) were assessed. Using the 61 patients with CT before CC as controls, 44 of the patients with CC first had attenuation values greater than the mean + 2SD of 22.6 Hounsfield unit (HU) and 19 had attenuation values greater than the maximum control patient value of 39.8 HU. All patients with incidental finding of high-density pericardial fluid followed a benign course. Bivariate correlations showed time gap between CC and CT (rho = -0.50, p < 0.001), estimated glomerular filtration rate (eGFR) (rho = -0.24, p = 0.004), and female gender (median (IQR) 17.4 (13.6, 29.6) vs. 15.8 (9.9, 23.7), p = 0.02) to be associated with HUavg. In multiple linear regression analysis, only time gap and female gender were independently significantly associated with average attenuation (both p < 0.001). The finding that patients with incidentally discovered high-density pericardial fluid followed an uneventful course suggests a benign etiology such as vicarious excretion, and in patients who are otherwise stable, observation rather than immediate intervention should be considered. PMID:24638997

  8. Ultrasound stylet for non-image-guided ventricular catheterization.

    PubMed

    Coulson, Nathaniel K; Chiarelli, Peter A; Su, David K; Chang, Jason J; MacConaghy, Brian; Murthy, Revathi; Toms, Peter; Robb, Terrence L; Ellenbogen, Richard G; Browd, Samuel R; Mourad, Pierre D

    2015-10-01

    OBJECT Urgent ventriculostomy placement can be a lifesaving procedure in the setting of hydrocephalus or elevated intracranial pressure. While external ventricular drain (EVD) insertion is common, there remains a high rate of suboptimal drain placement. Here, the authors seek to demonstrate the feasibility of an ultrasound-based guidance system that can be inserted into an existing EVD catheter to provide a linear ultrasound trace that guides the user toward the ventricle. METHODS The ultrasound stylet was constructed as a thin metal tube, with dimensions equivalent to standard catheter stylets, bearing a single-element, ceramic ultrasound transducer at the tip. Ultrasound backscatter signals from the porcine ventricle were processed by custom electronics to offer real-time information about ventricular location relative to the catheter. Data collected from the prototype device were compared with reference measurements obtained using standard clinical ultrasound imaging. RESULTS A study of porcine ventricular catheterization using the experimental device yielded a high rate of successful catheter placement after a single pass (10 of 12 trials), despite the small size of pig ventricles and the lack of prior instruction on porcine ventricular architecture. A characteristic double-peak signal was identified, which originated from ultrasound reflections off of the near and far ventricular walls. Ventricular dimensions, as obtained from the width between peaks, were in agreement with standard ultrasound reference measurements (p < 0.05). Furthermore, linear ultrasound backscatter data permitted in situ measurement of the stylet distance to the ventricular wall (p < 0.05), which assisted in catheter guidance. CONCLUSIONS The authors have demonstrated the ability of the prototype ultrasound stylet to guide ventricular access in the porcine brain. The alternative design of the device makes it potentially easy to integrate into the standard workflow for bedside EVD placement. The availability of a fast, easy-to-use, inexpensive guidance system can play a role in reducing the complication rate for EVD placement. PMID:26140670

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

    SciTech Connect

    Tercan, Fahri Oguzkurt, Levent; Ozkan, Ugur; Eker, Hatice Evren

    2008-05-15

    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.

  10. Cystostomie percutanée à la pince de Kelly: indications, technique et résultats

    PubMed Central

    Diabaté, Ibrahima; Ouédraogo, Bouréima; Sow, Ibrahima; Bâ, Aliou

    2015-01-01

    Introduction La dérivation urinaire sus-pubienne est pratiquée dans différentes circonstances. Cette étude vise à décrire la technique de cystostomie percutanée (CPC) pratiquée à l'aide d'une pince de Kelly pour la pose d'une sonde de Foley, à définir les indications de cette technique et à rapporter les résultats. Méthodes Du 1er janvier 2005 au 31 décembre 2014, il a été réalisé 194 CPC à la pince de Kelly dans notre service, en urgence, sous anesthésie locale, chez des patients en rétention vésicale. Cette technique, dérivée de la cystostomie par ponction au trocart vise à placer dans la vessie une sonde de Foley après incision cutanée et aponévrotique (de 1 cm sur la ligne médiane, à 1,5 - 2 cm au-dessus de la symphyse pubienne) et la ponction vésicale à la pince de Kelly à travers cette incision. Résultats Les 194 patients étaient tous de sexe masculin, âgés en moyenne de 50 ans ± 21 (extrêmes de 17 ans et 86 ans). Les pathologies à l'origine des rétentions vésicales étaient: les rétrécissements urétraux (n=119), les hypertrophies bénignes de la prostate (n=47), les cancers de prostate (n=21), les traumatismes de l'urètre (n=7). Tous les patients ont été opérés avec succès par cette méthode et les suites ont été simples. Le temps de réalisation était de 6 minutes ± 1. Les sondes de Foley mises en place étaient de charrière 16 (n=59), charrière 18 (n=116) et charrière 20 (n=19). La cicatrisation du trajet de la CPC après l'ablation de la sonde de Foley n'a posée aucun problème chez 146 patients suivis, les 48 autres ayant été perdus de vue. Conclusion La CPC à la pince de Kelly est une technique simple, rapide et pas onéreuse. Ses indications sont les mêmes que pour toute CPC et elle représente une alternative à la cystostomie par chirurgie ouverte. PMID:26893798

  11. On monitoring anthropogenic airborne uranium concentrations and (235)U/(238)U isotopic ratio by Lichen - bio-indicator technique.

    PubMed

    Golubev, A V; Golubeva, V N; Krylov, N G; Kuznetsova, V F; Mavrin, S V; Aleinikov, A Yu; Hoppes, W G; Surano, K A

    2005-01-01

    Lichens are widely used to assess the atmospheric pollution by heavy metals and radionuclides. However, few studies are available in publications on using lichens to qualitatively assess the atmospheric pollution levels. The paper presents research results applying epiphytic lichens as bio-monitors of quantitative atmospheric contamination with uranium. The observations were conducted during 2.5 years in the natural environment. Two experimental sites were used: one in the vicinity of a uranium contamination source, the other one - at a sufficient distance away to represent the background conditions. Air and lichens were sampled at both sites monthly. Epiphytic lichens Hypogimnia physodes were used as bio-indicators. Lichen samples were taken from various trees at about 1.5m from the ground. Air was sampled with filters at sampling stations. The uranium content in lichen and air samples as well as isotopic mass ratios (235)U/(238)U were measured by mass-spectrometer technique after uranium pre-extraction. Measured content of uranium were 1.45 mgkg(-1) in lichen at 2.09 E-04 microgm(-3) in air and 0.106 mgkg(-1) in lichen at 1.13 E-05 microgm(-3) in air. The relationship of the uranium content in atmosphere and that in lichens was determined, C(AIR)=exp(1.1 x C(LICHEN)-12). The possibility of separate identification of natural and man-made uranium in lichens was demonstrated in principle. PMID:16083999

  12. Bilateral hydrothorax and cardiac tamponade after right subclavian vein catheterization -A case report-

    PubMed Central

    Kim, Myoung Hwa; Kim, Mun Chul

    2010-01-01

    Central venous catheterization is typically used for the anesthetic management of patients undergoing a major surgery or care of patients in Intensive Care Unit (ICU). The occurrence of complications associated with central venous catheterization such as pneumothorax or vascular injury have decreased, while delayed complications such as hydrothorax, hydromediastinum, or cardiac tamponade have risen recently. We report a case of complications of bilateral hydrothorax with cardiac tamponade by superior vena cava perforation due to continuous mechanical force of the looped central venous catheter tip against SVC wall after subclavian vein cannulation. PMID:21286444

  13. Can the Anesthesiologist Use the Radial Artery for Monitoring After Transradial Artery Catheterization?

    PubMed

    Awad, Hamdy; Quevedo, Eduardo; Abas, Motaz; Brown, Michelle; Satiani, Bhagwan; Capers, Quinn; Starr, Jean E

    2015-06-15

    The use of transradial coronary angiography and intervention is growing because of its advantages over the femoral approach. However, the small size of the radial artery can contribute to complications. We present a case of an in situ access complication of transradial coronary artery catheterization. It is important for the anesthesiologist to know about the short-term and long-term consequences of this intervention, which could lead to narrowing of the artery even beyond the site of puncture. Understanding these changes could help anesthesiologists make better decisions about using the radial artery for monitoring after transradial coronary artery catheterization procedures. PMID:26050247

  14. Safety of cardiac catheterization at a center specializing in the care of patients with pulmonary arterial hypertension

    PubMed Central

    2013-01-01

    Abstract Cardiac catheterization is important for the management of patients with pulmonary arterial hypertension (PAH). It is used for diagnosis, assessment, and monitoring of PAH patients, as well as to perform interventions such as balloon atrial septostomy and coil embolization of collateral vessels. Although reports on the risks of catheterization in PAH patients are scarce, many centers hesitate to perform these procedures in such fragile patients. We performed a retrospective chart review of all cardiac catheterizations performed in PAH patients over 10 years at our pulmonary hypertension center. Demographic, hemodynamic, and outcome data were collected. Complication rates were determined, and multivariate proportional hazards modeling was performed to identify predictors of catheterization-related complications. There were 1,637 catheterizations performed in 607 patients over 10 years. Pediatric patients accounted for 50% of these cases, 48% were performed in patients with idiopathic PAH, and 49% were performed under general anesthesia. While the overall complication rate was 5.7%, the rate of major complications was only 1.2% (). Although there were 8 deaths during the admission following catheterization, only 4 of these were related to the procedure, yielding a catheterization-related mortality of 0.2%. In conclusion, when performed at a pulmonary hypertension center with expertise in the care of PAH patients, cardiac catheterization is associated with low complication rates and mortality, and it should remain an important tool in the management of these patients. PMID:25006398

  15. Cardiac Catheterization in Mice to Measure the Pressure Volume Relationship: Investigating the Bowditch Effect.

    PubMed

    Zhang, Bo; Davis, Jonathan P; Ziolo, Mark T

    2015-01-01

    Animal models that mimic human cardiac disorders have been created to test potential therapeutic strategies. A key component to evaluating these strategies is to examine their effects on heart function. There are several techniques to measure in vivo cardiac mechanics (e.g., echocardiography, pressure/volume relations, etc.). Compared to echocardiography, real-time left ventricular (LV) pressure/volume analysis via catheterization is more precise and insightful in assessing LV function. Additionally, LV pressure/volume analysis provides the ability to instantaneously record changes during manipulations of contractility (e.g., ?-adrenergic stimulation) and pathological insults (e.g., ischemia/reperfusion injury). In addition to the maximum (+dP/dt) and minimum (-dP/dt) rate of pressure change in the LV, an accurate assessment of LV function via several load-independent indexes (e.g., end systolic pressure volume relationship and preload recruitable stroke work) can be attained. Heart rate has a significant effect on LV contractility such that an increase in the heart rate is the primary mechanism to increase cardiac output (i.e., Bowditch effect). Thus, when comparing hemodynamics between experimental groups, it is necessary to have similar heart rates. Furthermore, a hallmark of many cardiomyopathy models is a decrease in contractile reserve (i.e., decreased Bowditch effect). Consequently, vital information can be obtained by determining the effects of increasing heart rate on contractility. Our and others data has demonstrated that the neuronal nitric oxide synthase (NOS1) knockout mouse has decreased contractility. Here we describe the procedure of measuring LV pressure/volume with increasing heart rates using the NOS1 knockout mouse model. PMID:26131569

  16. Assessment of soil erodibility indices for conservation reserve program lands in southwestern Kansas using satellite imagery and GIS techniques.

    PubMed

    Park, Sunyurp; Egbert, Stephen L

    2005-12-01

    The soil erodibility index (EI) of Conservation Reserve Program (CRP) lands, which was the major criterion for CRP enrollment, was assessed for six counties in southwestern Kansas using USGS seamless digital elevation model data and Geographical Informational System techniques. The proportion of land areas with EI values of 8 or lower was less than 1% of the entire study area and most of the land areas (72.5%) were concentrated on EI values between 8 and 24. Although land acreage with EI values of 24 or higher decreased dramatically, the proportion of CRP lands to the other land-use types did not change much from low to high EI levels. The soil EI and physical soil characteristics of the CRP lands were compared to those of other land-use types. In general, the mean EI values of the land-use types were strongly correlated with physical soil properties, including organic matter content, clay content, available water capacity, permeability, and texture. CRP lands were compared in detail with cropland in terms of their soil characteristics to infer the pivotal cause of the land transformation. Although there was no significant statistical difference in EI between cropland and CRP soils, soil texture, soil family, and permeability were statistically different between the two. Statistical analyses of these three variables showed that CRP soils had coarser texture and higher permeability on average than cropland soils, indicating that CRP lands in the study area are drier than cropland soils. Therefore, soil moisture characteristics, not necessarily soil erosion potential, might have been the key factor for CRP enrollment in the study area. PMID:16328681

  17. A Simple Evaluation Method for the Quality of Dietary Protein in Rats Using an Indicator Amino Acid Oxidation Technique.

    PubMed

    Ogawa, Aki; Murayama, Haruka; Hayamizu, Kohsuke; Kobayashi, Yukiko; Kuwahata, Masashi; Kido, Yasuhiro

    2015-01-01

    We demonstrated that the indicator amino acid oxidation (IAAO) method could be employed for the evaluation of quality of dietary protein by comparing the protein intakes required to meet metabolic demand in rats fed different proteins. The objective of this study was to validate a simple evaluation method for determining the quality of dietary protein using the IAAO technique. Male Sprague-Dawley rats (5-6 wk old) were fed meals composed of graded protein, using either casein, wheat gluten (WG), soy protein isolate (SPI), or egg white protein (EW), every 3 h from 09:00 to 18:00. Administration of L-[1-(13)C]phenylalanine was performed hourly from 15:00 to 18:00. The (13)CO2 level in breath CO2 was measured at 18:30. The protein intake values required to meet the metabolic demand based on the breath (13)CO2 data for the dietary casein, WG, SPI, and EW intake were 18.0, 22.2, 17.5, and 10.1 g/kg BW/d, respectively. The breath (13)CO2 concentrations corresponding to the protein intake of 7.5 g/kg BW/d for casein, WG, SPI, and EW were 9.8, 10.9, 10.3, and 8.9 (‰)/100 g BW, respectively. A significant correlation was demonstrated between the protein intake required to meet the metabolic demands and the (13)CO2 concentration in the breath for a protein intake of 7.5 g/kg BW/d (r=0.967; p<0.05). These results demonstrated that the protein intake required to meet metabolic demand could be estimated and that the quality of the dietary protein could be evaluated using the (13)CO2 concentration in the breath with a protein intake of 7.5 g/kg BW/d. PMID:26052142

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

    PubMed Central

    Georgescu, I; Gavriliu, S; Pârvan, A; Martiniuc, A; Japie, E; Ghiță, R; Drăghici, I; Hamei, S; Ţiripa, I; El Nayef, T; Dan, D

    2013-01-01

    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 Bacău, 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, Ştefan 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 cases of cubitus varus or valgus were reported. Conclusion. The Burnei’s "double X" osteosynthesis does not require cast immobilization. In oblique fractures, the stability is more difficult to obtain and by using other methods, elbow stiffness or ulnar nerve palsy may appear. The Burnei’s "double X" osteosynthesis ensures stability of these types of fractures and avoids complications. This technique allows early motion after surgery and, in case of polytrauma, ensures comfort both to the patient and the physician, allowing repetitive examinations, preferential positions or the nursing of the extensive skin lesions. PMID:23904871

  19. Hypertrophy of labia minora in myelodysplastic women. Labioplasty to ease clean intermittent catheterization.

    PubMed

    Kato, K; Kondo, A; Gotoh, M; Tanaka, J; Saitoh, M; Namiki, Y

    1988-04-01

    Female myelodysplastic patients are sometimes annoyed by hypertrophy of the labia minora, possibly caused by long-term diaper dermatitis. This condition makes intermittent catheterization difficult and impairs the cleanliness and aesthetic appearance of the external genitalia. We successfully performed labioplasty on 3 myelodysplastic females. PMID:3281364

  20. Radiation Dose Reduction during Radial Cardiac Catheterization: Evaluation of a Dedicated Radial Angiography Absorption Shielding Drape.

    PubMed

    Ertel, Andrew; Nadelson, Jeffrey; Shroff, Adhir R; Sweis, Ranya; Ferrera, Dean; Vidovich, Mladen I

    2012-01-01

    Objectives. Radiation scatter protection shield drapes have been designed with the goal of decreasing radiation dose to the operators during transfemoral catheterization. We sought to investigate the impact on operator radiation exposure of various shielding drapes specifically designed for the radial approach. Background. Radial access for cardiac catheterization has increased due to improved patient comfort and decreased bleeding complications. There are concerns for increased radiation exposure to patients and operators. Methods. Radiation doses to a simulated operator were measured with a RadCal Dosimeter in the cardiac catheterization laboratory. The mock patient was a 97.5 kg fission product phantom. Three lead-free drape designs were studied. The drapes were placed just proximal to the right wrist and extended medially to phantom's trunk. Simulated diagnostic coronary angiography included 6 minutes of fluoroscopy time and 32 seconds of cineangiography time at 4 standard angulated views (8 s each), both 15 frames/s. ANOVA with Bonferroni correction was used for statistical analysis. Results. All drape designs led to substantial reductions in operator radiation exposure compared to control (P < 0.0001). The greatest decrease in radiation exposure (72%) was with the L-shaped design. Conclusions. Dedicated radial shielding drapes decrease radiation exposure to the operator by up to 72% during simulated cardiac catheterization. PMID:22988525

  1. Radiation Dose Reduction during Radial Cardiac Catheterization: Evaluation of a Dedicated Radial Angiography Absorption Shielding Drape

    PubMed Central

    Ertel, Andrew; Nadelson, Jeffrey; Shroff, Adhir R.; Sweis, Ranya; Ferrera, Dean; Vidovich, Mladen I.

    2012-01-01

    Objectives. Radiation scatter protection shield drapes have been designed with the goal of decreasing radiation dose to the operators during transfemoral catheterization. We sought to investigate the impact on operator radiation exposure of various shielding drapes specifically designed for the radial approach. Background. Radial access for cardiac catheterization has increased due to improved patient comfort and decreased bleeding complications. There are concerns for increased radiation exposure to patients and operators. Methods. Radiation doses to a simulated operator were measured with a RadCal Dosimeter in the cardiac catheterization laboratory. The mock patient was a 97.5 kg fission product phantom. Three lead-free drape designs were studied. The drapes were placed just proximal to the right wrist and extended medially to phantom's trunk. Simulated diagnostic coronary angiography included 6 minutes of fluoroscopy time and 32 seconds of cineangiography time at 4 standard angulated views (8 s each), both 15 frames/s. ANOVA with Bonferroni correction was used for statistical analysis. Results. All drape designs led to substantial reductions in operator radiation exposure compared to control (P < 0.0001). The greatest decrease in radiation exposure (72%) was with the L-shaped design. Conclusions. Dedicated radial shielding drapes decrease radiation exposure to the operator by up to 72% during simulated cardiac catheterization. PMID:22988525

  2. Direct measurement of a patient's entrance skin dose during pediatric cardiac catheterization

    PubMed Central

    Sun, Lue; Mizuno, Yusuke; Iwamoto, Mari; Goto, Takahisa; Koguchi, Yasuhiro; Miyamoto, Yuka; Tsuboi, Koji; Chida, Koichi; Moritake, Takashi

    2014-01-01

    Children with complex congenital heart diseases often require repeated cardiac catheterization; however, children are more radiosensitive than adults. Therefore, radiation-induced carcinogenesis is an important consideration for children who undergo those procedures. We measured entrance skin doses (ESDs) using radio-photoluminescence dosimeter (RPLD) chips during cardiac catheterization for 15 pediatric patients (median age, 1.92 years; males, n = 9; females, n = 6) with cardiac diseases. Four RPLD chips were placed on the patient's posterior and right side of the chest. Correlations between maximum ESD and dose–area products (DAP), total number of frames, total fluoroscopic time, number of cine runs, cumulative dose at the interventional reference point (IRP), body weight, chest thickness, and height were analyzed. The maximum ESD was 80 ± 59 (mean ± standard deviation) mGy. Maximum ESD closely correlated with both DAP (r = 0.78) and cumulative dose at the IRP (r = 0.82). Maximum ESD for coiling and ballooning tended to be higher than that for ablation, balloon atrial septostomy, and diagnostic procedures. In conclusion, we directly measured ESD using RPLD chips and found that maximum ESD could be estimated in real-time using angiographic parameters, such as DAP and cumulative dose at the IRP. Children requiring repeated catheterizations would be exposed to high radiation levels throughout their lives, although treatment influences radiation dose. Therefore, the radiation dose associated with individual cardiac catheterizations should be analyzed, and the effects of radiation throughout the lives of such patients should be followed. PMID:24968708

  3. History of right heart catheterization: 100 years of experimentation and methodology development.

    PubMed

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

    2010-01-01

    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 intensive care unit 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 intensive care unit 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. PMID:20160536

  4. Acute kidney injury after using contrast during cardiac catheterization in children with heart disease.

    PubMed

    Hwang, Young Ju; Hyun, Myung Chul; Choi, Bong Seok; Chun, So Young; Cho, Min Hyun

    2014-08-01

    Acute kidney injury (AKI) is closely associated with the mortality of hospitalized patients and long-term development of chronic kidney disease, especially in children. The purpose of our study was to assess the evidence of contrast-induced AKI after cardiac catheterization in children with heart disease and evaluate the clinical usefulness of candidate biomarkers in AKI. A total of 26 children undergoing cardiac catheterization due to various heart diseases were selected and urine and blood samples were taken at 0 hr, 6 hr, 24 hr, and 48 hr after cardiac catheterization. Until 48 hr after cardiac catheterization, there was no significant increase in serum creatinine level in all patients. Unlike urine kidney injury molecule-1, IL-18 and neutrophil gelatinase-associated lipocalin, urine liver-type fatty acid-binding protein (L-FABP) level showed biphasic pattern and the significant difference in the levels of urine L-FABP between 24 and 48 hr. We suggest that urine L-FABP can be one of the useful biomarkers to detect subclinical AKI developed by the contrast before cardiac surgery. PMID:25120320

  5. Part versus Whole: A Randomized Trial of Central Venous Catheterization Education

    ERIC Educational Resources Information Center

    Chan, Angela; Singh, Sunita; Dubrowski, Adam; Pratt, Daniel D.; Zalunardo, Nadia; Nair, Parvarthy; McLaughlin, Kevin; Ma, Irene W. Y.

    2015-01-01

    Central venous catheterization (CVC) is a complex but commonly performed procedure. How best to teach this complex skill has not been clearly delineated. We conducted a randomized trial of the effects of two types of teaching of CVC on skill acquisition and retention. We randomly assigned novice internal medicine residents to learning CVC in-part…

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

    PubMed Central

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

    2010-01-01

    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. PMID:20160536

  7. Part versus Whole: A Randomized Trial of Central Venous Catheterization Education

    ERIC Educational Resources Information Center

    Chan, Angela; Singh, Sunita; Dubrowski, Adam; Pratt, Daniel D.; Zalunardo, Nadia; Nair, Parvarthy; McLaughlin, Kevin; Ma, Irene W. Y.

    2015-01-01

    Central venous catheterization (CVC) is a complex but commonly performed procedure. How best to teach this complex skill has not been clearly delineated. We conducted a randomized trial of the effects of two types of teaching of CVC on skill acquisition and retention. We randomly assigned novice internal medicine residents to learning CVC in-part…

  8. Evaluation of educational content of YouTube videos relating to neurogenic bladder and intermittent catheterization

    PubMed Central

    Ho, Matthew; Stothers, Lynn; Lazare, Darren; Tsang, Brian; Macnab, Andrew

    2015-01-01

    Introduction: Many patients conduct internet searches to manage their own health problems, to decide if they need professional help, and to corroborate information given in a clinical encounter. Good information can improve patients’ understanding of their condition and their self-efficacy. Patients with spinal cord injury (SCI) featuring neurogenic bladder (NB) require knowledge and skills related to their condition and need for intermittent catheterization (IC). Methods: Information quality was evaluated in videos accessed via YouTube relating to NB and IC using search terms “neurogenic bladder intermittent catheter” and “spinal cord injury intermittent catheter.” Video content was independently rated by 3 investigators using criteria based on European Urological Association (EAU) guidelines and established clinical practice. Results: In total, 71 videos met the inclusion criteria. Of these, 12 (17%) addressed IC and 50 (70%) contained information on NB. The remaining videos met inclusion criteria, but did not contain information relevant to either IC or NB. Analysis indicated poor overall quality of information, with some videos with information contradictory to EAU guidelines for IC. High-quality videos were randomly distributed by YouTube. IC videos featuring a healthcare narrator scored significantly higher than patient-narrated videos, but not higher than videos with a merchant narrator. About half of the videos contained commercial content. Conclusions: Some good-quality educational videos about NB and IC are available on YouTube, but most are poor. The videos deemed good quality were not prominently ranked by the YouTube search algorithm, consequently user access is less likely. Study limitations include the limit of 50 videos per category and the use of a de novo rating tool. Information quality in videos with healthcare narrators was not higher than in those featuring merchant narrators. Better material is required to improve patients’ understanding of their condition. PMID:26644803

  9. Application of spectrophotometric, densitometric, and HPLC techniques as stability indicating methods for determination of Zaleplon in pharmaceutical preparations

    NASA Astrophysics Data System (ADS)

    Metwally, Fadia H.; Abdelkawy, M.; Abdelwahab, Nada S.

    2007-12-01

    Spectrophotometric, spectrodensitometric and HPLC are stability indicating methods described for determination of Zaleplon in pure and dosage forms. As Zaleplon is easily degradable, the proposed techniques in this manuscript are adopted for its determination in presence of its alkaline degradation product, namely N-[4-(3-cyano-pyrazolo[1,5a]pyridin-7-yl)-phenyl]- N-ethyl-acetamide. These approaches are successfully applied to quantify Zaleplon using the information included in the absorption spectra of appropriate solutions. The second derivative (D 2) spectrophotometric method, allows determination of Zaleplon without interference of its degradate at 235.2 nm using 0.01N HCl as a solvent with obedience to Beer's law over a concentration range of 1-10 μg ml -1 with mean percentage recovery 100.24 ± 0.86%. The first derivative of the ratio spectra ( 1DD) based on the simultaneous use of ( 1DD) and measurement at 241.8 nm using the same solvent and over the same concentration range as (D 2) spectrophotometric method, with mean percentage recovery 99.9 ± 1.07%. The spectrodensitometric analysis allows the separation and quantitation of Zaleplon from its degradate on silica gel plates using chloroform:acetone:ammonia solution (9:1:0.2 by volume) as a mobile phase. This method depends on quantitave densitometric evaluation of thin layer chromatogram of Zaleplon at 338 nm over a concentration range of 0.2-1 μg band -1, with mean percentage recovery 99.73 ± 1.35. Also a reversed-phase liquid chromatographic method using 5-C8 (22 cm × 4.6 mm i.d. 5 μm particle size) column was described and validated for quantitation of Zaleplon using acetonitrile:deionised water (35:65, v/v) as a mobile phase using Paracetamol as internal standard and a flow rate of 1.5 ml min -1 with UV detection of the effluent at 232 nm at ambient temperature over a concentration range of 2-20 μg ml -1 with mean percentage recovery 100.19 ± 1.15%. The insignificance difference of the proposed methods results with those of the reference one proved their accuracy and precision.

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

    ERIC Educational Resources Information Center

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

    2005-01-01

    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…

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

    ERIC Educational Resources Information Center

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

    2005-01-01

    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…

  12. Robot-assisted needle insertion for venous catheterization.

    PubMed

    Pasternak, Jacyr

    2015-01-01

    Vein access can be challenging for a variety of patients. The development of robots-assisted central or peripheral veins puncture would facilitate life of health professionals and patients. New robots are under development for this purpose and probably they will become available for practical use in the near future. These techniques may decrease significantly the cost of medicine, which currently uses less informatics resources than other industries. PMID:26313434

  13. Video-assisted thoracoscopic implantation of a diaphragmatic pacemaker in a child with tetraplegia: indications, technique, and results.

    PubMed

    Filho Pinto, Darcy Ribeiro; Tedde, Miguel Lia; Avino, Alexandre José Gonçalves; Brandão, Suzan Lúcia Brancher; Zanatta, Iuri; Hahn, Rafael

    2015-01-01

    We report the case of a child with tetraplegia after cervical trauma, who subsequently underwent diaphragmatic pacemaker implantation. We reviewed the major indications for diaphragmatic pacing and the types of devices employed. We highlight the unequivocal benefit of diaphragmatic pacing in the social and educational reintegration of individuals with tetraplegia. PMID:25750678

  14. Cutaneous antimicrobial preparation prior to intravenous catheterization in healthy dogs: clinical, microbiological, and histopathological evaluation.

    PubMed Central

    Coolman, B R; Marretta, S M; Kakoma, I; Wallig, M A; Coolman, S L; Paul, A J

    1998-01-01

    The purpose of this study was to determine the effects of a one-minute chlorhexidine gluconate skin preparation protocol prior to cephalic vein catheterization. Twenty-three healthy beagle dogs had one leg aseptically prepared and the opposite leg served as a control. Twenty-six- and 77-hour time groups were studied. Chlorhexidine-treated legs had significantly lower cutaneous bacterial counts than the control legs prior to catheter insertion and prior to catheter withdrawal for both time groups. Control legs developed significantly more dermatitis than the treated legs after 77 h. A one-minute preparation with 4% chlorhexidine gluconate was an effective method for sustained reduction of cutaneous bacterial counts at peripheral intravenous catheter insertion points in dogs. Increased cutaneous bacterial counts were associated with significantly more microscopic dermatitis in untreated legs after 77 h of catheterization. Images Figure 1. PMID:9861500

  15. Renal Insufficiency and Early Bystander CPR Predict In-Hospital Outcomes in Cardiac Arrest Patients Undergoing Mild Therapeutic Hypothermia and Cardiac Catheterization: Return of Spontaneous Circulation, Cooling, and Catheterization Registry (ROSCCC Registry)

    PubMed Central

    Chelvanathan, Anjala; Allen, David; Bews, Hilary; Ducas, John; Minhas, Kunal; Ravandi, Amir; Jassal, Davinder S.; Hussain, Farrukh

    2016-01-01

    Objective. Out of hospital cardiac arrest (OHCA) patients are a critically ill patient population with high mortality. Combining mild therapeutic hypothermia (MTH) with early coronary intervention may improve outcomes in this population. The aim of this study was to evaluate predictors of mortality in OHCA patients undergoing MTH with and without cardiac catheterization. Design. A retrospective cohort of OHCA patients who underwent MTH with catheterization (MTH + C) and without catheterization (MTH + NC) between 2006 and 2011 was analyzed at a single tertiary care centre. Predictors of in-hospital mortality and neurologic outcome were determined. Results. The study population included 176 patients who underwent MTH for OHCA. A total of 66 patients underwent cardiac catheterization (MTH + C) and 110 patients did not undergo cardiac catheterization (MTH + NC). Immediate bystander CPR occurred in approximately half of the total population. In the MTH + C and MTH + NC groups, the in-hospital mortality was 48% and 78%, respectively. The only independent predictor of in-hospital mortality for patients with MTH + C, after multivariate analysis, was baseline renal insufficiency (OR = 8.2, 95% CI 1.8–47.1, and p = 0.009). Conclusion. Despite early cardiac catheterization, renal insufficiency and the absence of immediate CPR are potent predictors of death and poor neurologic outcome in patients with OHCA. PMID:26885436

  16. Renal Insufficiency and Early Bystander CPR Predict In-Hospital Outcomes in Cardiac Arrest Patients Undergoing Mild Therapeutic Hypothermia and Cardiac Catheterization: Return of Spontaneous Circulation, Cooling, and Catheterization Registry (ROSCCC Registry).

    PubMed

    Chelvanathan, Anjala; Allen, David; Bews, Hilary; Ducas, John; Minhas, Kunal; Vo, Minh; Kass, Malek; Ravandi, Amir; Tam, James W; Jassal, Davinder S; Hussain, Farrukh

    2016-01-01

    Objective. Out of hospital cardiac arrest (OHCA) patients are a critically ill patient population with high mortality. Combining mild therapeutic hypothermia (MTH) with early coronary intervention may improve outcomes in this population. The aim of this study was to evaluate predictors of mortality in OHCA patients undergoing MTH with and without cardiac catheterization. Design. A retrospective cohort of OHCA patients who underwent MTH with catheterization (MTH + C) and without catheterization (MTH + NC) between 2006 and 2011 was analyzed at a single tertiary care centre. Predictors of in-hospital mortality and neurologic outcome were determined. Results. The study population included 176 patients who underwent MTH for OHCA. A total of 66 patients underwent cardiac catheterization (MTH + C) and 110 patients did not undergo cardiac catheterization (MTH + NC). Immediate bystander CPR occurred in approximately half of the total population. In the MTH + C and MTH + NC groups, the in-hospital mortality was 48% and 78%, respectively. The only independent predictor of in-hospital mortality for patients with MTH + C, after multivariate analysis, was baseline renal insufficiency (OR = 8.2, 95% CI 1.8-47.1, and p = 0.009). Conclusion. Despite early cardiac catheterization, renal insufficiency and the absence of immediate CPR are potent predictors of death and poor neurologic outcome in patients with OHCA. PMID:26885436

  17. SU-E-P-10: Imaging in the Cardiac Catheterization Lab - Technologies and Clinical Applications

    SciTech Connect

    Fetterly, K

    2014-06-01

    Purpose: Diagnosis and treatment of cardiovascular disease in the cardiac catheterization laboratory is often aided by a multitude of imaging technologies. The purpose of this work is to highlight the contributions to patient care offered by the various imaging systems used during cardiovascular interventional procedures. Methods: Imaging technologies used in the cardiac catheterization lab were characterized by their fundamental technology and by the clinical applications for which they are used. Whether the modality is external to the patient, intravascular, or intracavity was specified. Specific clinical procedures for which multiple modalities are routinely used will be highlighted. Results: X-ray imaging modalities include fluoroscopy/angiography and angiography CT. Ultrasound imaging is performed with external, trans-esophageal echocardiography (TEE), and intravascular (IVUS) transducers. Intravascular infrared optical coherence tomography (IVOCT) is used to assess vessel endothelium. Relatively large (>0.5 mm) anatomical structures are imaged with x-ray and ultrasound. IVUS and IVOCT provide high resolution images of vessel walls. Cardiac CT and MRI images are used to plan complex cardiovascular interventions. Advanced applications are used to spatially and temporally merge images from different technologies. Diagnosis and treatment of coronary artery disease frequently utilizes angiography and intra-vascular imaging, and treatment of complex structural heart conditions routinely includes use of multiple imaging modalities. Conclusion: There are several imaging modalities which are routinely used in the cardiac catheterization laboratory to diagnose and treat both coronary artery and structural heart disease. Multiple modalities are frequently used to enhance the quality and safety of procedures. The cardiac catheterization laboratory includes many opportunities for medical physicists to contribute substantially toward advancing patient care.

  18. Giant urethral diverticulum's caused by traumatic vesicle catheterization in children: a case report

    PubMed Central

    Kkhattala, Khalid; Rami, Mohamed; Elmadi, Aziz; Chater, Lamia; Mahmoudi, Abdelhalim; Bouabadallah, Youssef

    2011-01-01

    Urethral diverticula are saclike dilations of the urethra and are classified as either congenital or acquired. While urethral diverticula are commonly seen in female patients, they are rarely seen in men. The most common etiologies of male acquired diverticula include urethral trauma, stricture, abscess or post-hypospadias repair. We report a case of acquired urethral diverticula caused by a traumatic vesical catheterization in a 6-year old boy and review the literature on the topic. PMID:22187597

  19. Risk of local adverse events following cardiac catheterization by hemostasis device use and gender.

    PubMed

    Tavris, Dale R; Gallauresi, Beverly Albrecht; Lin, Ba; Rich, Suzanne E; Shaw, Richard E; Weintraub, William S; Brindis, Ralph G; Hewitt, Kathleen

    2004-09-01

    Hemostasis devices are primarily used to stop bleeding from the femoral artery catheterization site after cardiac diagnostic or interventional procedures. Studies assessing the effectiveness of hemostatic devices compared to manual compression have produced mixed results regarding the relative risk of serious adverse events, such as hemorrhage. This study assessed the relative risk of serious complications following the use of the two main types of hemostasis devices (as compared with manual compression), and assessed the relative rates of these complications by gender. PMID:15353824

  20. Methicillin-Resistant Staphylococcus aureus Vertebral Osteomyelitis Following Epidural Catheterization: A Case Report and Literature Review

    PubMed Central

    Krishnakumar, R.; Renjitkumar, J.

    2012-01-01

    Indwelling epidural catheters are frequently used to manage postoperative pain. This report describes a patient who developed methicillin-resistant Staphylococcus aureus (MRSA) vertebral osteomyelitis of the lumbar spine following epidural catheterization. To the best of our knowledge, this is the first reported case of MRSA vertebral osteomyelitis secondary to epidural catheter use in the English orthopedic literature. The patient and his family consented to publishing the data. PMID:24353973

  1. Predictors of Conversion from Radial Into Femoral Access in Cardiac Catheterization

    PubMed Central

    Carvalho, Maria Salomé; Calé, Rita; Gonçalves, Pedro de Araújo; Vinhas, Hugo; Raposo, Luís; Teles, Rui; Martins, Cristina; Gabriel, Henrique Mesquita; Pereira, Helder; Almeida, Manuel

    2015-01-01

    Background Fewer bleeding complications and early ambulation make radial access a privileged route for cardiac catheterization. However, transradial (TR) approach is not always successful, requiring its conversion into femoral access. Objectives To evaluate the rate of conversion from radial into femoral access in cardiac catheterization and to identify its predictors. Methods Prospective dual-center registry, including 7632 consecutive patients undergoing catheterization via the radial access between Jan/2009 and Oct/2012. We evaluated the incidence of conversion into femoral access and its predictors by logistic regression analysis. Results The patients’ mean age was 66 ± 11 years, and 32% were women. A total of 2969 procedures (38.4%) were percutaneous coronary interventions (PCI), and the most used first intention arterial access was the right radial artery (97.6%). Radial access failure rate was 5.8%. Independent predictors of conversion from radial into femoral access were the use of short introducer sheaths (OR 3.047, CI: 2.380-3.902; p < 0.001), PCI (OR 1.729, CI: 1.375-2.173; p < 0.001), female sex (OR 1.569, CI: 1.234-1.996; p < 0.001), multivessel disease (OR 1.457, CI: 1.167-1.819; p = 0.001), body surface area (BSA) ? 1.938 (OR 1.448, CI: 1.120-1.871; p = 0.005) and age > 66 years (OR 1.354, CI: 1.088-1.684; p = 0.007). Conclusion Transradial approach for cardiac catheterization has a high success rate and the need for its conversion into femoral access in this cohort was low. Female sex, older age, smaller BSA, the use of short introducer sheaths, multivessel disease and PCI were independent predictors of conversion into femoral access. PMID:25789883

  2. Thrombus Formation After Percutaneous Catheterization and Manual Compression of the Femoral Artery in Heparinized Sheep

    SciTech Connect

    Kim, Young Hwan; Pavcnik, Dusan Kakizawa, Hideyaki; Uchida, Barry T.; Burke, Allen; Loriaux, Marc; Keller, Frederick S.; Rosch, Josef

    2010-04-15

    The purpose of this study was to evaluate the angiographic and histopathologic changes in the superficial femoral artery (SFA) in heparinized sheep shortly after catheterization with an 8-Fr sheath and manual compression hemostasis either with standard manual compression (SMC) or with the use of a procoagulant chitosan-based HemCon Bandage. The evaluation was done in 38 SFAs of 19 heparinized (100 mg/kg) sheep. After a 5-min catheterization with an 8-Fr sheath, a 5-min compression was applied. Follow-up angiograms to evaluate hemostasis were done immediately after release of compression and then at 2.5-min intervals until no extravasation was present. Compression was reapplied between angiograms. Final angiograms were performed approximately 30 min after hemostasis and after 3 min of passive flexion and extension of sheep hind limbs. Sheep were then euthanized and SFA specimens with surrounding tissues excised for histopathologic evaluation. Both types of compression caused similar changes in the catheterized SFAs. Follow-up angiograms showed mild arterial narrowing in 14 SFAs and intraluminal clots in 9 SFAs. Histology revealed periarterial hematoma in all 38 specimens. Intraluminal thrombi consisting predominantly of platelets and fibrin were present in 32 SFAs. Their size varied from superficial elevations (8 arteries) to medium-sized, 1- to 2-mm, polypoid protrusions (15 arteries) to large polypoid clots, 3-4 mm long (9 arteries). In six SFAs, the arterial access sites were not included in the obtained specimens. In conclusion, hemostasis with manual compression is achieved in the acute phase by formation of a predominantly platelet-fibrin thrombus occluding the arterial wall access site and often extending significantly into the arterial lumen. The healing process of arterial access sites should be explored several days after catheterization.

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

    PubMed Central

    Cornelius, Carl-Peter; Ehrenfeld, Michael

    2010-01-01

    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

  4. Decomposing the trade-environment nexus for Malaysia: what do the technique, scale, composition, and comparative advantage effect indicate?

    PubMed

    Ling, Chong Hui; Ahmed, Khalid; Binti Muhamad, Rusnah; Shahbaz, Muhammad

    2015-12-01

    This paper investigates the impact of trade openness on CO2 emissions using time series data over the period of 1970QI-2011QIV for Malaysia. We disintegrate the trade effect into scale, technique, composition, and comparative advantage effects to check the environmental consequence of trade at four different transition points. To achieve the purpose, we have employed augmented Dickey-Fuller (ADF) and Phillips-Perron (PP) unit root tests in order to examine the stationary properties of the variables. Later, the long-run association among the variables is examined by applying autoregressive distributed lag (ARDL) bounds testing approach to cointegration. Our results confirm the presence of cointegration. Further, we find that scale effect has positive and technique effect has negative impact on CO2 emissions after threshold income level and form inverted U-shaped relationship-hence validates the environmental Kuznets curve hypothesis. Energy consumption adds in CO2 emissions. Trade openness and composite effect improve environmental quality by lowering CO2 emissions. The comparative advantage effect increases CO2 emissions and impairs environmental quality. The results provide the innovative approach to see the impact of trade openness in four sub-dimensions of trade liberalization. Hence, this study attributes more comprehensive policy tool for trade economists to better design environmentally sustainable trade rules and agreements. PMID:26300360

  5. Hierarchical HMM based learning of navigation primitives for cooperative robotic endovascular catheterization.

    PubMed

    Rafii-Tari, Hedyeh; Liu, Jindong; Payne, Christopher J; Bicknell, Colin; Yang, Guang-Zhong

    2014-01-01

    Despite increased use of remote-controlled steerable catheter navigation systems for endovascular intervention, most current designs are based on master configurations which tend to alter natural operator tool interactions. This introduces problems to both ergonomics and shared human-robot control. This paper proposes a novel cooperative robotic catheterization system based on learning-from-demonstration. By encoding the higher-level structure of a catheterization task as a sequence of primitive motions, we demonstrate how to achieve prospective learning for complex tasks whilst incorporating subject-specific variations. A hierarchical Hidden Markov Model is used to model each movement primitive as well as their sequential relationship. This model is applied to generation of motion sequences, recognition of operator input, and prediction of future movements for the robot. The framework is validated by comparing catheter tip motions against the manual approach, showing significant improvements in the quality of catheterization. The results motivate the design of collaborative robotic systems that are intuitive to use, while reducing the cognitive workload of the operator. PMID:25333155

  6. Investigation of grapevine photosynthesis using hyperspectral techniques and development of hyperspectral band ratio indices sensitive to photosynthesis.

    PubMed

    Ozelkan, Emre; Karaman, Muhittin; Candar, Serkan; Coskun, Zafer; Ormeci, Cankut

    2015-01-01

    The photosynthetic rate of 9 different grapevines were analyzed with simultaneous photosynthesis and spectroradiometric measurements on 08.08.2012 (veraison) and 06.09.2012 (harvest). The wavelengths and spectral regions, which most properly express photosynthetic rate, were determined using correlation and regression analysis. In addition, hyperspectral band ratio (BR) indices sensitive to photosynthesis were developed using optimum band ratio (OBRA) method. The relation of BR results with photosynthesis values are presented with the correlation matrix maps created in this study. The examinations were performed for both specific dates (i.e., veraison and harvest) and also in aggregate (i.e., correlation between total spectra and photosynthesis data). For specific dates wavelength based analysis, the photosynthesis were best determined with -0.929 correlation coefficient (r) 609 nm of yellow region at veraison stage, and -0.870 at 641 nm of red region at harvest stage. For wavelength based aggregate analysis, 640 nm of red region was found to be correlated with 0.921 and -0.867 r values respectively and red edge (RE) (695 nm) was found to be correlated with -0.922 and -0.860 r values, respectively. When BR indices results were analyzed with photosynthetic values for specific dates, -0.987 r with R8../R, at veraison stage and -0.911 r with R696/R944 at harvest stage were found most correlated. For aggregate analysis of BR, common BR presenting great correlation with photosynthesis for both measurements was found to be R632/R971 with -0.974, -0.881 r values, respectively and other R610/R760 with -0.976, -0.879 r values. The final results of this study indicate that the proportion of RE region to a region with direct or indirect correlation with photosynthetic provides information about rate of photosynthesis. With the indices created in this study, the photosynthesis rate of vineyards can be determined using in-situ hyperspectral remote sensing. The findings of this study would enable cost-efficient, rapid and effective control of viticulture activities. PMID:26591887

  7. [Multicenter pediatric therapeutic interventional heart catheterization 1996-1998].

    PubMed

    Dinarevi?, S; Mesihovi?, H; Terzi?, R; Cengi?, H; Lojpur, V; Begi?, Z

    1999-01-01

    The aim of the study is to evaluate choice, efficacy and safety of transcatheter therapy in patients (pts) with congenital heart disease which has been performed in Europe on pts from the Paediatric Clinic of Sarajevo. From January 1996 to August 1998 out of 20 transcatheter therapeutic interventions, 5 have been done in pts whose congenital heart lesions: ductus arteriosus persistence (DAP), atrial septal defect (ASD), pulmonary artery valve stenosis (PS), aortic valve stenosis (AS), were diagnosed in first year of life. Pts were followed 11 months post interventions (the longest period of follow-up 19 months). All pts are well and asymptomatic. DAP closure has been done using "coil" devices in 2 pts (in Italy and Monaco) age 5 and 7.5 years. Duct diameter was 3.5 mm and 4 mm with percent of success within 24 hrs of 100%. With PW Doppler no residual ductual shunt has been proven. Transcatheter closure of ASD type secundum diameter 9 mm, using the "amplatz" device has been performed in Germany. No residual shunt has been proven by echocardiography. Balloon pulmonary valvuloplasty successfully was done in 1 pt in Austria age 3/12 with normal flow of right ventricle outflow tract post intervention. Balloon aortic valvuloplasty was performed in Sweden in neonate with decrease of pressure gradient of AS for 70%. Using Pencil Doppler, 8/12 post intervention in that pt restenosis occurred. The therapeutic catheterizational technique has been successful in alternating surgical approach to resolve congenital heart disease. With further development of catheter systems, techniques and longer periods of follow-up, possibilities of simpler, faster, safer and more efficient solvation of cardiac lesions will brightening up the future of paediatric interventional catheterisation. PMID:10758753

  8. Four techniques to measure complex refractive indices of liquids and solids at carbon dioxide laser wavelengths in the infrared spectral region

    NASA Astrophysics Data System (ADS)

    Wieliczka, David M.; Querry, Marvin R.

    1990-01-01

    Four techniques were developed to determine the optical constants of liquids and solids. Two cells were designed and constructed to obtain the optical constants of liquids, a wedge-shaped cell and an internal reflectance cell. The wedge-shaped cell was used to determine the optical constants of 11 liquids in the spectral range 500 to 12500/cm. The techniques of Querry and Avery were used in conjunction with the internal reflectance cell to obtain the complex refractive index of water and SF-96. The complex refractive indices of illite, kaolin, and montmorillinite were obtained from applying the techniques of Querrys and Averys. The error associated with each of the four techniques was also examined and is summarized.

  9. Three-dimensional modelling of the venous system by direct multislice helical computed tomography venography: technique, indications and results.

    PubMed

    Uhl, J F

    2012-09-01

    The aim of multislice helical computed tomography venography (CTV) is to provide a precise, global and three-dimensional (3D) anatomical depiction of the venous network of the lower limbs. A multislice and multidetector spiral CT acquisition of the lower limbs with contrast injection of the dorsal foot produces about 1000 slices in 30 seconds. Dedicated volume-rendering software can compute a realistic and interactive 3D model of the venous system in realtime. This new tool furnishes an accurate 3D representation of the whole venous system of the lower limb with a realistic 3D model of the limbs, providing a road map of the varicose networks complementary to the duplex ultrasound (DUS). CTV allows a complete morphological study of the deep veins, including the detection of anatomical variations and proximal venous obstruction, not easily detectable by DUS. In the case of deep vein thrombosis, it has been shown to be a good diagnostic tool, well correlated with sonography. It also demonstrates, in some cases, haemodynamic patterns which are not available by DUS, particularly for perforator veins and congenital vascular malformations. The use of virtual reality techniques enables a complete anatomical study of both deep and superficial veins including a virtual dissection of the limbs. CTV is also a great educational tool to learn anatomy of the venous system and a powerful research tool to improve our knowledge of venous anatomy. PMID:23155152

  10. Percutaneous ex-vivo femoral arterial bypass: a novel approach for treatment of acute limb ischemia as a complication of femoral arterial catheterization.

    PubMed

    Merhi, William M; Turi, Zoltan G; Dixon, Simon; Safian, Robert D

    2006-09-01

    This report describes the use of a percutaneous ex-vivo femoral arterial bypass in three patients with acute lower extremity ischemia that occurred as a complication of femoral artery catheterization. Utilizing standard equipment and techniques, a percutaneous ex-vivo femoral artery bypass can restore antegrade flow to the ischemic limb in patients with impaired aorto-iliac inflow circulation, which may arise from iatrogenic dissection or the need for large in-dwelling sheaths required for hemodynamic support. This technique is considered a temporizing measure when conventional therapies are not possible. Contrast angiography is recommended to localize and define the cause of limb ischemia, and to permit safe placement of vascular sheaths in the "donor and recipient" arteries. PMID:16892444

  11. Measuring urban sprawl on geospatial indices characterized by leap frog development using remote sensing and GIS techniques

    NASA Astrophysics Data System (ADS)

    Noor, N. M.; Asmawi, M. Z.; Rusni, N. A.

    2014-02-01

    Characterizing urban sprawl using spatial measures requires a concise definition of what constitutes sprawling urban spatial patterns. This research attempts to study a measurement of defining sprawl by using leapfrog development index through remote sensing and GIS approach. The IKONOS pan-sharpened and SPOT-5 with 1 and 2.5 meter resolution were used and combined with Geographical information system (GIS) database to analyze the geospatial indicators using the leapfrog development index. Kuantan city has been selected as a study area to examine the leapfrog development based on land use pattern for year 2012. The findings show Kuantan has identified as non-sprawling cities with result from characterization in leapfrog development that has been tested. However, the gap between sprawl and non-sprawling was very low. It is anticipated this research will provide a new direction in sprawl nationally that address finding of sprawl at the atomic level and present a robust analytical approach for characterizing urban development in city scale at once promoting a city via GIS & Remote Sensing technology respectively towards Digital and Green cities.

  12. Assessment of Immunization Status in the Slums of Surat by 15 Clusters Multi Indicators Cluster Survey Technique

    PubMed Central

    Sharma, Rashmi; Desai, Vikas K; Kavishvar, Abhay

    2009-01-01

    Research Question: What is the immunization status of children in the slums of Surat and what changes has it undergone in recent times? Objective: To assess the immunization status of children between the ages of 12 and 23 months in the slums of Surat and to compare it with the MICS from previous years. Study Design: This was a community-based cross-sectional study conducted in 15 clusters. Settings: 15 urban slums selected out of a total of 299 slums using the cluster sampling method. Study Tool: The Multi Indicator Cluster Sampling (MICS) method was used for sample selection and the proforma designed by UNICEF was used as a study tool. Statistical Analysis: Simple proportions and a Chi-square test. Results: Only 25% of the children between the ages of 12 and 23 months were fully immunized; coverage was highest for BCG (75%) and lowest for measles (29.9%). As far as the dropout rate is concerned, it was 60.2%, 31.9%, and 31.5% for BCG to measles, DPT1 to DPT3, and OPV1 to OPV3, respectively. Vitamin A was taken by only 28.9% of the subjects. Between the two, female children were more disadvantaged in terms of vaccination. When compared with the coverage of 1997 and 1998, the current coverage is poor, more so in relation to DPT and OPV. PMID:19966964

  13. Probing leukocyte traffic in lymph from oro-nasal mucosae by cervical catheterization in a sheep model.

    PubMed

    Schwartz-Cornil, Isabelle; Epardaud, Mathieu; Albert, Jean-Pierre; Bourgeois, Christian; Gérard, Franck; Raoult, Isabelle; Bonneau, Michel

    2005-10-30

    Lymph nodes are instructed via the lymph about ongoing events in tissues both during the steady state and under provoked inflammation. In order to probe for tissue-to-node transduction mechanisms, we have developed a novel in vivo technique of pseudo-afferent lymph collection from the oro-nasal mucosae which represent the main portals of entry of micro-organisms and efficient routes for vaccination. After lateral lymph node resection of the head, a network of lymph ducts was reconstructed as checked by lymphography. Subsequent catheterization of the cervical lymph duct allowed the collection of cells that were shown to originate from the oro-nasal mucosae. These cells included dendritic cells, monocytes, granulocytes, memory CD45RAneg CD2pos integrin beta7lo CD4 T cells, CD25pos CD4, CD8, gamma/delta T cells, and B lymphocytes. This approach, which permits lymph collection over several weeks, opens a valuable and unique way to study leukocyte and particulate (micro-organisms, vaccines) trafficking from head tissue to nodes under homeostastic and immuno-stimulatory conditions in a highly physiological setting. PMID:16143341

  14. Transhepatic vascular access for diagnostic and interventional procedures: techniques, outcome, and complications.

    PubMed

    Ebeid, Makram R

    2007-03-01

    Early or multiple cardiac catheterizations may result in occlusion of the femoral veins prohibiting their use. The internal jugular or sub-clavian approach may be an appropriate alternative. However, these approaches may not be suitable in patients with surgical interruption of the superior vena cava. In other patients, they may not allow easy access to certain areas of the heart. The transhepatic approach is an important alternative route for performing cardiac catheterization and interventions. Depending on the planned procedure, it may be the preferred route to perform the cardiac catheterization even in the presence of patent femoral veins. The indications, technical details and potential complications of this approach are discussed. PMID:17152092

  15. Possibility of analytical finding of glycerol caused by self-catheterization in doping control.

    PubMed

    Okano, Masato; Nishitani, Yasunori; Kageyama, Shinji

    2014-01-01

    Glycerol is listed on the World Anti-Doping Agency (WADA) prohibited list as a masking agent principally because the administration of glycerol increases plasma volume and decreases the concentration of haemoglobin and the value of haematocrit in blood. Glycerol is a naturally occurring substance; therefore, the threshold is set as 1.0 mg/mL in the WADA technical document (WADA TD2013DL). In a WADA-accredited doping control laboratory, three doping control urine specimens collected from impaired athletes were determined to contain a high concentration of glycerol (>1.0 mg/mL); two of these specimens were considered adverse analytical findings (AAFs). Self-catheterization is necessary for athletes with neurological disorders such as neurogenic bladder dysfunction. We conducted a simple simulation of self-catheterization as an experimental test using urethral catheters with an antiseptic agent containing glycerol to confirm the influence of this antiseptic agent on the quantitative value of glycerol in doping control analysis. Some users employ a catheter with glycerol solution (ca. 1 mL) to avoid pain during use. The urine sample passed through such a catheter exhibited a glycerol concentration (4.94 mg/mL) greater than the threshold level. In September 2014, the threshold for glycerol will change from 1.0 to 4.3 mg/mL (WADA TD2014DL); however, a possibility exists for the quantitative value of glycerol in doping control analysis to exceed the threshold because of the use of an antiseptic agent containing glycerol for self-catheterization. The AAF for glycerol for impaired athletes, particularly those who participate in Paralympic sports, should account for the use of a catheter with glycerol. PMID:25079056

  16. Effects of oral premedication on cognitive status of elderly patients undergoing cardiac catheterization

    PubMed Central

    Ashraf, Javed M; Schweiger, Marc; Vallurupalli, Neelima; Bellantonio, Sandra; Cook, James R

    2015-01-01

    Background Sedatives and analgesics are often administered to achieve conscious sedation for diagnostic and therapeutic procedures. Appropriate concerns have been raised regarding post procedure delirium related to peri-procedural medication in the elderly. The objective of this study was to investigate the effect of premedication on new onset delirium and procedural care in elderly patients. Methods Patients ? 70 years old and scheduled for elective cardiac catheterization were randomly assigned to receive either oral diphenhydramine and diazepam (25 mg/5 mg) or no premedication. All patients underwent a mini mental state exam and delirium assessment using confusion assessment method prior to the procedure and repeated at 4 h after the procedure and prior to discharge. Patients' cooperation during the procedure and ease of post-procedure were measured using Visual Analog Scale (VAS). The degree of alertness was assessed immediately on arrival to the floor, and twice hourly afterwards using Observer's Assessment of Alertness/Sedation Scale (OAA/S). Results A total of 93 patients were enrolled. The mean age was 77 years, and 47 patients received premedication prior to the procedure. None of the patients in either group developed delirium. Patients' cooperation and the ease of procedure was greater and pain medication requirement less both during and after the procedure in the pre-medicated group (P < 0.05 for both). Nurses reported an improvement with patient management in the pre-medicated group (P = 0.08). Conclusions In conclusion, premedication did not cause delirium in elderly patients undergoing cardiac catheterization. The reduced pain medication requirement, perceived procedural ease and post procedure management favors premedication in elderly patients undergoing cardiac catheterization. PMID:26089850

  17. [Bleeding during central venous catheterization : Cannot intubate, cannot ventilate due to massive cervical hematoma].

    PubMed

    Engelen, C; Trebes, C; Czarnecki, S; Junger, A

    2016-03-01

    Central venous catheterization is an invasive procedure which can be associated with severe complications. These include in particular unsuccessful arterial puncture and vascular injuries, which in addition to loss of blood can lead to massive soft tissue swelling. A 63-year-old female patient developed massive cervical bleeding during ultrasound-guided internal jugular vein puncture and the rapidly enlarging hematoma led to compromisation of the airway. A cannot intubate, cannot ventilate situation developed and the subsequent hypoxia led to cardiac arrest that was only resolved after emergency surgical tracheotomy during cardiopulmonary resuscitation. PMID:26867603

  18. Success Rate and Complications of Internal Jugular Vein Catheterization With and Without Ultrasonography Guide

    PubMed Central

    Karimi-Sari, Hamidreza; Faraji, Mehrdad; Mohazzab Torabi, Saman; Asjodi, Gholamreza

    2014-01-01

    Background: Central venous catheterization (CVC) is an important procedure in emergency departments (EDs). Despite existence of ultrasonography (US) devices in every ED, CVC is done using anatomical landmarks in many EDs in Iran. Objectives: This study aimed to compare the traditional landmark method vs. US-guided method of CVC placement in terms of complications and success rate. Patients and Methods: In this randomized controlled trial, patients who were candidate for internal jugular vein catheterization, and referred to Baqiyatallah Hospital ED were randomly allocated into US-guided CVC and anatomical landmarks guided CVC groups. Central vein access time, number of attempts, success rate, and complications in each group were evaluated. Mann-Whitney U, chi-square and Fisher exact tests along with Pearson and Spearman correlation coefficients were used to analyze the data. Results: Out of 100 patients, 56 were male and 44 were female. No significant differences were found between the US-guided and traditional landmark methods of CVC insertion in terms of age, gender, BMI, and site of catheter insertion. The mean access time was significantly lower in the US-guided group (37.12 ± 17.33 s vs. 63.42 ± 35.19 s, P < 0.001). The mean number of attempts was also significantly lower in the US-guided group (1.12 ± 0.3 vs. 1.58 ± 0.64 times, P < 0.001). Eighty-eight percent of patients in the US-guided group were catheterized in the first attempt, while 50% of patients in the traditional landmark group were catheterized in the second or more attempts (P < 0.001). The success rate was 100% in the US-guided group, while it was 88% in the landmark group (P = 0.013). Moreover, the rate of complications was significantly lower in the US-guided group (4% vs. 24%, P = 0.004). Conclusions: The US-guided method for CVC placement was superior to the traditional landmark method in terms of access time, number of attempts, success rate, and fewer complications. PMID:25741514

  19. Splenic Vein Thrombosis with Oesophageal Varices: A Late Complication of Umbilical Vein Catheterization

    PubMed Central

    Vos, L. J. M.; Potocky, V.; Bröker, F. H. L.; Vries, J. A. De; Postma, L.; Edens, E.

    1974-01-01

    On the basis of observations made on three infants, a description is given of a late complication of umbilical vein catheterization not hitherto reported. The children showed the symptoms of thrombosis of the splenic vein with secondary splenomegaly and marked gastric and/or esophageal varices, while the portal vein showed no abnormality. The diagnosis was preoperatively established by means of selective angiography of the superior mesenteric artery and the splenic artery. Treatment in these three cases consisted of splenectomy, with good clinical and radiological results. ImagesFig. 1.Fig. 2.Fig. 3.Fig. 4.Fig. 5.Fig. 6. PMID:4842977

  20. Bilateral Ureteral Obstruction and Acute Renal Failure in Spite of Prior Ureteral Catheterization in Radical Hysterectomy

    PubMed Central

    Fujimura, Masaaki; Sekita, Nobuyuki; Sakamoto, Shinichi; Sato, Hiroaki; Suzuki, Hiroyoshi; Mikami, Kazuo

    2015-01-01

    We present an extremely rare case of acute renal failure following radical hysterectomy although we inserted ureteral catheter bilaterally. A 76-year old female received bilateral ureteral catheterization prior to operation. Just after operation oliguria was admitted and serum creatinine level increased to 3.6 mg/dL. An abdominal computed tomography (CT) revealed bilateral hydronephrosis. From soon after exchange to double J catheter large amount of urine was collected and the level of creatinine normalized 2 days later. The shape of J catheter may be more effective than open-end catheter because it has multiple side hole and can ensure urinary drainage.

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

    SciTech Connect

    Franchi, Danilo; Rosa, Luigi; Placidi, Giuseppe

    2008-11-06

    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.

  2. Cardiac catheterization

    MedlinePLUS

    ... the doctor can: Collect blood samples from the heart Measure pressure and blood flow in the heart's chambers and ... congestive heart failure or cardiomyopathy Coronary artery disease Heart ... in the lungs ( pulmonary hypertension ) Problems with the ...

  3. Cardiac Catheterization

    MedlinePLUS

    ... The Heart Getting an EKG (Video) Your Heart & Circulatory System I Had Heart Surgery: Noah's Story Heart Murmurs Movie: Heart & Circulatory System Heart-Healthy Recipes Contact Us Print Resources Send ...

  4. Arterial Catheterization

    MedlinePLUS

    ... The arterial catheter allows accurate, second-to-second measurement of the blood pressure; repeated meas- urement is ... pressure must be lowered gradually in steps, and measurements with an arterial catheter help guide the treatment. ■ ...

  5. Hemodynamic rounds series: Left heart catheterization and mitral balloon valvuloplasty in a patient with a mechanical aortic valve.

    PubMed

    Kosmicki, Douglas; Michaels, Andrew D

    2008-02-15

    Patients with rheumatic heart disease and a history of mechanical aortic valve replacement will occasionally present with significant mitral stenosis for consideration of mitral balloon valvuloplasty. The conventional retrograde trans-aortic method for left heart catheterization cannot be done for patients with a mechanical aortic valve. We present a patient with a mechanical aortic valve who underwent successful left heart catheterization and mitral valvuloplasty via a transseptal approach. A 5 French pigtail catheter was advanced through the left atrial 8 French Mullins sheath into the left ventricle, for simultaneous pressure measurement across the mitral valve. This manuscript discusses the strengths and weaknesses of several approaches for left heart catheterization in patients with a mechanical aortic valve. PMID:18288758

  6. Echocardiography to magnetic resonance image registration for use in image-guided cardiac catheterization procedures

    NASA Astrophysics Data System (ADS)

    Ma, Ying Liang; Penney, Graeme P.; Aldo Rinaldi, C.; Cooklin, Mike; Razavi, Reza; Rhode, Kawal S.

    2009-08-01

    We present a robust method to register three-dimensional echocardiography (echo) images to magnetic resonance images (MRI) based on anatomical features, which is designed to be used in the registration pipeline for overlaying MRI-derived roadmaps onto two-dimensional live x-ray images during cardiac catheterization procedures. The features used in image registration are the endocardial surface of the left ventricle and the centre line of the descending aorta. The MR-derived left ventricle surface is generated using a fully automated algorithm, and the echo-derived left ventricle surface is produced using a semi-automatic segmentation method provided by the QLab software (Philips Healthcare) that it is routinely used in clinical practice. We test our method on data from six volunteers and four patients. We validated registration accuracy using two methods: the first calculated a root mean square distance error using expert identified anatomical landmarks, and the second method used catheters as landmarks in two clinical electrophysiology procedures. Results show a mean error of 4.1 mm, which is acceptable for our clinical application, and no failed registrations were observed. In addition, our algorithm works on clinical data, is fast and only requires a small amount of manual input, and so it is applicable for use during cardiac catheterization procedures.

  7. Technetium-99m dimercaptosuccinic acid uptake in long-term catheterized kidney. Comparison with renal function

    SciTech Connect

    Higashihara, E.; Tokuda, H.; Kishi, H.; Niijima, T.; Okada, Y.; Nishikawa, J.; Iio, M.

    1988-04-01

    We studied 23 long-term catheterized kidneys in 14 patients. The uptake of /sup 99m/Tc acid (/sup 99m/Tc-DMSA) was measured at one- and two-hour intervals after injection, and the uptake was corrected for variations in renal depth. These values were compared with inulin, creatinine, and para-amino hippurate (PAH) clearances which were measured in each kidney by collecting urine through long-term catheterization. Correlation coefficient was obtained between PAH clearance corrected for the body surface area and the two-hour uptake of /sup 99m/Tc-DMSA. The correlation coefficients between the two-hour uptake of /sup 99m/Tc-DMSA and the clearance values are not significantly different from those between the one-hour uptake and the clearance values. Corrections of the uptake for variations in renal depth did not improve the correlation coefficients. The results show that /sup 99m/Tc-DMSA is an excellent method to estimate the renal plasma flow and the one-hour uptake without correction for renal depth is clinically sufficient to evaluate the split renal function.

  8. New Echocardiographic Tehniques in Pulmonary Arterial Hypertension vs. Right Heart Catheterization – A Pilot Study

    PubMed Central

    CONSTANTINESCU, Tudor; MAGDA, Stefania Lucia; NICULESCU, Rodica; MINCU, Raluca Ileana; ZAHARIA, Dragos; TOMA, Claudia Lucia; CINTEZA, Mircea; BOGDAN, Miron Alexandru

    2013-01-01

    ABSTRACT Background: Pulmonary arterial hypertension (PAH) represents an emerging pathology in modern medicine. Transthoracic echocardiography is an inexpensive and reproducible method and it is the most commonly used non-invasive diagnostic tool to asses pulmonary artery pressure (PAP) and the function of the right ventricle. Although, the right heart catheterization is still considered as the standard for the diagnosis, according to the last guidelines, the new echocardiographic methods may offer an improved value in the PAH evaluation. Aim: To evaluate if cardiac ultrasonography data correlate with catheterization results in patients with PAH (Group I Dana Point 2008), and to compare the ultrasonography evaluation of PAH patients with that of normal. Methods: 15 consecutive patients (pts) (52±15 yrs, 5 men, time from onset of symptoms 1.6±1.7 years) with PAH of different aetiologies (12 pts with idiopathic PAH, 2 pts with PAH associated with scleroderma and one with persistent PAH after atrial septal defect (ASD) closure) were evaluated through: 1. clinical examination (NYHA class); 2. exercise capacity (6 minute walking test – 6MWT); 3. conventional echocardiography (diameter of right ventricle – RVD and right atrium, fractional area shortening – FAS, TAPSE, pulmonary ascension time – PA, systolic and mean PAP -sPAP, mPAP, tricuspid E/A ratio, cardiac index-CI) and 4. Tissue Doppler Imaging – TDI (systolic and diastolic myocardial velocities at the tricuspid annulus – S, D, A); 5. right heart catheterization (sPAP, mPAP, CI, pulmonary vascular resistance – PVR) We compared classical and TDI echo parameters with those obtained from 15 normal subjects, matched in age and sex. Results: PAH patients had high sPAP and mPAP with right heart dilation (RV - 44.8±7.3 mm), depressed TAPSE (16.2±5.9 mm) and cardiac index and low TDI systolic velocities at tricuspid level (7.3±2.9 cm/s). All parameters differed statistically significant from normal. There were no significant correlations between ultrasonography and catheterization (cath) parameters (sPAP 92±28.2 echo vs. 106.4±25.8 mmHg cath; mPAP 47.9±8.4 echo vs. 65.8±17.3 mmHg cath), excepting for CI 2.3±1.2 l/min/m2 vs. 2.08±0.3 ml/min/m2) and PVR (16.5 ± 15.3 Wood U echo, vs. 19.6 ± 7.9 cath). Conclusion: Classic and TDI cardiac ultrasonography represents a good screening and monitoring tool for PAH patients, but tends to underestimate the severity of the disease, leaving right heart catheterization as the essential diagnostic method for this rare disease. PMID:24371474

  9. Exercise right heart catheterization for inferior vena cava obstruction: confirming the hemodynamic significance of an anatomic lesion.

    PubMed

    Eleid, Mackram F; Bjarnason, Haraldur; Frye, Robert L; Nishimura, Rick A

    2014-01-01

    Retroperitoneal fibrosis is a rare condition characterized by the presence of inflammatory and fibrous retroperitoneal tissue that surrounds and often encases abdominal structures. In this report we describe an unusual presentation of retroperitoneal fibrosis and inferior vena cava (IVC) obstruction that was unidentified by noninvasive testing and ultimately diagnosed using exercise right heart catheterization and venography. Exercise hemodynamic catheterization revealed a high pressure gradient across the IVC obstruction during exercise that resulted in reduced preload and inappropriately low cardiac output reserve. The patient ultimately underwent angioplasty and stenting of the obstruction resulting in resolution of his symptoms. PMID:23766235

  10. Soluble CD40 Ligand in Aspirin-Treated Patients Undergoing Cardiac Catheterization

    PubMed Central

    Gremmel, Thomas; Frelinger, Andrew L.; Michelson, Alan D.

    2015-01-01

    Plasma soluble CD40 ligand (sCD40L) is mainly generated by cleavage of CD40L from the surface of activated platelets, and therefore considered a platelet activation marker. Although the predictive value of sCD40L for ischemic events has been demonstrated in patients with acute coronary syndromes (ACS), studies on the association of sCD40L with cardiovascular outcomes in lower risk populations yielded heterogeneous results. We therefore sought to investigate factors influencing sCD40L levels, and the predictive value of sCD40L for long-term ischemic events in unselected, aspirin-treated patients undergoing cardiac catheterization. sCD40L was determined by a commercially available enzyme-linked immunosorbent assay in 682 consecutive patients undergoing cardiac catheterization. Two-year follow-up data were obtained from 562 patients. Dual antiplatelet therapy with aspirin and clopidogrel was associated with significantly lower levels of sCD40L and lower platelet surface expressions of P-selectin and activated GPIIb/IIIa compared to aspirin monotherapy (all p≤0.01). Hypertension was linked to lower plasma concentrations of sCD40L, whereas female sex, increasing high-sensitivity C-reactive protein, and hematocrit were associated with higher sCD40L concentrations (all p<0.05). sCD40L levels were similar in patients without and with the primary endpoint in the overall study population (p = 0.4). Likewise, sCD40L levels did not differ significantly between patients without and with the secondary endpoints (both p≥0.4). Similar results were obtained when only patients with angiographically-proven coronary artery disease (n = 459), stent implantation (n = 205) or ACS (n = 125) were analyzed. The adjustment for differences in patient characteristics by multivariate regression analyses did not change the results. ROC curve analyses did not reveal cut-off values for sCD40L for the prediction of the primary or secondary endpoints. In conclusion, plasma sCD40L levels are reduced by antiplatelet therapy with clopidogrel, but not associated with long-term ischemic outcomes in unselected consecutive aspirin-treated patients undergoing cardiac catheterization. PMID:26237513

  11. Risk of cancer associated with cardiac catheterization procedures during childhood: a cohort study in France

    PubMed Central

    2013-01-01

    Background Radiation can be used effectively for diagnosis and medical treatment, but it can also cause cancers later on. Children with congenital heart disease frequently undergo cardiac catheterization procedures for diagnostic or treatment purposes. Despite the clear clinical benefit to the patient, the complexity of these procedures may result in high cumulative radiation exposure. Given children’s greater sensitivity to radiation and the longer life span during which radiation health effects can develop, an epidemiological cohort study is being launched in France to evaluate the risks of leukaemia and solid cancers in this specific population. Methods/design The study population will include all children who have undergone at least one cardiac catheterization procedure since 2000 and were under 10 years old and permanent residents of France at the time of the procedure. Electronically stored patient records from the departments of paediatric cardiology of the French national network for complex congenital heart diseases (M3C) are being searched to identify the children to be included. The minimum dataset will comprise: identification of the subject (file number in the centre or department, full name, sex, date and place of birth), and characteristics of the intervention (date, underlying disease, type of procedure, technical details, such as fluoroscopy time and dose area product, (DAP), which are needed to reconstruct the doses received by each child). The cohort will be followed up through linkage with the two French paediatric cancer registries, which have recorded all cases of childhood leukaemia and solid cancers in France since 1990 and 2000, respectively. Radiation exposure will be estimated retrospectively for each child. 4500 children with catherizations between 2000 and 2011 have been already included in the cohort, and recruitment is ongoing at the national level. The study is expected to finally include a total of 8000 children. Discussion This French cohort study is specifically designed to provide further knowledge about the potential cancer risks associated with paediatric cardiac catheterization procedures. It will also provide new information on typical dose levels associated with these procedures in France. Finally, it should help improve awareness of the importance of radiation protection in these procedures. PMID:23521893

  12. Comparing the Use of Global Rating Scale with Checklists for the Assessment of Central Venous Catheterization Skills Using Simulation

    ERIC Educational Resources Information Center

    Ma, Irene W. Y.; Zalunardo, Nadia; Pachev, George; Beran, Tanya; Brown, Melanie; Hatala, Rose; McLaughlin, Kevin

    2012-01-01

    The use of checklists is recommended for the assessment of competency in central venous catheterization (CVC) insertion. To explore the use of a global rating scale in the assessment of CVC skills, this study seeks to compare its use with two checklists, within the context of a formative examination using simulation. Video-recorded performances of…

  13. Comparing the use of global rating scale with checklists for the assessment of central venous catheterization skills using simulation.

    PubMed

    Ma, Irene W Y; Zalunardo, Nadia; Pachev, George; Beran, Tanya; Brown, Melanie; Hatala, Rose; McLaughlin, Kevin

    2012-10-01

    The use of checklists is recommended for the assessment of competency in central venous catheterization (CVC) insertion. To explore the use of a global rating scale in the assessment of CVC skills, this study seeks to compare its use with two checklists, within the context of a formative examination using simulation. Video-recorded performances of CVC insertion by 34 first-year medical residents were reviewed by two independent, trained evaluators. Each evaluator used three assessment tools: a ten-item checklist, a 21-item checklist, and a nine-item global rating scale. Exploratory principal component analysis of the global rating scale revealed two factors, accounting for 84.1% of the variance: technical ability and safety. The two checklist scores correlated positively with the weighted factor score on technical ability (0.49 [95% CI 0.17-0.71] for the 10-item checklist; 0.43 [95% CI 0.10-0.67] for the 21-item checklist) and negatively with the weighted factor score on safety (-0.17 [95% CI -0.48-0.18] for the 10-item checklist; -0.13 [95% CI -0.45-0.22] for the 21-item checklist). A checklist score of <80% was strong indication of incompetence. However, a high checklist score did not preclude incompetence. Ratings using the global rating scale identified an additional 11 candidates (32%) who were deemed incompetent despite scoring >80% on both checklists. All these candidates committed serious errors. In conclusion, the practice of universal adoption of checklists as the preferred method of assessment of procedural skills should be questioned. The inclusion of global rating scales should be considered. PMID:21877217

  14. Elevation of urinary liver-type fatty acid binding protein after cardiac catheterization related to cardiovascular events

    PubMed Central

    Kamijo-Ikemori, Atsuko; Hashimoto, Nobuyuki; Sugaya, Takeshi; Matsui, Katsuomi; Hisamichi, Mikako; Shibagaki, Yugo; Miyake, Fumihiko; Kimura, Kenjiro

    2015-01-01

    Purpose Contrast medium (CM) induces tubular hypoxia via endothelial damage due to direct cytotoxicity or viscosity. Urinary liver-type fatty acid binding protein (L-FABP) increases along with tubular hypoxia and may be a detector of systemic circulation injury. The aim of this study was to evaluate the clinical usefulness of detecting increases in urinary L-FABP levels due to administration of CM, as a prognostic biomarker for cardiovascular disease in patients without occurrence of CM-induced nephropathy undergoing cardiac catheterization procedure (CCP). Methods Retrospective longitudinal analyses of the relationship between urinary L-FABP levels and occurrence of cardiovascular events were performed (n=29). Urinary L-FABP was measured by ELISA before CCP, and at 6, 12, 24, and 48 hours after CCP. Results Urinary L-FABP levels were significantly higher at 12 hours (P<0.05) and 24 hours (P<0.005) after CCP compared with before CCP, only in the patients with occurrence of cardiovascular events (n=17), but not in those without cardiovascular events (n=12). The parameter with the largest area under the curve (0.816) for predicting the occurrence of cardiovascular events was the change in urinary L-FABP at 24 hours after CCP. The difference in urinary L-FABP levels (ΔL-FABP ≥11.0 μg/g creatinine) between before CCP and at 24 hours after CCP was a risk factor for the occurrence of cardiovascular events (hazard ratio, 4.93; 95% confidence interval, 1.27–19.13; P=0.021). Conclusion Measurement of urinary L-FABP before CCP and at 24 hours after CCP in patients with mild to moderate renal dysfunction may be an important indicator for risk stratification of onset of cardiovascular events. PMID:26316797

  15. Elementary Physics Considerations Indicate an Elegant Construction Technique For the Pyramids At Giza. Our Information Indicates They and the Sphinx Were Engineered and Built Around BCE 2500, Not Earlier!

    NASA Astrophysics Data System (ADS)

    Mc Leod, Roger D.; Mc Leod, David M.

    2002-10-01

    Archimedes articulated an applied physics experience of many children who observe the upward movement of floating objects when they get into their "tubs." This same principle can effectively allow massive Egyptian construction blocks and obelisks to be elevated and erected. Platform bases at Giza were leveled by means of water channels that were cut into the rock. There is a canal behind the pyramids. The bathtub technique can elevate or transport the water-borne block (or obelisk) to sites involved, including the Sphinx temple. Water outflow from the barge locks (tubs) can erode Sphinx surrounds, without invoking 7000+ year-ago rainy weather. Our previously detailed account of how constellations, Canis Major, Phoenix, Leo can be detected at sites like America's Stonehenge, while they are below the local horizon, also indicates ancient Egyptians may have done likewise. Orion, or Leo the Sphinx could have been detected while they were in the "underground," around BCE 2500, in alignments otherwise requiring a date of BCE 1050.

  16. Radiation exposure to the pediatric patient during cardiac catheterization and angiocardiography. Emphasis on the thyroid gland

    SciTech Connect

    Martin, E.C.; Olson, A.P.; Steeg, C.N.; Casarella, W.J.

    1981-07-01

    Thermoluminescent dosimetry was used to measure the radiation exposure to the skin, thyroid and gonads in 50 consecutive pediatric patients undergoing cardiac catheterization and angiocariography using cine photofluorography. Average exposures were 17.1 R to the skin, 2.3 R to the thyroid and 0.1 R to the gonads. Fluoroscopy accounted for approximately 80% of the skin and thyroid exposure and cine photofluorography for 20 to 25%. Occasional primary-beam irradiation was the major contributor to gonad exposure. Internal scatter of the incident x-ray beam was primarily responsible for thyroid exposure, so that infants received relatively high exposures; one receiving 7.3 R. The thyroid was not frequently in the primary beam. The significance of high radiation exposure to the thyroid, and in particular its relationship to thyroid carcinoma, are discussed. The results are compared with other series in the literature and relative exposures of cine photofluorography and serial filming are contrasted.

  17. Radiation exposure to the pediatric patient during cardiac catheterization and angiocardiography. Emphasis on the thyroid gland

    SciTech Connect

    Martin, E.C.; Olson, A.P.; Steeg, C.N.; Casarella, W.J.

    1981-07-01

    Thermoluminescent dosimetry was used to measure the radiation exposure to the skin, thyroid and gonads in 50 consecutive pediatric patients undergoing cardiac catheterization and angiocardiography using cine photofluorography. Average exposures were 17.1 R to the skin, 2.3 R to the thyroid and 0.1 R to the gonads. Fluoroscopy accounted for approximately 80% of the skin and thyroid exposure and cine photofluorography for 20-25%. Occasional primary-beam irradiation was the major contributor to gonad exposure. Internal scatter of the incident x-ray beam was primarily responsible for thyroid exposure, so that infants received relatively high exposures; one receiving 7.3 R. The thyroid was not frequently in the primary beam. The significance of high radiation exposure to the thyroid, and in particular its relationship to thyroid carcinoma, are discussed. The results are compared with other series in the literature and relative exposures of cine photofluorography and serial filming are contrasted.

  18. Unsteady non-Newtonian blood flow through a tapered overlapping stenosed catheterized vessel.

    PubMed

    Ali, N; Zaman, A; Sajid, M; Nieto, J J; Torres, A

    2015-11-01

    The unsteady flow characteristics of blood in a catheterized overlapping stenosed artery are analyzed in presence of body acceleration and magnetic field. The stenosed arterial segment is modeled as a rigid constricted tube. An improved shape of stenosis in the realm of the formulation of the arterial narrowing caused by atheroma is integrated in the present study. The catheter inside the artery is approximated by a thin rigid tube of small radius while the streaming blood in the artery is characterized by the Carreau model. Employing mild stenosis condition, the governing equation of the flow is derived which is then solving numerically using finite difference scheme. The variation of axial velocity, flow rate, resistance impendence and wall shear stress is shown graphically for various parameters of interest. The flow patterns illustrating the global behavior of blood are also presented. PMID:26361287

  19. [Nursing diagnoses in patients after heart catheterization--contribution of Orem].

    PubMed

    de Lima, Luciano Ramos; Pereira, Sandra Valéria Martins; Chianca, Tânia Couto Machado

    2006-01-01

    Sectional study of multiple cases involving 30 patients after heart catheterization aiming to establish the nursing diagnoges according to the North American Nursing Diagnoses Association (NANDA). The method of data collection was the Nursing Process based on the Self-care Deficit Theory. Twenty-five different nursing diagnoses had been established. All patients presented Impaired tissue integrity, Risk of infection, Pain incisive in the area inguinal, Injured physical mobility, Self-care deficit related to personal hygiene, and Risk of organic renal lesion. It has been concluded that the Self-care Deficit theory allowed the classification of all nursing diagnoses according to NANDA. It contributed to the nursing assistance individualization, humanization, and qualification. Beyond advance self-knowledge, self-control and patient participation on his/her self-car. PMID:17175715

  20. Slip effects on unsteady non-Newtonian blood flow through an inclined catheterized overlapping stenotic artery

    NASA Astrophysics Data System (ADS)

    Zaman, Akbar; Ali, Nasir; Sajid, M.

    2016-01-01

    Slip effects on unsteady non-Newtonian blood hydro-magnetic flow through an inclined catheterized overlapping stenotic artery are analyzed. The constitutive equation of power law model is employed to simulate the rheological characteristics of the blood. The governing equations giving the flow derived by assuming the flow to be unsteady and two-dimensional. Mild stenosis approximation is employed to obtain the reduced form of the governing equations. Finite difference method is employed to obtain the solution of the non-linear partial differential equation in the presence of slip at the surface. An extensive quantitative analysis is performed for the effects of slip parameter, Hartmann number, cathetered parameter and arterial geometrical parameters of stenosis on the quantities of interest such as axial velocity, flow rate, resistance impedance and wall shear stress. The streamlines for the blood flow through the artery are also included.

  1. Mycotic Saccular Abdominal Aortic Aneurysm in an Infant after Cardiac Catheterization: A Case Report.

    PubMed

    Benrashid, Ehsan; McCoy, Christopher C; Rice, Henry E; Shortell, Cynthia K; Cox, Mitchell W

    2015-10-01

    Abdominal aortic aneurysms (AAAs) are a rare entity in the pediatric population. Children with mycotic (infectious) AAA in particular are at risk of life-threatening rupture due to their rapid expansion coupled with aortic wall thinning and deterioration. Here, we present the case of a 10-month-old infant with prior 2-staged repair for hypoplastic left heart syndrome that was incidentally discovered to have a mycotic AAA on abdominal ultrasound (US) for evaluation of renovascular hypertension. Before the time of evaluation with US, the infant had developed methicillin-resistant Staphylococcus aureus bacteremia 3 days after cardiac catheterization with percutaneous thoracic aortic balloon angioplasty. She had normal aortic contours on contrasted computed tomography scan of the abdomen approximately 2 weeks before the aforementioned US evaluation. This infant subsequently underwent open aneurysmorrhaphy with cryopreserved vein patch angioplasty with resolution of her aneurysmal segment. PMID:26115611

  2. Rosuvastatin Treatment for Preventing Contrast-Induced Acute Kidney Injury After Cardiac Catheterization

    PubMed Central

    Yang, You; Wu, Yan-xian; Hu, Yun-zhao

    2015-01-01

    Abstract We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the protective effects of rosuvastatin on contrast-induced acute kidney injury (CI-AKI) and major adverse cardiovascular events (MACEs) in patients undergoing cardiac catherization. PubMed, MEDLINE, Web of Science, EMBASE, ClinicalTrials.gov, and the Cochrane Central RCTs were searched for RCTs from inception to May 2015, to compare rosuvastatin for preventing CI-AKI with placebo treatment in patients undergoing cardiac catherization. Five RCTs with a total of 4045 patients involving 2020 patients pretreated with rosuvastatin and 2025 control patients were identified and analyzed. Patients treated with rosuvastatin had a 51% lower risk of CI-AKI compared with the control group based on a fixed-effect model (OR?=?0.49, 95% CI?=?0.37–0.66, P?catheterization. However, rosuvastatin treatment did not seem to be effective for preventing CI-AKI in CKD patients undergoing elective cardiac catheterization. PMID:26222855

  3. A technique for determining the spectral refractive indices, size, and number density of soot particles from light scattering and spectral extinction measurements in flames

    SciTech Connect

    Felske, J.D. . Dept. of Mechanical and Aerospace Engineering); Ku, J.C. . Dept. of Mechanical Engineering)

    1992-10-01

    In this paper, the authors technique is presented that allows the spectral indices, size, and number density of soot particles in flames to be inferred from a combination of single-wavelength light scattering and multiwavelength extinction measurements. In contrast to previous schemes for inferring optical properties, the present approach does not require the introduction of a model for the spectral dispersion of the refractive index; it employs Kramers-Kronig theory instead. When applied to spherical particles, the only approximations involved are the usual ones associated with using Kramers-Kronig theory to analyze actual data, that is, for those spectral regions where experimental data are not obtainable, extrapolations and interpolations must be made. The influence of various spectral extrapolation schemes (required because of the finite spectral width of the transmittance data) is thoroughly investigated.

  4. Role of duration of catheterization and length of hospital stay on the rate of catheter-related hospital-acquired urinary tract infections

    PubMed Central

    Al-Hazmi, Hamdan

    2015-01-01

    Objective Our aim is to prove that duration of catheterization and length of hospital stay (LOS) are associated with the rate of hospital-acquired urinary tract infections (UTI), while taking into account type of urinary catheter used, the most common organisms found, patient diagnosis on admission, associated comorbidities, age, sex, precautions that should be taken to avoid UTI, and comparison with other studies. Methods The study was done in a university teaching hospital with a 920-bed capacity; this hospital is a tertiary care center in Riyadh, Saudi Arabia. The study was done on 250 selected patients during the year 2010 as a retrospective descriptive study. Patients were selected as purposive sample, all of them having been exposed to urinary catheterization; hospital-acquired UTI were found in 100 patients. Data were abstracted from the archived patients’ files in the medical record department using the annual infection control logbook prepared by the infection control department. The data collected were demographic information about the patients, clinical condition (diagnosis and the LOS), and possible risk factors for infection such as duration of catheterization, exposure to invasive devices or surgical procedures, and medical condition. Results There was a statistically significant association between the rate of UTI and duration of catheterization: seven patients had UTI out of 46 catheterized patients (15%) at 3 days of catheterization, while 30 patients had UTI out of 44 catheterized patients (68%) at 8 days of catheterization (median 8 days in infected patients versus 3 days in noninfected patients; P-value <0.05), which means that the longer the duration of catheterization, the higher the UTI rate. There was a statistically significant association between the rate of UTI and LOS: three patients had UTI out of 37 catheterized patients (8%) at 10 days LOS, while 42 patients had UTI out of 49 catheterized patients (85.7%) at 18 days LOS. The longer the LOS, the higher the UTI rate: LOS for each patient (median 18 days for infected patients versus 10 days for noninfected patients; P-value <0.05), and number of hospital-acquired catheter-related UTI (100 patients had UTI out of 250 catheterized patients, P=0.04). Conclusion Reduction of the duration of catheterization and LOS of the patient have a positive impact in reduction of catheter-related UTI. PMID:25848551

  5. Trans-radial versus trans-femoral access in patients with end-stage liver disease undergoing cardiac catheterization.

    PubMed

    Feng, Kent; Gupta, Vipul; Terrazas, Enrique; Yeghiazarians, Yerem; Ports, Thomas; Gregoratos, Gabriel; Tavakol, Mehdi; Roberts, John Paul; Boyle, Andrew

    2014-01-01

    Cardiac catheterization has been increasingly utilized to evaluate coronary artery disease in patients with end stage liver disease (ESLD). It is known in other populations that radial access reduces access site complications;however, there is a paucity of data in ESLD patients. We investigated vascular and bleeding complications rates between trans-femoral and trans-radial cardiac catheterizations in this high risk population. In this retrospective cohort study, three hundred and thirty four ESLD patients were identified between August 2004 and December 2012 who had undergone trans-femoral (femoral group) or trans-radial (radial group) cardiac catheterizations at our institution. The radial group was not significantly different from the femoral group in age (p = 0.056), proportions of genders (p = 0.85), and weight (p = 0.19); however, compared to the femoral group, the radial group had significantly lower blood pressure (p < 0.0001), hemoglobin (10.4 ± 1.9 vs 11.1 ± 2.02 g/dL, p = 0.001), and hematocrit (30.3 ± 5.7% vs 32.6 ± 6.0%, p < 0.0006), and had a significantly higher INR (1.94 ± 1.16 vs 1.59 ± 0.62, p = 0.0001). In terms of vascular complications, the radial group had a significantly lower rate of pseudoaneurysms (0% vs 3.7%, p = 0.019) than the femoral group. While there were no bleeding complications in either group or differences in transfusion requirements, there was a significantly lower percentage drop in hematocrit in the radial group compared to the femoral group (5.4% vs 7.8%, p = 0.039). In conclusion, trans-radial catheterization is associated with lower rates of vascular access site complications compared to trans-femoral catheterization. PMID:25360391

  6. Influence of the timing of cardiac catheterization and the amount of contrast media on acute renal failure after cardiac surgery.

    PubMed

    Ranucci, Marco; Ballotta, Andrea; Kunkl, Alessia; De Benedetti, Donatella; Kandil, Hassan; Conti, Daniela; Mollichelli, Nadia; Bossone, Eduardo; Mehta, Rajendra H

    2008-04-15

    Postoperative acute renal failure (ARF) is not uncommon after cardiac surgery and after angiography. However, limited information exists regarding the influence of the interval between cardiac catheterization and subsequent cardiac surgery and amount of contrast agent used during this procedure on the occurrence of postoperative ARF. Data for 423 consecutive adult patients who underwent elective cardiac surgery after cardiac catheterization were examined retrospectively. The influence of interval between cardiac catheterization and cardiac surgery on postoperative ARF (defined as postoperative serum creatinine > or =2 times baseline and >2 mg/dl and/or need for renal replacement therapy) was evaluated using multivariable logistic regression. ARF occurred in 24 patients (5.7%). Median time to angiography was 2 days (interquartile range 1 to 4.5), and median dose of contrast used was 1.36 ml/kg (interquartile range 1.12 to 1.69). Surgery on the day of cardiac catheterization was independently associated with increased risk of ARF (adjusted odds ratio 3.1, 95% confidence interval 1.1 to 8.8). This risk of ARF was highest in patients who underwent surgery on the same day as angiography and with a dose of contrast higher than median (14.6%) and lowest when surgery was delayed beyond 1 day of angiography and contrast dose was median or less (2.4%; adjusted odds ratio for same-day surgery and dose higher than median 4.2, 95% confidence interval 1.2 to 14.2). Cardiac surgery performed on the day of cardiac catheterization and higher dose of contrast agent used were both independently associated with increased risk of postoperative ARF. In conclusion, these findings suggest that delaying cardiac surgery beyond 24 hours of exposure to contrast agents (when feasible) and minimizing the use of these agents have significant potential to decrease the incidence of postoperative ARF in patients undergoing elective cardiac surgery. PMID:18394443

  7. Further fMRI validation of the visual half field technique as an indicator of language laterality: a large-group analysis.

    PubMed

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

    2011-08-01

    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 replace the invasive Wada-test. We evaluated the usefulness of behavioral visual half field (VHF) tasks for screening a large sample of healthy left-handers. Laterality indices (LIs) calculated on the basis of the latencies in a word and picture naming VHF task were compared to the brain activity measured in a silent word generation task in fMRI (pars opercularis/BA44 and pars triangularis/BA45). Results confirmed the usefulness of the VHF-tasks as a screening device. None of the left-handed participants with clear right visual field (RVF) advantages in the picture and word naming task showed right hemisphere dominance in the scanner. In contrast, 16/20 participants with a left visual field (LVF) advantage in both word and picture naming turned out to have atypical right brain dominance. Results were less clear for participants who failed to show clear VHF asymmetries (below 20 ms RVF advantage and below 60 ms LVF advantage) or who had inconsistent asymmetries in picture and word naming. These results indicate that the behavioral tasks can mainly provide useful information about the direction of speech dominance when both VHF differences clearly point in the same direction. PMID:21708178

  8. DIAGNOSTIC CARDIAC CATHETERIZATION USING THE MEDRAD AVANTA FLUID MANAGEMENT SYSTEM AS COMPARED TO THE TRADITIONAL MANUAL INJECTION METHOD

    SciTech Connect

    Winniford, Michael D

    2013-02-08

    Nearly 4 million patient procedures performed annually in US cardiac catheterization laboratories utilize contrast media to achieve vessel opacification. The amount of contrast media used is variable and depends on the complexity of the procedure, the method of contrast delivery as well as the skill-level of the operator. Since the total amount of contrast used for each procedure can have both patient safety and economic implications, it is essential for cardiologists to have the ability to control contrast delivery such that optimal angiographic image quality is achieved using the least amount of contrast. Although the complication rate associated with cardiac catheterization remains low, the most common serious complication, contrast-induced nephropathy (CIN), is associated with poor prognosis and a high mortality rate. Numerous interventional strategies for preventing and reducing the severity of CIN have demonstrated varying degrees of clinical benefit, but none has been shown to reliably prevent this serious complication. To date, the most effective approach for reducing the risk of CIN is to properly hydrate the patient and to minimize the amount of contrast media administered. Automated injection systems are intended for use in virtually all cardiac catheterization procedures and have numerous features which can provide potential advantages over traditional methods. With automated injection technology the operator is able to control and precisely monitor contrast delivery. Additionally, the MEDRAD Avanta Fluid Management Injection System utilizes a sterile contrast reservoir which eliminates the need to discard unused contrast in individual opened containers following each procedure. Considering that an average of 50% of opened contrast media is wasted using manual injection methods, this savings can provide a substantial economic benefit. Automated systems also facilitate the use of smaller (5 French) catheter sizes. Precise flow control and the use of smaller diameter catheters have both been shown to reduce the volume of contrast administered. The use of smaller size catheters also permits more rapid hemostasis, thus allowing shorter ambulation time without the need for costly wound closure devices. These factors can result in enhanced patient satisfaction as well as more efficient management of post-procedure rooms. The intent of this study was to demonstrate that using the MEDRAD Avanta Fluid Management Injection System (MEDRAD, INC., Pittsburgh, PA) for coronary diagnostic procedures can produce a reduction in the volume of contrast administered without loss of operational quality or efficiency. In addition, this study will explore procedure time and efficiency in an effort to minimize the amount of ionizing radiation delivered to the patient as well as the diagnostic team members. Study Design This is a post-market study designed to collect data during diagnostic cardiac catheterization when utilizing 5FR or 6FR catheters in conjunction with the Avanta Fluid Management System or a manual manifold injection method control group. A minimum of 420 patients scheduled for diagnostic cardiac catheterization will be enrolled in the study cohort. Patients will be assigned into the following two groups. Group 1: Catheterization with 5FR or 6FR catheters, using the traditional manual manifold injection method for contrast media delivery which is defined as manual hand injection of contrast media through a 3 or 4 port manifold and left ventriculography performed via standard fixed rate power injection. Group 2: Catheterization with 5FR or 6FR catheters, using the MEDRAD Avanta system for contrast media delivery. Study endpoints include volume of contrast media administered during diagnostic cardiac catheterization, volume of contrast media wasted post-procedure, procedure time (defined as the time from first catheter insertion to last diagnostic catheter removal), fluoroscopy time and angiographic image quality. The study demonstrated that use of the Advanta system reduced overall contrast utilization by decreasing the amount of contrast administered to the patient and reducing the amount of contrast wasted during preparation and post-procedure clean-up. The quality of the angiographic images and the radiation expsure to the patient ere not affected.

  9. Evaluation of a robotic arm for echocardiography to X-ray image registration during cardiac catheterization procedures.

    PubMed

    Ma, Yingliang; Penney, Graeme P; Bos, Dennis; Frissen, Peter; de Fockert, George; King, Andy; Gao, Gang; Yao, Cheng; Totman, John; Ginks, Matthew; Rinaldi, C; Razavi, Reza; Rhode, Kawal S

    2009-01-01

    We present an initial evaluation of a robotic arm for positioning a 3D echo probe during cardiac catheterization procedures. By tracking the robotic arm, X-ray table and X-ray C-arm, we are able to register the 3D echo images with live 2D X-ray images. In addition, we can also use tracking data from the robotic arm combined with system calibrations to create extended field of view 3D echo images. Both these features can be used for roadmapping to guide cardiac catheterization procedures. We have carried out a validation experiment of our registration method using a cross-wire phantom. Results show our method to be accurate to 3.5 mm. We have successfully demonstrated the creation of the extended field of view data on 2 healthy volunteers and the registration of echo and X-ray data on 1 patient undergoing a pacing study. PMID:19964867

  10. Subcutaneous rehydration: updating a traditional technique.

    PubMed

    Spandorfer, Philip R

    2011-03-01

    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

  11. A national clinical quality program for Veterans Affairs catheterization laboratories (from the Veterans Affairs clinical assessment, reporting, and tracking program).

    PubMed

    Maddox, Thomas M; Plomondon, Mary E; Petrich, Megan; Tsai, Thomas T; Gethoffer, Hans; Noonan, Gregory; Gillespie, Brian; Box, Tamara; Fihn, Stephen D; Jesse, Robert L; Rumsfeld, John S

    2014-12-01

    A "learning health care system", as outlined in a recent Institute of Medicine report, harnesses real-time clinical data to continuously measure and improve clinical care. However, most current efforts to understand and improve the quality of care rely on retrospective chart abstractions complied long after the provision of clinical care. To align more closely with the goals of a learning health care system, we present the novel design and initial results of the Veterans Affairs (VA) Clinical Assessment, Reporting, and Tracking (CART) program-a national clinical quality program for VA cardiac catheterization laboratories that harnesses real-time clinical data to support clinical care and quality-monitoring efforts. Integrated within the VA electronic health record, the CART program uses a specialized software platform to collect real-time patient and procedural data for all VA patients undergoing coronary procedures in VA catheterization laboratories. The program began in 2005 and currently contains data on 434,967 catheterization laboratory procedures, including 272,097 coronary angiograms and 86,481 percutaneous coronary interventions, performed by 801 clinicians on 246,967 patients. We present the initial data from the CART program and describe 3 quality-monitoring programs that use its unique characteristics-procedural and complications feedback to individual labs, coronary device surveillance, and major adverse event peer review. The VA CART program is a novel approach to electronic health record design that supports clinical care, quality, and safety in VA catheterization laboratories. Its approach holds promise in achieving the goals of a learning health care system. PMID:25439452

  12. Modeling groundwater quality over a humid subtropical region using numerical indices, earth observation datasets, and X-ray diffraction technique: a case study of Allahabad district, India.

    PubMed

    Singh, Sudhir Kumar; Srivastava, Prashant K; Singh, Dharmveer; Han, Dawei; Gautam, Sandeep Kumar; Pandey, A C

    2015-02-01

    Water is undoubtedly the vital commodity for all living creatures and required for well-being of the human society. The present work is based on the surveys and chemical analyses performed on the collected groundwater samples in a part of the Ganga basin in order to understand the sources and evolution of the water quality in the region. The two standard indices such as water quality index and synthetic pollution index for the classification of water in the region are computed. The soil and sediment analysis are carried out with the help of X-ray diffractometer (XRD) for the identification of possible source of ions in water from rock and soil weathering. The dominant minerals which include quartz, muscovite, plagioclase, and orthoclase are reported in the area. The study further utilizes the multivariate statistical techniques for handling large and complex datasets in order to get better information about the groundwater quality. The following statistical methods such as cluster analysis (CA), factor analysis (FA), and principal component analysis (PCA) are applied to handle the large datasets and to understand the latent structure of the data. Through FA/PCAs, we have identified a total of 3 factors in pre-monsoon and 4 factors in post-monsoon season, which are responsible for the whole data structure. These factors explain 77.62 and 82.39% of the total variance of the pre- and post-monsoon datasets. On the other hand, CA depicted the regions that have similar pollutants origin. The average value of synthetic pollution index of groundwater during pre-monsoon is 9.27, while during post-monsoon, it has been recorded as 8.74. On the other hand, the average values of water quality index of groundwater during pre-monsoon and post-monsoon seasons are found as 217.59 and 233.02, respectively. The study indicates that there occurs an extensive urbanization with gradual vast development of various small- and large-scale industries, which is responsible for degradation in water quality. The overall analysis reveals that the agricultural runoff, waste disposal, leaching, and irrigation with wastewater are the main causes of groundwater pollution followed by some degree of pollution from geogenic sources such as rock and soil weathering, confirmed through XRD analysis. PMID:25086613

  13. Validity of ICD-9-CM codes for the identification of complications related to central venous catheterization.

    PubMed

    Tukey, Melissa H; Borzecki, Ann M; Wiener, Renda Soylemez

    2015-01-01

    Two complications of central venous catheterization (CVC), iatrogenic pneumothorax and central line-associated bloodstream infection (CLABSI), have dedicated International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Despite increasing use of ICD-9-CM codes for research and pay-for-performance purposes, their validity for detecting complications of CVC has not been established. Complications of CVCs placed between July 2010 and December 2011 were identified by ICD-9-CM codes in discharge records from a single hospital and compared with those revealed by medical record abstraction. The ICD-9-CM code for iatrogenic pneumothorax had a sensitivity of 66.7%, specificity of 100%, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 99.5%. The ICD-9-CM codes for CLABSI had a sensitivity of 33.3%, specificity of 99.0%, PPV of 28.6%, and NPV of 99.2%. The low sensitivity and variable PPV of ICD-9-CM codes for detection of complications of CVC raise concerns about their use for research or pay-for-performance purposes. PMID:24343034

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

    NASA Astrophysics Data System (ADS)

    Morrell, Rachel E.; Rogers, Andy

    2004-12-01

    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.

  15. Delayed sudden radial artery rupture after left transradial coronary catheterization: a case report.

    PubMed

    Indolfi, Ciro; Passafaro, Francesco; Mongiardo, Annalisa; Spaccarotella, Carmen; Torella, Daniele; Sorrentino, Sabato; Polimeni, Alberto; Emanuele, Vittorio; Curcio, Antonio; De Rosa, Salvatore

    2015-03-01

    Local complications at the radial access site are not frequent, hence its large diffusion as the preferred access route for endovascular procedures. However, in a time of fast widespreading, better comprehension of all potential complications becomes critical to facilitate their early recognition and the most appropriate treatment. In this case report, we present for the first time a case of sudden massive bleeding at the left wrist, due to spontaneous gross rupture of the left radial artery bleeding 15 days after an endovascular procedure through a left radial arterial access. The patient had been readmitted to the hospital after evidence of local infection at the left wrist with loss of substance. The radial artery was patent with no evidence of pseudoaneurysm. After sudden radial artery rupture, with massive bleeding and suspicion that the local infection could have reached the arterial wall, surgical hemostasis with artery ligation was obtained. Healing of the large wound was then efficiently speeded up using a negative pressure wound therapy. This is the first case of macroscopic radial artery rupture associated with local wrist infection after arterial catheterization. After prompt surgical hemostasis, negative pressure wound therapy was very helpful in favoring healing of the large and deep wound. PMID:25761194

  16. Microcomputer-assisted filing system of cardiac catheterization records using a relational database management system.

    PubMed

    Mohri, M; Kikuchi, Y; Sagara, T; Sugihara, M

    1988-03-01

    To efficiently store and retrieve cardiac catheterization records, we have developed a computer-assisted database, which comprises a 16-bit microcomputer with dual floppy disk drives, a 20 MB random-access memory, hard disk drive, and a line printer. All programmings were accomplished using a relational database management system (R:base 5000, Microrim, Inc.). Data inquiry procedures could be performed with direct operational commands of the system as well as with preprogrammed command files, and final results of searches were printed out with a line printer. The major advantages of the present system described in this report include: (1) the relatively easy and rapid creation of the database, (2) ease of modification of the database structures even after the system design is finished, (3) operational commands in combination with conditional operator(s) are flexible and powerful enough to allow the end user to retrieve data based on various kinds of criteria, (4) a high-level programming language provided by the R:base automates a series of database procedures with relative ease, (5) relational capabilities of the database management system can enhance the possibility of reconstruction of a new data file from a single or several preexisting data files, and (6) the system can be realized at reasonable cost. PMID:3258556

  17. Physician liability for procedure related injury: Focused on central venous catheterization.

    PubMed

    Lee, Seok-Bae; Bae, Hyuna; Kim, Sung Eun

    2015-07-01

    Central venous catheterization (CVC) is one of essential procedures in critical care medicine. CVC is relatively safe when performed by experienced physicians. Complications may occur due to various risk factors. Although the incidence of CVC-related complications is not high, a serious risk may ensue in cases of such complications. Procedure related complications could lead to civil and criminal lawsuits. This study reviewed the occurrence patterns and rulings of the courts related to CVC in South Korea and tried to find pitfalls that medical professionals should keep in mind before, during and after medical procedures. Various patterns of CVC-related lawsuits have been raised. During the procedure, physicians should perform their duty considering risk factors such as patients' underlying diseases and age. In addition, before the procedure, physicians must obtain written consent for CVC from patients or their legal guardians including explanation of rare complications that could be lethal. After the completion of CVC, surveillance of anticipated complications including chest radiographs should be conducted for the immediate management of any possible complications. PMID:26048491

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

    PubMed

    Goerig, Michael; Agarwal, Kamayni

    2008-02-01

    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

  19. NOTE: Hybrid echo and x-ray image guidance for cardiac catheterization procedures by using a robotic arm: a feasibility study

    NASA Astrophysics Data System (ADS)

    Ma, YingLiang; Penney, Graeme P.; Bos, Dennis; Frissen, Peter; Aldo Rinaldi, C.; Razavi, Reza; Rhode, Kawal S.

    2010-07-01

    We present a feasibility study on hybrid echocardiography (echo) and x-ray image guidance for cardiac catheterization procedures. A self-tracked, remotely operated robotic arm with haptic feedback was developed that attached to a standard x-ray table. This was used to safely manipulate a three-dimensional (3D) trans-thoracic echo probe during simultaneous x-ray fluoroscopy and echo acquisitions. By a combination of calibration and tracking of the echo and x-ray systems, it was possible to register the 3D echo images with the 2D x-ray images. Visualization of the combined data was achieved by either overlaying triangulated surfaces extracted from segmented echo data onto the x-ray images or by overlaying volume rendered 3D echo data. Furthermore, in order to overcome the limited field of view of the echo probe, it was possible to create extended field of view (EFOV) 3D echo images by co-registering multiple tracked echo data to generate larger roadmaps for procedure guidance. The registration method was validated using a cross-wire phantom and showed a 2D target registration error of 3.5 mm. The clinical feasibility of the method was demonstrated during two clinical cases for patients undergoing cardiac pacing studies. The EFOV technique was demonstrated using two healthy volunteers.

  20. Balloon valvuloplasty as destination therapy in elderly with severe aortic stenosis: a cardiac catheterization study

    PubMed Central

    Kamperidis, Vasileios; Hadjimiltiades, Stavros; Ziakas, Antonios; Sianos, Georgios; Kazinakis, Georgios; Giannakoulas, George; Mouratoglou, Sophia-Anastasia; Sarafidou, Athanasia; Ventoulis, Ioannis; Efthimiadis, Georgios K; Parcharidis, Georgios; Karvounis, Haralambos

    2015-01-01

    Background In the current era of transcatheter aortic valve replacement, there is renewed interest in balloon aortic valvuloplasty (BAV) and invasive hemodynamic evaluation of aortic stenosis (AS). The current report aimed to study the invasive hemodynamics of severe AS patients treated with BAV as destination therapy and to identify factors associated with better hemodynamic outcome and prognosis. Methods From 2009 to 2012, 63 high risk elderly patients were treated with BAV as destination therapy for symptomatic severe AS and were all prospectively included in the study. Their hemodynamics were invasively evaluated during catheterization, pre- and post-BAV at the same session. All Post-BAV patients were regularly followed-up. Results The patients (82 ± 6 years, 52% male) had post-BAV aortic valve area index (AVAi) significantly increased and mean pressure gradient (MPG) significantly reduced. During the follow-up of 0.9 (maximum 3.3) years, those with post-BAV AVAi < 0.6 cm2/m2 compared with the AVAi ? 0.6 cm2/m2 group had significantly higher mortality (60% vs. 28%, log-rank P = 0.02), even after adjusting for age, gender, atrial fibrillation, chronic kidney disease, diabetes mellitus, coronary artery disease and EuroSCORE [HR: 5.58, 95% confidence interval (CI): 1.62?19.20, P = 0.006]. The only independent predictor of moderate AS post-BAV was the pre-BAV AVAi increase by 0.1cm2/m2 (OR: 3.81, 95% CI: 1.33?10.89, P = 0.01). Pre-BAV AVAi ? 0.39 cm2/m2 could predict with sensitivity 84% and specificity 70% the post-BAV hemodynamic outcome. Conclusions BAV as destination therapy for severe AS offered immediate and significant hemodynamic improvement. The survival was significantly better when a moderate degree of AS was present. PMID:26089844

  1. Part versus whole: a randomized trial of central venous catheterization education.

    PubMed

    Chan, Angela; Singh, Sunita; Dubrowski, Adam; Pratt, Daniel D; Zalunardo, Nadia; Nair, Parvarthy; McLaughlin, Kevin; Ma, Irene W Y

    2015-10-01

    Central venous catheterization (CVC) is a complex but commonly performed procedure. How best to teach this complex skill has not been clearly delineated. We conducted a randomized trial of the effects of two types of teaching of CVC on skill acquisition and retention. We randomly assigned novice internal medicine residents to learning CVC in-part or in-whole. The part-group was taught the first part of the procedure, followed by practice, followed by being taught the second and final portion of the procedure, and followed by practice. The whole-group was taught the procedure in its entirety, followed by practice. Teaching and practice time for both groups was otherwise held constant. Performances were assessed at baseline, post-training, and at 1 month. The primary outcome was skill retention at 1-month, rated by using a global rating scale and a 22-item checklist, and defined as the score increase between 1-month and baseline. Skill acquisition is defined as the score increase post-training and baseline. Raters were blinded to the participants' identity, group assignment, and time point. Participants in the part-task group outperformed the whole-task group in skill acquisition (2.2 ± 0.8 vs 1.3 ± 1.0; g = 1.01; p = 0.04) and in skill retention (1.5 ± 0.7 vs 0.5 ± 0.8; g = 1.39; p = 0.006) using the global rating scale. Scores rated by the checklist were not significantly different (52.0 ± 25.3 vs 43.5 ± 23.4; g = 0.33; p = 0.47 for skill acquisition; and 48.5 ± 34.9 vs 41.1 ± 20.4; g = 0.35; p = 0.44 for skill retention). For teaching ultrasound-guided CVC to novice learners, teaching in part is preferable than teaching in whole. PMID:25638697

  2. Comparison of calculated with measured oxygen consumption in children undergoing cardiac catheterization.

    PubMed

    Schmitz, Achim; Kretschmar, Oliver; Knirsch, Walter; Woitzek, Katja; Balmer, Christian; Tomaske, Maren; Bauersfeld, Urs; Weiss, Markus

    2008-11-01

    Our objective was to compare calculated (LaFarge) with measured oxygen consumption (VO(2)) using the AS/3 TM Compact Airway Module M-CAiOVX (Datex-Ohmeda, Helsinki, Finland; AS/3 TM) in children without cardiac shunts in a prospective, observational study. VO(2) was determined at the end of the routine diagnostic and/or interventional catheterization. VO(2 )was calculated according to the formula of LaFarge and Miettinen for each child and compared with the measured VO(2). Data were compared using simple regression and Bland Altman analysis. Fifty-two children aged from 0.5 to 16 years (median, 6.9 years) and weighing 3.4 to 59.4 kg (median, 22.9 kg) were investigated. Calculated VO(2 )values ranged from 59.0 to 230.8 ml/min, and measured VO(2) values from 62.7 to 282.2 ml/min. Comparison of calculated versus measured VO(2) values revealed a significant correlation (r = 0.90, p < 0.0001). Bias and precision were 8.9 and 48.3 ml/min, respectively (95% limits of agreement: -39.4 to 57.2 ml/min). Comparison of calculated VO(2) in children older than 3 years (n = 41), as restricted to the formula, with measured VO(2), revealed a slightly reduced correlation (r = 0.86, p < 0.0001). Bias and precision were 10.0 and 52.5 ml/min, respectively (95% limits of agreement: -42.4 to 62.5 ml/min). We conclude that calculation of VO(2) by the LaFarge formula does not provide reliable values compared to measured values. In clinical routine, measured rather than calculated VO(2) values should be used for the estimation of cardiac output and related variables. PMID:18592299

  3. Emergency central venous catheterization during trauma resuscitation: a safety analysis by site.

    PubMed

    Choron, Rachel L; Wang, Andrew; Van Orden, Kathryn; Capano-Wehrle, Lisa; Seamon, Mark J

    2015-05-01

    Central venous catheterization (CVC) is often necessary during initial trauma resuscitations, but may cause complications including catheter-related blood stream infection (CRBSI), deep venous thrombosis (DVT), pulmonary emboli (PE), arterial injury, or pneumothoraces. Our primary objective compared subclavian versus femoral CVC complications during initial trauma resuscitations. A retrospective review (2010-2011) at an urban, Level-I Trauma Center reviewed CVCs during initial trauma resuscitations. Demographics, clinical characteristics, and complications including: CRBSIs, DVTs, arterial injuries, pneumothoraces, and PEs were analyzed. Fisher's exact test and Student's t test were used; P ? 0.05 was considered statistically significant. Overall, 504 CVCs were placed (subclavian, n = 259; femoral, n = 245). No difference in age (47 ± 22 vs 45 ± 23 years) or body mass index (28 ± 6 vs 29 ± 16 kg/m(2)) was detected (P > 0.05) in subclavian vs femoral CVC, but subclavian CVCs had more blunt injuries (81% vs 69%), greater systolic blood pressure (95 ± 55 vs 83 ± 43 mmHg), greater Glasgow Coma Scale (10 ± 5 vs 9 ± 5), and less introducers (49% vs 73%) than femoral CVCs (all P < 0.05). Catheter related arterial injuries, PEs, and CRBSIs were similar in subclavian and femoral groups (3% vs 2%, 0% vs 1%, and 3% vs 3%; all P > 0.05). Catheter-related DVTs occurred in 2 per cent of subclavian and 9 per cent of femoral CVCs (P < 0.001). There was a 3 per cent occurrence of pneumothorax in the subclavian CVC population. In conclusion, both subclavian and femoral CVCs caused significant complications. Subclavian catheter-related pneumothoraces occurred more commonly and femoral CRBSIs less commonly than expected compared with prior literature in nonemergent scenarios. This suggests that femoral CVC may be safer than subclavian CVC during initial trauma resuscitations. PMID:25975341

  4. Comparing the cost-effectiveness of simulation modalities: a case study of peripheral intravenous catheterization training.

    PubMed

    Isaranuwatchai, Wanrudee; Brydges, Ryan; Carnahan, Heather; Backstein, David; Dubrowski, Adam

    2014-05-01

    While the ultimate goal of simulation training is to enhance learning, cost-effectiveness is a critical factor. Research that compares simulation training in terms of educational- and cost-effectiveness will lead to better-informed curricular decisions. Using previously published data we conducted a cost-effectiveness analysis of three simulation-based programs. Medical students (n = 15 per group) practiced in one of three 2-h intravenous catheterization skills training programs: low-fidelity (virtual reality), high-fidelity (mannequin), or progressive (consisting of virtual reality, task trainer, and mannequin simulator). One week later, all performed a transfer test on a hybrid simulation (standardized patient with a task trainer). We used a net benefit regression model to identify the most cost-effective training program via paired comparisons. We also created a cost-effectiveness acceptability curve to visually represent the probability that one program is more cost-effective when compared to its comparator at various 'willingness-to-pay' values. We conducted separate analyses for implementation and total costs. The results showed that the progressive program had the highest total cost (p < 0.001) whereas the high-fidelity program had the highest implementation cost (p < 0.001). While the most cost-effective program depended on the decision makers' willingness-to-pay value, the progressive training program was generally most educationally- and cost-effective. Our analyses suggest that a progressive program that strategically combines simulation modalities provides a cost-effective solution. More generally, we have introduced how a cost-effectiveness analysis may be applied to simulation training; a method that medical educators may use to investment decisions (e.g., purchasing cost-effective and educationally sound simulators). PMID:23728476

  5. Cardiac catheterization: impact of face and neck shielding on new estimates of effective dose.

    PubMed

    von Boetticher, Heiner; Lachmund, Jörn; Hoffmann, Wolfgang

    2009-12-01

    Optimization of radiation protection devices for the operator is achieved by minimizing the effective dose (E) on the basis of the recommendations of Publications 60 and 103 of the International Commission on Radiological Protection (ICRP). Radiation exposure dosimetry was performed with thermoluminescence dosimeters using one Alderson phantom in the patient position and a second one in the typical position of the operator. Various types of protective clothing as well as fixed leaded shieldings (table mounted shielding and overhead suspended shields) were considered calculating E. Shielding factors for protective equipment can readily be misinterpreted referring to the reduction of the effective dose because fixed protective barriers as well as radiation protection clothing are shielding only parts of the body. With the ICRP 103 approach relative to the exposure without lead protection, a lead apron of 0.35 or 0.5 mm thickness reduces E to 14.4 or 12.3%, respectively; by using an additional thyroid collar, these values are reduced to 9.7 or 7.5%. A thyroid collar reduces the effective dose by more than an increase of the lead equivalency of the existing apron. Wearing an apron of 0.5 mm lead-equivalent with a thyroid collar and using an additional side shield, E decreases to 6.8%. Using both a fixed side and face shield decreases E to 2.0%. For protective garments including thyroid protection, the values of the effective dose in cardiac catheterization are 47-106% higher with ICRP 103 than with ICRP 60 recommendations. This is essentially caused by the introduction of new factors for organs in the head and neck region in ICRP 103. PMID:19901597

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    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…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    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…

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

    SciTech Connect

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

    1988-04-01

    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 and cardiac catheterization from 1978 to 1981. Eighty-three patients had a revascularization procedure performed within 3 months of testing and were excluded from analysis. Of the remaining 299 patients, 210 had no events and 89 had events (41 deaths, nine nonfatal myocardial infarctions, and 39 revascularization procedures greater than or equal to 3 months after testing). When all clinical, exercise, thallium-201, and catheterization variables were analyzed by Cox regression analysis, the number of diseased vessels (when defined as greater than or equal to 50% luminal diameter narrowing) was the single most important predictor of future cardiac events (chi 2 = 38.1) followed by the number of segments demonstrating redistribution on delayed thallium-201 images (chi 2 = 16.3), except in the case of nonfatal myocardial infarction, for which redistribution was the most important predictor of future events. When coronary artery disease was defined as 70% or greater luminal diameter narrowing, the number of diseased vessels significantly (p less than .01) lost its power to predict events (chi 2 = 14.5). Other variables found to independently predict future events included change in heart rate from rest to exercise (chi 2 = 13.0), ST segment depression on exercise (chi 2 = 13.0), occurrence of ventricular arrhythmias on exercise (chi 2 = 5.9), and beta-blocker therapy (chi 2 = 4.3).

  9. Resource Utilisation Performance Indicators in the Public Sector of Higher Education, or Never Mind the Technique Feel the Structure. Coombe Lodge Information Bank Number 1450.

    ERIC Educational Resources Information Center

    Birch, Derek W.; Cuthbert, R. E.

    A discussion is presented of the process of resource allocation and the use of performance indicators in public sector higher education in Britain. First, background is presented on the method of providing resources to institutions of advanced further education (AFE) and non-advanced further education (NAFE) on the basis of pooled recurrent…

  10. Stenting as a Rescue Treatment of a Pulmonary Artery False Aneurysm Caused by Swan-Ganz Catheterization

    PubMed Central

    Keymel, Stefanie; Merx, Marc W.; Zeus, Tobias; Kelm, Malte; Steiner, Stephan

    2014-01-01

    Pulmonary vascular injury is a rare but life-threatening complication of Swan-Ganz catheterization. We report an 82-year old patient who underwent right heart catheterization by a balloon-tipped catheter because of suspected pulmonary hypertension. After deflation of the catheter in the wedge position, hemoptoe appeared associated with acute respiratory insufficiency requiring respiratory support by intubation and mechanical ventilation. Pulmonary angiography showed the formation of a false aneurysm of a segment artery of the left lower lobe. Immediate interventional therapy was performed by the implantation of two coated coronary stent grafts into the injured pulmonary artery thereby excluding the false aneurysm. Bleeding was stopped by this interventional approach while antegrade blood flow was maintained. Long term follow-up after 3 months showed an effective treatment with a completely thrombotic false aneurysm. However, despite oral anticoagulation and dual antiplatelet therapy, graft patency could not be achieved after 3 months. In summary, implantation of coated stents is a feasible and safe approach for the acute and long term treatment of potentially life-threatening condition of a pulmonary artery false aneurysm while treatment to achieve long term patency of the affected vessel still remains an issue to be resolved. PMID:25610693

  11. Evaluation of the probe dihydrocalcein acetoxymethylester as an indicator of reactive oxygen species formation and comparison with oxidative DNA base modification determined by modified alkaline elution technique.

    PubMed

    Rohnstock, A; Lehmann, L

    2007-12-01

    Reactive oxygen species (ROS) play a predominant role in various diseases and the development of fast and easy methods for the quantification of intracellular ROS represents an important goal. Therefore, the aim of the present study was the evaluation of the fluorogenic probe dihydrocalcein acetoxymethylester (AM) for the detection of intracellular ROS. A flow cytometric method was developed using MCF-7 cells and the kinetics of ester hydrolysis and the cellular distribution and stability of calcein were characterized using calcein AM. Then, MCF-7 cells were challenged with model agents for the generation of singlet oxygen (illumination with visible light), peroxyl and hydroxyl radicals (tert-butylhydroperoxide, tBHP), superoxide anion radicals (potassium dioxide), and the intracellular formation of superoxide anion radicals by redox cycling (menadione) and the formation of calcein was compared with the induction of oxidative DNA base modifications assessed by modified alkaline elution technique. Every model agent significantly induced formamidopyrimidine-DNA glycosylase-sensitive sites (i.e. oxidative DNA base modifications) and most also induced DNA strand breaks. In contrast, exclusively tBHP and illumination with visible light induced the intracellular formation of calcein. In conclusion, though intracellular oxidation of dihydrocalcein represents a fast screening method, it detects a limited spectrum of ROS. PMID:17574384

  12. Total Pancreatectomy and Islet Auto-Transplantation in Children for Chronic Pancreatitis. Indication, Surgical Techniques, Post Operative Management and Long-Term Outcomes

    PubMed Central

    Chinnakotla, Srinath; Bellin, Melena D.; Schwarzenberg, Sarah J.; Radosevich, David M.; Cook, Marie; Dunn, Ty B.; Beilman, Gregory J.; Freeman, Martin L.; Balamurugan, A.N.; Wilhelm, Josh; Bland, Barbara; Jimenez-Vega, Jose M; Hering, Bernhard J.; Vickers, Selwyn M.; Pruett, Timothy L.; Sutherland, David E.R.

    2014-01-01

    Objective Describe the surgical technique, complications and long term outcomes of total pancreatectomy and islet auto transplantation (TP-IAT) in a large series of pediatric patients. Summary Background Data Surgical management of childhood pancreatitis is not clear; partial resection or drainage procedures often provide transient pain relief, but long term recurrence is common due to the diffuse involvement of the pancreas. Total pancreatectomy (TP) removes the source of the pain, while islet auto transplantation (IAT) potentially can prevent or minimize TP-related diabetes. Methods Retrospective review of 75 children undergoing TP-IAT for chronic pancreatitis who had failed medical, endoscopic or surgical treatment between 1989–2012. Results Pancreatitis pain and the severity of pain statistically improved in 90% of patients after TP-IAT (p =<0.001). The relief from narcotics was sustained. Of the 75 patients undergoing TP-IAT, 31 (41.3%) achieved insulin independence. Younger age (p=0.032), lack of prior Puestow (p=0.018), lower body surface area (p=0.048), IEQ per Kg Body Weight (p=0.001) and total IEQ (100,000) (0.004) were associated with insulin independence. By multivariate analysis, 3 factors were associated with insulin independence after TP-IAT:(1) male gender, (2) lower body surface area and the (3) higher total IEQ per kilogram body weight. Total IEQ (100,000) was the single factor most strongly associated with insulin independence (OR = 2.62; p value < 0.001). Conclusions TP-IAT provides sustained pain relief and improved quality of life. The ? cell function is dependent on islet yield. TP-IAT is an effective therapy for children with painful pancreatitis that fail medical and or endoscopic management PMID:24509206

  13. A complete treatment of adult living donor liver transplantation: a review of surgical technique and current challenges to expand indication of patients.

    PubMed

    Lee, S-G

    2015-01-01

    The growing disparity between the number of liver transplant candidates and the supply of deceased donor organs has motivated the development of living donor liver transplantation (LDLT). Over the last two decades, the operation has been markedly improved by innovations rendering modern results comparable with those of deceased donor liver transplantation (DDLT). However, there remains room for further innovation, particularly in adult living donor liver transplantation (ALDLT). Unlike whole-size DDLT and pediatric LDLT, size-mismatching between ALDLT graft and recipient body weight and changing dynamics of posttransplant allograft regeneration have remained major challenges. A better understanding of the complex surgical anatomy and physiologic differences of ALDLT helps avoid small-for-size graft syndrome, graft congestion from outflow obstruction and graft hypoperfusion from portal flow steal. ALDLT for high-urgency patients (Model for End-Stage Liver Disease score >30) can achieve results comparable to DDLT in high volume centers. Size limitations of partial grafts and donor safety issues can be overcome with dual grafts and modified right-lobe grafts that preserve the donor's middle hepatic vein trunk. Extended application of LDLT for unresectable hepatocellular carcinoma above Milan criteria is an optional strategy at the cost of slightly compromised survival. ABO-blood group incompatibility obstacles have been broken down by introducing a paired donor exchange program and refined peri-operative management of ABO-incompatible ALDLT. This review focuses on recent innovations of surgical techniques, safe donor selection, current strategies to expand ALDLT with broadened patient selection criteria and important aspects of teamwork required for success. PMID:25358749

  14. Evaluation of spinal cord motor function in Alzheimer’s disease using electrophysiological techniques indicates association of acetylcholine receptors with the disease

    PubMed Central

    Yang, Li; Li, Chunxia; Chen, Xiuying; Wang, Jie; Gao, Shanshan; Yang, Liling; Zhao, Yunxia; Wang, Hua; Du, Yifeng

    2014-01-01

    Aims: This study is to evaluate the spinal cord motor function in patients with Alzheimer’s disease (AD). Methods: In this study, 40 patients were diagnosed to have AD. The stages of dementia were evaluated using Mini Mental State Examination and Activity of Daily Living scale. According to the levels of movement disturbances, the patient group was further divided into dyskinesia subgroup (14 cases) and non-dyskinesia subgroup (26 cases). In addition, 45 age-matched healthy volunteers were included into the control group. Transcranial magnetic stimulation was used to evaluate motor function in the whole motor conduction pathway from motor cortex to target muscles. Electrophysiological studies were used to analyze the pyramidal tract and anterior horn neurons of the spinal cord. Results: The mean duration of F waves was prolonged, while no significant differences were found between AD patients and control subjects in parameters such as spinal cord motor conduction velocity, amplitude of motor-evoked potential, F-wave persistence, minimal latency of F-waves and maximal amplitude of F-waves. These data indicated that the excitability of the spinal cord was increased, and the number and function of pyramidal tract and anterior horn cells were integral. Conclusions: The primary mechanism of AD is probably associated with acetylcholine receptors that may participate in the formation of senile plaques and neurofibrillary tangles. These findings may provide new therapeutic targets for the treatment of AD. PMID:25664084

  15. 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)

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

    2014-01-01

    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.

  16. GIS modeling of seismic vulnerability of residential fabrics considering geotechnical, structural, social and physical distance indicators in Tehran using multi-criteria decision-making techniques

    NASA Astrophysics Data System (ADS)

    Rezaie, F.; Panahi, M.

    2015-03-01

    The main issue in determining seismic vulnerability is having a comprehensive view of all probable damages related to earthquake occurrence. Therefore, taking into account factors such as peak ground acceleration at the time of earthquake occurrence, the type of structures, population distribution among different age groups, level of education and the physical distance to hospitals (or medical care centers) and categorizing them into four indicators of geotechnical, structural, social and physical distance to needed facilities and from dangerous ones will provide us with a better and more exact outcome. To this end, this paper uses the analytic hierarchy process to study the importance of criteria or alternatives and uses the geographical information system to study the vulnerability of Tehran to an earthquake. This study focuses on the fact that Tehran is surrounded by three active and major faults: Mosha, North Tehran and Rey. In order to comprehensively determine the vulnerability, three scenarios are developed. In each scenario, seismic vulnerability of different areas in Tehran is analyzed and classified into four levels: high, medium, low and safe. The results show that, regarding seismic vulnerability, the faults of Mosha, North Tehran and Rey make, respectively, 6, 16 and 10% of Tehran highly vulnerable, while 34, 14 and 27% is safe.

  17. GIS modelling of seismic vulnerability of residential fabrics considering geotechnical, structural, social and physical distance indicators in Tehran city using multi-criteria decision-making (MCDM) techniques

    NASA Astrophysics Data System (ADS)

    Rezaie, F.; Panahi, M.

    2014-09-01

    The main issue in determining the seismic vulnerability is having a comprehensive view to all probable damages related to earthquake occurrence. Therefore, taking factors such as peak ground acceleration (PGA) in the time of earthquake occurrence, the type of structures, population distribution among different age groups, level of education, the physical distance to a hospitals (or medical care centers), etc. into account and categorized under four indicators of geotechnical, structural, social and physical distance to needed facilities and distance from dangerous ones will provide us with a better and more exact outcome. To this end in this paper using analytic hierarchy process (AHP), the amount of importance of criteria or alternatives are determined and using geographical information system (GIS), the vulnerability of Tehran metropolitan as a result of an earthquake, is studied. This study focuses on the fact that Tehran is surrounded by three active and major faults of the Mosha, North Tehran and Rey. In order to comprehensively determine the vulnerability, three scenarios are developed. In each scenario, seismic vulnerability of different areas in Tehran city is analysed and classified into four levels including high, medium, low and safe. The results show that regarding seismic vulnerability, the faults of Mosha, North Tehran and Rey respectively make 6, 16 and 10% of Tehran area highly vulnerable and also 34, 14 and 27% are safe.

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

    NASA Technical Reports Server (NTRS)

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

    1991-01-01

    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.

  19. Baseline hemodynamic and echocardiographic indices in anesthetized calves.

    PubMed

    Chee, Hyun Keun; Tuzun, Egemen; Ferrari, Markus; Conger, Jeff L; Stainback, Raymond F; Hernandez, Antonieta; Bruno, Natalie; Shah, Neel Lalit; Tamez, Daniel; Eya, Kazuhiro; Clark, Laura L; Vaughn, William K; Gregoric, Igor D; Frazier, O H; Kadipasaoglu, Kamuran A

    2004-01-01

    The experimental calf model is used to assess mechanical circulatory support devices and prosthetic heart valves. Baseline indices of cardiac function have been established for the normal awake calf but not for the anesthetized calf. Therefore, we gathered hemodynamic and echocardiographic data from 16 healthy anesthetized calves (mean age, 189.0 +/- 87.0 days; mean body weight, 106.9 +/- 32.3 kg) by cardiac catheterization and noninvasive echocardiography, respectively. Baseline hemodynamic data included heart rate (65 +/- 12 beats per minute), mean aortic pressure (113.5 +/- 17.4 mm Hg), left ventricular end-diastolic pressure (16.3 +/- 38.9 mm Hg), and mean pulmonary artery pressure (21.7 +/- 8.3 mm Hg). Baseline two-dimensional echocardiographic data included left ventricular systolic dimension (3.5 +/- 0.7 cm), left ventricular diastolic dimension (5.6 +/- 0.8 cm), end-systolic intraventricular septal thickness (1.7 +/- 0.2 cm), end-diastolic intraventricular septal thickness (1.2 +/- 0.2 cm), ejection fraction (63 +/- 10%), and fractional shortening (37 +/- 10%). Doppler echocardiography revealed a maximum aortic valve velocity of 0.9 +/- 0.5 m/s and a cardiac index of 3.7 +/- 1.1 L/minute/m2. The collected baseline data will be useful in assessing prosthetic heart valves, cardiac assist pumps, new cannulation techniques, and robotics applications in the anesthetized calf model and in developing calf models of various cardiovascular diseases. PMID:15171480

  20. Echocardiographic, catheterization, and nuclear medicine findings of an aneurysm of the muscular interventricular septum associated with aneurysm of the interatrial septum.

    PubMed

    Roldan, F J; Vargas-Barrón, J; Keirns, C; Espinola-Zavaleta, N; Rijlaarsdam, M; Romero-Cardenas, A

    1999-10-01

    The unusual case of a young woman with an aneurysm of the muscular interventricular septum associated with an aneurysm of the interatrial septum and a muscular interventricular septal defect is presented. The echocardiographic, electrocardiographic, catheterization, and nuclear medicine findings are described. PMID:10511661

  1. Limitations of volumetric indices obtained by trans-thoracic thermodilution.

    PubMed

    Bigatello, L M; Kistler, E B; Noto, A

    2010-11-01

    Transthoracic thermodilution (TTT) measures cardiac output without the need for right heart catheterization. In addition, two volumetric hemodynamic indices have been derived from the mathematical analysis of the TTT curve: the global end diastolic volume (a quantitative measure of cardiac preload) and the extravascular lung water volume (a quantitative measure of pulmonary edema). Despite the undeniable appeal of these two novel parameters, uncertainty exists regarding both the validity of their mathematical derivation and their physiological significance. This concise review attempts to discuss such concerns. PMID:21102390

  2. Transcatheter aortic valve replacement: establishing a comprehensive program model for hybrid cardiac catheterization laboratories in the Department of Veterans Affairs.

    PubMed

    Speiser, Bernadette; Dutra-Brice, Cynthia

    2014-01-01

    Aortic valve disease, especially aortic stenosis, becomes progressively debilitating and carries a high mortality risk if it is categorized as severe and symptomatic (J Thorac Cardiovas Surg. 2012;144(3):e29-e84). In the past, the only treatment for aortic stenosis was surgical aortic valve replacement. Surgical treatment may require several hours of cardioplegia, and if the patient has comorbidities, such as renal failure or chronic obstructive pulmonary disease, their operative mortality percentage increases.In 2011, the US Food and Drug Administration approved the use of a transcatheter aortic valve replacement (TAVR) procedure for patients who were deemed high risk or inoperative for the routine surgical aortic valve replacement surgery. More than 20,?000 TAVRs have been performed in patients worldwide since 2002 when Dr Alain Cribier performed the first-in-man TAVR (Arch Cardiovasc Dis. 2012;105(3):145-152). The Edwards Lifesciences SAPIEN XT valve and the Medtronic CoreValve are commercially available.The clinical findings and economic statistic have supported the expansion of the TAVR procedure. However, there has been considerable controversy over where the procedure is to occur and who is directly responsible for directing the TAVR care. This debate has identified barriers to the implementation of a TAVR program. The operating rooms and a cardiac catheterization laboratory are underprepared for the hybrid valve replacement therapy. Because of the barriers identified, the Department of Veterans Affairs determined a need for a systematic approach to review the programs that applied for this structural heart disease program. A centralized team was developed to ensure room readiness and staff competency. The use of the Health Failure Mode and Effects Analysis can define high-risk clinical processes and conduct a hazard analysis. Worksheets can show potential failure modes and their probabilities, along with actions and outcome measures, team collaboration, extensive screening, and selection process. The TAVR program begins implementation with data entry with each case into CART-CL (Cardiovascular Assessment, Reporting and Tracking System for Cath Labs, Veteran Administration database for interventional cardiology procedures). If an untoward event occurs, within 24 hours the CART-CL Quality Assessment Team is activated to begin the review process. This provides real-time review and feedback to the local facility in an expeditious manner. Cardiac catheterization laboratories have been inundated with rapidly changing technological advances in the past decade. The era for structural heart repair is rapidly mobilizing from a surgical/operating room setting to a transcatheter/hybrid catheterization laboratory suite. The use of the new hybrid catheterization laboratories will continue to expand as the approval of future transcatheter therapies evolve. Editor's note: Due to the volume of important information presented in each table, only the first table is included in the print version of the article, however, all tables may be viewed in their entirety free of charge on the online version of this article: http://journals.lww.com/dccnjournal/pages/default.aspx. PMID:25144213

  3. Study of Radially Varying Magnetic Field on Blood Flow through Catheterized Tapered Elastic Artery with Overlapping Stenosis

    NASA Astrophysics Data System (ADS)

    Nadeem, S.; Ijaz, S.

    2015-11-01

    A precise model has been developed for studying the influence of metallic nanoparticles on blood flow through catheterized tapered elastic arteries with radially varying magnetic field. The model is solved under the mild stenosis approximation by considering blood as viscous fluid. The influence of different flow parameters associated with this problem such as Hartmann number, nanoparticle volume fraction, Grashof number and heat source or sink parameter is analyzed by plotting the graphs of the wall shear stress, resistance impedance to blood flow and stream lines. The influence of the radially varying magnetic field on resistance impedance to flow is analyzed and it is observed that the significantly strong magnetic force tends to increase in resistance.

  4. Community indicators

    PubMed Central

    Flynn, Andrea; Wells, Samantha

    2014-01-01

    Community indicators are used to assess the impact of alcohol on communities. This article reviews the main data sources for community indicators, discusses their strengths and limitations, and discusses indicators used in reference to four main topics relating to alcohol use and problems at the community level: alcohol use, patterns, and problems; alcohol availability; alcohol-related health outcomes/trauma; and alcohol-related crime and enforcement. It also reviews the challenges associated with collecting community indicator data, along with important innovations in the field that have contributed to better knowledge of how to collect and analyze community-level data on the impact of alcohol. PMID:24881322

  5. In-line positioning of ultrasound images using wireless remote display system with tablet computer facilitates ultrasound-guided radial artery catheterization.

    PubMed

    Tsuchiya, Masahiko; Mizutani, Koh; Funai, Yusuke; Nakamoto, Tatsuo

    2016-02-01

    Ultrasound-guided procedures may be easier to perform when the operator's eye axis, needle puncture site, and ultrasound image display form a straight line in the puncture direction. However, such methods have not been well tested in clinical settings because that arrangement is often impossible due to limited space in the operating room. We developed a wireless remote display system for ultrasound devices using a tablet computer (iPad Mini), which allows easy display of images at nearly any location chosen by the operator. We hypothesized that the in-line layout of ultrasound images provided by this system would allow for secure and quick catheterization of the radial artery. We enrolled first-year medical interns (n = 20) who had no prior experience with ultrasound-guided radial artery catheterization to perform that using a short-axis out-of-plane approach with two different methods. With the conventional method, only the ultrasound machine placed at the side of the head of the patient across the targeted forearm was utilized. With the tablet method, the ultrasound images were displayed on an iPad Mini positioned on the arm in alignment with the operator's eye axis and needle puncture direction. The success rate and time required for catheterization were compared between the two methods. Success rate was significantly higher (100 vs. 70 %, P = 0.02) and catheterization time significantly shorter (28.5 ± 7.5 vs. 68.2 ± 14.3 s, P < 0.001) with the tablet method as compared to the conventional method. An ergonomic straight arrangement of the image display is crucial for successful and quick completion of ultrasound-guided arterial catheterization. The present remote display system is a practical method for providing such an arrangement. PMID:25869898

  6. RBC indices

    MedlinePLUS

    ... concentration (MCHC); Mean corpuscular volume (MCV); Red blood cell indices ... RBCs transport hemoglobin which, in turn, transports oxygen. The ... cells. These RBC measures are used to diagnose types of anemia . ...

  7. Transcatheter Coronary Artery Diagnostic Techniques including Impedance-Catheter and Impedance-Guidewire Measurement of Absolute Coronary Blood Flow

    PubMed Central

    Vogel, Robert A.; Martin, Lisa W.

    1989-01-01

    Interventional cardiology requires precise assessment of coronary anatomy and physiology. Unfortunately, however, important interventional decisions are frequently made on the basis of arteriographic data alone. Increasing evidence suggests that visual interpretation of coronary arteriographic studies is irreproducible, inaccurate, and poorly predictive of coronary physiology. Moreover, arteriography is of little value in assessing endothelial ulceration and mural thrombus, which are important pathophysiologic features of unstable angina and acute myocardial infarction. In response to these limitations, several diagnostic transcatheter techniques have been developed that allow more complete assessment of coronary physiology and function. These include fiberoptic angioscopy, reflection spectroscopy (which can combine automated laser therapy with diagnosis), ultrasonic catheterization, and translesional gradient determination. Doppler catheterization permits the assessment of overall coronary flow reserve with the aid of induced hyperemia, whereas subselective digital radiography allows the evaluation of regional coronary flow reserve. The coronary flow reserve, however, may be falsely lowered immediately after balloon dilation, because of endothelial injury, repeated ischemia, or the administration of vasoactive drugs. To circumvent this problem, we have developed impedance-catheter and impedance-guidewire systems that, by applying impedance technology and the principles of indicator dilution, are capable of measuring absolute coronary blood flow. For a flow indicator, we use 0.5 mL of glucose solution (D5W), which has little effect on intrinsic blood flow. The validity of this approach has been demonstrated in experimental and clinical studies. The impedance guidewire is less obstructive than the catheter system, so it probably will become the method with clinical application. (Texas Heart Institute Journal 1989;16:195-203) Images PMID:15227207

  8. Position indicator

    DOEpatents

    Tanner, David E. (Poway, CA)

    1981-01-01

    A nuclear reactor system is described in which a position indicator is provided for detecting and indicating the position of a movable element inside a pressure vessel. The movable element may be a valve element or similar device which moves about an axis. Light from a light source is transmitted from a source outside the pressure vessel to a first region inside the pressure vessel in alignment with the axis of the movable element. The light is redirected by a reflector prism to a second region displaced radially from the first region. The reflector prism moves in response to movement of the movable element about its axis such that the second region moves arcuately with respect to the first region. Sensors are arrayed in an arc corresponding to the arc of movement of the second region and signals are transmitted from the sensors to the exterior of the reactor vessel to provide indication of the position of the movable element.

  9. Chemical Indicators.

    ERIC Educational Resources Information Center

    Prombain, Dorothy R.; And Others

    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…

  10. 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.

    PubMed

    Siwe, Rene Ngamabou; Koch, Barbara

    2008-10-01

    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

  11. Acute Hemodynamic Changes After Rapid Intravenous Bolus Dosing of Dexmedetomidine in Pediatric Heart Transplant Patients Undergoing Routine Cardiac Catheterization

    PubMed Central

    Jooste, EH; Muhly, WT; Ibinson, JW; Suresh, T; Damian, D; Phadke, A; Callahan, P; Miller, S; Feingold, B; Lichtenstein, SE; Cain, JG; Chrysostomou, C; Davis, PJ

    2011-01-01

    Introduction Dexmedetomidine is a highly selective ?2-adrenoceptor agonist with sedative, anxiolytic and analgesic properties that has minimal effects on respiratory drive. Its sedative and hypotensive effects are mediated via central ?2A and imidazoline type 1 receptors while activation of peripheral ?2B–adrenoceptors result in an increase in arterial blood pressure and systemic vascular resistance (SVR). In this randomized, prospective, clinical study we attempted to quantify the short-term hemodynamic effects resulting from a rapid IV bolus administration of dexmedetomidine in pediatric cardiac transplant patients. Methods Twelve patients, aged ?10 years of age, weighing ?40kg, presenting for routine surveillance of right and left heart cardiac catheterization after cardiac transplantation were enrolled. After an inhaled or IV induction, the tracheas were intubated and anesthesia was maintained with 1 minimum alveolar concentration of isoflurane in room air, fentanyl (1mcg/kg) and rocuronium (1mg/kg). At the completion of the planned cardiac catheterization, 100% oxygen was administered. After recording a set of baseline values that included heart rate (HR), systolic blood pressure, diastolic blood pressure, central venous pressure, systolic pulmonary artery pressure, diastolic pulmonary artery pressure, pulmonary artery wedge pressure and thermodilution-based cardiac output, a rapid IV dexmedetomidine bolus of either 0.25mcg/kg or 0.5mcg/kg was administered over 5 seconds. The hemodynamic measurements were repeated at 1 min and 5 mins. Results There were 6 patients in each group. Investigation suggested that systolic blood pressure, diastolic blood pressure, systolic pulmonary artery pressure, diastolic pulmonary artery pressure, pulmonary artery wedge pressure and systemic vascular resistance all increased at 1 minute after rapid IV bolus for both doses, and decreased significantly to near baseline for both doses by 5 minutes. The transient increase in pressures was more pronounced in the systemic system than in the pulmonary system. In the systemic system there was a larger percent increase in the diastolic pressures than the systolic pressures. Cardiac output, CVP and pulmonary vascular resistance did not change significantly. HR decreased at 1 min for both doses and was, within the 0.5 mcg/kg group, the only hemodynamic variable still changed from baseline at the 5 min time point Conclusion Rapid IV bolus administration of dexmedetomidine in this small sample of children having undergone heart transplants was clinically well tolerated, although it resulted in a transient but significant increase in systemic and pulmonary pressure and a decrease in HR. In the systemic system there is a larger percent increase in the diastolic pressures than the systolic pressures, and furthermore these transient increases in pressures were more pronounced in the systemic system than in the pulmonary system. PMID:21059743

  12. Radial Artery Coursing Behind the Biceps Brachii Tendon: Significance for the Transradial Catheterization and a Clinically Oriented Classification of the Radial Artery Variations

    SciTech Connect

    Jelev, L. Surchev, L.

    2008-09-15

    In routine clinical practice the variations of the radial artery are the main reason for technical failure during transradial catheterization. If these variations are well documented, however, they do not represent a problem in the transradial approach. Therefore, we report here a rare case of the radial artery which is very strange but potentially valuable for the clinical practice: it arises at a right angle from the brachial artery and passes behind the biceps brachii tendon. Based on our findings and on an extensive literature review, we propose for the first time a clinically oriented classification of the variations of the radial artery. This classification is related to the catheterization success at the usual access site of the radial artery at the wrist.

  13. 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

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

    1988-07-01

    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.

  14. Emergence of antimicrobial-resistant uropathogens isolated from pediatric patients with cystitis on daily clean intermittent catheterization.

    PubMed

    Hiyama, Yoshiki; Takahashi, Satoshi; Uehara, Teruhisa; Hashimoto, Jiro; Nishinaka, Kazuyuki; Kitamura, Hiroshi; Masumori, Naoya

    2015-10-01

    One of the major complications of clean intermittent catheterization (CIC) is urinary tract infection (UTI). Recent reports showed that community-acquired UTIs caused by antimicrobial-resistant pathogens were gradually presenting in adults. However, there have been few reports about UTIs caused by antimicrobial-resistant bacteria in pediatric patients. Therefore, we retrospectively reviewed the medical charts of 45 children with CIC due to neurogenic bladder dysfunction from January 2010 to March 2013. Sixty-two episodes of cystitis occurred in 27 patients. Seventy bacterial strains were isolated from urine samples. The rate of Gram-negative bacteria was 84.3%. Six extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) strains were isolated from 4 patients. An ESBL-producing Proteus mirabilis strain and a methicillin-resistant Staphylococcus aureus strain were isolated from one patient each. Most of the pathogens of cystitis in the pediatric patients with CIC were Gram-negative bacilli, especially E. coli. We should be aware that ESBL producing E. coli as potential pathogens cause cystitis and regularly survey antimicrobial susceptibility to understand the resistant strains that develop. PMID:26194974

  15. Numbness after Transradial Cardiac Catheterization: the Results from a Nerve Conduction Study of the Superficial Radial Nerve

    PubMed Central

    Jang, Ho-Jun; Kim, Ji-Young; Han, Jae Deok; Lee, Hyun Jong; Kim, Je Sang; Park, Jin Sik; Choi, Rak Kyeong; Choi, Young Jin; Shim, Won-Heum; Kwon, Sung Woo

    2016-01-01

    Background and Objectives Numbness on the hand occurs infrequently after a transradial cardiac catheterization (TRC). The symptom resembles that of neuropathy. We, therefore, investigated the prevalence, the predicting factors and the presence of neurological abnormalities of numbness, using a nerve conduction study (NCS). Subjects and Methods From April to December 2013, all patients who underwent a TRC were prospectively enrolled. From among these, the patients who experienced numbness on the ipsilateral hand were instructed to describe their symptoms using a visual analogue scale; subsequently, NCSs were performed on these patients. Results Of the total 479 patients in the study sample, numbness occurred in nine (1.8%) following the procedure. The NCS was performed for eight out of the nine patients, four (50%) of which had an abnormal NCS result at the superficial radial nerve. A larger sheath and history of myocardial infarction (p=0.14 and 0.08 respectively) tended towards the occurrence of numbness; however, only the use of size 7 French sheaths was an independent predictor for the occurrence of numbness (odds ratio: 5.50, 95% confidence interval: 1.06-28.58, p=0.042). The symptoms disappeared for all patients but one, within four months. Conclusion A transient injury of the superficial radial nerve could be one reason for numbness after a TRC. A large sheath size was an independent predictor of numbness; therefore, large sized sheaths should be used with caution when performing a TRC. PMID:27014346

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

    NASA Astrophysics Data System (ADS)

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

    2009-06-01

    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.

  17. Horner's syndrome in patients admitted to the intensive care unit that have undergone central venous catheterization: a prospective study.

    PubMed

    Butty, Z; Gopwani, J; Mehta, S; Margolin, E

    2016-01-01

    PurposeCentral venous catheterization (CVC) is estimated to be performed in millions of patients per year. Swan-Ganz catheters used for CVC are most often inserted into the internal jugular vein and during this procedure they may come into contact with the sympathetic chain. This study aims to determine the incidence of Horner's syndrome in patients admitted to intensive care unit that have undergone internal jugular CVC insertion during their admission and to determine whether ultrasonography-assisted insertion has decreased the frequency of this complication.Patients and methodsA total of 100 prospective patients admitted to the ICU were examined for the presence of anisocoria and ptosis after undergoing recent CVC. Presence of Horner's syndrome was confirmed by testing with 0.5% apraclonidine and looking for the reversal of anisocoria.ResultsFrequency of Horner's syndrome after CVC was 2% in a sample of 100 prospectively examined patients.ConclusionHorner's syndrome remains a relatively rare but definitive complication of CVC. ICU physicians should be educated about its existence and prevalence and ophthalmologists should inquire about any history of ICU admission necessitating CVC insertion in any patient presenting with Horner's syndrome. PMID:26381100

  18. Clinical performance indicators for percutaneous coronary intervention.

    PubMed

    Vermeulen, Robert P; Jessurun, Gillian A; Peels, Hans O; Jaarsma, Tiny; Zijlstra, Felix

    2008-06-01

    Quality indicators in cardiology can be used to guide performance at a patient level, or at an organizational level. To positively influence adherence to performance guidelines, policymakers have to ensure that employees are involved in the development of guidelines and indicators. The first phase for selecting performance measures is creating a set of performance indicators. The aim of this study was to identify performance indicators with a high degree of consensus among professionals in daily practice for interventional cardiology. Each of the 50 predefined performance indicators was rated by 17 cardiologists and 17 head nurses (one from each participating center) on a 5-point scale. The cluster of indicators with the highest scores was resubmitted to the participants of the first phase for verification. After the second phase, performance indicators with >90% positive score for inclusion were qualified as key performance indicator (KPI). In the first phase, 24 of 34 response forms were returned (71%). Performance indicators with the highest overall mean scores were complications (4.71), in-hospital delay for patients with acute myocardial infarction (4.67), mortality (4.63), technical result (4.42), and patient satisfaction (4.38). The scores of cardiologists and nurses showed similar patterns. Nineteen indicators were selected for verification. After the second phase, 8 indicators qualified as KPI: complications, data flow, in-hospital delay, frequency of heart team meetings, number of procedures per center, mortality, restenosis rate, and use of protocols. The 8 KPI are both quantifiable and aimed at the catheterization laboratory as a unit. PMID:18520530

  19. Image Fusion of Preprocedural CTA with Real-time Fluoroscopy to Guide Proper Hepatic Artery Catheterization During Transarterial Chemoembolization of Hepatocellular Carcinoma: A Feasibility Study

    SciTech Connect

    Bargellini, Irene Turini, Francesca; Bozzi, Elena; Lauretti, Dario; Cicorelli, Antonio; Lunardi, Alessandro; Cioni, Roberto; Bartolozzi, Carlo

    2013-04-15

    To assess feasibility of proper hepatic artery catheterization using a 3D model obtained from preprocedural computed tomographic angiography (CTA), fused with real-time fluoroscopy, during transarterial chemoembolization of hepatocellular carcinoma. Twenty consecutive cirrhotic patients with hepatocellular carcinoma undergoing transarterial chemoembolization were prospectively enrolled onto the study. The early arterial phase axial images of the preprocedural CTA were postprocessed on an independent workstation connected to the angiographic system (Innova 4100; GE Healthcare, Milwaukee, WI), obtaining a 3D volume rendering image (VR) that included abdominal aorta, splanchnic arteries, and first and second lumbar vertebrae. The VR image was manually registered to the real-time X-ray fluoroscopy, with the lumbar spine used as the reference. The VR image was then used as guidance to selectively catheterize the proper hepatic artery. The procedure was considered successful when performed with no need for intraarterial contrast injections or angiographic acquisitions. The procedure was successful in 19 (95 %) of 20 patients. In one patient, celiac trunk angiography was required for the presence of a significant ostial stenosis that was underestimated at computed tomography. Time for image reconstruction and registration was <10 min in all cases. The use of preprocedural CTA model with fluoroscopy enables confident and direct catheterization of the proper hepatic artery with no need for preliminary celiac trunk angiography, thus reducing radiation exposure and contrast media administration.

  20. Successful Ultrasound-Guided Femoral Nerve Blockade and Catheterization in a Patient with Von Willebrand Disease.

    PubMed

    DiStefano, Youmna E; Lazar, Michael D

    2015-01-01

    Peripheral nerve blockade (PNB) is superior to neuraxial anesthesia and/or opioid therapy for perioperative analgesia in total knee replacement (TKR). Evidence on the safety of PNB in patients with coagulopathy is lacking. We describe the first documented account of continuous femoral PNB for perioperative analgesia in a patient with Von Willebrand Disease (vWD). Given her history of opioid tolerance and after an informative discussion, a continuous femoral PNB was planned for in this 34-year-old female undergoing TKR. A Humate-P intravenous infusion was started and the patient was positioned supinely. Using sterile technique with ultrasound guidance, a Contiplex 18 Gauge Tuohy needle was advanced in plane through the fascia iliaca towards the femoral nerve. A nerve catheter was threaded through the needle and secured without complications. Postoperatively, a levobupivacaine femoral catheter infusion was maintained, and twice daily Humate-P intravenous infusions were administered for 48 hours; enoxaparin thromboprophylaxis was initiated thereafter. The patient was discharged uneventfully on postoperative day 4. Given documentation of delayed, unheralded bleeding from PNB in coagulopathic patients, we recommend individualized PNB in vWD patients. Multidisciplinary team involvement is required to guide factor supplementation and thromboprophylaxis, as is close follow-up to elicit signs of bleeding throughout the delayed postoperative period. PMID:26113995

  1. Long-term catheterization: current approaches in the diagnosis and treatment of port-related infections

    PubMed Central

    Bustos, Cesar; Aguinaga, Aitziber; Carmona-Torre, Francisco; Del Pozo, Jose Luis

    2014-01-01

    Since the first description in 1982, totally implanted venous access ports have progressively improved patients’ quality of life and medical assistance when a medical condition requires the use of long-term venous access. Currently, they are part of the standard medical care for oncohematologic patients. However, apart from mechanical and thrombotic complications, there are also complications associated with biofilm development inside the catheters. These biofilms increase the cost of medical assistance and extend hospitalization. The most frequently involved micro-organisms in these infections are gram-positive cocci. Many efforts have been made to understand biofilm formation within the lumen catheters, and to resolve catheter-related infection once it has been established. Apart from systemic antibiotic treatment, the use of local catheter treatment (ie, antibiotic lock technique) is widely employed. Many different antimicrobial options have been tested, with different outcomes, in clinical and in in vitro assays. The stability of antibiotic concentration in the lock solution once instilled inside the catheter lumen remains unresolved. To prevent infection, it is mandatory to perform hand hygiene before catheter insertion and manipulation, and to disinfect catheter hubs, connectors, and injection ports before accessing the catheter. At present, there are still unresolved questions regarding the best antimicrobial agent for catheter-related bloodstream infection treatment and the duration of concentration stability of the antibiotic solution within the lumen of the port. PMID:24570595

  2. Successful Ultrasound-Guided Femoral Nerve Blockade and Catheterization in a Patient with Von Willebrand Disease

    PubMed Central

    DiStefano, Youmna E.; Lazar, Michael D.

    2015-01-01

    Peripheral nerve blockade (PNB) is superior to neuraxial anesthesia and/or opioid therapy for perioperative analgesia in total knee replacement (TKR). Evidence on the safety of PNB in patients with coagulopathy is lacking. We describe the first documented account of continuous femoral PNB for perioperative analgesia in a patient with Von Willebrand Disease (vWD). Given her history of opioid tolerance and after an informative discussion, a continuous femoral PNB was planned for in this 34-year-old female undergoing TKR. A Humate-P intravenous infusion was started and the patient was positioned supinely. Using sterile technique with ultrasound guidance, a Contiplex 18 Gauge Tuohy needle was advanced in plane through the fascia iliaca towards the femoral nerve. A nerve catheter was threaded through the needle and secured without complications. Postoperatively, a levobupivacaine femoral catheter infusion was maintained, and twice daily Humate-P intravenous infusions were administered for 48 hours; enoxaparin thromboprophylaxis was initiated thereafter. The patient was discharged uneventfully on postoperative day 4. Given documentation of delayed, unheralded bleeding from PNB in coagulopathic patients, we recommend individualized PNB in vWD patients. Multidisciplinary team involvement is required to guide factor supplementation and thromboprophylaxis, as is close follow-up to elicit signs of bleeding throughout the delayed postoperative period. PMID:26113995

  3. Validation of the Use of Nonnaive Surgically Catheterized Rats for Pharmacokinetics Studies

    PubMed Central

    Deshmukh, Sujal V; Durston, Jessica; Shomer, Nirah H

    2008-01-01

    Although large animals, such as dogs and nonhuman primates, often are used for more than 1 pharmacokinetics study, common practice is to use only naive rodents for pharmacokinetics studies. We undertook a series of studies to validate whether surgically cannulated nonnaive rats could be used again after a 7-d washout. When vascular catheters are cared for appropriately, we find that they remain patent for more than 2 wk, with negligible drug carryover. Hematocrit decreased approximately 11% after pharmacokinetics studies but rebounded to prestudy levels after a 7-d washout. We empirically tested whether drugs known to alter drug disposition (1-aminobenzotriazole and quinidine) had residual effects on drug disposition after a 7-d washout and found that they did not. This finding suggests that after a 7-d washout, nonnaive rats likely would produce pharmacokinetics data similar to those of naive rats. We also tested reference compounds in naive and nonnaive rats and found no difference in pharmacokinetics parameters. Using surgically cannulated rats for a second study was feasible because of the relatively noninvasive nature of pharmacokinetics sampling (unrestrained rats attached to automated blood samplers). In addition, reusing surgically altered animals yields considerable cost savings. Our studies indicate that pharmacokinetics parameters did not differ significantly between naive and nonnaive rats. Cost–benefit analysis, monetary considerations, and validation studies support using rats for a second study after a 7-d washout period. PMID:19049252

  4. Short- and long-term transfer of urethral catheterization skills from simulation training to performance on patients

    PubMed Central

    2013-01-01

    Background Inexperienced interns are responsible for most iatrogenic complications after urethral catheterization (UC). Although training on simulators is common, little is known about the transfer of learned skills to real clinical practice. This study aimed to evaluate the short- and long-term effects of UC simulated skills training on performance on real patients and to examine whether watching a video of the procedure immediately before assessment enhanced clinical performance. Methods This was an experimental study of the effect of a UC simulation-based skills course on medical students’ short-term (after one week) and long-term (after six weeks) performance. The additional effect of video instruction before performance testing on real patients was studied in a randomized trial. Sixty-four students participated in the study, which was preceded by a pilot study investigating the validity aspects of a UC assessment form. Results The pilot study demonstrated sufficient inter-rater reliability, intra-class correlation coefficient 0.86, and a significant ability to discriminate between trainee performances when using the assessment form, p= 0.001. In the main study, more than 90% of students demonstrated an acceptable performance or better when tested on real patients. There was no significant difference in the total score between the one-week and the six-week groups when tested on real patients and no significant difference between the video and the control groups. Conclusions Medical students demonstrated good transfer of UC skills learned in the skills lab to real clinical situations up to six weeks after training. Simulated UC training should be the standard for all medical school curricula to reduce avoidable complications. However, this study did not demonstrate that an instructional video, as a supplement to simulated skills training, improved clinical UC performance. Trial registration Current Controlled Trials ISRCTN:ISRCTN90745002 PMID:23433258

  5. Fast catheter segmentation from echocardiographic sequences based on segmentation from corresponding X-ray fluoroscopy for cardiac catheterization interventions.

    PubMed

    Wu, Xianliang; Housden, James; Ma, YingLiang; Razavi, Benjamin; Rhode, Kawal; Rueckert, Daniel

    2015-04-01

    Echocardiography is a potential alternative to X-ray fluoroscopy in cardiac catheterization given its richness in soft tissue information and its lack of ionizing radiation. However, its small field of view and acoustic artifacts make direct automatic segmentation of the catheters very challenging. In this study, a fast catheter segmentation framework for echocardiographic imaging guided by the segmentation of corresponding X-ray fluoroscopic imaging is proposed. The complete framework consists of: 1) catheter initialization in the first X-ray frame; 2) catheter tracking in the rest of the X-ray sequence; 3) fast registration of corresponding X-ray and ultrasound frames; and 4) catheter segmentation in ultrasound images guided by the results of both X-ray tracking and fast registration. The main contributions include: 1) a Kalman filter-based growing strategy with more clinical data evalution; 2) a SURF detector applied in a constrained search space for catheter segmentation in ultrasound images; 3) a two layer hierarchical graph model to integrate and smooth catheter fragments into a complete catheter; and 4) the integration of these components into a system for clinical applications. This framework is evaluated on five sequences of porcine data and four sequences of patient data comprising more than 3000 X-ray frames and more than 1000 ultrasound frames. The results show that our algorithm is able to track the catheter in ultrasound images at 1.3 s per frame, with an error of less than 2 mm. However, although this may satisfy the accuracy for visualization purposes and is also fast, the algorithm still needs to be further accelerated for real-time clinical applications. PMID:25291790

  6. Alternative technique for clot retrieval: The "tip of the iceberg" technique.

    PubMed

    Agid, Ronit; Power, Sarah

    2015-12-01

    We present a variation of the classical technique of stent retriever thrombectomy which we found helpful in two patients presenting with acute stroke. CT angiography in both patients demonstrated thrombus within a middle cerebral artery M2 branch. In both cases the occluded artery was not visualized on DSA and only the proximal tip of the clot could be seen as a filling defect "hanging" into the parent artery reminiscent of a "tip of an iceberg". Rather than selectively catheterizing the occluded branch we placed the stent retriever in the patent parent artery crossing only the tip of the clot. In both cases one pass of the stent retriever was sufficient to retrieve the whole clot by its tip and reopen the occluded branch. We suggest trying this technique whenever the clot is seated in the proximal part of a secondary branch such as an M2 segment of middle cerebral artery. This "tip of the iceberg" technique prevents the need to selectively catheterize the occluded branch which, if difficult, can prolong procedural and ischemic time. PMID:26472639

  7. Cardiac imaging of congenital heart diseases during interventional procedures continues to evolve: Pros and cons of the main techniques.

    PubMed

    Hascoët, Sebastien; Warin-Fresse, Karine; Baruteau, Alban-Elouen; Hadeed, Khaled; Karsenty, Clement; Petit, Jérôme; Guérin, Patrice; Fraisse, Alain; Acar, Philippe

    2016-02-01

    Cardiac catheterization has contributed to the progress made in the management of patients with congenital heart disease (CHD). First, it allowed clarification of the diagnostic assessment of CHD, by offering a better understanding of normal cardiac physiology and the pathophysiology and anatomy of complex malformations. Then, it became an alternative to surgery and a major component of the therapeutic approach for some CHD lesions. Nowadays, techniques have evolved and cardiac catheterization is widely used to percutaneously close intracardiac shunts, to relieve obstructive valvar or vessel lesions, and for transcatheter valve replacement. Accurate imaging is mandatory to guide these procedures. Cardiac imaging during catheterization of CHD must provide accurate images of lesions, surrounding cardiac structures, medical devices and tools used to deliver them. Cardiac imaging has to be 'real-time' with an excellent temporal resolution to ensure 'eyes-hands' synchronization and 'device-target area' accurate positioning. In this comprehensive review, we provide an overview of conventional cardiac imaging tools used in the catheterization laboratory in daily practice, as well as the effect of recent evolution and future imaging modalities. PMID:26858142

  8. Endovascular treatment of intracranial aneurysms: diversity in treatment techniques of varying anatomical presentations.

    PubMed

    Putu, Patriawan; Firman, Sitanggang; Ismail, Mohd Redzuan; Nik-Ismail, Nik Azuan; Yaacob, Nur Yazmin; Muda, Ahmad Sobri

    2014-01-01

    We discuss and illustrate various endovascular treatment options for intracranial aneurysms, to reflect common technique used in endovascular treatment of brain aneurysm. We select five cases of various aneurysm types to show assortments of endovascular treatment (EVT) are performed. Selective catheterization of the intracranial aneurysms and endovascular treatments are technically feasible, offering a viable alternative to the surgical approach. We discuss the radiographic features, clinical presentation, and strategies of endovascular treatment of intracranial aneurysms. PMID:24760813

  9. Influence of Different Protocols of Urethral Catheterization after Pharmacological Induction (Ur.Ca.P.I.) on Semen Quality in the Domestic Cat.

    PubMed

    Cunto, M; Küster, D G; Bini, C; Cartolano, C; Pietra, M; Zambelli, D

    2015-12-01

    The aim of this study was to evaluate the influence that different protocols of urethral catheterization after pharmacological induction (Ur.Ca.P.I.) may have on the semen quality of the domestic cat. The study has been divided into two experiments: one in which different dosages of medetomidine administrated are evaluated and the second one in which the timing of the catheterization after pharmacological induction is tested. In the first experiment, 18 cats were sedated with the recommended dosage of medetomidine (130 ?g/kg i.m.) while the other 18 were sedated with a lower dose of the same drug (50 ?g/kg i.m.). In the second experiment, three groups were implemented, each containing 25 subjects. In group 1, the semen collection was performed immediately once the pharmacological effect of the drug was reached; in group 2, the semen collection was performed three times every 5 min after the pharmacological effect was reached; finally, in group 3, Ur.Ca.P.I. was performed 20 min after the pharmacological effect was reached. All the different protocols permitted sperm collection, nevertheless the first experiment showed a better quality in terms of volume, concentration, total number of spermatozoa (p < 0.01) and quality of the movement (motility p < 0.05 and forward progressive motility p < 0.01), using a high medetomidine dosage rather than 50 ?g/kg i.m. In the second experiment, forward motility was statistically higher (p < 0.01) in the first group and total volume was higher (p < 0.01) in the second and third group, while other parameters were statistically not different. Results suggest that a single catheterization immediately after the onset of the pharmacological effect leads to a good-quality semen with the lowest possibility of damaging the urethra and that a sedation with 130 ?g/kg of medetomidine leads to a better quality sperm collection than 50 ?g/kg does. PMID:26482317

  10. The use of web-based learning for simulation-based education and training of central venous catheterization in novice learners.

    PubMed

    Cheung, Jeffrey J H; Koh, Jansen; Mackinnon, Kim; Brett, Clare; Bägli, Darius; Kapralos, Bill; Dubrowski, Adam

    2013-01-01

    Both simulation-based education and training (SBET) and Web-based Learning (WBL) are increasingly used in medical education. We developed a Web-based learning course on "Observational Practice and Educational Networking" (OPEN), to augment SBET for central venous catheterization (CVC), a complex clinical skill, for novice learners. This pilot study aimed to firstly, understand the perspectives of novice learners on using WBL in preparation for SBET for a psychomotor skill and secondly, to observe how learners use the OPEN courseware to learn more about how to perform this skill. PMID:23400133

  11. [Current indications for intravenous numerical angiography in the study of the ilio-femoral axis].

    PubMed

    Raynaud, A; Seurot, M; Angel, C; Roth, J P; Gaux, J C

    1983-06-18

    A study of the arterial axis from the aortic bifurcation to the femoral bifurcation was conducted by intravenous digital angiography in 40 patients. In 92.5% of these, opacification and visualization of the arteries were good or excellent. In 12 out of 15 patients the images were judged to be of the same quality as those obtained by conventional arteriography. A limitation of the method is the size of the intensifying screen (23 cm), which only allows exploration of one segment at each injection. This, however, is a minor drawback when this technique is used for control examination after percutaneous angioplasty or to investigate an accident of catheterization. PMID:6224146

  12. Left heart catheterization (image)

    MedlinePLUS

    ... provide therapeutic interventions in certain types of heart conditions. The test can determine pressure and blood flow in the heart's chambers, collect blood samples from the heart, and examine the arteries of the heart by X-ray (fluoroscopy).

  13. Cardiac catheterization - discharge

    MedlinePLUS

    A catheter was inserted into an artery in your groin or arm. Then it was carefully guided up to your heart. Once it reached your heart, the catheter was placed into the arteries that deliver blood ...

  14. Self catheterization - male

    MedlinePLUS

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

  15. Self catheterization - female

    MedlinePLUS

    ... may use cotton balls with mild soap and water. Rinse well and dry if you use soap and water. Apply the K-Y Jelly or other gel ... and floor). Follow these steps: Wash your hands well. Rinse out the ... and 4 parts water. Or, you can soak it in hydrogen peroxide ...

  16. Bladder catheterization, female (image)

    MedlinePLUS

    ... catheter (a hollow tube, often with an inflatable balloon tip) may be inserted into the urinary bladder ... kept empty (decompressed) and urinary flow assured. The balloon holds the catheter in place for a duration ...

  17. Radial Artery Catheterization

    MedlinePLUS

    ... CIRCULATIONAHA.111.019802 Extract Free Figures Only Free » Full Text Free PDF Free PPT Slides of All Figures ... manager Request Permissions Metrics Total Downloads Abstract: 1712 Full-text: 84005 PDF: 4120 Citing Articles Load citing article ...

  18. Use of Genetically Encoded Calcium Indicators (GECIs) Combined with Advanced Motion Tracking Techniques to Examine the Behavior of Neurons and Glia in the Enteric Nervous System of the Intact Murine Colon

    PubMed Central

    Hennig, Grant W.; Gould, Thomas W.; Koh, Sang Don; Corrigan, Robert D.; Heredia, Dante J.; Shonnard, Matthew C.; Smith, Terence K.

    2015-01-01

    Genetically encoded Ca2+ indicators (GECIs) have been used extensively in many body systems to detect Ca2+ transients associated with neuronal activity. Their adoption in enteric neurobiology has been slower, although they offer many advantages in terms of selectivity, signal-to-noise and non-invasiveness. Our aims were to utilize a number of cell-specific promoters to express the Ca2+ indicator GCaMP3 in different classes of neurons and glia to determine their effectiveness in measuring activity in enteric neural networks during colonic motor behaviors. We bred several GCaMP3 mice: (1) Wnt1-GCaMP3, all enteric neurons and glia; (2) GFAP-GCaMP3, enteric glia; (3) nNOS-GaMP3, enteric nitrergic neurons; and (4) ChAT-GCaMP3, enteric cholinergic neurons. These mice allowed us to study the behavior of the enteric neurons in the intact colon maintained at a physiological temperature, especially during the colonic migrating motor complex (CMMC), using low power Ca2+ imaging. In this preliminary study, we observed neuronal and glial cell Ca2+ transients in specific cells in both the myenteric and submucous plexus in all of the transgenic mice variants. The number of cells that could be simultaneously imaged at low power (100–1000 active cells) through the undissected gut required advanced motion tracking and analysis routines. The pattern of Ca2+ transients in myenteric neurons showed significant differences in response to spontaneous, oral or anal stimulation. Brief anal elongation or mucosal stimulation, which evokes a CMMC, were the most effective stimuli and elicited a powerful synchronized and prolonged burst of Ca2+ transients in many myenteric neurons, especially when compared with the same neurons during a spontaneous CMMC. In contrast, oral elongation, which normally inhibits CMMCs, appeared to suppress Ca2+ transients in some of the neurons active during a spontaneous or an anally evoked CMMC. The activity in glial networks appeared to follow neural activity but continued long after neural activity had waned. With these new tools an unprecedented level of detail can be recorded from the enteric nervous system (ENS) with minimal manipulation of tissue. These techniques can be extended in order to better understand the roles of particular enteric neurons and glia during normal and disordered motility. PMID:26617487

  19. A novel technique for simultaneous whole-body and multi-organ decellularization: umbilical artery catheterization as a perfusion-based method in a sheep foetus model.

    PubMed

    Kajbafzadeh, Abdol-Mohammad; Khorramirouz, Reza; Akbarzadeh, Aram; Sabetkish, Shabnam; Sabetkish, Nastaran; Saadat, Paria; Tehrani, Mona

    2015-04-01

    The aim of this study was to develop a method to generate multi-organ acellular matrices. Using a foetal sheep model have developed a method of systemic pulsatile perfusion via the umbilical artery which allows for simultaneous multi-organ decellularization. Twenty sheep foetuses were systemically perfused with Triton X-100 and sodium dodecyl sulphate. Following completion of the whole-body decellularization, multiple biopsy samples were taken from different parts of 21 organs to ascertain complete cell component removal in the preserved extracellular matrices. Both the natural and decellularized organs were subjected to several examinations. The samples were obtained from the skin, eye, ear, nose, throat, cardiovascular, respiratory, gastrointestinal, urinary, musculoskeletal, central nervous and peripheral nervous systems. The histological results depicted well-preserved extracellular matrix (ECM) integrity and intact vascular structures, without any evidence of residual cellular materials, in all decellularized bioscaffolds. Scanning electron microscope (SEM) and biochemical properties remained intact, similar to their age-matched native counterparts. Preservation of the collagen structure was evaluated by a hydroxyproline assay. Dense organs such as bone and muscle were also completely decellularized, with a preserved ECM structure. Thus, as shown in this study, several organs and different tissues were decellularized using a perfusion-based method, which has not been previously accomplished. Given the technical challenges that exist for the efficient generation of biological scaffolds, the current results may pave the way for obtaining a variety of decellularized scaffolds from a single donor. In this study, there have been unique responses to the single acellularization protocol in foetuses, which may reflect the homogeneity of tissues and organs in the developing foetal body. PMID:26031202

  20. 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

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

    2009-01-01

    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. PMID:19814822

  1. Ultrasound-guided central venous catheterization in cancer patients improves the success rate of cannulation and reduces mechanical complications: A prospective observational study of 1,978 consecutive catheterizations

    PubMed Central

    2010-01-01

    Background A central venous catheter (CVC) currently represents the most frequently adopted intravenous line for patients undergoing infusional chemotherapy and/or high-dose chemotherapy with hematopoietic stem-cell transplantation and parenteral nutrition. CVC insertion represents a risk for pneumothorax, nerve or arterial punctures. The aim of this prospective observational study was to explore the safety and efficacy of CVC insertion under ultrasound (US) guidance and to confirm its utility in clinical practice in cancer patients. Methods Consecutive adult patients attending the oncology-hematology department were eligible if they had solid or hematologic malignancies and required CVC insertion. Four types of possible complication were defined a priore: mechanical, thrombotic, infection and malfunctioning. The patient was placed in Trendelenburg's position, a 7.5 MHZ puncturing US probe was placed in the supraclavicular site and a 16-gauge needle was advanced under real-time US guidance into the last portion of internal jugular vein. The Seldinger technique was used to place the catheter, which was advanced into the superior vena cava until insertion into right atrium. Within two hours after each procedure, an upright chest X-ray and ultrasound scanning were carried out to confirm the CVC position and to rule out a pneumotorax. CVC-related infections, symptomatic vein thrombosis and malfunctioning were recorded. Results From December 2000 to January 2009, 1,978 CVC insertional procedures were applied to 1,660 consecutive patients. The procedure was performed 580 times in patients with hematologic malignancies and 1,398 times those with solid tumors. A single-needle puncture of the vein was performed on 1,948 of 1,978 procedures (98.48%); only eighteen attempts among 1,978 failed (0.9%). No pneumotorax, no major bleeding, and no nerve puncture were reported; four cases (0.2%) showed self-limiting hematomas. The mean lifespan of CVC was 189.7 +/- 18.6 days (range 7-701). Symptomatic deep-vein thrombosis of the upper limbs developed in 48 patients (2.42%). Catheter-related infections occurred in 197 (9.96%) of the catheters inserted. They were successfully treated with antibiotics and only in 48 (2.9%) patients definitive CVC removal was required for infection and/or thrombosis or malfunctioning. Conclusions This study represents the largest published series of consecutive patients with cancer undergoing CVC insertion under US guidance; this procedure allowed the completion of the therapeutic program for 1,930/1,978 (97.6%) of the catheters inserted. The absence of pneumotorax and other major complications indicates that US guidance should be mandatory for CVC insertion in patients with cancer. PMID:20958986

  2. N-acetylcysteine and/or ascorbic acid versus placebo to prevent contrast-induced nephropathy in patients undergoing elective cardiac catheterization: The NAPCIN trial; A single-center, prospective, randomized trial.

    PubMed

    Habib, Mohammed; Hillis, Alaa; Hammad, Amen

    2016-01-01

    Several protective measures have been described to prevent contrast-induced nephropathy (CIN). This study is aimed to evaluate the effect of a high dose of N-acetylcysteine (NAC) plus hydration, a low dose of NAC plus ascorbic acid and hydration or hydration alone on the prevention of CIN in high-risk patients undergoing elective coronary artery intervention. We conducted a randomized, prospective, placebo-controlled trial of 105 high-risk patients undergoing elective cardiac catheterization. The patients were divided into three different groups: Group A (n = 30), NAC 1200 mg orally before angiography and 1200 mg orally twice daily for three doses along with good hydration; Group B (n = 30), NAC 600 mg before angiography and 600 mg orally twice daily for three doses plus ascorbic acid (3000 mg one dose) before angiography and 2000 mg two doses after angiography and good hydration; and Group C (n = 45), hydration with 0.9% saline started just before contrast media injection and continued for 12 h at a rate 1.0 mL/kg//min after angiography or 0.5 mL/kg/h in cases with overt heart failure for 12 h. CIN was defined as an increase in serum creatinine of >25% of baseline or an absolute increase of 0.5 mg/dL above baseline after 48 h. The incidence of CIN was significantly lower in Group A (6.66%) compared with Group B (16.66%) or Group C (17.77%). The difference between Groups A and B and between Groups A and C was also highly significant (P = 0.001). In contrast, the difference between Groups B and C was not statistically significant (P = 0.37). Our study indicates that high doses of NAC plus hydration provide better protection against CIN than combination therapy of NAC and ascorbic acid plus hydration, or hydration alone. PMID:26787567

  3. Coronary arteriography and angioplasty

    SciTech Connect

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

    1985-01-01

    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.

  4. Rosuvastatin Treatment for Preventing Contrast-Induced Acute Kidney Injury After Cardiac Catheterization: A Meta-Analysis of Randomized Controlled Trials.

    PubMed

    Yang, You; Wu, Yan-Xian; Hu, Yun-Zhao

    2015-07-01

    We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the protective effects of rosuvastatin on contrast-induced acute kidney injury (CI-AKI) and major adverse cardiovascular events (MACEs) in patients undergoing cardiac catherization.PubMed, MEDLINE, Web of Science, EMBASE, ClinicalTrials.gov, and the Cochrane Central RCTs were searched for RCTs from inception to May 2015, to compare rosuvastatin for preventing CI-AKI with placebo treatment in patients undergoing cardiac catherization.Five RCTs with a total of 4045 patients involving 2020 patients pretreated with rosuvastatin and 2025 control patients were identified and analyzed. Patients treated with rosuvastatin had a 51% lower risk of CI-AKI compared with the control group based on a fixed-effect model (OR = 0.49, 95% CI = 0.37-0.66, P < 0.001), and showed a trend toward a reduced risk of MACEs (OR = 0.62, 95% CI = 0.36-1.07, P = 0.08). A subgroup analysis showed that studies with Jadad score ?3 showed a significant reduction of CI-AKI (OR = 0.53, 95% CI, 0.38-0.73, P < 0.001). However, the risk of CI-AKI did not significantly differ in the studies with Jadad score <3 (OR = 0.54, 95% CI, 0.13-2.24, P = 0.40). In addition, the rosuvastatin treatment showed no effect for preventing CI-AKI in patients with chronic kidney disease (CKD) undergoing elective cardiac catherization (I = 0%, OR = 0.81, 95% CI = 0.41-1.61, P = 0.55).This updated meta-analysis demonstrated that preprocedural rosuvastatin treatment could significantly reduce the incidence of CI-AKI, with a trend toward a reduced risk of MACEs in patients undergoing cardiac catheterization. However, rosuvastatin treatment did not seem to be effective for preventing CI-AKI in CKD patients undergoing elective cardiac catheterization. PMID:26222855

  5. Right ventricle functional assessment: have new techniques supplanted the old faithful conductance catheter?

    PubMed

    McCabe, Colm; White, Paul A; Rana, Bushra S; Gopalan, Deepa; Agrawal, Bobby; Pepke-Zaba, Joanna; Hoole, Stephen P

    2014-01-01

    This review explores the historical development of conductance catheterization of the human right ventricle (RV) and its current diagnostic role in assessing RV function in an era of contemporary noninvasive imaging. Significant advances in echocardiography, cardiothoracic computed tomography, and cardiac magnetic resonance in the last decade have led a paradigm shift away from invasive hemodynamic assessment toward noninvasive measurement of RV function. However, imaging modalities are not without some disadvantages. For example, they do not provide the beat-to-beat pressure-volume assessment that is obtained by conductance catheterization, which is still arguably the gold standard for measuring cardiac performance. Right heart catheterization remains an integral part of the assessment of patients with RV dysfunction, and a burgeoning interest in early RV insufficiency in a range of cardiopulmonary diseases has brought the detailed interrogation of RV function back into focus. Although conductance volume assessment of the RV is more limited than the left ventricle, the scope for improving the understanding of RV adaptation to pulmonary and valvular pathologies and RV myocardial disease by using a conductance catheter still exists. We review the up-to-date functional applications of echocardiography and computed tomography/cardiac magnetic resonance to assess the RV and illustrate the potential of contemporary conductance catheter techniques to complement noninvasive imaging in the assessment of RV function. PMID:24621859

  6. A novel technique in the treatment of retroperitoneal lymphatic leakage: direct percutaneous embolization through the leakage pouch.

    PubMed

    Dinç, Hasan; O?uz, ?ükrü; Sar?, Ahmet

    2015-01-01

    Lymphangiography and percutaneous embolization of injured lymphatics are minimally invasive and effective techniques for the diagnosis and treatment of thoracic and retroperitoneal lymphatic leaks. We present a 58-year-old man who had abdominal chylous collection developed after multiple abdominal surgeries. Retroperitoneal lymphatic duct leakage was detected by ultrasound-guided intranodal lymphangiography and treated successfully using computed tomography (CT)-guided transabdominal embolization with percutaneous N-butyl cyanoacrylate (NBCA) glue and percutaneous NBCA glue and coil embolization by directly catheterizing the leaking lymphatic channel through the chylous collection. To the best of our knowledge, this is the first report of a lymphatic leakage case treated by percutaneous direct catheterization and embolization of leaking lymphatic channels through the chylous fluid collection. PMID:26200485

  7. Titration Techniques

    NASA Astrophysics Data System (ADS)

    Jacobsen, Jerrold J.; Houston Jetzer, Kelly; Patani, Néha; Zimmerman, John; Zweerink, Gerald

    1995-07-01

    Significant attention is paid to the proper technique for reading a meniscus. Video shows meniscus-viewing techniques for colorless and dark liquids and the consequences of not reading a meniscus at eye level. Lessons are provided on approaching the end point, focusing on end point colors produced via different commonly used indicators. The concept of a titration curve is illustrated by means of a pH meter. Carefully recorded images of the entire range of meniscus values in a buret, pipet, and graduated cylinder are included so that you can show your students, in lecture or pre-lab discussion, any meniscus and discuss how to read the buret properly. These buret meniscus values are very carefully recorded at the rate of one video frame per hundredth of a milliliter, so that an image showing any given meniscus value can be obtained. These images can be easily incorporated into a computer-based multimedia environment for testing or meniscus-reading exercises. Two of the authors have used this technique and found the exercise to be very well received by their students. Video on side two shows nearly 100 "bloopers", demonstrating both the right way and wrong ways to do tasks associated with titration. This material can be used in a variety of situations: to show students the correct way to do something; to test students by asking them "What is this person doing wrong?"; or to develop multimedia, computer-based lessons. The contents of Titration Techniques are listed below: Side 1 Titration: what it is. A simple titration; Acid-base titration animation; A brief redox titration; Redox titration animation; A complete acid-base titration. Titration techniques. Hand technique variations; Stopcock; Using a buret to measure liquid volumes; Wait before reading meniscus; Dirty and clean burets; Read meniscus at eye level (see Fig. 1); Meniscus viewing techniques--light colored liquids; Meniscus viewing techniques--dark liquids; Using a magnetic stirrer; Rough titration; Significant figures; Approaching the end point; End point colors; Titration with a pH meter; Titration curves; Colors of indicators. Meniscus values. Buret meniscus values; Pipet meniscus values; Graduated cylinder meniscus values. Side 2"Bloopers". Introducing the people; Titration animation; Inspecting the buret; Rinsing the buret with water; Preparing a solid sample; Obtaining a liquid sample; Delivering a liquid sample with a Mohr pipet; Pipetting a liquid sample with a Mohr pipet; Rinsing the Mohr pipet with sample; Using the Mohr pipet to transfer sample; Delivering a liquid sample with a volumetric pipet; Pipetting a liquid sample with a volumetric pipet; Rinsing the volumetric pipet with sample; Using the volumetric pipet to transfer sample; Obtaining the titrant; Rinsing the buret with titrant; Filling the buret with titrant; Adding the indicator; The initial reading; Beginning the titration; Delivering titrant; The final reading. Figure 3. Near the end point a single drop of titrant can cause a lasting color change.

  8. Association of Roadway Proximity with Fasting Plasma Glucose and Metabolic Risk Factors for Cardiovascular Disease in a Cross-Sectional Study of Cardiac Catheterization Patients

    PubMed Central

    Kraus, William E.; Blach, Colette; Haynes, Carol S.; Dowdy, Elaine; Miranda, Marie Lynn; Devlin, Robert B.; Diaz-Sanchez, David; Cascio, Wayne E.; Mukerjee, Shaibal; Stallings, Casson; Smith, Luther A.; Gregory, Simon G.; Shah, Svati H.; Hauser, Elizabeth R.; Neas, Lucas M.

    2015-01-01

    Background The relationship between traffic-related air pollution (TRAP) and risk factors for cardiovascular disease needs to be better understood in order to address the adverse impact of air pollution on human health. Objective We examined associations between roadway proximity and traffic exposure zones, as markers of TRAP exposure, and metabolic biomarkers for cardiovascular disease risk in a cohort of patients undergoing cardiac catheterization. Methods We performed a cross-sectional study of 2,124 individuals residing in North Carolina (USA). Roadway proximity was assessed via distance to primary and secondary roadways, and we used residence in traffic exposure zones (TEZs) as a proxy for TRAP. Two categories of metabolic outcomes were studied: measures associated with glucose control, and measures associated with lipid metabolism. Statistical models were adjusted for race, sex, smoking, body mass index, and socioeconomic status (SES). Results An interquartile-range (990 m) decrease in distance to roadways was associated with higher fasting plasma glucose (β = 2.17 mg/dL; 95% CI: –0.24, 4.59), and the association appeared to be limited to women (β = 5.16 mg/dL; 95% CI: 1.48, 8.84 compared with β = 0.14 mg/dL; 95% CI: –3.04, 3.33 in men). Residence in TEZ 5 (high-speed traffic) and TEZ 6 (stop-and-go traffic), the two traffic zones assumed to have the highest levels of TRAP, was positively associated with high-density lipoprotein cholesterol (HDL-C; β = 8.36; 95% CI: –0.15, 16.9 and β = 5.98; 95% CI: –3.96, 15.9, for TEZ 5 and 6, respectively). Conclusion Proxy measures of TRAP exposure were associated with intermediate metabolic traits associated with cardiovascular disease, including fasting plasma glucose and possibly HDL-C. Citation Ward-Caviness CK, Kraus WE, Blach C, Haynes CS, Dowdy E, Miranda ML, Devlin RB, Diaz-Sanchez D, Cascio WE, Mukerjee S, Stallings C, Smith LA, Gregory SG, Shah SH, Hauser ER, Neas LM. 2015. Association of roadway proximity with fasting plasma glucose and metabolic risk factors for cardiovascular disease in a cross-sectional study of cardiac catheterization patients. Environ Health Perspect 123:1007–1014; http://dx.doi.org/10.1289/ehp.1306980 PMID:25807578

  9. Hydrologic indices for nontidal wetlands

    USGS Publications Warehouse

    Lent, R.M.; Weiskel, P.K.; Lyford, F.P.; Armstrong, D.S.

    1997-01-01

    Two sets of hydrologic indices were developed to characterize the water-budget components of nontidal wetlands. The first set consisted of six water-budget indices for input and output variables, and the second set consisted of two hydrologic interaction indices derived from the water-budget indices. The indices then were applied to 19 wetlands with previously published water-budget data. Two trilinear diagrams for each wetland were constructed, one for the three input indices and another for the three output indices. These two trilinear diagrams then were combined with a central quadrangle to form a Piper-type diagram, with data points from the trilinear diagrams projected onto the quadrangle. The quadrangle then was divided into nine fields that summarized the water-budget information. Two quantitative "interaction indices" were calculated from two of the six water-budget indices (precipitation and evapotranspiration). They also were obtained graphically from the water-budget indices, which were first projected to the central quadrangle of a Piper-type diagram from the flanking trilinear plots. The first interaction index (l) defines the strength of interaction between a wetland and the surrounding ground- and surface-water system. The second interaction index (S) defines the nature of the interaction between the wetland and the surrounding ground- and surface-water system (source versus sink). Evaluation of these indices using published wetland water-budget data illustrates the usefulness of the technique.

  10. Aerodynamic measurement techniques. [laser based diagnostic techniques

    NASA Technical Reports Server (NTRS)

    Hunter, W. W., Jr.

    1976-01-01

    Laser characteristics of intensity, monochromatic, spatial coherence, and temporal coherence were developed to advance laser based diagnostic techniques for aerodynamic related research. Two broad categories of visualization and optical measurements were considered, and three techniques received significant attention. These are holography, laser velocimetry, and Raman scattering. Examples of the quantitative laser velocimeter and Raman scattering measurements of velocity, temperature, and density indicated the potential of these nonintrusive techniques.

  11. Virtual-Reality Simulator System for Double Interventional Cardiac Catheterization Using Fractional-Order Vascular Access Tracker and Haptic Force Producer

    PubMed Central

    Chen, Guan-Chun; Lin, Chia-Hung; Li, Chien-Ming; Hsieh, Kai-Sheng; Du, Yi-Chun; Chen, Tainsong

    2015-01-01

    This study proposes virtual-reality (VR) simulator system for double interventional cardiac catheterization (ICC) using fractional-order vascular access tracker and haptic force producer. An endoscope or a catheter for diagnosis and surgery of cardiovascular disease has been commonly used in minimally invasive surgery. It needs specific skills and experiences for young surgeons or postgraduate year (PGY) students to operate a Berman catheter and a pigtail catheter in the inside of the human body and requires avoiding damaging vessels. To improve the training in inserting catheters, a double-catheter mechanism is designed for the ICC procedures. A fractional-order vascular access tracker is used to trace the senior surgeons' consoled trajectories and transmit the frictional feedback and visual feedback during the insertion of catheters. Based on the clinical feeling through the aortic arch, vein into the ventricle, or tortuous blood vessels, haptic force producer is used to mock the elasticity of the vessel wall using voice coil motors (VCMs). The VR establishment with surgeons' consoled vessel trajectories and hand feeling is achieved, and the experimental results show the effectiveness for the double ICC procedures. PMID:26171419

  12. Underrated value of repeated right heart catheterization in pulmonary hypertension with heart failure—a case of persisted pulmonary arterial hypertension after treatment for biventricular failure

    PubMed Central

    Park, Shinhee; Yoon, Hee Young; Jeung, Soomin; Lee, Nah Kyum; Kim, Min-Seok; Ahn, Jung-Min; Kim, Dae-Hee

    2015-01-01

    Pulmonary hypertension (PH) is a common complication of left heart disease and its presence in patients with heart failure predicts worse clinical outcomes. Specific agents targeting pulmonary arterial hypertension (PAH) have been developed over the last few years, but the efficacy of these agents in pulmonary hypertension due to left heart disease (PH-LHD) is uncertain. We report a case of idiopathic pulmonary arterial hypertension (IPAH) initially presented with biventricular failure, which was misdiagnosed as PH-LHD. A 31-year-old man who had a history of recurrent hemoptysis was referred to our center with biventricular failure. Right heart catheterization (RHC) showed elevated mean pulmonary arterial pressure (mPAP) and pulmonary capillary wedge pressure (PCWP). He was diagnosed as having PH-LHD, specifically combined post-capillary and precapillary PH (CpcPH). We treated him for 2 years with diuretics, a beta blocker, an angiotensin-converting enzyme (ACE) inhibitor, and sildenafil, which was added to treat CpcPH. A follow-up echocardiography showed that biventricular function had improved, but not PH. A second RHC revealed elevated mPAP and normal PCWP, which made us change the diagnosis to IPAH. In conclusion, it is important to perform repeated RHC in CpcPH patients after the improvement of left heart dysfunction to distinguish CpcPH from IPAH. PMID:26623126

  13. Effects of electroacupuncture combined with clean intermittent catheterization on urinary retention after spinal cord injury: a single blind randomized controlled clinical trial

    PubMed Central

    Gu, Xu-Dong; Wang, Jing; Yu, Peng; Li, Jian-Hua; Yao, Yun-Hai; Fu, Jian-Ming; Wang, Zhong-Li; Zeng, Ming; Li, Liang; Shi, Ming; Pan, Wen-Ping

    2015-01-01

    Purpose: This study aimed to evaluate the therapeutic effects of electroacupuncture (EA) combined with clean intermittent catheterization (CIC) on spinal cord injury (SCI) induced urinary retention. Methods: A total of 107 patients with SCI induced urinary retention were randomly divided into 3 groups, including group 1 (CIC treatment), group 2 (EA combined with CIC treatment), and group 3 (sham acupuncture combined with CIC treatment). After different treatments, the residual urine volume, voided volume (each time), number of bladder balance patients, and frequency of CIC were recorded and compared. Results: There were no significant differences between group 1 and 3 in number of bladder balance patients and voided volume (ml) at the 1st month. The rate of patients reaching bladder balance was significantly higher in group 2 than group 1 and 3 (P<0.05). The frequency of CIC was significantly less in group 2 than the other groups (P<0.001). The voided volume at the 1st and the 3rd month after surgery was significantly higher in group 2 than that in group 1 and 3 (P<0.001). Meanwhile, after 1 month and 3 months of treatment, residual urine volume was significantly reduced in group 2 compared with that in group 1 and 3 (P<0.001). Conclusion: The therapeutic effects of EA were effective for SCI induced urinary retention by reducing residual urine volume and the frequency of CIC, increasing voided volume, and promoting the balance of vesical function. PMID:26770641

  14. Underrated value of repeated right heart catheterization in pulmonary hypertension with heart failure-a case of persisted pulmonary arterial hypertension after treatment for biventricular failure.

    PubMed

    Park, Shinhee; Yoon, Hee Young; Jeung, Soomin; Lee, Nah Kyum; Kim, Min-Seok; Ahn, Jung-Min; Kim, Dae-Hee; Lee, Jae Seung

    2015-10-01

    Pulmonary hypertension (PH) is a common complication of left heart disease and its presence in patients with heart failure predicts worse clinical outcomes. Specific agents targeting pulmonary arterial hypertension (PAH) have been developed over the last few years, but the efficacy of these agents in pulmonary hypertension due to left heart disease (PH-LHD) is uncertain. We report a case of idiopathic pulmonary arterial hypertension (IPAH) initially presented with biventricular failure, which was misdiagnosed as PH-LHD. A 31-year-old man who had a history of recurrent hemoptysis was referred to our center with biventricular failure. Right heart catheterization (RHC) showed elevated mean pulmonary arterial pressure (mPAP) and pulmonary capillary wedge pressure (PCWP). He was diagnosed as having PH-LHD, specifically combined post-capillary and precapillary PH (CpcPH). We treated him for 2 years with diuretics, a beta blocker, an angiotensin-converting enzyme (ACE) inhibitor, and sildenafil, which was added to treat CpcPH. A follow-up echocardiography showed that biventricular function had improved, but not PH. A second RHC revealed elevated mPAP and normal PCWP, which made us change the diagnosis to IPAH. In conclusion, it is important to perform repeated RHC in CpcPH patients after the improvement of left heart dysfunction to distinguish CpcPH from IPAH. PMID:26623126

  15. Genetic determination of high-density lipoprotein-cholesterol and apolipoprotein A-1 plasma levels in a family study of cardiac catheterization patients

    SciTech Connect

    Prenger, V.L.; Beaty, T.H.; Kwiterovich, P.O. )

    1992-11-01

    Plasma levels of two lipoprotein risk factors, high-density lipoprotein-cholesterol (HDL-C) and apolipoprotein A-1 (apo A-1), have been shown to be negatively associated with the risk of developing coronary artery disease, and several reports have examined familial factors in HDL-C and apo A-1 levels. A number of studies suggest that shared genes influence familial resemblance of these lipoprotein levels far more than do shared environments. Possible mechanisms for the inheritance of these risk factors (HDL-C and apo A-1 plasma levels) are explored using data from 390 individuals in 69 families ascertained through probands undergoing diagnostic cardiac catheterization. Segregation analysis was used to test a series of specific models of inheritance. Evidence for single-locus control of apo A-1 levels, with Mendelian transmission of a dominant allele leading to elevated apo A-1 levels, was seen in these families, although there was additional correlation among sibs present. This locus accounted for 48.6% and 37.2% of the total variation in apo A-1 levels in males and females, respectively. Similar evidence of segregation at a single locus controlling HDL-C levels was not seen in these families. 27 refs., 3 figs., 5 tabs.

  16. Concentrated arabinoxylan but not concentrated β-glucan in wheat bread has similar effects on postprandial insulin as whole-grain rye in porto-arterial catheterized pigs.

    PubMed

    Christensen, Kirstine L; Hedemann, Mette S; Lærke, Helle N; Jørgensen, Henry; Mutt, Shivaprakash J; Herzig, Karl-Heinz; Bach Knudsen, Knud E

    2013-08-14

    The acute glycemic effects of concentrated dietary fibers (DF) versus whole-grain rye were studied in porto-arterial catheterized pigs. Two white wheat breads with wheat arabinoxylan (AX) or oat β-glucan (BG), two rye breads with intact rye kernels (RK) or milled rye (GR), and a low DF white wheat bread were fed to six pigs in a randomized crossover design. Blood profiles were collected for 4 h after feeding. Glucose absorption was reduced in pigs fed the AX bread at 60 min postprandial (3.1 mmol/min for AX compared to 9.4 mmol/min for WF, P = 0.02) and insulin secretion was lowered at 30 min postprandial for AX and GR (74.4 and 129 pmol/min for AX and GR, respectively, compared to 738 pmol/min for WF, P < 0.04). In conclusion, the GR and AX breads were most effective in improving insulin economy, suggesting that arabinoxylan from wheat and rye induces similar outcomes in the metabolic response. PMID:23919413

  17. Virtual-Reality Simulator System for Double Interventional Cardiac Catheterization Using Fractional-Order Vascular Access Tracker and Haptic Force Producer.

    PubMed

    Chen, Guan-Chun; Lin, Chia-Hung; Li, Chien-Ming; Hsieh, Kai-Sheng; Du, Yi-Chun; Chen, Tainsong

    2015-01-01

    This study proposes virtual-reality (VR) simulator system for double interventional cardiac catheterization (ICC) using fractional-order vascular access tracker and haptic force producer. An endoscope or a catheter for diagnosis and surgery of cardiovascular disease has been commonly used in minimally invasive surgery. It needs specific skills and experiences for young surgeons or postgraduate year (PGY) students to operate a Berman catheter and a pigtail catheter in the inside of the human body and requires avoiding damaging vessels. To improve the training in inserting catheters, a double-catheter mechanism is designed for the ICC procedures. A fractional-order vascular access tracker is used to trace the senior surgeons' consoled trajectories and transmit the frictional feedback and visual feedback during the insertion of catheters. Based on the clinical feeling through the aortic arch, vein into the ventricle, or tortuous blood vessels, haptic force producer is used to mock the elasticity of the vessel wall using voice coil motors (VCMs). The VR establishment with surgeons' consoled vessel trajectories and hand feeling is achieved, and the experimental results show the effectiveness for the double ICC procedures. PMID:26171419

  18. A novel transurethral resection technique for superficial flat bladder tumor: Grasp and bite technique

    PubMed Central

    Oh, Kyung Jin; Choi, Yoo-Duk; Chung, Ho Suck; Hwang, Eu Chang; Jung, Seung Il; Kwon, Dong Deuk

    2015-01-01

    Purpose Transurethral resection of bladder tumor (TURBT) can be a challenging procedure for an inexperienced surgeon. We suggest an easy technique for TURBT, which we have named the "grasp and bite" technique. We describe this technique and compare its effectiveness and safety with that of conventional TURBT. Materials and Methods Monopolar TURBT (24-Fr Karl Storz) was performed in 35 patients who had superficial bladder tumors. After defining the tumor margin, the tumor and surrounding mucosa were grasped by use of a loop electrode and resectoscope sheath. With tight grasping, linear moving resection was performed. The patients' demographic, intraoperative, and postoperative data were analyzed between the conventional and grasp and bite TURBT groups. Results Of 35 patients, 16 patients underwent conventional TURBT (group 1), and the other 19 patients underwent grasp and bite TURBT (group 2). Both groups were similar in age, tumor multiplicity, size, anesthesia method, and location. Grasp and bite TURBT could be performed as safely and effectively as conventional TURBT. There were no significant differences in irrigation duration, urethral catheterization, postoperative hemoglobin drop, or length of hospital stay. No significant side effects such as bladder perforation, severe obturator reflex, or persistent bleeding occurred. There were no significant pathological differences between specimens according to the type of resection technique. Conclusions The grasp and bite TURBT technique was feasible for superficial bladder tumors. It may be a good tool for inexperienced surgeons owing to its convenient and easy manner. PMID:25763127

  19. Comparison of two noninvasive devices for measurement of central systolic blood pressure with invasive measurement during cardiac catheterization.

    PubMed

    Ott, Christian; Haetinger, Siegberto; Schneider, Markus P; Pauschinger, Matthias; Schmieder, Roland E

    2012-09-01

    Recently, a new device for noninvasive assessment of central systolic blood pressure (cSBP) (BPro device with A-Pulse) was approved by the US Food and Drug Administration, but available data are limited. In 52 patients undergoing invasive elective cardiac evaluation, central hemodynamics were measured invasively. Immediately thereafter, radial artery waveforms were sampled by two noninvasive techniques, the BPro and, as a comparator, the SphygmoCor System. Then, central hemodynamics were measured invasively for a second time. The invasively recorded cSBP (137 ± 27 mm Hg) did not differ with both noninvasively assessed cSBP by BPro (136 ± 21 mm Hg, P = .627 vs invasive cSBP) and by SphygmoCor (136 ± 23 mm Hg, P=.694 vs invasive cSBP) and correlated highly between invasively recorded and both noninvasively assessed cSBP. However, using Bland-Altman plots, spreading of compared data of both devices can be found (BPro: 0.87 ± 13 mm Hg vs invasive cSBP; SphygmoCor: 0.77 ± 14 mm Hg vs invasive cSBP). There was an excellent correlation of both noninvasive devices for the calculation of cSBP (r=0.961, P<.001). cSBP differed by only 0.1 ± 6 mm Hg (P=.913) between the two noninvasive devices. Therefore, both noninvasive devices showed an accurate agreement in cSBP compared with invasively measured cSBP. PMID:22947354

  20. Sterile technique

    MedlinePLUS

    ... if you are having trouble using the sterile technique. ... Perry AG, Potter PA. Sterile technique. In: Perry AG, Potter PA. Clinical Nursing Skills and Techniques . 7th ed. Philadelphia, PA: Elsevier Mosby; 2010:chap 8.

  1. Validation of the association between a branched chain amino acid metabolite profile and extremes of coronary artery disease in patients referred for cardiac catheterization

    PubMed Central

    Bhattacharya, Sayanti; Granger, Christopher B.; Craig, Damian; Haynes, Carol; Bain, James; Stevens, Robert D.; Hauser, Elizabeth R.; Newgard, Christopher B.; Kraus, William E.; Newby, L. Kristin; Shah, Svati H.

    2016-01-01

    Objective To validate independent associations between branched-chain amino acids (BCAA) and other metabolites with coronary artery disease (CAD). Methods We conducted mass-spectrometry-based profiling of 63 metabolites in fasting plasma from 1983 sequential patients undergoing cardiac catheterization. Significant CAD was defined as CAD index ≥ 32 (at least one vessel with ≥95% stenosis; N = 995) and no CAD as CAD index ≤ 23 and no previous cardiac events (N = 610). Individuals (N = 378) with CAD severity between these extremes were excluded. Principal components analysis (PCA) reduced large numbers of correlated metabolites into uncorrelated factors. Association between metabolite factors and significant CAD vs. no CAD was tested using logistic regression; and between metabolite factors and severity of CAD was tested using linear regression. Results Of twelve PCA-derived metabolite factors, two were associated with CAD in multivariable models: factor 10, composed of BCAA (adjusted odds ratio, OR, 1.20; 95% CI 1.05–1.35, p = 0.005) and factor 7, composed of short-chain acylcarnitines, which include byproducts of BCAA metabolism (adjusted OR 1.30; 95% CI 1.14–1.48, p = 0.001). After adjustment for glycated albumin (marker of insulin resistance [IR]) both factors 7 (p = 0.0001) and 10 (p = 0.004) remained associated with CAD. Severity of CAD as a continuous variable (including patients with non-obstructive disease) was associated with metabolite factors 2, 3, 6, 7, 8 and 9; only factors 7 and 10 were associated in multivariable models. Conclusions We validated the independent association of metabolites involved in BCAA metabolism with CAD extremes. These metabolites may be reporting on novel mechanisms of CAD pathogenesis that are independent of IR and diabetes. PMID:24401236

  2. [Assessment of cardiac function by left heart catheterization: an analysis of left ventricular pressure-volume (length) loops].

    PubMed

    Sasayama, S; Nonogi, H; Sakurai, T; Kawai, C; Fujita, M; Eiho, S; Kuwahara, M

    1984-01-01

    The mechanical property of the cardiac muscle has been classically analyzed in two ways; shortening of muscle fiber, and the development of tension within the muscle. In the ejecting ventricle, left ventricular (LV) function can be analyzed by the analogous two-dimensional framework of pressure-volume loops, which are provided by plotting the instantaneous volume against corresponding LV pressure. The integral pressure with respect to volume allows to assess a total external ventricular work during ejection. The diastolic pressure-volume relations reflect a chamber stiffness of the ventricle. Force-velocity relations also provide an useful conceptual framework for understanding how the ventricle contracts under given afterload, with modification of preload. In the presence of coronary artery disease, the regional nature of left ventricular contractile function should be defined as well as the global ventricular function as described above, because the latter is determined by the complex interaction of dysfunction of the ischemic myocardium and of compensatory augmentation of shortening of the normally perfused myocardium. We utilized a computer technique to analyze the local wall motion of the ischemic heart by cineventriculography. The boundaries of serial ventricular images are automatically traced and superimposed using the external reference system. Radial grids are drawn from the center of gravity of the end-diastolic image. Measurement of length of each radial grid throughout cardiac cycle provides the analysis of movement of the ventricle at a particular point on the circumference. Using phasic pressure obtained simultaneously with opacification as the common parameter, segmental pressure-length loops are constructed simultaneously at various segments. The loops are similar over the entire circumference in the normal heart, being rectangular in morphology and with synchronous behavior during contraction and relaxation. However, the marked distortion of pressure-length loops with clockwise rotation or figure of eight inscription is observed in the ischemic segments. Systolic work of the ischemic segment diminishes dramatically, and the loops exhibit varying degrees of inclination. The control segment loops also show an inclination to the opposite direction of the ischemic loops. These differences are presumably related to the local redistribution of the myocardial tension during systole in the ischemic ventricle. Thus, the method described should be of particular value in assessing the regional myocardial function in the ischemic ventricle and effects of various interventions which modify ischemia. PMID:6394655

  3. Pediatric Abdominal Organ Transplantation: Current Indications, Techniques, and Imaging Findings.

    PubMed

    Stanescu, A Luana; Hryhorczuk, Anastasia L; Chang, Patricia T; Lee, Edward Y; Phillips, Grace S

    2016-03-01

    The anatomy, normal postoperative radiological appearance, and imaging features of common postoperative complications of pediatric abdominal transplants are reviewed, including renal, liver, and intestinal transplants. Doppler ultrasound is the mainstay of imaging after transplantation. Computed tomography (CT) and CT angiography, MR imaging and magnetic resonance (MR) angiography, MR cholangiopancreatography, conventional angiography, and nuclear medicine imaging may be used for problem-solving in pediatric transplant patients. Accurate and timely radiological diagnosis of transplant complications facilitates appropriate treatment and minimizes morbidity and mortality. PMID:26896225

  4. Intraoral mandibular distraction: indications, technique and long-term results.

    PubMed

    Diner, P A; Tomat, C; Soupre, V; Martinez, H; Vazquez, M P

    1999-09-01

    This report describes the experience of the Trousseau Hospital, Paris, France, with distraction osteogenesis of the mandible using an intraoral distraction device. From 1993 to 1998, 26 paediatric patients with mandibular hypoplasia underwent distraction of the mandible using the Leibinger Intraoral Distractor. The majority of the patients had hemifacial microsomia. Distraction was performed at a rate of 1 mm a day following complete osteotomy of the mandible. A mean of 15 mm of distraction was obtained. In conjunction with combined orthodontic management, satisfactory morphologic results were achieved in the majority of patients with good facial symmetry, adequate occlusal relationships and balanced maxillary mandibular relationships. Radiographic evaluation revealed that substantial new bone formation and remodelling was induced by the intraoral distraction along the entire hemimandible on the distracted side and that this contributed significantly to the aesthetically pleasing clinical results. PMID:10597346

  5. The Huckstep intramedullary compression nail. Indications, technique, and results.

    PubMed

    Huckstep, R L

    1986-11-01

    A four-sided, intramedullary compression nail of solid titanium alloy has been developed since 1967. This nail is 12.5 mm in diameter with 4.5-mm transverse holes at 15-mm intervals, for 4-mm fine threaded screws. It has four oblique holes in the proximal end to allow 4.5-mm lag screws to be inserted up the femoral neck. A compressor over the trochanter can be used for compression in transverse fractures. Advantages include inert titanium alloy, which is stronger than the average femoral shaft, a recessed end of the nail, reaming to only 13 mm, and a quadrilateral shape. No operative roentgenograms are usually required. Comminuted, oblique, and infected fractures of the entire length of the femoral shaft down to the supracondylar region can be held rigidly, usually allowing for immediate weight-bearing. The femur can be lengthened or shortened with compression and the knee can be arthrodesed with a 60-cm nail. One hundred twenty-two nails inserted since 1974 included 32 comminuted or oblique acute femoral fractures. Forty-two patients had had failure of other implants. Among these, 34 had nonunion for one year and 17 nonunion for more than three years. Fifty-one bones in 47 patients were stabilized for pathologic fractures and other conditions. Complications were minimal. PMID:3769297

  6. Fireplace damper indicator

    SciTech Connect

    Beyer, C.L.; Fox, B.E.

    1982-09-21

    Disclosed herein is an indicator system and linkage for a fireplace damper whereby the open and closed modes of a fireplace damper are readily indicated without the necessity of inspecting the damper itself. The apparatus includes a series of links which alternatively expose a pair of indicators which reveal the mode that the damper door is currently in.

  7. ECOLOGICAL INDICATOR OVERVIEW

    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...

  8. Fluid leak indicator

    NASA Technical Reports Server (NTRS)

    Anderson, George E. (Inventor); Loo, Shu (Inventor)

    1989-01-01

    A fluid leak indicator (30) for detecting and indicating leaks in visually inaccessible fluid tubing joints (20, 21), such as those obstructed by insulation (24), includes a bag system (25) and a wicking system (30) surrounding or wrapping the joints (20, 21) under the visual obstructing material (24). Leaking fluid is collected in the bag (25) or on the wicking material (34) where it is conducted along the wicking material (34) to a visibly accessible capturing transparent indicator bulb (35) for providing a visual indication of the leak without requiring a chemical change in the capturing indicator bulb (35).

  9. Fluid leak indicator

    NASA Technical Reports Server (NTRS)

    Anderson, G. E.; Loo, S. (Inventor)

    1985-01-01

    A fluid leak indicator for detecting and indicating leaks in visually inaccessible fluid tubing joints, such as those obstructed by insulation includes a bag system and a wicking system surrounding or wrapping the joints under the visual obstructing material. Leaking fluid is collected in the bag or on the wicking material where it is conducted along the wicking material to a visily accessible capturing transparent indicator bulb for providing a visual indication of the leak without requiring a chemical change in the capturing indicator bulb.

  10. Energy-conservation indicators

    SciTech Connect

    Belzer, D.B.

    1982-06-01

    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 indicators are presented in some 30 one-page indicator summaries. Indicators are shown graphically, followed by several paragraphs that explain their derivation and highlight key findings. Indicators are classified according to broad end-use sectors: Aggregate (economy), Residential, Commercial, Industrial, and transportation. In most cases annual time series information is presented covering the period 1960 through 1981.

  11. Welding-Current Indicator

    NASA Technical Reports Server (NTRS)

    Hensley, Milton C.; Huston, Steven W.; Kroy, Ralph E.

    1990-01-01

    Light flashes on to indicate high current. Simple, inexpensive display circuit indicates when 3,000-A welding current flows in welding gun. Onset of welding current induces voltage and current in 1,000-turn, 28-gauge copper-wire coil. Single-transistor amplifier amplifies induced current, energizing light-emitting diode (LED) connected to collector of transistor. Light from LED gives simple, direct indication of welding current.

  12. Chemical Calcium Indicators

    PubMed Central

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

    2008-01-01

    Our understanding of the underlying mechanisms of Ca2+ signaling as well as our appreciation for its ubiquitous role in cellular processes and 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. Advantages, limitations and relevant procedures will be presented for each dye including their spectral qualities, dissociation constants, chemical forms, loading methods and equipment for optimal imaging. Chemical indicators that are now available allow for intracellular Ca2+ detection over a very large range (<50 nM to >50 ?M). Higher affinity indicators can be used to quantify Ca2+ levels in the cytosol while lower affinity indicators can be optimized for measuring Ca2+ in subcellular compartments with higher concentrations. Indicators can be classified into either single wavelength or ratiometric dyes. Both classes require specific lasers, filters, and/or detection methods that are dependent upon their spectral properties and both classes have advantages and limitations. Single wavelength indicators are generally very bright and optimal for Ca2+ detection when more than one fluorophore is being imaging. Ratiometric indicators can be calibrated very precisely and they minimize the most common problems associated with chemical Ca2+ indicators including uneven dye loading, leakage, photobleaching and changes in cell volume. Recent technical advances that permit in vivo Ca2+ measurements will also be discussed. PMID:18929663

  13. Deflection resistance indicator

    NASA Technical Reports Server (NTRS)

    Massey, H. S.; Pontious, H. L.; Zinsley, W. M.

    1972-01-01

    Instrument for nondestructively measuring compression resistance of spray foam used as thermal insulation was developed. Cylindrical indicator has probe with coil spring to provide force and indicating dial. Probe is manually pressed against area to be tested until complete foot area contacts foam surfaces.

  14. Quality Indicator System Report.

    ERIC Educational Resources Information Center

    Colorado Commission on Higher Education, Denver.

    This report is a product of the implementation of a quality indicator system for Colorado's public higher education system. In 1999, the Colorado Commission on Higher Education established a core set of nine indicators, for which data were gathered and benchmarks were identified for measuring performance in terms of these benchmarks. The first…

  15. Cobb's Red Cabbage Indicator.

    ERIC Educational Resources Information Center

    Cobb, Vicki

    1998-01-01

    Describes the use of an indicator made from the pigment in red cabbage. Cabbage is grated then soaked in water. When the water is a strong red, the cabbage is strained out. The cabbage-juice indicator is then used to test for acids and bases. Includes a list of good foods to test for acidity and alkalinity. (PVD)

  16. Temperature-indicating Paints

    NASA Technical Reports Server (NTRS)

    Penzig, F

    1939-01-01

    This report is an attempt at a new method of coating the surface of the cylinder with materials that undergo chemical change at definite temperatures as indicated by a change in color. In this way it was hoped that the substance itself would indicate directly the position of its isotherms, which in measurements with thermocouples requires a tedious amount of labor.

  17. Film advance indicator

    NASA Technical Reports Server (NTRS)

    Freeman, E. T.; Stump, C. W.; Dreisbach, F. W. (inventors)

    1982-01-01

    A film advancement indicator which includes an optical sensor that detects the rotational movement of a disc that rotates only when the film advance is described. When the film does not advance, an indicator light is activated. A counter is included in the electronic circuit to determine the number of film frames advanced.

  18. Retractable Visual Indicator Assembly

    NASA Technical Reports Server (NTRS)

    Hackler, George R. (Inventor); Gamboa, Ronald J. (Inventor); Dominquez, Victor (Inventor)

    1998-01-01

    A retractable indicator assembly may be mounted on a container which transmits air through the container and removes deleterious gases with an activated charcoal medium in the container. The assembly includes: an elongate indicator housing has a chamber therein; a male adaptor with an external threads is used for sealing engagement with the container; a plug located at the upper end of the housing; a housing that includes a transparent wall portion for viewing at least a portion of the chamber; a litmus indicator, moveable by a retractable rod from a retracted position within the container to an extended position within the chamber of the housing; and an outer housing that is secured to the upper end of the rod, and protects the indicator housing while the litmus indicator is in its normally retracted position. The assembly may be manually manipulated between its extended position wherein the litmus indicator may be viewed through the transparent wall of the indicator housing, and a retracted position wherein the outer housing encloses the indicator housing and engages the exterior of the container.

  19. School Readiness Indicator Items.

    ERIC Educational Resources Information Center

    Calkins, Julia; Ling, Thomson; Moore, Eric; Halle, Tamara; Hair, Beth; Moore, Kris; Zaslow, Marty

    This report provides a compilation of indicators of school readiness used in national, state, and local surveys in the United States, delineating the advantages and disadvantages for each indicator. The report begins with a legend to assist in interpreting the tables and includes contact information for national and state surveys. The remainder of…

  20. School Readiness Indicator Items.

    ERIC Educational Resources Information Center

    Calkins, Julia; Ling, Thomson; Moore, Eric; Halle, Tamara; Hair, Beth; Moore, Kris; Zaslow, Marty

    This report provides a compilation of indicators of school readiness used in national, state, and local surveys in the United States, delineating the advantages and disadvantages for each indicator. The report begins with a legend to assist in interpreting the tables and includes contact information for national and state surveys. The remainder of…

  1. [Cardiac transplantation. Indications, delays, surveillance].

    PubMed

    Merlet, P; Benvenuti, C; Deleuze, P; Dubois-Randé, J L; Loisance, D; Castaigne, A; Cachera, J P

    1990-11-01

    The number cardiac transplantation has been dramatically increasing for the last year and the results are satisfactory regarding survival or functional capacity. The observed increase of cardiac transplantation may tend to vulgarize it. However, this intervention should be only considered in a selected group of patients who have no other option. Many reports concerned various technical approach for a clearcut determination of high and low risk population of patients with congestive heart failure. But, considering individual patients, the value of each prognostic parameter remains unresolved. Nevertheless the more discriminant parameters for the prognosis assessment are: the left ventricular ejection fraction, the NYHA class, right heart catheterization data, the functional capacity, the cardiothoracic ratio on chest X ray, the ischemic etiology of the disease. The role of neuro-hormonal determinant such as norepinephrine circulating concentration or cardiac uptake on MIBG imaging should be further investigated, especially for patients treated by ACE inhibitors or beta blockers. Contraindications for cardiac transplantation are less restrictive, nowadays. Concerning patients selected, and waiting for heart transplantation or patients non primary selected survival can be improved by adjusting medical therapy on objective efficacy criteria. PMID:2125416

  2. Dismantling techniques

    SciTech Connect

    Wiese, E.

    1998-03-13

    Most of the dismantling techniques used in a Decontamination and Dismantlement (D and D) project are taken from conventional demolition practices. Some modifications to the techniques are made to limit exposure to the workers or to lessen the spread of contamination to the work area. When working on a D and D project, it is best to keep the dismantling techniques and tools as simple as possible. The workers will be more efficient and safer using techniques that are familiar to them. Prior experience with the technique or use of mock-ups is the best way to keep workers safe and to keep the project on schedule.

  3. The radon indicator

    NASA Astrophysics Data System (ADS)

    Samuelsson, L.

    2005-11-01

    The radon indicator is an efficient instrument for measuring the radon daughter concentrations in a house or dwelling. Physics or environmental science students could build a radon indicator as a student project. Another possibility would be to use a radon indicator in a student investigation of radon levels in different houses. Finally the radon indicator is an excellent device for producing a radioactive source, free of charge, for the study of ?-, ?- and ?-radiation. The half-life of the activity collected is approximately 40 min. The radon indicator makes use of an electrostatic method by which charged particles are drawn to a small aluminium plate with a high negative voltage (-5 kV), thus creating a strong electric field between the plate and a surrounding copper wire. The radioactivity on the plate is subsequently measured by a GM-counter and the result calculated in Bq m-3. The collecting time is just 5.5 min and therefore the instrument is only suitable for use in a short-time method for indicating the radon concentration. An improved diagram, ground-radon and/or wall-radon in houses, is presented on the basis of the author's measurements recorded with the radon indicator over many years. This diagram is very useful when discussing how to reduce radiation levels in homes.

  4. OCT techniques

    NASA Astrophysics Data System (ADS)

    Fercher, Adolf F.; Drexler, Wolfgang; Hitzenberger, Christoph K.

    1996-12-01

    Optical coherence tomography (OCT) has become one of the most promising imaging techniques in biology and medicine. Microscopic techniques using rapid image acquisition by scanning beam techniques and large-sample macroscopic techniques using scanning-stages have been developed. Basic to all OCT imaging schemes described so far is the use of low coherence techniques to detect the depth position of light remitting sites in the object. Either time-domain OCT imaging or Fourier-domain OCT imaging can be used. Furthermore, OCT techniques have been developed for metrologic application s like the measurement of the refractive index of tissue and the velocity profile of fluids in tubes. This paper reviews OCT imaging techniques used in experimental and clinical applications and discusses arrangement s to improve longitudinal and transversal resolution.

  5. Tamper indicating bolt

    DOEpatents

    Blagin, Sergei V.; Barkanov, Boris P.

    2004-09-14

    A tamper-indicating fastener has a cylindrical body with threads extending from one end along a portion of the body, and a tamper indicating having a transducer for converting physical properties of the body into electronic data; electronics for recording the electronic data; and means for communicating the recorded information to a remote location from said fastener. The electronics includes a capacitor that varies as a function of force applied by the fastener, and non-volatile memory for recording instances when the capacitance varies, providing an indication of unauthorized access.

  6. [Sacral block: indications and effectiveness].

    PubMed

    Grob, D; Dvorak, J

    1998-02-25

    It has been shown that during injection of 17 to 20 ml local anesthetics combined with a corticosteroid via the hiatus canalis sacralis that the solution is distributed up to the level of the thoraco-lumbar junction. The indication for therapeutical peridural injection are radicular symptoms as a result of disc herniation, foraminal stenosis as well as neurogenic claudicatio. Contraindications are anticoagulation, local infection as well as suspicion of systemic inflammatory disease of the peripheral nervous system. With proper technique and adequate desinfection, complications and side effects are very rare. PMID:9545833

  7. Position indicating, rotating boom

    NASA Technical Reports Server (NTRS)

    Dibble, A. C.; Gibson, F. W.; Padelt, J. R.; Saunders, W. S.

    1972-01-01

    Universal multiplanar position indicating, rotating boom for mounting various instruments or sensors is described. Boom is telescoping, and apparatus is capable of 3 types of rotation controlled by electric motors. Movement may be continuous or incremental.

  8. ENVIRONMENTAL PUBLIC HEALTH INDICATORS

    EPA Science Inventory

    Environmental Public Health Indicators (EPHIs), quantitative measures of health factors and environmental influences tracked over time, can be used to identify specific areas and populations for intervention and prevention efforts and to evaluate the outcomes of implemented polic...

  9. Sustainability Indicators and Metrics

    EPA Science Inventory

    Sustainability is about preserving human existence. Indicators and metrics are absolutely necessary to provide at least a semi-quantitative assessment of progress towards or away from sustainability. Otherwise, it becomes impossible to objectively assess whether progress is bei...

  10. Assessing asset indices.

    PubMed

    Filmer, Deon; Scott, Kinnon

    2012-02-01

    The use of asset indices in welfare analysis and poverty targeting is increasing, especially in cases in which data on expenditures are unavailable or hard to collect. We compare alternative approaches to welfare measurement. Our analysis shows that inferences about inequalities in education, health care use, fertility, and child mortality, as well as labor market outcomes, are quite robust to the economic status measure used. Different measures-most significantly per capita expenditures versus the class of asset indices-do not, however, yield identical household rankings. Two factors stand out in predicting the degree of congruence in rankings. First is the extent to which expenditures can be explained by observed household and community characteristics. Rankings are most similar in settings with small transitory shocks to expenditure or with little random measurement error in expenditure. Second is the extent to which expenditures are dominated by individually consumed goods, such as food. Asset indices are typically derived from indicators of goods that are effectively public at the household level, while expenditures are often dominated by food, an almost exclusively private good. In settings in which individually consumed goods are the main component of expenditures, asset indices and per capita consumption yield the least similar results. PMID:22135117

  11. Indicator Systems and Evaluation

    NASA Technical Reports Server (NTRS)

    Canright, Shelley; Grabowski, Barbara

    1995-01-01

    Participants in the workshop session were actively engaged in a hands-on, minds-on approach to learning about indicators and evaluation processes. The six hour session was broken down into three two hour sessions. Each session was built upon an instructional model which moved from general understanding to specific IITA application. Examples and practice exercises served to demonstrate tand reinforce the workshop concepts. Each successive session built upon the previous session and addressed the major steps in the evaluation process. The major steps covered in the workshop included: project descriptions, writing goals and objectives for categories, determining indicators and indicator systems for specific projects, and methods and issues of data collection. The workshop served as a baseline upon which the field centers will build during the summer in undertaking a comprehensive examination and evaluation of their existing K-12 education projects.

  12. Internationally Comparable Health Indices

    PubMed Central

    Meijer, Erik; Kapteyn, Arie; Andreyeva, Tatiana

    2013-01-01

    One of the most intractable problems in international health research is the lack of comparability of health measures across countries or cultures. We develop a cross-country measurement model for health in which functional limitations, self-reports of health, and a physical measure are interrelated to construct health indices. To establish comparability across countries, we define the measurement scales by the physical measure while other parameters vary by country to reflect cultural and linguistic differences in response patterns. We find significant cross-country variation in response styles of health reports along with variability in genuine health that is related to differences in national income. Our health indices achieve satisfactory reliability of about 80% and their gradients by age, income, and wealth for the most part show the expected patterns. Moreover, the health indices correlate much more strongly with income and net worth than self reported health measures. PMID:20572201

  13. Treatment of High-Flow Vascular Malformations by Venous Embolization Aided by Flow Occlusion Techniques

    SciTech Connect

    Jackson, James E.; Mansfield, Averil O.; Allison, David J.

    1996-09-15

    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.

  14. Enzymatic temperature change indicator

    DOEpatents

    Klibanov, Alexander M.; Dordick, Jonathan S.

    1989-01-21

    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.

  15. Fluorescent Gage Indication

    NASA Technical Reports Server (NTRS)

    Barns, C. E.; Gilbaugh, B. L.; Gin, B.; Holt, W. L.; Lesak, P.; Mancini, R.; Spencer, H. F.

    1985-01-01

    Transfer of dye shows quality of contact between two mating parts. Mating parts checked for fit by spreading fluorescent dye on one, making brief light contact with other, and looking (under UV light) for transferred dye. Dye offers greater visibility under ultraviolet illumination, allowing better indication of how precisely parts match and what areas interfere.

  16. Triboluminescent indicator system

    DOEpatents

    Goods, Steven H. (Livermore, CA); Dentinger, Paul M. (Sunol, CA); Whinnery, Jr., Leroy L. (Danville, CA)

    2003-06-24

    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.

  17. "Healthy" Human Development Indices

    ERIC Educational Resources Information Center

    Engineer, Merwan; Roy, Nilanjana; Fink, Sari

    2010-01-01

    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…

  18. Indicators of Reading Education.

    ERIC Educational Resources Information Center

    Guthrie, John T.

    Monitoring the effectiveness of reading education is central to the appraisal of the productivity of schooling, yet most measures currently being used do not take into account the full range of processes which lead to successful reading education. A model of indicators relevant to reading education (outcome, process, and input) can be used to…

  19. "Healthy" Human Development Indices

    ERIC Educational Resources Information Center

    Engineer, Merwan; Roy, Nilanjana; Fink, Sari

    2010-01-01

    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…

  20. 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...

  1. ZERO-TIME INDICATOR

    DOEpatents

    Sander, H.H.

    1960-08-30

    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.

  2. Trends & Indicators: Enrollment Period

    ERIC Educational Resources Information Center

    Harney, John O.

    2011-01-01

    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 to…

  3. Trends & Indicators: Enrollment Period

    ERIC Educational Resources Information Center

    Harney, John O.

    2011-01-01

    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 to…

  4. Science and Technology Indicators.

    ERIC Educational Resources Information Center

    OECD Observer, 1986

    1986-01-01

    Presents the salient characteristics of science and technology activities in the Organization for Economic Cooperation and Development area and indicates the main similarities and differences between member countries. Includes data on: trends in research and development (R & D) spending; university research; R & D in industry; and other areas. (JN)

  5. 1989 Education Indicators.

    ERIC Educational Resources Information Center

    Baker, Curtis O., Ed.; And Others

    The National Center for Education Statistics (NCES) gathers and produces statistics and other information on the status and progress of education in the United States. In 1989 as in 1988, the center published the "indicators" (key data that measure the health of education, monitor important developments, and show trends in major aspects of…

  6. Nematode Indicators of Organic Enrichment

    PubMed Central

    Ferris, Howard; Bongers, Tom

    2006-01-01

    The organisms of the soil food web, dependent on resources from plants or on amendment from other sources, respond characteristically to enrichment of their environment by organic matter. Primary consumers of the incoming substrate, including bacteria, fungi, plant-feeding nematodes, annelids, and some microarthropods, are entry-level indicators of enrichment. However, the quantification of abundance and biomass of this diverse group, as an indicator of resource status, requires a plethora of extraction and assessment techniques. Soluble organic compounds are absorbed by bacteria and fungi, while fungi also degrade more recalcitrant sources. These organisms are potential indicators of the nature of incoming substrate, but current methods of biomass determination do not reliably indicate their community composition. Guilds of nematodes that feed on bacteria (e.g., Rhabditidae, Panagrolaimidae) and fungi (e.g., Aphelenchidae, Aphelenchoididae) are responsive to changes in abundance of their food. Through direct herbivory, plant-feeding nematodes (e.g., many species of Tylenchina) also contribute to food web resources. Thus, analysis of the nematode community of a single sample provides indication of carbon flow through an important herbivore channel and through channels mediated by bacteria and fungi. Some nematode guilds are more responsive than others to resource enrichment. Generally, those bacterivores with short lifecycles and high reproductive potential (e.g., Rhabditidae) most closely mirror the bloom of bacteria or respond most rapidly to active plant growth. The feeding habits of some groups remain unclear. For example, nematodes of the Tylenchidae may constitute 30% or more of the individuals in a soil sample; further study is necessary to determine which resource channels they portray and the appropriate level of taxonomic resolution for this group. A graphic representation of the relative biomass of bacterivorous, fungivorous, and herbivorous nematodes provides a useful tool for assessing the importance of the bacterial, fungal, and plant resource channels in an extant food web. PMID:19259424

  7. LEADING WITH LEADING INDICATORS

    SciTech Connect

    PREVETTE, S.S.

    2005-01-27

    This paper documents Fluor Hanford's use of Leading Indicators, management leadership, and statistical methodology in order to improve safe performance of work. By applying these methods, Fluor Hanford achieved a significant reduction in injury rates in 2003 and 2004, and the improvement continues today. The integration of data, leadership, and teamwork pays off with improved safety performance and credibility with the customer. The use of Statistical Process Control, Pareto Charts, and Systems Thinking and their effect on management decisions and employee involvement are discussed. Included are practical examples of choosing leading indicators. A statistically based color coded dashboard presentation system methodology is provided. These tools, management theories and methods, coupled with involved leadership and employee efforts, directly led to significant improvements in worker safety and health, and environmental protection and restoration at one of the nation's largest nuclear cleanup sites.

  8. New indications for antidepressants.

    PubMed

    Schatzberg, A F

    2000-01-01

    The second and third generation of antidepressants, i.e., the selective serotonin reuptake inhibitors, nefazodone, venlafaxine, and mirtazapine, are proving to be useful in a variety of seemingly diverse disorders, including most anxiety disorders. In addition to receiving approval from the U.S. Food and Drug Administration (FDA) for major depressive disorder, some of the newer antidepressants have received FDA approval for other disorders, e.g., generalized anxiety disorder (venlafaxine), bulimia nervosa (fluoxetine), obsessive-compulsive disorder (fluvoxamine, paroxetine, sertraline, and fluoxetine), social phobia (paroxetine), panic disorder (sertraline, paroxetine), and posttraumatic stress disorder (sertraline). In controlled studies, these agents have also shown usefulness in premenstrual dysphoric disorder, borderline personality disorder, obesity, smoking cessation, and alcoholism. This article describes the new and potential indications for recently developed antidepressants and the studies that suggested these indications. PMID:10926050

  9. MODIS Vegetation Indices

    NASA Astrophysics Data System (ADS)

    Huete, Alfredo; Didan, Kamel; van Leeuwen, Willem; Miura, Tomoaki; Glenn, Ed

    Assessments of vegetation condition, cover, change, and processes are major ­components of global change research programs, and are topics of considerable societal relevance. Spectral vegetation indices are among the most widely used satellite data products, which provide key measurements for climate, hydrologic, and biogeochemical studies; phenology, land cover, and land cover change detection; natural resource management and sustainable development. Vegetation indices (VI) are robust and seamless data products computed similarly across all pixels in time and space, regardless of biome type, land cover condition, and soil type, and thus represent true surface measurements. The simplicity of VIs enables their amalgamation across ­sensor systems, which facilitates an ensured continuity of critical datasets for long-term land surface modeling and climate change studies. Currently, a more than two decades long NOAA Advanced Very High Resolution Radiometer (AVHRR)-derived consistent global normalized difference vegetation index (NDVI) land record exists, which has contributed significantly to global biome, ecosystem, and agricultural studies.

  10. Tamper-indicating seal

    DOEpatents

    Fiarman, Sidney (Port Jefferson, NY); Degen, Michael F. (Patchogue, NY); Peters, Henry F. (Brookhaven, NY)

    1985-01-01

    There is disclosed a tamper-indicating seal that permits in the field inspection and detection of tampering. Said seal comprises a shrinkable tube having a visible pattern of markings which is shrunk over the item to be sealed, and a second transparent tube, having a second visible marking pattern, which is shrunk over the item and the first tube. The relationship between the first and second set of markings produces a pattern so that the seal may not be removed without detection.

  11. Indices of thyroid epidemiology

    PubMed Central

    Kalra, Sanjay; Kumar, Arun; Jarhyan, Prashant; Unnikrishnan, Ambika Gopalakrishnan

    2015-01-01

    This brief communication proposes various indices of epidemicity and endemicity which may be used to predict the future prevalence of hypothyroidism. Taking advantage of knowledge related to the natural progression of autoimmune thyroid disease, it uses data from two recent Indian epidemiological studies to assess the epidemicity or endemicity of thyroid disease in the country. The hypothesis generated in this communication will be of help to clinicians as well as policy makers.

  12. Reproductive health indicators for China's rural areas.

    PubMed

    Wang, Caroline C; Wang, Yan; Zhang, Kaining; Fang, Jing; Liu, Wei; Luo, Shusheng; Tang, Songyuan; Wang, Shaoxian; Li, Virginia C

    2003-07-01

    We report community-based development of reproductive health indicators for China's rural areas. To generate these indicators, we sequenced two participatory techniques known as nominal group process and Delphi survey methodology. Nominal group process entailed grassroots reproductive health workers' generating indicators, followed by refinement and prioritization of these indicators through a consensus-building Delphi process among nationally and internationally known reproductive health experts. Major criteria for the indicators were practicality, feasibility, and measurability within China's rural areas. We explain the importance of establishing these indicators for application in rural China and other developing countries as a complement to the World Health Organization's reproductive health indicators for global monitoring; present the identified indicators; and describe lessons learned from field testing in low-, middle-, and high-income counties of China's countryside. PMID:12765703

  13. Fiber Techniques

    ERIC Educational Resources Information Center

    Nalle, Leona

    1976-01-01

    Describes a course in fiber techniques, which covers design methods involving fibers and fabric, that students in the Art Department at Sleeping Giant Junior High School had the opportunity to learn. (Author/RK)

  14. [Indication for bariatric surgery].

    PubMed

    Hanusch-Enserer, Ursula; Enserer, Christian; Rosen, Harald R; Prager, Rudolf

    2004-01-01

    Morbid obesity is defined as obesity with body mass index (BMI) > or = 40 kg/m2 with secondary serious diseases. Conservative treatment generally fails to produce long-term weight loss in these patients, since several bariatric surgical techniques have been developed which are based on gastric restriction and/or gastric malabsorption resulting in permanent weight loss over years. Preoperative evaluation might detect suitable patients and reduce both non-surgical and surgical complications. Postoperative follow-up in a multidisciplinary program, including specialists in various fields of medicine, e.g. surgery, internal medicine, radiology, paediatrics and nutritional surveillance are mandatory in the treatment of patients after obesity surgery. Bariatric surgery results in a major weight loss, with amelioration of most obesity-associated conditions. The most serious side effect of some surgical procedere is malnutrition. PMID:15732247

  15. [Indications for liver transplant].

    PubMed

    Aguirre-Valadez, Jonathan; Torre, Aldo; Vilatobá, Mario; Contreras, Alan; Sánchez-Cedillo, Aczel; Antolinez-Motta, Jorge; García-Juárez, Ignacio

    2014-01-01

    Liver transplantation (LT) is the treatment of choice in selected patients with end-stage liver disease and in some with acute liver failure, hepatocellular carcinoma (HCC) and other diseases with no synthetic liver failure. Currently, LT has an overall survival > 90 % at 1 year. Proper selection of LT candidates is important given the shortage in organ donation. The allocation and priorization of organs to patients with chronic liver failure (CLF) in waiting lists, is determined by the MELD priority score (Model of End Stage Liver Disease). Indications for LT in patients with CLF are the same regardless of the etiology (any type of hepatic decompensation or development of HCC). Priority MELD is a variant to this classification used only in special cases such as in those with stable hepatopathy but severe extra-hepatic features (e.g., HCC or hepato-pulmonary syndrome). The indication for LT in patients with acute liver failure (ALF) and acute failure associated to chronic liver failure (ACLF) are not fully established; there are prognostic factors that may guide the decision for urgent LT and some centers, like the King's College Hospital criteria in the UK. Currently, LT is a therapeutic modality in some primary liver tumors (HCC, cholangiocarcinoma) and neuroendocrine liver metastatic tumors. These protocols have provided significant opportunities for long-term survival (> 70% at 5 years). The high demand and shortage of organs have fostered the development of new strategies to benefit more patients, such as the use of extended criteria donors, or "domino" transplants. This review focuses on the most relevant data on the different indications of LT. PMID:25729871

  16. Slickenside kinematic indicators

    NASA Astrophysics Data System (ADS)

    Doblas, Miguel

    1998-09-01

    A new classification of slickenside kinematic indicators is presented based on 61 criteria. These slickensides have been subdivided into eleven major groups: `V' or crescentic markings, steps, fractures, trains of inclined planar structures, trailed material, asymmetric elevations, deformed elements, mineralogical/crystallographic orientations, asymmetric plan-view features, asymmetric cavities, and asymmetric folds. This classification constitutes a useful tool for geologists interested in the determination of the shear sense in fault surfaces bearing slickensides. Examples of application of this classification to natural fault surfaces at different scales are presented.

  17. Tamper-indicating seal

    DOEpatents

    Fiarman, S.; Degen, M.F.; Peters, H.F.

    1982-08-13

    There is disclosed a tamper-indicating seal that permits in the field inspection and detection of tampering. Said seal comprises a shrinkable tube having a visible pattern of markings which is shrunk over th item to be sealed, and a second transparent tube, having a second visible marking pattern, which is shrunk over the item and the first tube. The relationship between the first and second set of markings produces a pattern so that the seal may not be removed without detection. The seal is particularly applicable to UF/sub 6/ cylinder valves.

  18. Colonoscopy: Quality Indicators

    PubMed Central

    Anderson, Joseph C; Butterly, Lynn F

    2015-01-01

    Effective endoscopic screening for colorectal cancer (CRC), one of the few preventable cancers, is dependent on the adequate detection and removal of potentially precancerous lesions. However, observed variation in colonoscopy performance in practice and outcomes has highlighted the need for consistent quality measures. Quality indicators or measures are tools that help to quantify health-care processes and can aid in providing high-quality health care. The primary colonoscopy quality indicator is the adenoma detection rate (ADR), which is defined as the proportion of an endoscopist's screening colonoscopies in which one or more adenomas have been detected. The risk of post-colonoscopy CRC is inversely correlated with an endoscopist's ADR. However, ADR is dependent on other quality measures, including cecal intubation rates, withdrawal times, and quality of bowel preparation. Achieving suggested benchmarks for these other quality measures will aid the endoscopist in achieving the recently updated ADR benchmark of 25% in their practice. In addition, beyond ensuring adequate ADRs, endoscopists should have high compliance rates with guideline-recommended and evidence-based screening and surveillance intervals. Compliance with quality measures will ensure effective and safe CRC prevention and better patient outcomes. PMID:25716302

  19. Nonintegral Maslov indices

    SciTech Connect

    Friedrich, H.; Trost, J.

    1996-08-01

    The phase loss of a wave reflected by a smooth potential generally varies continuously from {pi} in the long-wave limit to {pi}/2 in the limit of short waves. Incorporating the corresponding nonintegral multiples of {pi}/2 as nonintegral Maslov indices in the formulation of the WKB approximation leads to a substantial improvement of accuracy when the conditions for applicability of the WKB method are violated only near the classical turning points. We demonstrate the efficacy of using nonintegral Maslov indices for a Woods-Saxon potential and a repulsive 1/{ital x}{sup 2} potential. The nonintegral Maslov index for a given 1/{ital x}{sup 2} potential yields far more accurate wave functions than the conventional Langer modification of the potential in conjunction with phase loss {pi}/2. The energy spectrum of the radial harmonic oscillator (including the centrifugal potential), which is reproduced exactly by the standard WKB method with the Langer modification, is also reproduced exactly without the Langer modification when the nonintegral Maslov index is used. We suggest a method for approximately calculating the nonintegral Maslov index near the long-wave limit from the decaying WKB wave function in the classically forbidden region. {copyright} {ital 1996 The American Physical Society.}

  20. Tamper indicating packaging

    SciTech Connect

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

    1994-08-01

    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 equipment and monitoring sensors, and the retail storage of medicine and food products. The spectrum of adversarial tampering ranges from attempted concealment of a pin-hole sized penetration to the complete container replacement, which would involve counterfeiting efforts of various degrees. Sandia National Laboratories (SNL) has developed a technology base for advanced TIP materials, sensors, designs, and processes which can be adapted to various future monitoring systems. The purpose of this technology base is to investigate potential new technologies, and to perform basic research of advanced technologies. This paper will describe the theory of TIP technologies and recent investigations of TIP technologies at SNL.

  1. Breathiness in Indic languages

    NASA Astrophysics Data System (ADS)

    Esposito, Christina; Khan, Sameeruddowla; Hurst, Alex

    2005-04-01

    Previous work on breathiness in Indic languages has focused on the acoustic properties of breathy oral stops in languages like Hindi ([bal] hair versus [bhal] forehead) or Bengali ([baSa] house versus [bhaSa] language). However, breathiness in Indic languages often extends to nasals (e.g., Marathi ([maar] beat versus [mhaar] a caste). It is unclear if languages such as Hindi and Bengali have breathy nasals in addition to breathy oral stops. This study addresses the following questions: (1) Are breathy nasals (Nh) acoustically different from N+h sequences, both in languages where they are phonemic and ones where they are not? (2) In sequences of a breathy stop and a modal nasal (e.g., Hindi [udhmi] naughty) where is the breathiness realized, if at all? To answer these questions, audio, aerodynamic, and electroglottographic recordings will be made of Hindi, Bengali, and Marathi speakers. It is hypothesized that acoustically breathy nasals in Hindi and Bengali will not be distinct from sequences of N+ h. We believe that this will also be true for the oral stops. In addition, it is believed that in sequences of breathy oral stop followed by a modal nasal (e.g., ChN), the breathiness will be produced on the nasal.

  2. Decomposition techniques

    USGS Publications Warehouse

    Chao, T.T.; Sanzolone, R.F.

    1992-01-01

    Sample decomposition is a fundamental and integral step in the procedure of geochemical analysis. It is often the limiting factor to sample throughput, especially with the recent application of the fast and modern multi-element measurement instrumentation. The complexity of geological materials makes it necessary to choose the sample decomposition technique that is compatible with the specific objective of the analysis. When selecting a decomposition technique, consideration should be given to the chemical and mineralogical characteristics of the sample, elements to be determined, precision and accuracy requirements, sample throughput, technical capability of personnel, and time constraints. This paper addresses these concerns and discusses the attributes and limitations of many techniques of sample decomposition along with examples of their application to geochemical analysis. The chemical properties of reagents as to their function as decomposition agents are also reviewed. The section on acid dissolution techniques addresses the various inorganic acids that are used individually or in combination in both open and closed systems. Fluxes used in sample fusion are discussed. The promising microwave-oven technology and the emerging field of automation are also examined. A section on applications highlights the use of decomposition techniques for the determination of Au, platinum group elements (PGEs), Hg, U, hydride-forming elements, rare earth elements (REEs), and multi-elements in geological materials. Partial dissolution techniques used for geochemical exploration which have been treated in detail elsewhere are not discussed here; nor are fire-assaying for noble metals and decomposition techniques for X-ray fluorescence or nuclear methods be discussed. ?? 1992.

  3. Endovascular extraction techniques

    PubMed Central

    Bracke, F.A.; Meijer, A.; van Gelder, B.

    2001-01-01

    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 PMID:25696699

  4. Mirtazapine: other indications.

    PubMed

    Falkai, P

    1999-01-01

    During the last decade, it became evident that antidepressants may represent a useful treatment option for a variety of primary psychiatric disorders other than depression. Improved understanding of both underlying etiology of these disorders and pharmacologic modes of action of available treatments has led to an improvement in conditions such as panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, and premenstrual dysphoric disorder. In addition, evidence is accumulating that some new antidepressants may be of therapeutic value in treatment of some subtypes of depressive disorder previously unresponsive to treatment or difficult to treat, such as seasonal affective disorder, depression with atypical features, and recurrent brief depression. Mirtazapine is an antidepressant with mode of action different from other currently available antidepressants. A review of currently available data of mirtazapine's use in indications other than depression and in some types of depressive disorder is presented. PMID:10446741

  5. Enhanced tamper indicator

    DOEpatents

    Garcia, Anthony R.; Johnston, Roger G.

    2003-07-08

    The present invention provides an apparatus and method whereby the reliability and tamper-resistance of tamper indicators can be improved. A flexible connector may be routed through a latch for an enclosure such as a door or container, and the free ends of the flexible connector may be passed through a first locking member and firmly attached to an insert through the use of one or more attachment members such as set screws. A second locking member may then be assembled in interlocking relation with the first locking member to form an interlocked assembly around the insert. The insert may have one or more sharp projections extending toward the first or second locking member so that any compressive force applied in an attempt to disassemble the interlocked assembly results in permanent, visible damage to the first or second locking member.

  6. Tracer Technique

    NASA Astrophysics Data System (ADS)

    Haba, H.; Motomura, S.; Kamino, S.; Enomoto, S.

    In radioactive tracer technique, radioactive nuclides are used to follow the behavior of elements or chemical species in chemical and other processes. This is realized by means of radioactivity measurement. In 1913, Hevesy and Paneth succeeded in determining the extremely low solubility of lead salts by using naturally occurring 210Pb as a radioactive tracer. As various radioactive nuclides became artificially available, this technique has been widely employed in studies of chemical equilibrium and reactions as well as in chemical analysis. It is also an essential technique in biochemical, biological, medical, geological, and environmental studies. Medical diagnosis and industrial process control are the fields of its most important practical application. In this chapter, fundamental ideas concerning radioactive tracers will be described followed by their application with typical examples. Detailed description on their application to life sciences and medicine is given in Vol. 4.

  7. Miscellaneous Techniques

    NASA Astrophysics Data System (ADS)

    Jha, Shyam N.

    Nondestructive way of determining the food quality is the need of the hour. Till now major methods such as colour measurements and their modeling; machine vision systems; X-ray, CT and MRI; NIR spectroscopy; electronic nose and tongue; and ultrasonic technology have been discussed in detail. These techniques, in general, are considered to be sophisticated and costly, and therefore probably are not being adopted as fast as it should be. I am however of the reverse opinion. While going through these techniques, it has been seen that majority of quality parameters have been measured and correlated with the signals obtained using different equipment.

  8. Pleurodesis: indications and radiologic appearance.

    PubMed

    Sonoda, Akinaga; Jeudy, Jean; White, Charles S; Kligerman, Seth J; Nitta, Norihisa; Lempel, Jason; Frazier, Aletta Ann

    2015-05-01

    Pleurodesis is frequently performed to prevent recurrence of pneumothorax or recurrent pleural effusion in benign or malignant conditions. In essence, it involves producing an area of adhesion between the parietal and the visceral layers of the pleura. The approach to this procedure can be divided into chemical and mechanical methods. Chemical pleurodesis is performed by introducing various substances such as talc, bleomycin, povidone iodine or other chemicals into the pleural space typically using a pleural catheter. The instilled substances cause inflammation of the parietal and the visceral layers of the pleura and leads to adhesion of the pleural surfaces, preventing further fluid or air accumulation. Mechanical pleurodesis, which is performed with thoracotomy or thoracoscopy, involves mechanical irritation of the pleura or removal of parietal pleura. It is important for the radiologist to develop an understanding of the clinical indications for pleurodesis, methods for the procedure and post-procedure imaging appearance so the radiologist can provide a correct interpretation and avoid misdiagnosis of the radiologic appearance as chronic infection, tumor or other entities with a similar appearance. Thus, the aim of this article is to review the indications, techniques and post-procedural appearances of pleurodesis from an imaging perspective. PMID:25791777

  9. Measurement of maximal coronary flow reserve: a technique for assessing the physiologic significance of coronary arterial lesions in humans.

    PubMed

    Wilson, R F; White, C W

    1987-06-01

    Recent studies suggest that angiographic measurements of coronary arterial stenosis are poorly correlated with direct measurements of the capacity of the artery to conduct hyperemic blood flow. Direct measurement of coronary blood flow and the flow reserve capacity of individual coronary vessels in conscious humans, however, has been hampered by methodologic limitations. We have developed and validated a coronary Doppler catheter capable of subselectively measuring coronary blood flow velocity at the time of cardiac catheterization. Studies in seven calves demonstrated that measurements of the change in coronary blood flow velocity assessed using the Doppler catheter were highly correlated with simultaneous measurements of the change in coronary sinus blood flow (r = 0.97, slope = 1.06) and changes in blood flow velocity assessed using an epicardial Doppler probe (r = 0.95, slope = 1.04). Additional studies demonstrated that the catheter did not produce physiologically significant obstruction to coronary blood flow. Subsequent studies in 215 humans undergoing catheterization have shown that acceptable signals of phasic coronary blood flow velocity could be recorded in 176 patients. Subsequent dose response kinetic studies demonstrated that intracoronary administration of papaverine can rapidly produce maximal coronary hyperemia, equivalent in magnitude to intravenous dipyridamole, but short enough in duration to permit multiple measurements of coronary flow reserve during a single catheterization. Measurements of coronary flow reserve in patients with obstructive coronary artery disease have permitted characterization of the physiologic significance of individual obstructive coronary lesions. The development of this coronary Doppler catheter system and technique for measurement of maximal coronary flow reserve should facilitate characterization of the physiologic impact of coronary arterial lesions on coronary blood flow and studies of the coronary circulation in conscious humans. PMID:3623398

  10. A case of difficult catheterization of the contralateral limb of the Ovation Abdominal Stent Graft System in challenging aortoiliac anatomy, facilitated through the brachial access: a word of caution.

    PubMed

    Georgakarakos, Efstratios; Ioannou, Chris V; Kontopodis, Nikolaos; Tsetis, Dimitrios

    2015-02-01

    The Ovation Stent Graft System is a new trimodular endoprosthesis for the treatment of abdominal aortic aneurysms. A long nitinol stent with anchors serves the suprarenal fixation, whereas inflatable rings in the main body achieve sealing. This dissociation precludes the presence of a nitinol skeleton in the endograft, thus, avoiding competing for the same space within the delivery system, enabling the latter to achieve ultra-low profiles. However, the lack of nitinol support may render the endograft's docking limb prone to collapse in cases of narrow aortoiliac anatomy. We present a case of challenging contralateral limb catheterization, facilitated effectively through the brachial access. Preparing for the brachial route remains a useful and time-sparing adjunctive measure that guarantees the device's safety and effectiveness in challenging anatomies. PMID:25433281

  11. 'Light bar' attitude indicator

    NASA Technical Reports Server (NTRS)

    Enevoldson, E. K.; Horton, V. W.

    1982-01-01

    The development and evaluation of a light bar attitude indicator to help maintain proper aircraft attitude during high altitude night flying is described. A standard four-inch ADI was modified to project an artificial horizon across the instrument panel for pitch and roll information. A light bulb was put in the center of the ADI and a thin slit cut on the horizon, resulting in a thin horizontal sheet of light projecting from the instrument. The intensity of the projected beam is such that it can only be seen in a darkened room or at night. The beam on the instrument panel of the T-37 jet trainer is shown, depicting various attitudes. The favorable comments of about 50 pilots who evaluated the instrument are summarized, including recommendations for improving the instrument. Possible uses for the instrument to ease the pilot task are listed. Two potential problems in using the device are the development of pilot complacency and an upright-inverted ambiguity in the instrument.

  12. Entanglement-breaking indices

    NASA Astrophysics Data System (ADS)

    Lami, L.; Giovannetti, V.

    2015-09-01

    We study a set of new functionals (called entanglement-breaking indices) which characterize how many local iterations of a given (local) quantum channel are needed in order to completely destroy the entanglement between the system of interest over which the transformation is defined and an external ancilla. The possibility of contrasting the noisy effects introduced by the channel iterations via the action of intermediate (filtering) transformations is analyzed. We provide some examples in which our functionals can be exactly calculated. The differences between unitary and non-unitary filtering operations are analyzed showing that, at least for systems of dimension d larger than or equal to 3, the non-unitary choice is preferable (the gap between the performances of the two cases being divergent in some cases). For d = 2 (qubit case), on the contrary, no evidences of the presence of such gap is revealed: we conjecture that for this special case unitary filtering transformations are optimal. The scenario in which more general filtering protocols are allowed is also discussed in some detail. The case of a depolarizing noise acting on a two-qubit system is exactly solved in a general case.

  13. Clinical application of monitoring techniques: radioisotopic methods.

    PubMed

    Parodi, O; Marzullo, P; Neglia, D; Marcassa, C; L'Abbate, A

    1986-07-01

    The availability of mobile gamma cameras or the nearness of nuclear medicine devices to the coronary care unit make the assessment of transient myocardial ischemia by radioisotopic techniques practical. Nuclear cardiology provides information on the presence, site and extent of ischemia and helps the clinician in the evaluation of myocardial functional impairment and recovery. Monitoring of myocardial wall motion by radionuclide ventriculography demonstrates that during angina at rest; global ejection fraction is not always sensitive to regional ischemia; episodes of angina with undetectable electrocardiographic signs of ischemia can be associated with severe myocardial dysfunction; separate left and right phase analysis of radionuclide ventriculography is a sensitive tool to assess segmental dyssynergy localized to the left or the right ventricle; a prevalent right ventricular impairment during ischemia, not measurable by Thallium scintigraphy, is possible; the recovery of function after ischemia is usually fast and apparently complete. In addition, useful diagnostic information can be derived by left ventricular injection of radioactive microspheres during cardiac catheterization followed by gated acquisitions of the intramyocardial radioactivity. Gated microsphere acquisitions, providing diastolic and systolic images, avoid blurring of images due to cardiac motion and enhance contrast between myocardium and background: the overall result is an improved detection and definition of small perfusion defects. Furthermore, this technique permits simultaneous assessment of regional perfusion and wall motion. An appraisal of potential mismatches between flow and function after revascularization procedures can be recognized by this approach. The development of technology is improving the performance of nuclear medicine instrumentation, hampered, at present, by limited spatial and temporal resolution.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3756580

  14. Precipitation Indices Low Countries

    NASA Astrophysics Data System (ADS)

    van Engelen, A. F. V.; Ynsen, F.; Buisman, J.; van der Schrier, G.

    2009-09-01

    Since 1995, KNMI published a series of books(1), presenting an annual reconstruction of weather and climate in the Low Countries, covering the period AD 763-present, or roughly, the last millennium. The reconstructions are based on the interpretation of documentary sources predominantly and comparison with other proxies and instrumental observations. The series also comprises a number of classifications. Amongst them annual classifications for winter and summer temperature and for winter and summer dryness-wetness. The classification of temperature have been reworked into peer reviewed (2) series (AD 1000-present) of seasonal temperatures and temperature indices, the so called LCT (Low Countries Temperature) series, now incorporated in the Millennium databases. Recently we started a study to convert the dryness-wetness classifications into a series of precipitation; the so called LCP (Low Countries Precipitation) series. A brief outline is given here of the applied methodology and preliminary results. The WMO definition for meteorological drought has been followed being that a period is called wet respectively dry when the amount of precipitation is considerable more respectively less than usual (normal). To gain a more quantitative insight for four locations, geographically spread over the Low Countries area (De Bilt, Vlissingen, Maastricht and Uccle), we analysed the statistics of daily precipitation series, covering the period 1900-present. This brought us to the following definition, valid for the Low Countries: A period is considered as (very) dry respectively (very) wet if over a continuous period of at least 60 days (~two months) cq 90 days (~three months) on at least two out of the four locations 50% less resp. 50% more than the normal amount for the location (based on the 1961-1990 normal period) has been measured. This results into the following classification into five drought classes hat could be applied to non instrumental observations: Very wet period (+2): Wide scale river flooding, marshy acres and meadows.-Farmers cope with poor harvests of hay, grains, fruit etc. resulting in famines.-Late grape harvests, poor yield quantity and quality of wine. Wet period (+1): High water levels cq discharges of major rivers, tributaries and brooks, local river floodings, marshy acres and meadows in the low lying areas.-Wearisome and hampered agriculture. Normal (0) Dry period (-1): Low water levels cq discharges of major rivers, tributaries and brooks. Some brooks may dry up.-Summer half year: local short of yield of grass, hay and other forage.-Summer half year: moor-, peat- and forest fires. Very dry period (-2): Very low water levels cq discharges of major rivers and tributaries. Brooks and wells dry up. Serious shortage of drinking water; especially in summer.-Major agricultural damage, shortage of water, mortality stock of cattle. Shortage of grain. Flour can not be produced due to water mills running out of water, shortage of bread, bread riots, famines.-Large scale forest and peat areas, resulting in serious air pollution. Town fires. By verifying the historical evidence on these criterions, a series of 5 step indices ranging from very dry to very wet for summer and winter half year of the Low Countries was obtained. Subsequently these indices series were compared with the instrumentally observed seasonal precipitation sums for De Bilt (1735-2008), which is considered to be representative for the Central Netherlands. For winter (Oct-March) and summer half year (Apr.-Sept.) the accumulated precipitation amounts are calculated; these amounts are approximately normally distributed. Based on this distribution, the cumulative frequency distribution is calculated. By tabulating the number of summers in the pre-instrumental period 1201-1750 for each of the drought classes, a distribution is calculated which is then related to the modern accumulated precipitation distribution. Assuming that the accumulated precipitation amount has not been below (above) the mean precipitation minus (plus) three standard deviations for the corresponding season, an accumulated precipitation amount which relates to each of the five drought classes in the classification can be estimated. (1) Buisman, J. , Van Engelen, A.F.V. (editor), Duizend jaar weer wind en water in de Lage Landen, Van Wijnen, Franeker (Netherlands), Vol. I763-1300, 1995, Vol. II, 1300-1450, 1996, Vol. III, 1450-1575, 1998, Vol. IV, 1575-1675, 2000, Vol. V, 1675-1750, 2006. (2) Shabalova, M.V., Van Engelen, A.F.V., Evaluation of a reconstruction of winter and summer temperatures in the Low Countries, AD 764-1998, Climatic Change 58: 219-242, 2003

  15. Aseptic technique.

    PubMed

    Bykowski, Tomasz; Stevenson, Brian

    2008-11-01

    This chapter describes common laboratory procedures that can reduce the risk of culture contaminations (sepsis), collectively referred as "aseptic technique." Two major strategies of aseptic work are described: using a Bunsen burner and a laminar flow hood. Both methods are presented in the form of general protocols applicable to a variety of laboratory tasks such as pipetting and dispensing aliquots, preparing growth media, and inoculating, passaging, and spreading microorganisms on petri dishes. PMID:19016438

  16. Electrochemical Techniques

    SciTech Connect

    Chen, Gang; Lin, Yuehe

    2008-07-20

    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.

  17. PARTICLE ASSOCIATION EFFECTS ON MICROBIAL INDICATOR CONCENTRATIONS AND CSO DISINFECTION

    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...

  18. Percutaneous Nephrostomy: Technical Aspects and Indications

    PubMed Central

    Dagli, Mandeep; Ramchandani, Parvati

    2011-01-01

    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. PMID:23204641

  19. Accuracy of a new clean-catch technique for diagnosis of urinary tract infection in infants younger than 90 days of age

    PubMed Central

    Herreros, María Luisa; Tagarro, Alfredo; García-Pose, Araceli; Sánchez, Aida; Cañete, Alfonso; Gili, Pablo

    2015-01-01

    OBJECTIVE: To evaluate the accuracy of diagnosing urinary tract infections using a new, recently described, standardized clean-catch collection technique. METHODS: Cross-sectional study of infants <90 days old admitted due to fever without a source, with two matched samples of urine obtained using two different methods: clean-catch standardized stimulation technique and bladder catheterization. RESULTS: Sixty paired urine cultures were obtained. The median age was 44-days-old. Seventeen percent were male infants. Clean-catch technique sensitivity was 97% (95% CI 82% to 100%) and specificity was 89% (95% CI 65% to 98%). The contamination rate of clean-catch samples was lower (5%) than the contamination rate of catheter specimens (8%). CONCLUSIONS: The sensitivity and specificity of urine cultures obtained using the clean-catch method through the new technique were accurate and the contamination rate was low. These results suggest that this technique is a valuable, alternative method for urinary tract infection diagnosis. PMID:26435675

  20. Management Technique

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Ball Aerospace Systems Division developed a highly efficient management method known as the "total integrated systems approach" a technique developed of necessity for managing extremely complex aerospace programs involving integration of a great many individual systems. These systems, developed at different times by many different companies, must not only work perfectly when separately tested, they must also perform compatibly when integrated into the complete prime system. Systems approach is essentially a carefully considered, painstakingly executed master plan for coordinated design, development and assembly of the multitude of elements that constitute the end product. Intent is to eliminate problems that may occur when specific parts of total functioning system fail to come together to provide the requisite performance of the prime system.

  1. Illustrating Chemiluminescence with Siloxene Indicator.

    ERIC Educational Resources Information Center

    Hoff, Ray

    1981-01-01

    Discusses the nature of light-producing reactions and provides a procedure for demonstrating chemical luminescence using siloxene indicator. Indicates source of this chemical and safety precautions. (SK)

  2. [Operative technique: The clitoral transposition].

    PubMed

    Chevrot, A; Lousquy, R; Arfi, A; Haddad, B; Paniel, B J; Touboul, C

    2015-10-01

    Female sexual mutilations result in an important physical and mental suffering. A large number of women have been affected and require a global management, including surgical clitoral transposition. This surgical technique is allowing a rapid improvement of clinical symptoms. In this article, we will describe the indications and operative technique of the clitoral transposition. PMID:25818112

  3. The "hinge-twist" technique for anomalous origin of the left coronary artery.

    PubMed

    Lopez, Leo; Mercer-Rosa, Laura; Zahn, Evan M; Altman, Nolan R; Dubois, Renato; Burke, Redmond P

    2006-08-01

    A murmur was heard in an asymptomatic boy (age 4), and transthoracic echocardiography revealed anomalous origin of the left main coronary artery (LMCA) from the right sinus of Valsalva (age 6). Confirmed by catheterization and computed tomographic angiography (age 10), the LMCA followed a short interarterial course between the aorta and main pulmonary artery before supplying the anterior descending and circumflex coronary arteries. An intramural segment was not clearly seen. Results of stress testing were normal. Because sudden death was a concern, the patient underwent surgery at age 11. The "hinge-twist" technique was utilized in the absence of an intramural component or ostial stenosis in an effort to avoid the long-term complications of coronary reimplantation, ostial patching, or bypass grafting. PMID:16863730

  4. The attribute measurement technique

    SciTech Connect

    Macarthur, Duncan W; Langner, Diana; Smith, Morag; Thron, Jonathan; Razinkov, Sergey; Livke, Alexander

    2010-01-01

    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.

  5. Complementarity as a biodiversity indicator strategy.

    PubMed Central

    Reyers, B; van Jaarsveld, A S; Krüger, M

    2000-01-01

    Richness, rarity, endemism and complementarity of indicator taxon species are often used to select conservation areas, which are then assumed to represent most regional biodiversity. Assessments of the degree to which these indicator conservation areas coincide across different taxa have been conducted on a variety of vertebrate, invertebrate and plant groups at a national scale in Britain, Canada, USA and South Africa and at a regional scale in Cameroon, Uganda and the USA. A low degree of spatial overlap among and within these selected indicator conservation areas has been demonstrated. These results tend to suggest that indicator conservation areas display little congruence across different taxa. However, some of these studies demonstrate that many conservation areas for indicator taxa capture a high proportion of non-target species. Thus it appears that indicator conservation areas might sample overall biodiversity efficiently. These indicator conservation areas may, however, exclude species essential for effective conservation, e.g. rare, endemic or endangered species. The present study investigated the value of indicator taxa as biodiversity surrogates using spatial congruence and representativeness of different indicator priority conservation areas. The conservation status of species excluded by the indicator approaches is also assessed. Indicator priority conservation areas demonstrate high land area requirements in order to fully represent non-target species. These results suggest that efficient priority area selection techniques must reach a compromise between maximizing non-target species gains and minimizing land-use requirements. Reserve selection procedures using indicator-based complementarity appear to be approaches which best satisfy this trade-off. PMID:10737409

  6. Techniques of Male Circumcision

    PubMed Central

    Abdulwahab-Ahmed, Abdullahi; Mungadi, Ismaila A.

    2013-01-01

    Male circumcision is a controversial subject in surgical practice. There are, however, clear surgical indications of this procedure. The American Academy of Pediatrics (AAP) recommends newborn male circumcision for its preventive and public health benefits that has been shown to outweigh the risks of newborn male circumcision. Many surgical techniques have been reported. The present review discusses some of these techniques with their merits and drawbacks. This is an attempt to inform the reader on surgical aspects of male circumcision aiding in making appropriate choice of a technique to offer patients. Pubmed search was done with the keywords: Circumcision, technique, complications, and history. Relevant articles on techniques of circumcision were selected for the review. Various methods of circumcision including several devices are in use for male circumcision. These methods can be grouped into three: Shield and clamp, dorsal slit, and excision. The device methods appear favored in the pediatric circumcision while the risk of complications increases with increasing age of the patient at surgery. PMID:24470842

  7. Calibration of a universal indicated turbulence system

    NASA Technical Reports Server (NTRS)

    Chapin, W. G.

    1977-01-01

    Theoretical and experimental work on a Universal Indicated Turbulence Meter is described. A mathematical transfer function from turbulence input to output indication was developed. A random ergodic process and a Gaussian turbulence distribution were assumed. A calibration technique based on this transfer function was developed. The computer contains a variable gain amplifier to make the system output independent of average velocity. The range over which this independence holds was determined. An optimum dynamic response was obtained for the tubulation between the system pitot tube and pressure transducer by making dynamic response measurements for orifices of various lengths and diameters at the source end.

  8. [Scintigraphic radio-spirometry. Methods and indications].

    PubMed

    Kampmann, H; Matthys, H; Bitter, F; Adam, W E; Konjetzko, N

    1975-01-01

    Scintigraphic radio-spirometry combines conventional spirometry with the advantages of a functional isotope technique, thereby providing a clinically useful method for the study of pulmonary function. The advantage of the method consist principally in the ability to estimate physiological values separately for the two lungs, and also for selective portions of each lung. The apparatus, method and quantitative evaluation of the results are discussed in detail and the method is critically evaluated. Indications for radiospirometry are given. PMID:122958

  9. Bifurcated aortoiliac endograft limb occlusion during deployment and its bailout conversion using the external iliac artery to internal iliac artery endograft technique.

    PubMed

    Kehagias, Elias; Kontopodis, Nikolaos; Tsetis, Dimitrios; Ioannou, Christos V

    2015-07-01

    Endovascular aneurysm repair has become the preferred method to treat abdominal aortic aneurysms (AAAs). The Ovation TriVascular Stent-Graft system introduces a unique concept of separation of the metal (stent) and fabric (graft) portion of the endograft's main body to facilitate delivery through ultra-low profile 14F devices. In the setting of a narrow distal aneurysmal lumen, usually due to the presence of thrombus, deployment of this endograft may be complicated by folding and collapse of the (unsupported by a stent) aortic body or limbs, making catheterization and ballooning impossible. We present a case of Ovation endograft contralateral limb collapse in a tight AAA lumen due to thrombus deposition, which led to folding and total occlusion of the limb and made limb catheterization impossible. This is a real-life example of how the external iliac artery to internal iliac artery endograft technique may be used as a bailout procedure, converting the procedure into an aortouni-iliac graft. To our knowledge, this is the first reported bailout use of this technique in English literature which may be used in selected cases. PMID:25770386

  10. Relationship of echocardiographic indices to pulmonary capillary wedge pressures in healthy volunteers

    NASA Technical Reports Server (NTRS)

    Firstenberg, M. S.; Levine, B. D.; Garcia, M. J.; Greenberg, N. L.; Cardon, L.; Morehead, A. J.; Zuckerman, J.; Thomas, J. D.

    2000-01-01

    OBJECTIVES: We sought to determine the relationship between different echocardiographic indices and pulmonary capillary wedge pressures (PCWP) in normal volunteers. BACKGROUND: Indices based on tissue Doppler (TDE) and color M-mode (CMM) echocardiography have been proposed to reflect left (LV) ventricular filling pressures. These include the ratio of early diastolic transmitral velocity (E) to early myocardial velocity measured by TDE (E') and the ratio of E to the wave propagation velocity (Vp) measured from CMM images. These indices, however, have not been validated in normal individuals. METHODS: We studied seven volunteers during two phases of preload altering maneuvers, baseline, with two stages of lower body negative pressure, and repeat baseline with two stages of volume loading. The PCWP obtained from right heart catheterization was compared with diastolic indices using pulsed Doppler, TDE and CMM echocardiography. RESULTS: The PCWP ranged from 2.2 to 23.5 mm Hg. During preload alterations, significant changes in E and septal E' (both p < 0.05) but not lateral E' or Vp were observed. Furthermore, E, septal E' and E/Vp correlated with PCWP (all r > 0.80) but not combined E and TDE indices (both r < 0.15). Within individuals, a similar linear relationship was observed among E/Vp, E and septal E' (average r > 0.80). CONCLUSIONS: In subjects without heart disease, E, septal E' and E/Vp correlate with PCWP. Because the influence of ventricular relaxation is minimized, the ratio E/Vp may be the best overall index of LV filling pressures.

  11. Edible Acid-Base Indicators.

    ERIC Educational Resources Information Center

    Mebane, Robert C.; Rybolt, Thomas R.

    1985-01-01

    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)

  12. Urban health indicators and indices--current status.

    PubMed

    Rothenberg, Richard; Stauber, Christine; Weaver, Scott; Dai, Dajun; Prasad, Amit; Kano, Megumi

    2015-01-01

    Though numbers alone may be insufficient to capture the nuances of population health, they provide a common language of appraisal and furnish clear evidence of disparities and inequalities. Over the past 30 years, facilitated by high speed computing and electronics, considerable investment has been made in the collection and analysis of urban health indicators, environmental indicators, and methods for their amalgamation. Much of this work has been characterized by a perceived need for a standard set of indicators. We used publication databases (e.g. Medline) and web searches to identify compilations of health indicators and health metrics. We found 14 long-term large-area compilations of health indicators and determinants and seven compilations of environmental health indicators, comprising hundreds of metrics. Despite the plethora of indicators, these compilations have striking similarities in the domains from which the indicators are drawn--an unappreciated concordance among the major collections. Research with these databases and other sources has produced a small number of composite indices, and a number of methods for the amalgamation of indicators and the demonstration of disparities. These indices have been primarily used for large-area (nation, region, state) comparisons, with both developing and developed countries, often for purposes of ranking. Small area indices have been less explored, in part perhaps because of the vagaries of data availability, and because idiosyncratic local conditions require flexible approaches as opposed to a fixed format. One result has been advances in the ability to compare large areas, but with a concomitant deficiency in tools for public health workers to assess the status of local health and health disparities. Large area assessments are important, but the need for small area action requires a greater focus on local information and analysis, emphasizing method over prespecified content. PMID:25981640

  13. Online Handwriting Recognition for Indic Scripts

    NASA Astrophysics Data System (ADS)

    Bharath, A.; Madhvanath, Sriganesh

    Online handwriting recognition refers to the problem of machine recognition of handwriting captured in the form of pen trajectories. The recognition technology holds significant promise for Indic scripts, given that the Indic languages are used by a sixth of the world’s population, and the greater ease of use of handwriting-based text input for these scripts compared to keyboard-based methods. Even though the recognition of handwritten Devanagari, Bangla, and Tamil has received significant attention in recent times, one may say that research efforts directed at Indic script recognition in general are in their early stages. The structure of the scripts and the variety of shapes and writing styles pose challenges that are different from other scripts and hence require customized techniques for feature representation and recognition. In this chapter, we describe the challenges in recognizing online handwriting in Indic scripts and provide an overview of the state of the art for isolated character and word recognition. We then present in brief some of the promising applications, starting with handwriting-based text input systems (IMEs) that have been built for entering Indic scripts. In the last section, we provide a few pointers to resources such as tools and data sets that are currently available for online Indic script recognition research. endabstract

  14. Calibration of rod position indicators

    SciTech Connect

    Ginsberg, A.P.; Mooney, J.P.

    1991-04-30

    This patent describes a procedure for calibration of a rod position indicator in a nuclear reactor having movable control rods without total shutdown of the reactor. It comprises: noting that the indicated position of a rod differs from a demand position of the rod by an extent exceeding a predetermined error range, determining that the rod is actually within the predetermined error range; calculating an amount of power reduction at which the rod can be properly and safely fully inserted for the purpose of calibration of the rod position indicator; reducing power by the calculated amount, and; fully inserting the rod and calibrating the rod position indicator while withdrawing the rod.

  15. Knowledge Discovery from Remotely Sensed Vegetation Indices

    NASA Astrophysics Data System (ADS)

    White, A. B.; Kumar, P.

    2002-12-01

    The objective of this research is to develop KDD (knowledge discovery in databases) techniques for spatio-temporal geo-data, and use these techniques to examine seasonal and inter-annual vegetation health signals. The underlying hypothesis of the research is that the signatures of inter-annual variability of climate on vegetation dynamics as represented by the statistical descriptors of vegetation index variations depend upon a variety of attributes related to the climate, physiography, topography, and hydrology. Several scientific questions related to the identification and characterization of the inter-annual variability ensue as a consequence of this hypothesis. Various vegetation indices will be enlisted to represent vegetation health, such as NDVI (normalized difference vegetation index), EVI (enhanced vegetation index), LAI (leaf area index), FPAR (fraction of photosynthetically active radiation), PSN (photosynthesis), and NPP (net primary product). Relationships between these indices and topography and its derivatives (slope, aspect, etc.), nearness to water bodies, precipitation, temperature, etc. will be analyzed. Preliminary investigations were performed using 13 years of 1 km resolution NDVI data from the AVHRR instrument on NOAA's POES (polar-orbiting operational environmental satellite). Deviations from the 13-year average were utilized in order to identify anomalous behavior. The pilot KDD technique includes distance-based clustering algorithms and Apriori association rule algorithms adapted for spatial-temporal data. Future work will incorporate more complex algorithms such as density-based clustering and constraint-based association mining algorithms.

  16. Catheterization of the Carotid Artery and Jugular Vein to Perform Hemodynamic Measures, Infusions and Blood Sampling in a Conscious Rat Model

    PubMed Central

    Feng, Jing; Fitz, Yvonne; Li, Yan; Fernandez, Melinda; Cortes Puch, Irene; Wang, Dong; Pazniokas, Stephanie; Bucher, Brandon; Cui, Xizhong; Solomon, Steven B.

    2015-01-01

    The success of a small animal model to study critical illness is, in part, dependent on the ability of the model to simulate the human condition. Intra-tracheal inoculation of a known amount of bacteria has been successfully used to reproduce the pathogenesis of pneumonia which then develops into sepsis. Monitoring hemodynamic parameters and providing standard clinical treatment including infusion of antibiotics, fluids and drugs to maintain blood pressure is critical to simulate routine supportive care in this model but to do so requires both arterial and venous vascular access. The video details the surgical technique for implanting carotid artery and common jugular vein catheters in an anesthetized rat. Following a 72 hr recovery period, the animals will be re-anesthetized and connected to a tether and swivel setup attached to the rodent housing which connects the implanted catheters to the hemodynamic monitoring system. This setup allows free movement of the rat during the study while continuously monitoring pressures, infusing fluids and drugs (antibiotics, vasopressors) and performing blood sampling. PMID:25741606

  17. 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 ...

  18. Performance Indicators: Accountable to Whom?

    ERIC Educational Resources Information Center

    Conlon, Michael

    2004-01-01

    In this paper the author examines the implementation of key performance indicators in Canadian post-secondary education institutions. More specifically he charts their implementation from the perspective of students and the effect they have on the quality and delivery of education. Key performance indicators (KPI) in Canada are administered by the…

  19. Science Indicators and Science Priorities.

    ERIC Educational Resources Information Center

    Brooks, Harvey

    1982-01-01

    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…

  20. A Primer on Performance Indicators.

    ERIC Educational Resources Information Center

    Research File, 1995

    1995-01-01

    This report discusses the use of performance indicators (PIs) in higher education, focusing on definitions, frameworks, examples, and implications for universities. It notes that demands for accountability have led to intense interest in university performance measures, and that early indicators simply described the university or the system and…

  1. Science Indicators and Science Priorities.

    ERIC Educational Resources Information Center

    Brooks, Harvey

    1982-01-01

    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…

  2. 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...

  3. Quality Indicators for Learning Analytics

    ERIC Educational Resources Information Center

    Scheffel, Maren; Drachsler, Hendrik; Stoyanov, Slavi; Specht, Marcus

    2014-01-01

    This article proposes a framework of quality indicators for learning analytics that aims to standardise the evaluation of learning analytics tools and to provide a mean to capture evidence for the impact of learning analytics on educational practices in a standardised manner. The criteria of the framework and its quality indicators are based on…

  4. Precipitation-Based ENSO Indices

    NASA Technical Reports Server (NTRS)

    Adler, Robert; Curtis, Scott

    1998-01-01

    In this study gridded observed precipitation data sets are used to construct rainfall-based ENSO indices. The monthly El Nino and La Nina Indices (EI and LI) measure the steepest zonal gradient of precipitation anomalies between the equatorial Pacific and the Maritime Continent. This is accomplished by spatially averaging precipitation anomalies using a spatial boxcar filter, finding the maximum and minimum averages within a Pacific and Maritime Continent domain for each month, and taking differences. EI and LI can be examined separately or combined to produce one ENSO Precipitation Index (ESPI). ESPI is well correlated with traditional sea surface temperature and pressure indices, leading Nino 3.4. One advantage precipitation indices have over more conventional indices, is describing the strength and position of the Walker circulation. Examples are given of tracking the impact of ENSO events on the tropical precipitation fields.

  5. Fecal Indicator Bacteria and Environmental Observations: Validation of Virtual Beach

    EPA Science Inventory

    Contamination of recreational waters by fecal material is often assessed using indicator bacteria such as enterococci. Enumeration based on culturing methods can take up to 48 hours to complete, limiting the accuracy of water quality evaluations. Molecular microbial techniques em...

  6. Validation of the use of photogrammetry to register pre-procedure MR images to intra-procedure patient position for image-guided cardiac catheterization procedures

    NASA Astrophysics Data System (ADS)

    Gao, Gang; Tarte, Segolene; King, Andy; Ma, Yingliang; Chinchapatnam, Phani; Schaeffter, Tobias; Razavi, Reza; Hawkes, Dave; Hill, Derek; Rhode, Kawal

    2008-03-01

    A hybrid X-ray and magnetic resonance imaging system (XMR) has been proposed as an interventional guidance for cardiovascular catheterisation procedure. However, very few hospitals can benefit from the XMR system because of its limited availability. In this paper we describe a new guidance strategy for cardiovascular catheterisation procedure. In our technique, intra-operative patient position is estimated by using a chest surface reconstructed from a photogrammetry system. The chest surface is then registered with the same surface derived from pre-procedure magnetic resonance (MR) images. The catheterisation procedure can therefore be guided by a roadmap derived from the MR images. Patients were required to hold the breath at end expiration during MRI acquisition. The surface matching accuracy is improved by using a robust trimmed iterative closest point (ICP) matching algorithm, which is especially designed for incomplete surface matching. Compared to the XMR system, the proposed guidance strategy is low cost and easy to set up. Experimental data were acquired from 6 volunteers and 1 patient. The patient data were collected during an electrophysiology procedure. In 6 out of 7 subjects, the experimental results show our method is accurate in term of reciprocal residual error (range from 1.66m to 3.75mm) and constant (closed-loop TREs range from 1.49mm to 3.55mm). For one subject, trimmed ICP failed to find the optimal transform matrix (residual = 4.89, TRE = 9.32) due to the poor quality of the photogrammetry-reconstructed surface. More studies are being carried on in clinical trials.

  7. Developing indicators for European birds

    PubMed Central

    Gregory, Richard D; van Strien, Arco; Vorisek, Petr; Gmelig Meyling, Adriaan W; Noble, David G; Foppen, Ruud P.B; Gibbons, David W

    2005-01-01

    The global pledge to deliver ‘a significant reduction in the current rate of biodiversity loss by 2010’ is echoed in a number of regional and national level targets. There is broad consensus, however, that in the absence of conservation action, biodiversity will continue to be lost at a rate unprecedented in the recent era. Remarkably, we lack a basic system to measure progress towards these targets and, in particular, we lack standard measures of biodiversity and procedures to construct and assess summary statistics. Here, we develop a simple classification of biodiversity indicators to assist their development and clarify purpose. We use European birds, as example taxa, to show how robust indicators can be constructed and how they can be interpreted. We have developed statistical methods to calculate supranational, multi-species indices using population data from national annual breeding bird surveys in Europe. Skilled volunteers using standardized field methods undertake data collection where methods and survey designs differ slightly across countries. Survey plots tend to be widely distributed at a national level, covering many bird species and habitats with reasonable representation. National species' indices are calculated using log-linear regression, which allows for plot turnover. Supranational species' indices are constructed by combining the national species' indices weighted by national population sizes of each species. Supranational, multi-species indicators are calculated by averaging the resulting indices. We show that common farmland birds in Europe have declined steeply over the last two decades, whereas woodland birds have not. Evidence elsewhere shows that the main driver of farmland bird declines is increased agricultural intensification. We argue that the farmland bird indicator is a useful surrogate for trends in other elements of biodiversity in this habitat. PMID:15814345

  8. Image compression technique

    DOEpatents

    Fu, C.Y.; Petrich, L.I.

    1997-03-25

    An image is compressed by identifying edge pixels of the image; creating a filled edge array of pixels each of the pixels in the filled edge array which corresponds to an edge pixel having a value equal to the value of a pixel of the image array selected in response to the edge pixel, and each of the pixels in the filled edge array which does not correspond to an edge pixel having a value which is a weighted average of the values of surrounding pixels in the filled edge array which do correspond to edge pixels; and subtracting the filled edge array from the image array to create a difference array. The edge file and the difference array are then separately compressed and transmitted or stored. The original image is later reconstructed by creating a preliminary array in response to the received edge file, and adding the preliminary array to the received difference array. Filling is accomplished by solving Laplace`s equation using a multi-grid technique. Contour and difference file coding techniques also are described. The techniques can be used in a method for processing a plurality of images by selecting a respective compression approach for each image, compressing each of the images according to the compression approach selected, and transmitting each of the images as compressed, in correspondence with an indication of the approach selected for the image. 16 figs.

  9. Image compression technique

    DOEpatents

    Fu, Chi-Yung; Petrich, Loren I.

    1997-01-01

    An image is compressed by identifying edge pixels of the image; creating a filled edge array of pixels each of the pixels in the filled edge array which corresponds to an edge pixel having a value equal to the value of a pixel of the image array selected in response to the edge pixel, and each of the pixels in the filled edge array which does not correspond to an edge pixel having a value which is a weighted average of the values of surrounding pixels in the filled edge array which do correspond to edge pixels; and subtracting the filled edge array from the image array to create a difference array. The edge file and the difference array are then separately compressed and transmitted or stored. The original image is later reconstructed by creating a preliminary array in response to the received edge file, and adding the preliminary array to the received difference array. Filling is accomplished by solving Laplace's equation using a multi-grid technique. Contour and difference file coding techniques also are described. The techniques can be used in a method for processing a plurality of images by selecting a respective compression approach for each image, compressing each of the images according to the compression approach selected, and transmitting each of the images as compressed, in correspondence with an indication of the approach selected for the image.

  10. Non-thermal myocardial electrical conduction block by photosensitization reaction with catheterization in right atrium isthmus of porcine heart in vivo

    NASA Astrophysics Data System (ADS)

    Ito, Arisa; Kajihara, Takuro; Suenari, Tsukasa; Takahashi, Mei; Kimura, Takehiro; Fukumoto, Kotaro; Takatsuki, Seiji; Miyoshi, Shunichiro; Arai, Tsunenori

    2011-03-01

    We have studied a new type of myocardial catheter ablation with photosensitization reaction to realize non-thermal therapy for atrial arrhythmia, such as atrial fibrillation. Photochemically-generated reactive oxygen species may induce myocardial electrophysiological damage without heat generation. In this study, to demonstrate photosensitization reaction-induced myocardial electrical conduction block, the inferior vena cava to tricuspid annulus (IVC-TA) isthmus linear ablation was conducted with photosensitization reaction in porcine heart in vivo, using a newly developed laser catheter (7 Fr.). The end point of the procedure was the production of IVC-TA isthmus block under the electrophysiological analysis by diagnostic catheter with 10-bipole electrodes placed in right atrium along the isthmus. Talaporfin sodium (NPe6) as a photosensitizer was injected intravenously to pigs at 2.5-5.0 mg/kg. About 15 min after the injection, the laser light at the wavelength of 663 nm with a catheter output power density of 40-60 W/cm2 in about 1.4 mm spot size was irradiated through the laser catheter point by point in line crossing the isthmus under the fluoroscopic guidance. Before the photosensitization procedure, pacing signal from the distal electrodes of the diagnostic catheter, propagated through the isthmus in order. During the irradiation, electrical potential at the irradiated area was diminished. After the completion of the irradiation line, the bidirectional conduction block on the IVC-TA isthmus was validated by pacing from the distal and proximal bipole. These results indicated that photosensitization reaction could achieve the electrical conduction block of myocardial tissue immediately after the irradiation. We think that photosensitization reaction could become a novel therapy for atrial arrhythmia.

  11. Transurethral plasmakinetic resection of the prostate is a reliable minimal invasive technique for benign prostate hyperplasia: a meta-analysis of randomized controlled trials

    PubMed Central

    Wang, Kai; Li, Yao; Teng, Jing-Fei; Zhou, Hai-Yong; Xu, Dan-Feng; Fan, Yi

    2015-01-01

    To evaluate the efficacy and safety of plasmakinetic resection of the prostate (PKRP) versus transurethral resection of the prostate (TURP) for the treatment of patients with benign prostate hyperplasia (BPH), a meta-analysis of randomized controlled trials was carried out. We searched PubMed, Embase, Web of Science and the Cochrane Library. The pooled estimates of maximum flow rate, International Prostate Symptom Score, operation time, catheterization time, irrigated volume, hospital stay, transurethral resection syndrome, transfusion, clot retention, urinary retention and urinary stricture were assessed. There was no notable difference in International Prostate Symptom Score between TURP and PKRP groups during the 1-month, 3 months, 6 months and 12 months follow-up period, while the pooled Qmax at 1-month favored PKRP group. PKRP group was related to a lower risk rate of transurethral resection syndrome, transfusion and clot retention, and the catheterization time and operation time were also shorter than that of TURP. The irrigated volume, length of hospital stay, urinary retention and urinary stricture rate were similar between groups. In conclusion, our study suggests that the PKRP is a reliable minimal invasive technique and may anticipatorily prove to be an alternative electrosurgical procedure for the treatment of BPH. PMID:25337839

  12. Communication Indicators. I. Communication Indicators and Indicators of Socio-Economic Development. Communication and Society 3.

    ERIC Educational Resources Information Center

    O'Brien, Rita Cruise; And Others

    This report summarizes a Unesco-sponsored study of indicators of international communication and socioeconomic development. Following a brief description of the background, purpose, and methodology of the study, the report discusses its findings in the following areas: (1) communication and social indicators; (2) communications and the growth of…

  13. Behavioral indicators of pilot workload

    NASA Technical Reports Server (NTRS)

    Galanter, E.; Hochberg, J.

    1984-01-01

    Using a technique that requires a subject to consult an imagined or remembered spatial array while performing a visual task, a reliable reduction in the number of directed eye movements that are available for the acquisition of visual information is shown.

  14. Behavioral indicators of pilot workload

    NASA Technical Reports Server (NTRS)

    Galanter, E.; Hochberg, J.

    1983-01-01

    Using a technique that requires a subject to consult an imagined or remembered spatial array while performing a visual task, a reliable reduction in the number of directed eye movements that are available for the acquisition of visual information is shown.

  15. Investigation of Some Metallochromic Indicators.

    ERIC Educational Resources Information Center

    Jones, A. V.; Nelson, M.

    1979-01-01

    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)

  16. EVALUATION GUIDELINES FOR ECOLOGICAL INDICATORS

    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...

  17. Analytical techniques: A compilation

    NASA Technical Reports Server (NTRS)

    1975-01-01

    A compilation, containing articles on a number of analytical techniques for quality control engineers and laboratory workers, is presented. Data cover techniques for testing electronic, mechanical, and optical systems, nondestructive testing techniques, and gas analysis techniques.

  18. Weld width indicates weld strength

    NASA Technical Reports Server (NTRS)

    Nunes, A. C. J.; Novak, H. L.; Mcllwain, M. C.

    1982-01-01

    Width of butt weld in 2219-T87 aluminum has been found to be more reliable indicator of weld strength than more traditional parameters of power input and cooling rate. Yield stress and ultimate tensile strength tend to decrease with weld size. This conclusion supports view of many professional welders who give priority to weld geometry over welding energy or cooling rate as indicator of weld quality.

  19. A Novel Technique for Retrieval of a Drug-Eluting Stent After Catheter Break and Stent Loss

    PubMed Central

    Wani, Sunil P.; Park, Ji Young; Poddar, Kanhaiya L; Wang, Lin; Ramasamy, Sureshkumar; Moon, Ji Mi; Kim, Ji Bak; Ryu, Sang Ryol; Shin, Seung Yong; Choi, Un-Jung; Choi, Cheol Ung; Lim, Hong Euy; Kim, Jin Won; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo

    2010-01-01

    Break of a stent delivery catheter and subsequent stent loss (SL) has been a rare event in the drug-eluting stent (DES) era. We here report a case of successful retrieval of a stent after a break if the delivery catheter and SL from a balloon catheter at a culprit lesion. We finally resolved this situation using a simple balloon technique for both the broken stent catheter inside of the guide catheter and the unexpanded stent in the culprit lesion. Thus balloons are an important weapon in our armamentarium in the cardiac catheterization laboratory for urgent retrieval of a lost stent. Their apt use definitely allowed our patient to avoid undergoing emergency cardiovascular thoracic surgery. PMID:20830255

  20. Energy Efficiency Indicators Methodology Booklet

    SciTech Connect

    Sathaye, Jayant; Price, Lynn; McNeil, Michael; de la rue du Can, Stephane

    2010-05-01

    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.

  1. Testing a fast dynamical indicator: The MEGNO

    NASA Astrophysics Data System (ADS)

    Maffione, N. P.; Giordano, C. M.; Cincotta, P. M.

    2011-01-01

    To investigate non-linear dynamical systems, like for instance artificial satellites, Solar System, exoplanets or galactic models, it is necessary to have at hand several tools, such as a reliable dynamical indicator. The aim of the present work is to test a relatively new fast indicator, the Mean Exponential Growth factor of Nearby Orbits (MEGNO), since it is becoming a widespread technique for the study of Hamiltonian systems, particularly in the field of dynamical astronomy and astrodynamics, as well as molecular dynamics. In order to perform this test we make a detailed numerical and statistical study of a sample of orbits in a triaxial galactic system, whose dynamics was investigated by means of the computation of the Finite Time Lyapunov Characteristic Numbers (FT-LCNs) by other authors.

  2. Critical evaluation of the AE indices

    SciTech Connect

    Kroehl, H.W.

    1989-01-01

    The computation of the total eastward and westward auroral electrojets from numerical modeling techniques for three different intervals during disturbed conditions provides a unique opportunity to evaluate the accuracy of the standard Auroral Electrojet indices AU(12) and AL(12). The effect on the indices of replacing the local magnetic coordinate system with a global system, of increasing the latitudinal coverage by increasing the number of stations from 12 to 57, and of integrating the current density to obtain the total current is considered as new indices are correlated with the standard ones. We conclude that AL(12) is a reasonable measure of the westward electrojet current in a statistical sense, that Au(12) is not as good a measure of the eastward current, and that values of AU(12) and AL(12) during quiet conditions, i.e., less than 50 nT, must be treated separately from disturbed conditions. It should also be noted that a rotation of the perturbation vectors into a global coordinate system improves the indices more than an increase in the number of stations. Reprints. (rrh)

  3. Analyzing Crisis in Global Financial Indices

    NASA Astrophysics Data System (ADS)

    Kumar, Sunil; Deo, Nivedita

    We apply the Random Matrix Theory and complex network techniques to 20 global financial indices and study the correlation and network properties before and during the financial crisis of 2008 respectively. We find that the largest eigenvalue deviate significantly from the upper bound which shows a strong correlation between financial indices. By using a sliding window of 25 days we find that largest eigenvalue represent the collective information about the correlation between global financial indices and its trend indicate the market conditions. It is confirmed that eigenvectors corresponding to second largest eigenvalue gives useful information about the sector formation in the global financial indices. We find that these clusters are formed on the basis of the geographical location. The correlation network is constructed using threshold method for different values of threshold θ in the range 0 to 0.9, at θ=0.2 the network is fully connected. At θ=0.6, the Americas, Europe and Asia/Pacific form different clusters before the crisis but during the crisis Americas and Europe are strongly linked. If we further increase the threshold to 0.9 we find that European countries France, Germany and UK consistently constitute the most tightly linked markets before and during the crisis. We find that the structure of Minimum Spanning Tree before the crisis is more star like whereas during the crisis it changes to be more chain like. Using the multifractal analysis, we find that Hurst exponents of financial indices increases during the period of crisis as compared to the period before the crisis. The empirical results verify the validity of measures, and this has led to a better understanding of complex financial markets.

  4. Gear selector indicator adjustment mechanism

    SciTech Connect

    Kobylarz, L.P.

    1989-04-18

    A motor vehicle automatic transmission gear selector indicator assembly is described which indicates the position of a gear shifter and permits the indicated gear position to be adjusted comprising: a display having gear selector designations and movable means for indicating one of the gear selector designations, and compliant means urging the movable means in one direction, a cable assembly having an outer sheath with first and second mounting means for mounting the opposite ends of the sheath, the cable assembly further having a cable core sliding within the sheath with a first end connected to the display movable means and a second end connected to the gear shifter, wherein tension on the core urges the indicator movable means to move against the compliant means, and an adjustment mechanism including a hollow externally threaded tube with the sheath fixed to the tube with the core passing through the tube, an adjustment wheel having a threaded bore meshing with the external threads of the tube, and a bracket which traps the adjustment wheel, the tube and the bracket including anti-rotation means for preventing rotation of the tube.

  5. Indo-China Monsoon Indices

    NASA Astrophysics Data System (ADS)

    Tsai, Chinleong; Behera, Swadhin K.; Waseda, Takuji

    2015-01-01

    Myanmar and Thailand often experience severe droughts and floods that cause irreparable damage to the socio-economy condition of both countries. In this study, the Southeastern Asian Summer Monsoon variation is found to be the main element of interannual precipitation variation of the region, more than the El Niño/Southern Oscillation (ENSO). The ENSO influence is evident only during the boreal spring season. Although the monsoon is the major factor, the existing Indian Monsoon Index (IMI) and Western North Pacific Monsoon Index (WNPMI) do not correlate well with the precipitation variation in the study regions of Southern Myanmar and Thailand. Therefore, a new set of indices is developed based on the regional monsoon variations and presented here for the first time. Precipitation variations in Southern Myanmar and Thailand differ as well as the elements affecting the precipitation variations in different seasons. So, separate indices are proposed for each season for Southern Myanmar and Thailand. Four new monsoon indices based on wind anomalies are formulated and are named as the Indochina Monsoon Indices. These new indices correlate better with the precipitation variations of the study region as compared to the existing IMI and WNPMI.

  6. Indo-China Monsoon Indices

    PubMed Central

    Tsai, ChinLeong; Behera, Swadhin K.; Waseda, Takuji

    2015-01-01

    Myanmar and Thailand often experience severe droughts and floods that cause irreparable damage to the socio-economy condition of both countries. In this study, the Southeastern Asian Summer Monsoon variation is found to be the main element of interannual precipitation variation of the region, more than the El Niño/Southern Oscillation (ENSO). The ENSO influence is evident only during the boreal spring season. Although the monsoon is the major factor, the existing Indian Monsoon Index (IMI) and Western North Pacific Monsoon Index (WNPMI) do not correlate well with the precipitation variation in the study regions of Southern Myanmar and Thailand. Therefore, a new set of indices is developed based on the regional monsoon variations and presented here for the first time. Precipitation variations in Southern Myanmar and Thailand differ as well as the elements affecting the precipitation variations in different seasons. So, separate indices are proposed for each season for Southern Myanmar and Thailand. Four new monsoon indices based on wind anomalies are formulated and are named as the Indochina Monsoon Indices. These new indices correlate better with the precipitation variations of the study region as compared to the existing IMI and WNPMI. PMID:25630503

  7. Indo-China monsoon indices.

    PubMed

    Tsai, ChinLeong; Behera, Swadhin K; Waseda, Takuji

    2015-01-01

    Myanmar and Thailand often experience severe droughts and floods that cause irreparable damage to the socio-economy condition of both countries. In this study, the Southeastern Asian Summer Monsoon variation is found to be the main element of interannual precipitation variation of the region, more than the El Niño/Southern Oscillation (ENSO). The ENSO influence is evident only during the boreal spring season. Although the monsoon is the major factor, the existing Indian Monsoon Index (IMI) and Western North Pacific Monsoon Index (WNPMI) do not correlate well with the precipitation variation in the study regions of Southern Myanmar and Thailand. Therefore, a new set of indices is developed based on the regional monsoon variations and presented here for the first time. Precipitation variations in Southern Myanmar and Thailand differ as well as the elements affecting the precipitation variations in different seasons. So, separate indices are proposed for each season for Southern Myanmar and Thailand. Four new monsoon indices based on wind anomalies are formulated and are named as the Indochina Monsoon Indices. These new indices correlate better with the precipitation variations of the study region as compared to the existing IMI and WNPMI. PMID:25630503

  8. Indicating the Attitudes of High School Students to Environment

    ERIC Educational Resources Information Center

    Ozkan, Recep

    2013-01-01

    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 has…

  9. Identifying Quality Indicators of SAE and FFA: A Delphi Approach

    ERIC Educational Resources Information Center

    Jenkins, Charles Cordell, III; Kitchel, Tracy

    2009-01-01

    The purpose of this study was to determine quality indicators for SAE and FFA according to 36 experts across the United States. This is a part of a larger study looking at all components of the traditional three-circle model. The study utilized the Delphi technique to garner expert opinion about quality indicators in Agricultural Education. For…

  10. Proliferation indices in malignant lymphomas.

    PubMed Central

    Crocker, J

    1989-01-01

    In view of the importance of adjusting therapy to prognostic groups in malignant lymphomas, there have been numerous attempts over the past two decades to assess proliferation rates in these neoplasms. The techniques employed include radiolabelled thymidine uptake, DNA flow cytometry, the application of antibodies to proliferation-associated antigens and the enumeration of nucleolar organizer regions. The evolution of these methods is reviewed and their usefulness is evaluated. PMID:2680181

  11. Permanent makeup: indications and complications.

    PubMed

    De Cuyper, Christa

    2008-01-01

    Cosmetic tattoos, simulating makeup, have become very popular in the last decades; the technique of micropigmentation consists of implantation of pigment into the skin using a tattoo pen. The procedure can also be used to camouflage vitiligo, to mask scars, and as an adjunct to reconstructive surgery. Risks and complications include infections, allergic reactions, scarring, fanning, fading, and dissatisfaction about color and shape. Lasers offer the best cosmetic result for removal of unwanted tattoos. PMID:18280902

  12. Welfare indicators during broiler slaughtering.

    PubMed

    Grilli, C; Loschi, A R; Rea, S; Stocchi, R; Leoni, L; Conti, F

    2015-01-01

    1. The aim of this study was to identify the most relevant welfare indicators for unloading, lairage, stunning, killing and post-mortem inspection in a poultry slaughter plant. Different indicators were unloading duration, lairage time, environmental variables in the lairage facilities, shackling time and electrical variables used in the water bath. 2. Lairage time did not correlate strongly with dead on arrival. Heat stress was limited by means of ventilation systems, correct cage placement and appropriate stocking density per crate. The acceptable shackling period was about 30 s. 3. The presence of a corneal reflex showed that an animal was alive, while spontaneous wing flapping, spontaneous eye blinking and response to a painful stimulus were regarded as indicators of stunning efficiency. 4. It was concluded that the presence of recent traumatic injuries during the post-mortem inspection could be a valid means to establish whether corrective measures concerning the handling, transport and loading procedures should be taken. PMID:25567419

  13. VELOCITY INDICATOR FOR EXTRUSION PRESS

    DOEpatents

    Digney, F.J. Jr.; Bevilacqua, F.

    1959-04-01

    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.

  14. [Use of lubricants in urology. Indications and results].

    PubMed

    Sperling, H; Lümmen, G; Rübben, H

    2005-06-01

    Lubricants are used for catheterization and/or endoscopic maneuvers. "The lubricant" should guarantee sufficient lubrification of the urinary tract, good visualization during endoscopy, and excellent local anesthesia. Additionally, asepsis or reliable control of the local bacterial flora of the urethra should be ensured. Modern lubricants fulfil these recommendations; in addition, they provide therapeutic opportunities for local therapy, for instance, of non-gonococcal urethritis. The latest results show that there are a few lubricants with antimicrobiotic influence on MRSA (methicillin-resistant Staphylococcus aureus), which is of great importance because of the steady increase in MRSA-dependent infections. PMID:15806342

  15. Novel tamper-indicating protective devices

    SciTech Connect

    DeVolpi, A.

    1995-07-01

    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.

  16. 5 Indicators of Decimal Understandings

    ERIC Educational Resources Information Center

    Cramer, Kathleen; Monson, Debra; Ahrendt, Sue; Colum, Karen; Wiley, Bethann; Wyberg, Terry

    2015-01-01

    The authors of this article collaborated with fourth-grade teachers from two schools to support implementation of a research-based fraction and decimal curriculum (Rational Number Project: Fraction Operations and Initial Decimal Ideas). Through this study, they identified five indicators of rich conceptual understanding of decimals, which are…

  17. College Readiness Indicator Systems Framework

    ERIC Educational Resources Information Center

    Borsato, Graciela N.; Nagaoka, Jenny; Folley, Ellen

    2013-01-01

    A new framework from the CRIS initiative provides guidance for schools and districts to implement a system of indicators and supports for students who are off track for post-secondary success. The CRIS framework is intended as a tool to help districts and schools implement the conditions, processes, and supports needed to increase the number of…

  18. Proximity Indicator for Remote Manipulator

    NASA Technical Reports Server (NTRS)

    Bejczy, A. K.

    1985-01-01

    Display indicates pitch, yaw, and distance of remote manipulator with respect to object to be grasped. Displays numerical values and bargraph simulation of position and orientation of hand. When errors in position and orientation are small enough to ensure successful grasp, unit alerts operator with audible and visible signals.

  19. Quality Indicators of Online Programs

    ERIC Educational Resources Information Center

    Hirner, Leo; Kochtanek, Thomas

    2012-01-01

    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…

  20. Physiological Indications of Organic Involvement

    ERIC Educational Resources Information Center

    Burrows, Roy E.

    1971-01-01

    The presence of three or more minor and/or major anomalies in an individual with mental retardation may indicate not just a developmental relationship between the retardation and malformation syndromes, but a common cause for the entire retardation malformation syndrome. Tables, Bibliography. (Author)

  1. Measuring School Choice Using Indicators.

    ERIC Educational Resources Information Center

    Archbald, Doug

    1996-01-01

    Devising better definitions and measures of school choice practices and policies would improve understanding of choice and help evaluate its prevalence and effects. This article proposes system/district-level indicators of school choice that could operationalize the concept and produce valuable interdistrict comparative information on choice…

  2. Social Indicators and Social Reporting

    ERIC Educational Resources Information Center

    Parke, Robert; Seidman, David

    1978-01-01

    Describes the several research traditions which combine to form the social indicators movement. All the traditions share concern for measurement, analysis, and reporting of aspects of social conditions to a general audience. Journal available from: American Academy of Political and Social Science, 3937 Chestnut Street, Philadelphia, Pennsylvania…

  3. Developing Indicators of Student Coursework.

    ERIC Educational Resources Information Center

    McDonnell, Lorraine M.; Ormseth, Tor

    The School Reform Assessment (SRA) project began in 1987 with the objective of developing indicators of student coursework that reliably and validly measure this central feature of schooling, while remaining sensitive to major policy changes and the information needs of policymakers, and efficiently collecting and reporting data. This paper…

  4. Scale-Independent Bibliometric Indicators

    ERIC Educational Resources Information Center

    Katz, J. Sylvan

    2005-01-01

    This article presents the author's critique of Anthony F. J. van Raan's article titled, "Measurement of Central Aspects of Scientific Research: Performance, Interdisciplinarity, Structure." van Raan makes an excellent case for using bibliometric data to measure some central aspects of scientific research and to construct indicators of groups:…

  5. MSPI False Indication Probability Simulations

    SciTech Connect

    Dana Kelly; Kurt Vedros; Robert Youngblood

    2011-03-01

    This paper examines false indication probabilities in the context of the Mitigating System Performance Index (MSPI), in order to investigate the pros and cons of different approaches to resolving two coupled issues: (1) sensitivity to the prior distribution used in calculating the Bayesian-corrected unreliability contribution to the MSPI, and (2) whether (in a particular plant configuration) to model the fuel oil transfer pump (FOTP) as a separate component, or integrally to its emergency diesel generator (EDG). False indication probabilities were calculated for the following situations: (1) all component reliability parameters at their baseline values, so that the true indication is green, meaning that an indication of white or above would be false positive; (2) one or more components degraded to the extent that the true indication would be (mid) white, and “false” would be green (negative) or yellow (negative) or red (negative). In key respects, this was the approach taken in NUREG-1753. The prior distributions examined were the constrained noninformative (CNI) prior used currently by the MSPI, a mixture of conjugate priors, the Jeffreys noninformative prior, a nonconjugate log(istic)-normal prior, and the minimally informative prior investigated in (Kelly et al., 2010). The mid-white performance state was set at ?CDF = ?10 ? 10-6/yr. For each simulated time history, a check is made of whether the calculated ?CDF is above or below 10-6/yr. If the parameters were at their baseline values, and ?CDF > 10-6/yr, this is counted as a false positive. Conversely, if one or all of the parameters are set to values corresponding to ?CDF > 10-6/yr but that time history’s ?CDF < 10-6/yr, this is counted as a false negative indication. The false indication (positive or negative) probability is then estimated as the number of false positive or negative counts divided by the number of time histories (100,000). Results are presented for a set of base case parameter values, and three sensitivity cases in which the number of FOTP demands was reduced, along with the Birnbaum importance of the FOTP.

  6. [Letter: social indications for sterilization].

    PubMed

    Rieger, H J

    1973-09-21

    The question as to whether voluntary sterilization for social indications is permitted by current law has not been legally clarified. According to the present West German penal code even voluntary sterilization represents an assault (bodily injury) when this violates "good morals," not specifically defined. Although the German Federal Court stated that voluntary sterilization is not criminal (in its opinion of October 27, 1964) this interpretation was not accepted by penal law experts. However, in public opinion and legal literature, acceptance of voluntary steriliztion for genetic and social indications, along with medical indications, is increasing. This view has also been legislated in the draft of a 5th law for reform of the penal code (February 14, 1972) in which voluntary sterilization performed by a doctor is not criminal if the concerned party is willing and is at least 25-years-old. If the concerned party is not 25-years-old, the operation is not illegal if 1) there is a serious medical indication, 2) she already has at least 4 children, and 3) if the woman is at least 18 and there is a medical indication on the basis of the family history. In the case of a minor, the consent of the legal guardian is also required. Thus, a physician who performs a sterilization according to these conditions is no longer liable to prosecution. It is advisable, however, to obtain the written permission of the concerned party and when necessary, the legal guardian as well as a written statement that the concerned party is aware of the irreversibility of the procedures. PMID:4742514

  7. Physiologic indicators of vitamin A status.

    PubMed

    Congdon, Nathan G; West, Keith P

    2002-09-01

    Physiologic indicators reflect the functional consequences of vitamin A deficiency and may be particularly useful for detecting early perturbations in vitamin A status. In conjunctival impression cytology (CIC), epithelial morphology and the presence or absence of mucin spots and goblet cells allow samples, obtained by applying filter paper to the temporal conjunctiva, to be characterized as normal or typical of vitamin A-deficient keratinizing metaplasia. The validity of CIC has been established with reference to other indicators of vitamin A status, and a prevalence of > or =20% abnormal results has been suggested as indicative of a public health problem. However, interpretation of specimens requires considerable training, and nonresponsiveness to supplementation is a frequent problem, which limits the utility of CIC as a method for evaluating the impact of intervention programs. Several simplified field protocols for dark adaptation have been developed, including one in which dark adaptation is assessed by the responsiveness of the pupil to light. Night blind subjects have consistently shown abnormal results on this test, and a significant response to placebo-controlled dosing has been demonstrated for children and pregnant women. Scores have correlated significantly with serum retinol and relative dose response. Pupillary dark adaptation testing is acceptable to most children as young as 2 y old. Limitations of this technique include a time course for recovery after dosing as long as 4-6 wk, a testing time of 20 min, and the need for 1-3 d of training. Given its low cost, noninvasive nature, and lack of the need to transport samples, pupillary dark adaptation offers advantages over other techniques for assessing a population's vitamin A status. PMID:12221266

  8. Scaling drug indication curation through crowdsourcing

    PubMed Central

    Khare, Ritu; Burger, John D.; Aberdeen, John S.; Tresner-Kirsch, David W.; Corrales, Theodore J.; Hirchman, Lynette; Lu, Zhiyong

    2015-01-01

    Motivated by the high cost of human curation of biological databases, there is an increasing interest in using computational approaches to assist human curators and accelerate the manual curation process. Towards the goal of cataloging drug indications from FDA drug labels, we recently developed LabeledIn, a human-curated drug indication resource for 250 clinical drugs. Its development required over 40 h of human effort across 20 weeks, despite using well-defined annotation guidelines. In this study, we aim to investigate the feasibility of scaling drug indication annotation through a crowdsourcing technique where an unknown network of workers can be recruited through the technical environment of Amazon Mechanical Turk (MTurk). To translate the expert-curation task of cataloging indications into human intelligence tasks (HITs) suitable for the average workers on MTurk, we first simplify the complex task such that each HIT only involves a worker making a binary judgment of whether a highlighted disease, in context of a given drug label, is an indication. In addition, this study is novel in the crowdsourcing interface design where the annotation guidelines are encoded into user options. For evaluation, we assess the ability of our proposed method to achieve high-quality annotations in a time-efficient and cost-effective manner. We posted over 3000 HITs drawn from 706 drug labels on MTurk. Within 8 h of posting, we collected 18 775 judgments from 74 workers, and achieved an aggregated accuracy of 96% on 450 control HITs (where gold-standard answers are known), at a cost of $1.75 per drug label. On the basis of these results, we conclude that our crowdsourcing approach not only results in significant cost and time saving, but also leads to accuracy comparable to that of domain experts. Database URL: ftp://ftp.ncbi.nlm.nih.gov/pub/lu/LabeledIn/Crowdsourcing/. PMID:25797061

  9. Covariance propagation in spectral indices

    SciTech Connect

    Griffin, P. J.

    2015-01-09

    In this study, the dosimetry community has a history of using spectral indices to support neutron spectrum characterization and cross section validation efforts. An important aspect to this type of analysis is the proper consideration of the contribution of the spectrum uncertainty to the total uncertainty in calculated spectral indices (SIs). This study identifies deficiencies in the traditional treatment of the SI uncertainty, provides simple bounds to the spectral component in the SI uncertainty estimates, verifies that these estimates are reflected in actual applications, details a methodology that rigorously captures the spectral contribution to the uncertainty in the SI, and provides quantified examples that demonstrate the importance of the proper treatment the spectral contribution to the uncertainty in the SI.

  10. Covariance propagation in spectral indices

    DOE PAGESBeta

    Griffin, P. J.

    2015-01-09

    In this study, the dosimetry community has a history of using spectral indices to support neutron spectrum characterization and cross section validation efforts. An important aspect to this type of analysis is the proper consideration of the contribution of the spectrum uncertainty to the total uncertainty in calculated spectral indices (SIs). This study identifies deficiencies in the traditional treatment of the SI uncertainty, provides simple bounds to the spectral component in the SI uncertainty estimates, verifies that these estimates are reflected in actual applications, details a methodology that rigorously captures the spectral contribution to the uncertainty in the SI, andmore »provides quantified examples that demonstrate the importance of the proper treatment the spectral contribution to the uncertainty in the SI.« less

  11. Chapter A7. Biological Indicators

    USGS Publications Warehouse

    Myers, Donna N.; Wilde, Franceska D.

    2003-01-01

    The National Field Manual for the Collection of Water-Quality Data (National Field Manual) provides guidelines and standard procedures for U.S. Geological Survey (USGS) personnel who collect data used to assess the quality of the Nation's surface-water and ground-water resources. This chapter of the manual includes procedures for the (1) determination of biochemical oxygen demand using a 5-day bioassay test; (2) collection, identification, and enumeration of fecal indicator bacteria; (3) collection of samples and information on two laboratory methods for fecal indicator viruses (coliphages); and (4) collection of samples for protozoan pathogens. Each chapter of the National Field Manual is published separately and revised periodically. Newly published and revised chapters are posted on the World Wide Web on the USGS page 'National Field Manual for the Collection of Water-Quality Data.' The URL for this page is http://pubs.water.usgs.gov/twri9A/ (accessed November 25, 2003).

  12. Covariance propagation in spectral indices

    SciTech Connect

    Griffin, P. J.

    2015-01-09

    The dosimetry community has a history of using spectral indices to support neutron spectrum characterization and cross section validation efforts. An important aspect to this type of analysis is the proper consideration of the contribution of the spectrum uncertainty to the total uncertainty in calculated spectral indices (SIs). This study identifies deficiencies in the traditional treatment of the SI uncertainty, provides simple bounds to the spectral component in the SI uncertainty estimates, verifies that these estimates are reflected in actual applications, details a methodology that rigorously captures the spectral contribution to the uncertainty in the SI, and provides quantified examples that demonstrate the importance of the proper treatment the spectral contribution to the uncertainty in the SI.

  13. Covariance Propagation in Spectral Indices

    SciTech Connect

    Griffin, P.J.

    2015-01-15

    The dosimetry community has a history of using spectral indices to support neutron spectrum characterization and cross section validation efforts. An important aspect to this type of analysis is the proper consideration of the contribution of the spectrum uncertainty to the total uncertainty in calculated spectral indices (SIs). This paper identifies deficiencies in the traditional treatment of the SI uncertainty, provides simple bounds to the spectral component in the SI uncertainty estimates, verifies that these estimates are reflected in actual applications, details a methodology that rigorously captures the spectral contribution to the uncertainty in the SI, and provides quantified examples that demonstrate the importance of the proper treatment the spectral contribution to the uncertainty in the SI.

  14. Polychaetes as environmental indicators revisited.

    PubMed

    Giangrande, Adriana; Licciano, Margherita; Musco, Luigi

    2005-11-01

    The utilization of polychaetes in descriptive ecology is reviewed in the light of recent research especially concerning the biota hard bottom environments. Polychaetes, often linked in the past to the concept of opportunistic species able to proliferate after an increase in organic matter, have played an important role especially with regard to impacted soft-bottom habitats. Increased knowledge of the group, suggests that not only opportunistic species can be utilised as indicators, so that these organisms can be disengaged from the old concept of opportunistic taxa. Moreover, recent researches conducted on this group allowed demonstrating as surrogacy is not always applicable. Among polychaetes inhabiting hard bottom environment, the analysis of family Syllidae appears particularly promising. Studied conducted in our laboratory demonstrated as syllid species decrease in abundance or completely disappear under varying sources of negative impact. The distribution of species also appeared indicative in underlying effects of marine protected areas (MPA) functioning, or in describing different climatic areas within biogeographical sectors. It is obvious that good results can only be obtained on the basis of good taxonomic resolution. We suggested that, in monitoring studies, operational time could be optimized not only by working at a higher-level on the whole invertebrate data set, but by also selecting a particularly indicative group and working at fine level. PMID:16197965

  15. Indications for eye removal surgeries

    PubMed Central

    Koylu, Mehmet T.; Gokce, Gokcen; Uysal, Yusuf; Ceylan, Osman M.; Akıncıoglu, Dorukcan; Gunal, Armagan

    2015-01-01

    Objectives: To analyze the indications and types of eye removals at a military tertiary care hospital in Turkey. Methods: The medical records (age, gender, affected eye, type of surgical procedure, indications of surgery) of 123 patients who underwent evisceration and enucleation in the course of a 15-year period (January 2000 to December 2014) at Gulhane Military Medical Academy, Ankara, Turkey were reviewed retrospectively. Results: The mean age was 35.61±18.52 (range 3-80 years). The number of male in the patient group was 92 (74.8%) and female was 31 (25.2%). Patients who underwent evisceration were 95 (77.2%), whereas 28 (22.8%) of them underwent enucleation. The mean age of the eviscerated patients was 30.63±13.08, whereas the mean age of the enucleated patients was 52.50±23.92 (p<0.001). The leading indications for eye amputations were trauma (n=62, 50.4%), malignancy (n=20, 16.3%), painful blind eye and absolute glaucoma (n=20, 16.3%), endophthalmitis (n=12, 9.7%), and phthisis bulbi, and cosmetic reasons (n=9, 7.3%). Conclusion: Trauma was the most common etiology for evisceration, and malignancy was the most common etiology for enucleation. Using protective eyewear and early detection of intraocular malignancy and glaucoma through routine ophthalmic examinations are essential for providing non-invasive treatment modalities instead of eye removal. PMID:26446332

  16. DOE performance indicators guidance document

    SciTech Connect

    Not Available

    1992-12-01

    SEN-29-91 directed that a Department-wide uniform process for trending and analysis of operational data be established for DOE facilities. This Performance Indicator (PI) Program establishes a uniform system for trending and analyzing operational data providing an important tool to help assess and support progress in improving performance and strengthening both DOE and contractor line management control of operations. DOE, similar to the commercial nuclear industry, considers that facilities with good performance, as measured by an overall set of performance indicators, are well-managed facilities. The Performance Indicator Program established by SEN-29-91 is but one of several initiatives undertaken by DOE to instill a new DOE and DOE contractor line management culture committed to achieving a rising standard of acceptable performance. Line management trending and analysis of data depicting the performance of their facilities is an essential element in creating this culture of ``continuous improvement,`` where performance gains achieved are maintained and early identification of deteriorating environmental, safety, and health conditions is accomplished.

  17. Indices of 1-forms, intersection indices, and Newton polyhedra

    NASA Astrophysics Data System (ADS)

    Esterov, A. I.

    2006-08-01

    The intersection indices of a certain kind of analytic set (resultant cycles) are expressed in terms of the Newton polyhedra of the corresponding defining systems of functions, provided that the principal parts of the functions are in general position. Among special cases of resultant cycles are complete intersections and the loci of matrix rank drop. Among special cases of the intersection indices of such sets are the index of a singularity of a Poincaré-Hopf vector field and its generalizations to the case of singular varieties, the index of a system of germs of 1-forms at an isolated singularity of a Gusein-Zade-Ebeling complete intersection, and the Suwa residue of a system of germs of sections of a vector bundle. One also obtains as a consequence the well-known Kushnirenko-Oka formula for the Milnor number of the germ of a map in terms of the Newton polyhedra of its components. A generalization of the well-known equality of the above-mentioned invariants of singularities to the dimensions of certain local rings is also presented.

  18. Coronary physiology assessment in the catheterization laboratory

    PubMed Central

    Díez-delhoyo, Felipe; Gutiérrez-Ibañes, Enrique; Loughlin, Gerard; Sanz-Ruiz, Ricardo; Vázquez-Álvarez, María Eugenia; Sarnago-Cebada, Fernando; Angulo-Llanos, Rocío; Casado-Plasencia, Ana; Elízaga, Jaime; Fernández Avilés Diáz, Francisco

    2015-01-01

    Physicians cannot rely solely on the angiographic appearance of epicardial coronary artery stenosis when evaluating patients with myocardial ischemia. Instead, sound knowledge of coronary vascular physiology and of the methods currently available for its characterization can improve the diagnostic and prognostic accuracy of invasive assessment of the coronary circulation, and help improve clinical decision-making. In this article we summarize the current methods available for a thorough assessment of coronary physiology. PMID:26413229

  19. Coronary physiology assessment in the catheterization laboratory.

    PubMed

    Díez-Delhoyo, Felipe; Gutiérrez-Ibañes, Enrique; Loughlin, Gerard; Sanz-Ruiz, Ricardo; Vázquez-Álvarez, María Eugenia; Sarnago-Cebada, Fernando; Angulo-Llanos, Rocío; Casado-Plasencia, Ana; Elízaga, Jaime; Fernández Avilés Diáz, Francisco

    2015-09-26

    Physicians cannot rely solely on the angiographic appearance of epicardial coronary artery stenosis when evaluating patients with myocardial ischemia. Instead, sound knowledge of coronary vascular physiology and of the methods currently available for its characterization can improve the diagnostic and prognostic accuracy of invasive assessment of the coronary circulation, and help improve clinical decision-making. In this article we summarize the current methods available for a thorough assessment of coronary physiology. PMID:26413229

  20. Pathogenesis of infections related to intravascular catheterization.

    PubMed Central

    Goldmann, D A; Pier, G B

    1993-01-01

    Over the past few decades, there have been major technological improvements in the manufacture of intravenous solutions and the manufacture and design of catheter materials. However, the risk of infection in patients receiving infusion therapy remains substantial, in part because of host factors (for example, increased use of immunosuppressive therapy, more aggressive surgery and life support, and improved survival at the extremes of life) and in part because of the availability of catheters that can be left in place for very long periods. Microbial components of normal skin flora, particularly coagulase-negative staphylococci, have emerged as the predominant pathogens in catheter-associated infections. Therefore, efforts to prevent skin microorganisms from entering the catheter wound (such as tunnelling of catheters and use of catheter cuffs and local antimicrobial agents) are logical and relatively effective. The specific properties of microorganisms that transform normally harmless commensals such as coagulase-negative staphylococci into formidable pathogens in the presence of a plastic foreign body are being explored. For example, Staphylococcus epidermidis elaborates a polysaccharide adhesin that also functions as a capsule and is a target for opsonic killing. However, the interactions between microorganism and catheter that lead to adherence, persistence, infection, and dissemination appear to be multifactorial. Images PMID:8472248