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Sample records for endoscopic papillary balloon

  1. Comparison of endoscopic papillary balloon dilatation and endoscopic sphincterotomy for bile duct stones.

    PubMed

    Sakai, Yuji; Tsuyuguchi, Toshio; Sugiyama, Harutoshi; Hayashi, Masahiro; Senoo, Jun-Ichi; Kusakabe, Yuko; Yasui, Shin; Mikata, Rintaro; Yokosuka, Osamu

    2016-05-25

    Endoscopic treatment for bile duct stones is low-invasive and currently considered as the first choice of the treatment. For the treatment of bile duct stones, papillary treatment is necessary, and the treatments used at the time are broadly classified into two types; endoscopic papillary balloon dilatation where bile duct closing part is dilated with a balloon and endoscopic sphincterotomy (EST) where bile duct closing part is incised. Both procedures have advantages and disadvantages. Golden standard is EST, however, there are patients with difficulty for EST, thus we must select the procedure based on understanding of the characteristics of the procedure, and patient backgrounds. PMID:27247706

  2. Comparison of endoscopic papillary balloon dilatation and endoscopic sphincterotomy for bile duct stones

    PubMed Central

    Sakai, Yuji; Tsuyuguchi, Toshio; Sugiyama, Harutoshi; Hayashi, Masahiro; Senoo, Jun-ichi; Kusakabe, Yuko; Yasui, Shin; Mikata, Rintaro; Yokosuka, Osamu

    2016-01-01

    Endoscopic treatment for bile duct stones is low-invasive and currently considered as the first choice of the treatment. For the treatment of bile duct stones, papillary treatment is necessary, and the treatments used at the time are broadly classified into two types; endoscopic papillary balloon dilatation where bile duct closing part is dilated with a balloon and endoscopic sphincterotomy (EST) where bile duct closing part is incised. Both procedures have advantages and disadvantages. Golden standard is EST, however, there are patients with difficulty for EST, thus we must select the procedure based on understanding of the characteristics of the procedure, and patient backgrounds. PMID:27247706

  3. Is endoscopic papillary balloon dilatation really a risk factor for post-ERCP pancreatitis?

    PubMed

    Fujisawa, Toshio; Kagawa, Koichi; Hisatomi, Kantaro; Kubota, Kensuke; Nakajima, Atsushi; Matsuhashi, Nobuyuki

    2016-07-14

    Endoscopic papillary balloon dilatation (EPBD) is useful for decreasing early complications of endoscopic retrograde cholangio-pancreatography (ERCP), including bleeding, biliary infection, and perforation, but it is generally avoided in Western countries because of a relatively high reported incidence of post-ERCP pancreatitis (PEP). However, as the efficacy of endoscopic papillary large-balloon dilatation (EPLBD) becomes widely recognized, EPBD is attracting attention. Here we investigate whether EPBD is truly a risk factor for PEP, and seek safer and more effective EPBD procedures by reviewing past studies. We reviewed thirteen randomised control trials comparing EPBD and endoscopic sphincterotomy (EST) and ten studies comparing direct EPLBD and EST. Three randomized controlled trials of EPBD showed significantly higher incidence of PEP than EST, but no study of EPLBD did. Careful analysis of these studies suggested that longer and higher-pressure inflation of balloons might decrease PEP incidence. The paradoxical result that EPBD with small-calibre balloons increases PEP incidence while EPLBD does not may be due to insufficient papillary dilatation in the former. Insufficient dilatation could cause the high incidence of PEP through the use of mechanical lithotripsy and stress on the papilla at the time of stone removal. Sufficient dilation of the papilla may be useful in preventing PEP. PMID:27468185

  4. Is endoscopic papillary balloon dilatation really a risk factor for post-ERCP pancreatitis?

    PubMed Central

    Fujisawa, Toshio; Kagawa, Koichi; Hisatomi, Kantaro; Kubota, Kensuke; Nakajima, Atsushi; Matsuhashi, Nobuyuki

    2016-01-01

    Endoscopic papillary balloon dilatation (EPBD) is useful for decreasing early complications of endoscopic retrograde cholangio-pancreatography (ERCP), including bleeding, biliary infection, and perforation, but it is generally avoided in Western countries because of a relatively high reported incidence of post-ERCP pancreatitis (PEP). However, as the efficacy of endoscopic papillary large-balloon dilatation (EPLBD) becomes widely recognized, EPBD is attracting attention. Here we investigate whether EPBD is truly a risk factor for PEP, and seek safer and more effective EPBD procedures by reviewing past studies. We reviewed thirteen randomised control trials comparing EPBD and endoscopic sphincterotomy (EST) and ten studies comparing direct EPLBD and EST. Three randomized controlled trials of EPBD showed significantly higher incidence of PEP than EST, but no study of EPLBD did. Careful analysis of these studies suggested that longer and higher-pressure inflation of balloons might decrease PEP incidence. The paradoxical result that EPBD with small-calibre balloons increases PEP incidence while EPLBD does not may be due to insufficient papillary dilatation in the former. Insufficient dilatation could cause the high incidence of PEP through the use of mechanical lithotripsy and stress on the papilla at the time of stone removal. Sufficient dilation of the papilla may be useful in preventing PEP. PMID:27468185

  5. Is Endoscopic Papillary Large Balloon Dilation Safe for Treating Large CBD Stones?

    PubMed Central

    Shim, Chan Sup; Kim, Ji Wan; Lee, Tae Yoon; Cheon, Young Koog

    2016-01-01

    In recent years, endoscopic papillary large balloon dilation (EPLBD) with endoscopic sphincterotomy (EST) has been shown to be an effective technique for the removal of large or difficult common bile duct (CBD) stones, as an alternative to EST. Reviewing the literature published since 2003, it is understood that EPLBD has fewer associated overall complications than EST. Bleeding occurred less frequently with EPLBD than with EST. There was no significant difference in postendoscopic retrograde cholangiopancreatography pancreatitis or perforation. Recent accumulated results of EPLBD with or even without EST suggest that it is a safe and effective procedure for the removal of large or difficult bile duct stones without any additional risk of severe adverse events, when performed under appropriate guidelines. Since use of a larger balloon can tear the sphincter as well as the bile duct, possibly resulting in bleeding and perforation, a balloon size that is equal to or smaller in diameter than the diameter of the native distal bile duct is recommended. The maximum transverse diameter of the stone and the balloon-stone diameter ratio have a tendency to affect the success or failure of complete removal of stones by large balloon dilation to prevent adverse effects such as perforation and bleeding. One should take into account the size of the native bile duct, the size and burden of stones, the presence of stricture of distal bile duct, and the presence of the papilla in or adjacent to a diverticulum. Even though the results of EPLBD indicate that it is a relatively safe procedure in patients with common duct stones with a dilated CBD, the recommended guidelines should be followed strictly for the prevention of major adverse events such as bleeding and perforation. PMID:27488319

  6. Endoscopic papillary balloon dilatation may preserve sphincter of Oddi function after common bile duct stone management: evaluation from the viewpoint of endoscopic manometry

    PubMed Central

    Sato, H; Kodama, T; Takaaki, J; Tatsumi, Y; Maeda, T; Fujita, S; Fukui, Y; Ogasawara, H; Mitsufuji, S

    1997-01-01

    Background—Endoscopic papillary balloon dilatation (EPBD) has been reported as a safe and effective alternative to endoscopic sphincterotomy in the management of common bile duct (CBD) stones; its effect on papillary function has yet to be elucidated. 
Aim—To investigate sphincter of Oddi (SO) motility before and after EPBD to determine its effect on SO function. 
Patients and methods—The papillary function of 10 patients with CBD stones was studied using endoscopic manometry before and one week after EPBD. The manometric studies were repeated one month after EPBD in seven patients. 
Results—One week after EPBD, CBD pressure, SO peak pressure, SO basal pressure, and SO frequency decreased significantly. One month after EPBD, however, all parameters increased although the increases in SO basal pressure and CBD pressure were not significant. There was no significant difference in values of any parameter before and one month after EPBD. No serious complications occurred. 
Conclusion—These data suggest at least partial recovery of papillary function one month after the procedure. EPBD seems to preserve papillary function in treatment of CBD stones; a longer term follow up study with SO manometry should be performed to clarify the effect of EPBD on SO function. 

 Keywords: endoscopic papillary balloon dilatation; sphincter of Oddi PMID:9391256

  7. Association of Endoscopic Sphincterotomy or Papillary Balloon Dilatation and Biliary Cancer

    PubMed Central

    Peng, Yen-Chun; Lin, Cheng-Li; Hsu, Wan-Yun; Chow, Wai-Keung; Lee, Show-Wu; Yeh, Hong-Zen; Chang, Chi-Sen; Kao, Chia-Hung

    2015-01-01

    Abstract Endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilatation (EPBD) have become the main therapeutic procedures in the treatment of biliary and pancreas disease. The risk of cholangiocarcinoma (CCA) is not well investigated among post-EST/EPBD patients with benign diseases, particularly in Asia population. A retrospective nationwide cohort study using data from Taiwan's National Health Insurance Research Database (from January 1, 1998 through December 31, 2010) was conducted. Among patients with history of biliary stone with cholangitis, there were 17,503 patients in the EST/EPBD cohort and 69,998 subjects in the comparison. The incidence rate ratio was calculated using the Poisson regression model. Multivariable Cox proportional hazard models, adjusted for potential confounding factors, were used to assess the risk of developing CCA associated with endoscopic EST/EPBD. The cumulative incidences of CCA in the 2 cohorts were calculated using Kaplan–Meier analyses, and differences between the survival curves of the 2 cohorts were analyzed using a log-rank test. The overall incidence of CCA in the EST/EPBD cohort was higher than in the controls (1.36 vs 7.37 per 1000 person-years, IRR = 5.40, 95% CI = 5.15–5.67), with an adjusted HR of 4.41 (95% CI = 3.86–5.04). There were no CCA occurrences among patients receiving EST over the follow-up period 3 year after EST performed. The cumulative incidence of extrahepatic CCA seemed to be little growing in patients receiving EPBD. The cumulative incidence of intrahepatic CCA was also steady increasing in patients treated with EPBD and was more than patients receiving EST 10 years after EPBD by Kaplan–Meier analysis. In the population-based cohort study, EST is not associated with a long-term risk of intrahepatic and extrahepatic CCA. The risk of CCA for EPBD needs further investigation. PMID:26061315

  8. Endoscopic papillary large balloon dilation for the removal of bile duct stones.

    PubMed

    Kim, Jin Hong; Yang, Min Jae; Hwang, Jae Chul; Yoo, Byung Moo

    2013-12-14

    Endoscopic papillary large balloon dilation (EPLBD) with endoscopic sphincterotomy (EST) has been widely used as the alternative to EST along with endoscopic mechanical lithotripsy (EML) for the removal of large or difficult bile duct stones. Furthermore, EPLBD without EST was recently introduced as its simplified alternative technique. Thus, we systematically searched PubMed, Medline, the Cochrane Library and EMBASE, and analyzed all gathered data of EPLBD with and without EST, respectively, by using a single standardized definition, reviewing relevant literatures, published between 2003 and June 2013, where it was performed with large-diameter balloons (12-20 mm). The outcomes, including the initial success rate, the rate of needs for EML, and the overall success rate, and adverse events were assessed in each and compared between both of two procedures: "EPLBD with EST" and "EPLBD without EST". A total of 2511 procedures from 30 published articles were included in EPLBD with EST, while a total of 413 procedures from 3 published articles were included in EPLBD without EST. In the results of outcomes, the overall success rate was 96.5% in EPLBD with EST and 97.2% in EPLBD without EST, showing no significant difference between both of them. The initial success rate (84.0% vs 76.2%, P < 0.001) and the success rate of EPLBD without EML (83.2% vs 76.7%, P = 0.001) was significantly higher, while the rate of use of EML was significantly lower (14.1% vs 21.6%, P < 0.001), in EPLBD with EST. The rate of overall adverse events, pancreatitis, bleeding, perforation, other adverse events, surgery for adverse events, and fatal adverse events were 8.3%, 2.4%, 3.6%, 0.6%, 1.7%, 0.2% and 0.2% in EPLBD with EST and 7.0%, 3.9%, 1.9%, 0.5%, 0.7%, 0% and 0% in EPLBD without EST, respectively, showing no significant difference between both of them. In conclusion, recent accumulated results of EPLBD with or even without EST suggest that it is a safe and effective procedure for the

  9. Two Cases of Cerebral Air Embolism That Occurred during Esophageal Ballooning and Endoscopic Retrograde Cholangiopancreatography

    PubMed Central

    Park, Suyeon; Ahn, Ji Yong; Ahn, Young Eun; Jeon, Sang-Beom; Lee, Sang Soo; Jung, Hwoon-Yong; Kim, Jin-Ho

    2016-01-01

    Cerebral air embolism is an extremely rare complication of endoscopic procedure and often life threatening. We present two cases of cerebral infarction due to air embolization caused by an endoscopic intervention. The first case occurred during esophageal balloon dilatation for the treatment of a stricture of an anastomosis site in a 59-year-old man and the second case occurred during endoscopic papillary balloon dilatation in a 69-year-old man who had distal common bile duct stones. After the procedure, cardiopulmonary instability and altered mental status were observed in both patients, and cerebral air embolism was diagnosed in both cases. Hyperbaric oxygen therapy was started in the first case, and high FiO2 therapy was applied in the second case. Although this complication is rare, patient outcomes can be improved if physicians are aware of this potential complication, and immediately begin proper management. PMID:26898514

  10. Two Cases of Cerebral Air Embolism That Occurred during Esophageal Ballooning and Endoscopic Retrograde Cholangiopancreatography.

    PubMed

    Park, Suyeon; Ahn, Ji Yong; Ahn, Young Eun; Jeon, Sang-Beom; Lee, Sang Soo; Jung, Hwoon-Yong; Kim, Jin-Ho

    2016-03-01

    Cerebral air embolism is an extremely rare complication of endoscopic procedure and often life threatening. We present two cases of cerebral infarction due to air embolization caused by an endoscopic intervention. The first case occurred during esophageal balloon dilatation for the treatment of a stricture of an anastomosis site in a 59-year-old man and the second case occurred during endoscopic papillary balloon dilatation in a 69-year-old man who had distal common bile duct stones. After the procedure, cardiopulmonary instability and altered mental status were observed in both patients, and cerebral air embolism was diagnosed in both cases. Hyperbaric oxygen therapy was started in the first case, and high FiO2 therapy was applied in the second case. Although this complication is rare, patient outcomes can be improved if physicians are aware of this potential complication, and immediately begin proper management. PMID:26898514

  11. Superiority of 10-mm-wide Balloon over 8-mm-wide Balloon in Papillary Dilation for Bile Duct Stones: A Matched Cohort Study

    PubMed Central

    Akiyama, Dai; Hamada, Tsuyoshi; Isayama, Hiroyuki; Nakai, Yousuke; Tsujino, Takeshi; Umefune, Gyotane; Takahara, Naminatsu; Mohri, Dai; Kogure, Hirofumi; Matsubara, Saburo; Ito, Yukiko; Yamamoto, Natsuyo; Sasahira, Naoki; Tada, Minoru; Koike, Kazuhiko

    2015-01-01

    Background/Aims: Endoscopic papillary balloon dilation (EPBD) is a possible alternative to endoscopic sphincterotomy (EST) for common bile duct (CBD) stones. To date, 10- and 8-mm EPBD have not been fully compared. Patients and Methods: Patients who underwent EPBD for CBD stones at two Japanese tertiary care centers between May 1994 and January 2014 were identified. Matched pairs with 10- and 8-mm EPBD were generated. Short- and long-term outcomes were compared between the two groups. Results: A total of 869 patients were identified (61 and 808 patients for 10- and 8-mm EPBD, respectively), and 61 well-balanced pairs were generated. The rate of complete stone removal within a single session was higher in the 10-mm EPBD group than in the 8-mm EPBD group (69% vs. 44%, P < 0.001), and use of lithotripsy was less frequent in the 10-mm EPBD group (23% vs. 56%, P < 0.001). The rates of post-ERCP pancreatitis were similar between the 10- and 8-mm EPBD groups (11% vs. 8%). Cumulative biliary complication-free rates were not statistically different between the two groups: 88% [95% confidence interval (CI): 79–97%] and 94% (95% CI: 88–100%) at 1 year and 69% (95% CI: 56–85%) and 80% (95% CI: 69–93%) at 2 years in the 10- and 8-mm EPBD groups, respectively. In the 10-mm EPBD group, ascending cholangitis was not observed, and pneumobilia was found in 5% of cases during the follow-up period. Conclusions: EPBD using a 10-mm balloon for CBD stones is safe and more effective than 8-mm EPBD. The sphincter function is highly preserved after 10-mm EPBD. PMID:26228364

  12. Endoscopic-assisted minimally invasive resection of a papillary muscle blood cyst in an adult patient.

    PubMed

    Okamoto, Kazuma; Kudo, Mikihiko; Hayashi, Kanako; Shimizu, Hideyuki

    2016-02-01

    We describe endoscopic-assisted minimally invasive resection of a blood cyst originating from the papillary muscle that caused severe mitral regurgitation and necessitated mitral valve replacement in an active adult woman, as well as a review of the relevant literature. An endoscopic view increases the visibility of the surgical target and facilitates a precise observation of the tumour and dissection at the appropriate layer. The On-X mechanical valve was chosen for mitral valve repair to minimize thromboembolic risk. This patient additionally benefited from endoscopic-assisted right minithoracotomy in terms of both cosmetic and functional aspects. PMID:26586675

  13. Percutaneous papillary large balloon dilation during percutaneous cholangioscopic lithotripsy for the treatment of large bile-duct stones: a feasibility study.

    PubMed

    Han, Jee Young; Jeong, Seok; Lee, Don Haeng

    2015-03-01

    When access to a major duodenal papilla or endoscopic retrograde cholangiopancreatography has failed, percutaneous transhepatic cholangioscopic lithotripsy (PTCS-L) may be useful for removing common bile duct (CBD) stones. However, the feasibility and usefulness of percutaneous transhepatic papillary large-balloon dilation (PPLBD) during PTCS-L for the removal of large CBD stones has not been established. We aimed to determine the safety and efficacy of PPLBD for the treatment of large CBD stones. Eleven patients with large CBD stones in whom the access to the major papilla or bile duct had failed were enrolled prospectively. Papillary dilation was performed using a large (12-20 mm) dilation balloon catheter via the percutaneous transhepatic route. Post-procedure adverse events and efficacy of the stone retrieval were measured. The initial success rate of PPLBD was 100%. No patient required a basket to remove a stone after PPLBD. Electrohydraulic lithotripsy was required in 2 (18.2%) patients. The median time to complete stone removal after PPLBD was 17.8 min and no adverse events occurred after PPLBD. Asymptomatic hyperamylasemia was not encountered in any patients. This study indicates that PPLBD is safe and effective for removal of large CBD stones. PMID:25729250

  14. Double-balloon enteroscopy for ERCP in patients with Billroth II anatomy: results of a large series of papillary large-balloon dilation for biliary stone removal

    PubMed Central

    Cheng, Chi-Liang; Liu, Nai-Jen; Tang, Jui-Hsiang; Yu, Ming-Chin; Tsui, Yi-Ning; Hsu, Fang-Yu; Lee, Ching-Song; Lin, Cheng-Hui

    2015-01-01

    Background and study aims: Data on double-balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatogrphy (ERCP) in patients with Billroth II gastrectomy and the use of endoscopic papillary large-balloon dilation (EPLBD) for the removal of common bile duct stones in Billroth II anatomy are limited. The aims of the study were to evaluate the success of DBE-assisted ERCP in patients with Billroth II gastrectomy and examine the efficacy of EPLBD ( ≥ 10 mm) for the removal of common bile duct stones. Patients and methods: A total of 77 patients with Billroth II gastrectomy in whom standard ERCP had failed underwent DBE-assisted ERCP. DBE success was defined as visualizing the papilla and ERCP success as completing the intended intervention. The clinical results of EPLBD for the removal of common bile duct stones were analyzed. Results: DBE was successful in 73 of 77 patients (95 %), and ERCP success was achieved in 67 of these 73 (92 %). Therefore, the rate of successful DBE-assisted ERCP was 87 % (67 of a total of 77 patients). The reasons for ERCP failure (n = 10) included tumor obstruction (n = 2), adhesion obstruction (n = 2), failed cannulation (n = 3), failed stone removal (n = 2), and bowel perforation (n = 1). Overall DBE-assisted ERCP complications occurred in 5 of 77 patients (6.5 %). A total of 48 patients (34 male, mean age 75.5 years) with common bile duct stones underwent EPLBD. Complete stone removal in the first session was accomplished in 36 patients (75 %); mechanical lithotripsy was required in 1 patient. EPLBD-related mild perforation occurred in 2 patients (4 %). No acute pancreatitis occurred. Conclusions: DBE permits therapeutic ERCP in patients who have a difficult Billroth II gastrectomy with a high success rate and acceptable complication rates. EPLBD is effective and safe for the removal of common bile duct stones in patients with Billroth II anatomy. PMID:26171434

  15. Endoscopic ultrasonography-guided drainage of infected intracystic papillary adenocarcinoma of the liver.

    PubMed

    Kodama, Ryo; Saegusa, Hisanobu; Ushimaru, Hiroyasu; Ikeno, Tatsuo; Makino, Mutsuki; Kawaguchi, Kenji

    2015-10-01

    We describe a case of effective use of endoscopic ultrasonography (EUS)-guided drainage of an infected intracystic papillary adenocarcinoma (ICPA) of the liver. The patient was an 84-year-old woman who was admitted with complaints of continuous epigastric pain and a slight fever. Laboratory data revealed severe inflammation. Computed tomography scanning showed a 110-mm cystic lesion with enhanced papillary tumors in the medial segment of the liver associated with a cyst in the right lobe and subcapsular cyst of the liver. Streptococcus species were detected in the culture of cystic fluid, and a diagnosis of infected ICPA was suspected. Although the patient was medicated by antibiotics, the fever did not resolve. EUS-guided transgastric drainage was performed for the abscess of the medial segment of the liver. Fourteen days after the endoscopic procedure, the plastic drainage tube was replaced with a metal stent. Inserting an endoscope into the liver cyst through the metal stent permitted observation and biopsy of an intracystic tumor, and the diagnosis of ICPA was confirmed. The patient was discharged with the internal metal stent still in place. PMID:26412329

  16. Short-type single balloon enteroscope for endoscopic retrograde cholangiopancreatography with altered gastrointestinal anatomy

    PubMed Central

    Yamauchi, Hiroshi; Kida, Mitsuhiro; Okuwaki, Kosuke; Miyazawa, Shiro; Iwai, Tomohisa; Takezawa, Miyoko; Kikuchi, Hidehiko; Watanabe, Maya; Imaizumi, Hiroshi; Koizumi, Wasaburo

    2013-01-01

    AIM: To evaluate the effectiveness of a short-type single-balloon-enteroscope (SBE) for endoscopic retrograde cholangiopancreatography (ERCP) in patients with a reconstructed intestine. METHODS: Short-type SBE was developed to perform ERCP in postoperative patients with a reconstructed intestine. Short-type SBE is a direct-viewing endoscope with the following specifications: working length, 1520 mm; total length, 1840 mm; channel diameter, 3.2 mm. In addition, short-type SBE has a water-jet channel. The study group comprised 22 patients who underwent 31 sessions of short-type SBE-assisted ERCP from June 2011 through May 2012. Reconstruction was performed by Billroth-II (B-II) gastrectomy in 6 patients (8 sessions), Roux-en-Y (R-Y) gastrectomy in 14 patients (21 sessions), and R-Y hepaticojejunostomy in 2 patients (2 sessions). We retrospectively studied the rate of reaching the blind end (papilla of Vater or choledochojejunal anastomosis), mean time required to reach the blind end, diagnostic success rate (defined as the rate of successfully imaging the bile and pancreatic ducts), therapeutic success rate (defined as the rate of successfully completing endoscopic treatment), mean procedure time, and complications. RESULTS: Among the 31 sessions of ERCP, the rate of reaching the blind end was 88% in B-II gastrectomy, 91% in R-Y gastrectomy, and 100% in R-Y hepaticojejunostomy. The mean time required to reach the papilla was 18.3 min in B-II gastrectomy, 21.1 min in R-Y gastrectomy, and 32.5 min in R-Y hepaticojejunostomy. The diagnostic success rates in all patients and those with an intact papilla were respectively 86% and 86% in B-II gastrectomy, 90% and 87% in R-Y gastrectomy, and 100% in R-Y hepaticojejunostomy. The therapeutic success rates in all patients and those with an intact papilla were respectively 100% and 100% in B-II gastrectomy, 94% and 92% in R-Y gastrectomy, and 100% in R-Y hepaticojejunostomy. Because the channel diameter was 3.2 mm, stone

  17. Endoscopic sinus surgery might reduce exacerbations and symptoms more than balloon sinuplasty

    PubMed Central

    Koskinen, Anni; Penttilä, Matti; Myller, Jyri; Hammarén-Malmi, Sari; Silvola, Juha; Haahtela, Tari; Hytönen, Maija

    2012-01-01

    Background: Endoscopic sinus surgery (ESS) is considered after medical therapy failure of chronic rhinosinusitis (CRS). The balloon sinuplasty dilates the natural ostium without moving mucosa or bone. It still lacks evidence from randomized controlled trials. The aim of this retrospective controlled study was to compare the symptom outcomes after maxillary sinus surgery with either the ESS or the balloon sinuplasty technique. No previous or additional sinonasal operations were accepted. Methods: Two hundred eight patients with CRS without nasal polyps underwent either balloon sinuplasty or ESS. The patients who met with the inclusion criteria (n = 45 in ESS group and n = 40 in balloon group) replied to a questionnaire of history factors, exacerbations, and a visual analog scale (VAS) scoring of the change in symptoms, on average 28 ± 6 (mean ± SD) months postoperatively. Results: The groups were identical in the response rate (64%), patient characteristics, and the improvement in all of the asked symptoms. Patients with CRS-related comorbidity and/or present occupational exposure had a statistically significantly better symptom reduction after ESS than after balloon sinusotomy. Moreover, the balloon sinusotomy group reported a statistically significant higher number of maxillary sinus punctures and antibiotic courses during the last 12 months. Conclusion: ESS might be superior to balloon sinuplasty, especially in patients with risk factors. There is a need to perform more controlled studies on the treatment choices of CRS. PMID:23232189

  18. Endoscopic therapy for weight loss: Gastroplasty, duodenal sleeves, intragastric balloons, and aspiration

    PubMed Central

    Kumar, Nitin

    2015-01-01

    A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and weight loss surgery. Endoscopic procedures have the potential to bridge the gap between medical therapy and surgery. Current primary endoscopic bariatric therapies can be classified as restrictive, bypass, space-occupying, or aspiration therapy. Restrictive procedures include the USGI Primary Obesity Surgery Endolumenal procedure, endoscopic sleeve gastroplasty using Apollo OverStitch, TransOral GAstroplasty, gastric volume reduction using the ACE stapler, and insertion of the TERIS restrictive device. Intestinal bypass has been reported using the EndoBarrier duodenal-jejunal bypass liner. A number of space-occupying devices have been studied or are in use, including intragastric balloons (Orbera, Reshape Duo, Heliosphere BAG, Obalon), Transpyloric Shuttle, and SatiSphere. The AspireAssist aspiration system has demonstrated efficacy. Finally, endoscopic revision of gastric bypass to address weight regain has been studied using Apollo OverStitch, the USGI Incisionless Operating Platform Revision Obesity Surgery Endolumenal procedure, Stomaphyx, and endoscopic sclerotherapy. Endoscopic therapies for weight loss are potentially reversible, repeatable, less invasive, and lower cost than various medical and surgical alternatives. Given the variety of devices under development, in clinical trials, and currently in use, patients will have multiple endoscopic options with greater efficacy than medical therapy, and with lower invasiveness and greater accessibility than surgery. PMID:26240686

  19. Endoscopic therapy for weight loss: Gastroplasty, duodenal sleeves, intragastric balloons, and aspiration.

    PubMed

    Kumar, Nitin

    2015-07-25

    A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and weight loss surgery. Endoscopic procedures have the potential to bridge the gap between medical therapy and surgery. Current primary endoscopic bariatric therapies can be classified as restrictive, bypass, space-occupying, or aspiration therapy. Restrictive procedures include the USGI Primary Obesity Surgery Endolumenal procedure, endoscopic sleeve gastroplasty using Apollo OverStitch, TransOral GAstroplasty, gastric volume reduction using the ACE stapler, and insertion of the TERIS restrictive device. Intestinal bypass has been reported using the EndoBarrier duodenal-jejunal bypass liner. A number of space-occupying devices have been studied or are in use, including intragastric balloons (Orbera, Reshape Duo, Heliosphere BAG, Obalon), Transpyloric Shuttle, and SatiSphere. The AspireAssist aspiration system has demonstrated efficacy. Finally, endoscopic revision of gastric bypass to address weight regain has been studied using Apollo OverStitch, the USGI Incisionless Operating Platform Revision Obesity Surgery Endolumenal procedure, Stomaphyx, and endoscopic sclerotherapy. Endoscopic therapies for weight loss are potentially reversible, repeatable, less invasive, and lower cost than various medical and surgical alternatives. Given the variety of devices under development, in clinical trials, and currently in use, patients will have multiple endoscopic options with greater efficacy than medical therapy, and with lower invasiveness and greater accessibility than surgery. PMID:26240686

  20. Benign Post-Radiation Rectal Stricture Treated with Endoscopic Balloon Dilation and Intralesional Triamcinolone Injection

    PubMed Central

    Karanikas, Michael; Touzopoulos, Panagiotis; Mitrakas, Alexandros; Zezos, Petros; Zarogoulidis, Paul; Machairiotis, Nikolaos; Efremidou, Eleni; Liratzopoulos, Nikolaos; Polychronidis, Alexandros; Kouklakis, George

    2012-01-01

    Post-radiation stricture is a rare complication after pelvis irradiation, but must be in the mind of the clinician evaluating a lower gastrointestinal obstruction. Endoscopy has gained an important role in chronic radiation proctitis with several therapeutic options for management of intestinal strictures. The treatment of rectal strictures has been limited to surgery with high morbidity and mortality. Therefore, a less invasive therapeutic approach for benign rectal strictures, endoscopic balloon dilation with or without intralesional steroid injection, has become a common treatment modality. We present a case of benign post-radiation rectal stricture treated successfully with balloon dilation and adjuvant intralesional triamcinolone injection. A 70-year-old woman presented to the emergency room complaining for 2 weeks of diarrhea and meteorism, 11 years after radiation of the pelvis due to adenocarcinoma of the uterus. Colonoscopy revealed a stricture at the rectum and multiple endoscopic biopsies were obtained from the stricture. The stricture was treated with endoscopic balloon dilation and intralesional triamcinolone injection. The procedure appears to have a high success rate and a very low complication rate. Histologic examination of the biopsies revealed non-specific inflammatory changes of the rectal mucosa and no specific changes of the mucosa due to radiation. All biopsies were negative for malignancy. The patient is stricture-free 12 months post-treatment. PMID:23271987

  1. From Capsule Endoscopy to Balloon-Assisted Deep Enteroscopy: Exploring Small-Bowel Endoscopic Imaging

    PubMed Central

    Cooley, D. Matthew; Walker, Andrew J.

    2015-01-01

    In the past 15 years, the use of endoscopic evaluations in patients with obscure gastrointestinal bleeding has become more common. Indications for further endoscopic interventions include iron deficiency anemia, suspicion of Crohn’s disease or small-bowel tumors, assessment of celiac disease or of ulcers induced by nonsteroidal anti-inflammatory drugs, and screening for familial adenomatous polyposis. Often, capsule endoscopy is performed in concert with other endoscopic studies and can guide decisions regarding whether enteroscopy should be carried out in an anterograde or a retrograde approach. Retrograde endoscopy is beneficial in dealing with disease of the more distal small bowel. Multiple studies have examined the diagnostic yield of balloon-assisted deep enteroscopy and have estimated a diagnostic yield of 40% to 80%. Some of the studies have found that diagnostic yields are higher when capsule endoscopy is performed before balloon-assisted deep enteroscopy in a search for small-bowel bleeds. Each of these procedures has a role when performed alone; however, research suggests that they are especially effective as complementary techniques and together can provide better-directed therapy. Both procedures are relatively safe, with high diagnostic and therapeutic yields that allow evaluation of the small bowel. Because both interventions are relatively new to the world of gastroenterology, much research remains to be done regarding their overall efficacy, cost, and safety, as well as further indications for their use in the detection and treatment of diseases of the small bowel. PMID:27099585

  2. From Capsule Endoscopy to Balloon-Assisted Deep Enteroscopy: Exploring Small-Bowel Endoscopic Imaging.

    PubMed

    Cooley, D Matthew; Walker, Andrew J; Gopal, Deepak V

    2015-03-01

    In the past 15 years, the use of endoscopic evaluations in patients with obscure gastrointestinal bleeding has become more common. Indications for further endoscopic interventions include iron deficiency anemia, suspicion of Crohn's disease or small-bowel tumors, assessment of celiac disease or of ulcers induced by nonsteroidal anti-inflammatory drugs, and screening for familial adenomatous polyposis. Often, capsule endoscopy is performed in concert with other endoscopic studies and can guide decisions regarding whether enteroscopy should be carried out in an anterograde or a retrograde approach. Retrograde endoscopy is beneficial in dealing with disease of the more distal small bowel. Multiple studies have examined the diagnostic yield of balloon-assisted deep enteroscopy and have estimated a diagnostic yield of 40% to 80%. Some of the studies have found that diagnostic yields are higher when capsule endoscopy is performed before balloon-assisted deep enteroscopy in a search for small-bowel bleeds. Each of these procedures has a role when performed alone; however, research suggests that they are especially effective as complementary techniques and together can provide better-directed therapy. Both procedures are relatively safe, with high diagnostic and therapeutic yields that allow evaluation of the small bowel. Because both interventions are relatively new to the world of gastroenterology, much research remains to be done regarding their overall efficacy, cost, and safety, as well as further indications for their use in the detection and treatment of diseases of the small bowel. PMID:27099585

  3. A Novel Endoscopic Method to Relieve Food Impaction Using an Inflatable Balloon.

    PubMed

    Anand, Rohit; Garg, Shashank; Dubin, Ethan; Dutta, Sudhir

    2015-01-01

    Food impaction in the esophagus is a relatively common medical emergency. Most of these food impactions are relieved spontaneously. But for complete esophageal food impactions or impactions not relieved spontaneously, traditional endoscopic methods like using a Roth net, polypectomy snare, or rat or alligator tooth forceps are used to gently manipulate the food material into the stomach. However, these methods may not work in certain circumstances. We present a case of proximal esophageal food impaction that was relieved using an inflatable balloon after the conventional methods proved unsuccessful. PMID:26266059

  4. Using balloon-overtube-assisted enteroscopy for postoperative endoscopic retrograde cholangiopancreatography

    PubMed Central

    Skinner, Matthew; Velázquez-Aviña, Jacobo

    2014-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is technically more challenging in patients with postsurgical anatomy such as Roux-en-Y anastomosis, frequently mandating an operative intervention. Although limited, there is growing evidence that ERCP can be performed using the balloon-overtube-assisted enteroscopy (BOAE) in patients with complex postoperative anatomy. We present the technical aspects of performing ERCP with the BOAE in patients presenting with complex postsurgical anatomy having biliary problems. ERCP using the BOAE is feasible in patients with complex postsurgical anatomy, permitting diagnostic and therapeutic interventions in 80% of patients. PMID:25364385

  5. Successful Treatment of Early-Stage Jejunum Adenocarcinoma by Endoscopic Mucosal Resection Using Double-Balloon Endoscopy: A Case Report

    PubMed Central

    Suzuki, Hirobumi; Yamada, Atsuo; Watabe, Hirotsugu; Kobayashi, Yuka; Hirata, Yoshihiro; Yamaji, Yutaka; Yoshida, Haruhiko; Koike, Kazuhiko

    2012-01-01

    Small bowel adenocarcinoma (SBA) has generally been considered to have a poor prognosis because of nonspecific presentations and difficulties in detection of the disease. The advent of capsule endoscopy (CE) and double-balloon endoscopy (DBE) makes it possible to access to the small intestine for endoscopic interventions. We describe a successful case of early jejunum adenocarcinoma completely resected by endoscopic mucosal resection (EMR) using double-balloon endoscopy (DBE). Early diagnosis and EMR using new technologies such as CE and DBE may improve the recognition of this disease that, at present, has a poor prognosis. PMID:22844191

  6. Successful endoscopic hemostasis for ruptured duodenal varices after balloon-occluded retrograde transvenous obliteration.

    PubMed

    Soga, Koichi; Tomikashi, Koichi; Fukumoto, Kohei; Miyawaki, Ki-Ichirou; Okuda, Kotaro; Konishi, Hideyuki; Yagi, Nobuaki; Wakabayashi, Naoki; Kokura, Satoshi; Naito, Yuji; Yoshikawa, Toshikazu

    2010-10-01

    A 75-year-old man with general malaise and appetite loss was transferred to our hospital for assessment and treatment of liver failure. Laboratory findings on admission showed anemia, and gastroduodenoscopy (GDS) revealed linear esophageal varices and tensive duodenal varices (DV) in the second portion of the duodenum. Systemic examinations did not reveal any significant lesion capable of explaining his anemia, except for DV. Balloon-occluded retrograde transvenous obliteration was carried out to prevent DV bleeding. Good pooling of sclerosant was observed using two balloon catheters. However, contrast-enhanced computed tomography after the procedure revealed no thrombosis in DV, and the patient complained of tarry stools before additional therapy. Emergent GDS revealed ruptured DV with fresh blood and erosions on the surface. Emergent endoscopic obliteration using the tissue adhesive N-butyl-2-cyanoacrylate was carried out and complete hemostasis was achieved. Although no rebleeding episodes were observed after emergent obliteration, the patient died of sepsis following spontaneous bacterial peritonitis 53 days after admission. Autopsy revealed that DV dropped out, and the deep vein was replaced by granulation tissue. No signs of thrombi were detected, except varices. This autopsy case revealed the difficulty in DV management. PMID:21175490

  7. Endoscopic management of difficult common bile duct stones

    PubMed Central

    Trikudanathan, Guru; Navaneethan, Udayakumar; Parsi, Mansour A

    2013-01-01

    Endoscopy is widely accepted as the first treatment option in the management of bile duct stones. In this review we focus on the alternative endoscopic modalities for the management of difficult common bile duct stones. Most biliary stones can be removed with an extraction balloon, extraction basket or mechanical lithotripsy after endoscopic sphincterotomy. Endoscopic papillary balloon dilation with or without endoscopic sphincterotomy or mechanical lithotripsy has been shown to be effective for management of difficult to remove bile duct stones in selected patients. Ductal clearance can be safely achieved with peroral cholangioscopy guided laser or electrohydraulic lithotripsy in most cases where other endoscopic treatment modalities have failed. Biliary stenting may be an alternative treatment option for frail and elderly patients or those with serious co morbidities. PMID:23345939

  8. Innovations and techniques for balloon-enteroscope-assisted endoscopic retrograde cholangiopancreatography in patients with altered gastrointestinal anatomy.

    PubMed

    Yamauchi, Hiroshi; Kida, Mitsuhiro; Imaizumi, Hiroshi; Okuwaki, Kosuke; Miyazawa, Shiro; Iwai, Tomohisa; Koizumi, Wasaburo

    2015-06-01

    Endoscopic retrograde cholangiopancreatography (ERCP) remains challenging in patients who have undergone surgical reconstruction of the intestine. Recently, many studies have reported that balloon-enteroscope-assisted ERCP (BEA-ERCP) is a safe and effective procedure. However, further improvements in outcomes and the development of simplified procedures are required. Percutaneous treatment, Laparoscopy-assisted ERCP, endoscopic ultrasound-guided anterograde intervention, and open surgery are effective treatments. However, treatment should be noninvasive, effective, and safe. We believe that these procedures should be performed only in difficult-to-treat patients because of many potential complications. BEA-ERCP still requires high expertise-level techniques and is far from a routinely performed procedure. Various techniques have been proposed to facilitate scope insertion (insertion with percutaneous transhepatic biliary drainage (PTBD) rendezvous technique, Short type single-balloon enteroscopes with passive bending section, Intraluminal injection of indigo carmine, CO2 inflation guidance), cannulation (PTBD or percutaneous transgallbladder drainage rendezvous technique, Dilation using screw drill, Rendezvous technique combining DBE with a cholangioscope, endoscopic ultrasound-guided rendezvous technique), and treatment (overtube-assisted technique, Short type balloon enteroscopes) during BEA-ERCP. The use of these techniques may allow treatment to be performed by BEA-ERCP in many patients. A standard procedure for ERCP yet to be established for patients with a reconstructed intestine. At present, BEA-ERCP is considered the safest and most effective procedure and is therefore likely to be recommended as first-line treatment. In this article, we discuss the current status of BEA-ERCP in patients with surgically altered gastrointestinal anatomy. PMID:26074685

  9. Innovations and techniques for balloon-enteroscope-assisted endoscopic retrograde cholangiopancreatography in patients with altered gastrointestinal anatomy

    PubMed Central

    Yamauchi, Hiroshi; Kida, Mitsuhiro; Imaizumi, Hiroshi; Okuwaki, Kosuke; Miyazawa, Shiro; Iwai, Tomohisa; Koizumi, Wasaburo

    2015-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) remains challenging in patients who have undergone surgical reconstruction of the intestine. Recently, many studies have reported that balloon-enteroscope-assisted ERCP (BEA-ERCP) is a safe and effective procedure. However, further improvements in outcomes and the development of simplified procedures are required. Percutaneous treatment, Laparoscopy-assisted ERCP, endoscopic ultrasound-guided anterograde intervention, and open surgery are effective treatments. However, treatment should be noninvasive, effective, and safe. We believe that these procedures should be performed only in difficult-to-treat patients because of many potential complications. BEA-ERCP still requires high expertise-level techniques and is far from a routinely performed procedure. Various techniques have been proposed to facilitate scope insertion (insertion with percutaneous transhepatic biliary drainage (PTBD) rendezvous technique, Short type single-balloon enteroscopes with passive bending section, Intraluminal injection of indigo carmine, CO2 inflation guidance), cannulation (PTBD or percutaneous transgallbladder drainage rendezvous technique, Dilation using screw drill, Rendezvous technique combining DBE with a cholangioscope, endoscopic ultrasound-guided rendezvous technique), and treatment (overtube-assisted technique, Short type balloon enteroscopes) during BEA-ERCP. The use of these techniques may allow treatment to be performed by BEA-ERCP in many patients. A standard procedure for ERCP yet to be established for patients with a reconstructed intestine. At present, BEA-ERCP is considered the safest and most effective procedure and is therefore likely to be recommended as first-line treatment. In this article, we discuss the current status of BEA-ERCP in patients with surgically altered gastrointestinal anatomy. PMID:26074685

  10. Single Balloon Enteroscopy for Endoscopic Retrograde Cholangiography in a Patient with Hepaticojejunostomy after Liver Transplant

    PubMed Central

    Di Pisa, Marta; Miraglia, Roberto; Volpes, Riccardo; Gruttadauria, Salvatore; Traina, Mario

    2010-01-01

    We report a case of a post-transplant patient with hepaticojejunostomy in whom we used a single balloon enteroscopy to access the biliary tree. This procedure seems to be safe and feasible for approaching the biliary anastomosis by means of the overtube and fixation of the small bowel by the balloon. PMID:20454574

  11. Quality of life and cosmetic result of single-port access endoscopic thyroidectomy via axillary approach in patients with papillary thyroid carcinoma

    PubMed Central

    Huang, Jian-kang; Ma, Ling; Song, Wen-hua; Lu, Bang-yu; Huang, Yu-bin; Dong, Hui-ming

    2016-01-01

    Background Endoscopic thyroidectomy for minimally invasive thyroid surgery has been widely applied in the past decade. The present study aimed to evaluate the effects of single-port access transaxillary totally endoscopic thyroidectomy on the postoperative outcomes and functional parameters, including quality of life and cosmetic result in patients with papillary thyroid carcinoma (PTC). Patients and methods Seventy-five patients with PTC who underwent endoscopic thyroidectomy via a single-port access transaxillary approach were included (experimental group). A total of 123 patients with PTC who were subjected to conventional open total thyroidectomy served as the control group. The health-related quality of life and cosmetic and satisfaction outcomes were assessed postoperatively. Results The mean operation time was significantly increased in the experimental group. The physiological functions and social functions in the two groups were remarkably augmented after 6 months of surgery. However, there was no significant difference in the scores of speech and taste between the two groups at the indicated time of 1 month and 6 months. In addition, the scores for appearance, satisfaction with appearance, role-physical, bodily pain, and general health in the experimental group were better than those in the control group at 1 month and 6 months after surgery. Conclusion The single-port access transaxillary totally endoscopic thyroidectomy is safe and feasible for the treatment of patients with PTC. The subjects who underwent this technique have a good perception of their general state of health and are likely to participate in social activities. It is worthy of being clinically used for patients with PTC. PMID:27445496

  12. Endoscopic balloon dilatation of postsurgical intestinal strictures in Crohn's disease: case report and review of the literature.

    PubMed

    Ljubicić, Neven; Bisćanin, Alen; Nikić, Ines; Budimir, Ivan; Nikolić, Marko; Pavić, Tajana

    2013-09-01

    Strictures are one of the most common complications of Crohn's disease. If symptomatic and resistant to medical anti-inflammatory therapy, and especially in cases of acute obstruction, surgical correction may be unavoidable. Although surgical treatment is dramatically effective in curing Crohn's disease strictures, a high rate of postsurgical restenosis has been recognized, ultimately requiring additional surgery. To avoid the risks and costs entailed by repeated surgical resection, endoscopic balloon dilatation (EBD) has been proposed as a conservative treatment option for intestinal strictures in Crohn's disease, in which the stricture is pneumatically dilated with through-the-scope balloons of different diameters. The main clinical indication for EBD is the appearance of obstructive symptoms associated with the stricture, especially if they are postoperative and shorter than 4 centimeters. Usually more than one dilatation session is required for every stricture. EBD is applied infrequently, possibly due to the perceived risk of perforation and early stricture recurrence, but studies have demonstrated that EBD has a high success rate, a low chance of complications, excellent symptomatic response, as well as good short-term and long-term outcomes, proving that it is a relatively simple and successful technique that provides long-term effective palliation of the symptoms with minimal risk in patients with simple strictures, and offers a reasonable alternative to surgery. PMID:24558771

  13. Sinuplasty (Balloon Catheter Dilation)

    MedlinePlus

    ... development of the balloon dilating catheter and its adaptation to sinus surgery. In the 1980s, the field ... used in endoscopic sinus surgery. It is the adaptation or application of minimally-invasive balloon technology to ...

  14. [A case of ruptured duodenal varices successfully treated by combination therapy with endoscopic clipping and balloon-occluded retrograde transvenous obliteration].

    PubMed

    Taniguchi, Hideaki; Shibagaki, Koutaro; Goto, Daisuke; Kakehi, Eiichi

    2015-11-01

    An 80-year-old woman with a history of chronic hepatitis B was referred to our hospital because of upper gastrointestinal bleeding of unknown origin. Dynamic computed tomography revealed liver cirrhosis and hepatofugal collateral vessels around the duodenum. Emergency esophagogastroduodenoscopy showed duodenal varices with an erosive spot, highly suggestive of a variceal rupture site. We immediately performed endoscopic clipping of the ruptured site to achieve temporary hemostasis. Ten days later, elective balloon-occluded retrograde transvenous obliteration (B-RTO) was performed to prevent recurrence. We describe a successfully treated case of duodenal variceal rupture managed by combination therapy with endoscopic clipping and B-RTO. PMID:26537327

  15. Successful balloon overtube-guided colorectal endoscopic submucosal dissection by a gastroscope.

    PubMed

    Pérez-Cuadrado Robles, Enrique; Yamada, Masayoshi; Saito, Yutaka

    2016-05-01

    Colorectal ESD can achieve en-bloc resection. However, cecum, hepatic and splenic flexures are difficult locations because of unstable scope maneuvers and narrow working space. In these cases, balloon overtube-guided ESD may confer a better approach, improving the access to the lesion and scope manoeuvres. This overtube has a large outer diameter and enables the use of a therapeutic gastroscope. The procedure can also facilitate traction-assisted techniques allowing a high-rate of en-bloc resections. In addition, large specimens can be easily retrieved through. PMID:27188591

  16. Balloon-occluded retrograde transvenous obliteration versus endoscopic injection sclerotherapy for isolated gastric varices: a comparative study.

    PubMed

    Emori, Keigo; Toyonaga, Atsushi; Oho, Kazuhiko; Kumamoto, Masafumi; Haruta, Tsuyoshi; Inoue, Hiroto; Morita, Yukihiko; Mitsuyama, Keiichi; Tsuruta, Osamu; Sata, Michio

    2014-01-01

    Isolated gastric varices (IGV) have a lower risk of bleeding than esophageal varices, however IGV bleeding is associated with a higher mortality than bleeding of esophageal varices. In recent years, two widely used treatments for IGV have been balloon-occluded retrograde transvenous obliteration (B-RTO) and endoscopic injection sclerotherapy (EIS) using cyanoacrylate or ethanolamine oleate (EO). This study compared these two treatment methods for IGV. The subjects were 112 patients who were treated at our hospital for IGV bleeding between October 1990 and December 2003. Forty-nine (49) patients were treated with B-RTO and 63 patients with EIS. These two patient groups were compared as regards content of treatment, post-treatment incidence of variceal bleeding, incidence of IGV rebleeding, survival rate, cause of death, and complications. Multivariate analysis was performed on post-treatment variceal bleeding and survival. Although EO was used in higher amounts in the B-RTO group than in the EIS group, the B-RTO group had a significantly lower number of treatment sessions and a significantly shorter treatment period (p<0.05). The EIS group had significantly more patients with IGV rebleeding after treatment than the B-RTO group. Treatment method was the only independent prognostic factor of IGV bleeding after treatment (p=0.024). The two groups did not differ significantly in the percentage of patients with aggravated esophageal varices after treatment. Bleeding from ectopic varices was not observed in any patient. There was no significant difference in survival by treatment method. The presence of hepatocellular carcinoma was the only independent prognostic factor for survival (p=0.003). It is concluded that B-RTO was more effective than EIS in the eradication of IGV and prevention of IGV recurrence and rebleeding. PMID:24858411

  17. The Efficacy and Safety of Endoscopic Balloon Dilation Combined with Stenting in Patients with Biliary Anastomotic Strictures After Orthotopic Liver Transplantation.

    PubMed

    Peng, Chunyan; Ma, Chao; Xu, Guifang; Shen, Shanshan; Lv, Ying; Zou, Xiaoping

    2015-06-01

    Endoscopic balloon dilation combined with stenting has been increasingly used in managing biliary anastomotic strictures (BAS) after orthotopic liver transplantation (OLT). However, data on the efficacy and safety vary among different studies. To obtain reliable estimates for the efficacy and safety of this endoscopic combination therapy in post-OLT BAS. A systematic search was conducted in the literature published until June 2012. The outcomes of individual study were transformed into comparable data using the Freeman-Tukey double arcsine transformation method. Fixed-effect or random-effect models were built to simulate the outcomes. Subgroup analysis and meta-regression were used to explore the sources of clinical heterogeneity. Clinical resolution and recurrence were defined as the primary outcomes and complications and mortality as secondary outcomes. Nineteen studies (15 retrospective, 4 prospective; 17 full-texts, 2 abstracts) were included, with a total of 745 patients. Fully covered self-expandable metal stent was only reported in one study, achieving a resolution rate of 92.3 %, recurrence rate of 8.3 %, and complication rate of 7.7 %. For 18 studies using plastic stents, the pooled resolution rate was 86 % (95 % CI 80-91 %; I (2) = 74.7 %). Abstracts, study design, and the delay from OLT to BAS diagnosis were contributing factors for heterogeneity in resolution. The pooled recurrence rate was 9 % (95 % CI 5-13 %; I (2) = 59.6 %). Longer stenting duration predicted less recurrence (OR = 0.95, p = 0.002). The pooled complication rate was 14 % (95 % CI 8-21 %, I (2) = 71.2 %). No procedure-related mortality was reported. Endoscopic balloon dilation combined with stenting is a relatively effective and safe modality in post-OLT BAS. PMID:25552252

  18. Endoscopic removal of a spontaneously fractured biliary uncovered self-expandable metal stent.

    PubMed

    Kawakubo, Kazumichi; Isayama, Hiroyuki; Tsujino, Takeshi; Nakai, Yousuke; Sasahira, Naoki; Kogure, Hirofumi; Hamada, Tsuyoshi; Nagano, Rie; Miyabayashi, Kouji; Yamamoto, Keisuke; Mohri, Dai; Sasaki, Takashi; Ito, Yukiko; Yamamoto, Natsuyo; Hirano, Kenji; Tada, Minoru; Koike, Kazuhiko

    2012-05-01

    Self-expandable metal stents (SEMS) are widely used for the palliative treatment of unresectable malignant biliary obstruction. However, the long-term durability of SEMSs in biliary strictures is not clear. We describe a case of endoscopic removal of spontaneously fractured uncovered biliary SEMS. A 59-year-old woman presented to our institution with a 1-year history of recurrent cholangitis. Her medical history included a proctectomy for rectal cancer and right hemihepatectomy for liver metastasis 10 years earlier. Five years after these operations, she developed a benign hilar stricture and had an uncovered SEMS placed in another hospital. Endoscopic retrograde cholangiopancreatography demonstrated that the SEMS was torn in half and the distal part of the stent was floating in the dilated common bile duct. The papillary orifice was dilated by endoscopic papillary large balloon dilation (EPLBD) using a 15-mm wire-guided balloon catheter. Subsequently, we inserted biopsy forceps into the bile duct and grasped the distal end of the broken SEMS under fluoroscopy. We successfully removed the fragment of the SEMS from the bile duct, along with the endoscope. The patient was discharged without complications. Placement of an uncovered biliary SEMS is not the preferred treatment for benign biliary strictures. Spontaneous fracture of an uncovered biliary SEMS is an extremely rare complication. We should be aware that stent fracture can occur when placing uncovered biliary SEMSs in patients with a long life expectancy. EPLBD is very useful for retrieving the fractured fragment of SEMS. PMID:22507093

  19. Immediate detection of endoscopic retrograde cholangiopancreatography-related periampullary perforation: Fluoroscopy or endoscopy?

    PubMed Central

    Motomura, Yasuaki; Akahoshi, Kazuya; Gibo, Junya; Kanayama, Kenji; Fukuda, Shinichiro; Hamada, Shouhei; Otsuka, Yoshihiro; Kubokawa, Masaru; Kajiyama, Kiyoshi; Nakamura, Kazuhiko

    2014-01-01

    AIM: To investigate the causes and intraoperative detection of endoscopic retrograde cholangiopancreatography (ERCP)-related perforations to support immediate or early diagnosis. METHODS: Consecutive patients who underwent ERCP procedures at our hospital between January 2008 and June 2013 were retrospectively enrolled in the study (n = 2674). All procedures had been carried out using digital fluoroscopic assistance with the patient under conscious sedation. For patients showing alterations in the gastrointestinal anatomy, a short-type double balloon enteroscope had been applied. Cases of perforation had been identified by the presence of air in or leakage of contrast medium into the retroperitoneal space, or upon endoscopic detection of an abdominal cavity related to the perforated lumen. For patients with ERCP-related perforations, the data on medical history, endoscopic findings, radiologic findings, diagnostic methods, management, and clinical outcomes were used for descriptive analysis. RESULTS: Of the 2674 ERCP procedures performed during the 71-mo study period, only six (0.22%) resulted in perforations (male/female, 2/4; median age: 84 years; age range: 57-97 years). The cases included an endoscope-related duodenal perforation, two periampullary perforations related to endoscopic sphincterotomy, two periampullary perforations related to endoscopic papillary balloon dilation, and a periampullary or bile duct perforation secondary to endoscopic instrument trauma. No cases of guidewire-related perforation occurred. The video endoscope system employed in all procedures was only able to immediately detect the endoscope-related perforation; the other five perforation cases were all detected by subsequent digital fluoroscope applied intraoperatively (at a median post-ERCP intervention time of 15 min). Three out of the six total perforation cases, including the single case of endoscope-related duodenal injury, were surgically treated; the remaining three cases were

  20. Papillary adenoma —

    Cancer.gov

    Consists primarily of papillary structures lined by cuboidal to columnar cells. Cells forming papillary structures are frequently more hyperchromatic and atypical, which is regarded as indication of potential progression towards malignancy.

  1. Endoscopic Bariatric Therapies.

    PubMed

    Goyal, Deepinder; Watson, Rabindra R

    2016-06-01

    Obesity and its associated cardio-metabolic comorbidities have emerged as a global pandemic. The efficacy of various hypo-caloric diets and prescription drugs has been poor with respect to sustained weight loss. Recent advancements in endoscopic technology and techniques have opened a new field of minimally invasive endoscopic treatment options for combatting obesity both as a first line and adjunctive therapy. Presently, two endoscopic space-occupying devices in the form of intragastric balloons have received FDA approval for 6-month implantation in patients within a BMI range of 30-40 kg/m(2). Furthermore, full-thickness suturing has led to the development of primary endoscopic sleeve gastroplasty and Roux-en-Y gastric bypass revision as viable endoscopic alternatives to surgical approaches. These techniques have the potential to reduce adverse events, cost, and recovery times. Looking forward, a variety of promising and novel medical devices and endoscopic platforms that target obesity and diabetes are in various phases of development and investigation. The present review aims to discuss the current and forthcoming endoscopic bariatric therapies with emphasis on relevant procedural technique and review of available evidence. PMID:27098813

  2. Renal papillary necrosis

    MedlinePlus

    ... renal papillary necrosis, especially after taking over-the-counter pain medicines ... diabetes or sickle cell anemia may reduce your risk. To prevent renal ... over-the-counter pain relievers. Do not take more than the ...

  3. Balloons Revisited

    ERIC Educational Resources Information Center

    Jeskova, Z.; Featonby, D.; Fekova, V.

    2012-01-01

    Whilst everyone is familiar with the process of blowing up a balloon, few of us have gone further to quantify the actual pressures involved at different stages in the inflation process. This paper seeks to describe experiments to fill some of those gaps and examine some of the apparently anomalous behaviour of connected balloons. (Contains 12…

  4. Balloons for Science.

    ERIC Educational Resources Information Center

    Lally, Vincent E.

    1982-01-01

    Discusses the nature and use of scientific balloons. Topics addressed include: (1) types of balloons; (2) lifting gases; (3) polyethylene balloons; (4) duration of balloon flight; and (5) use of balloons in scientific research. (JN)

  5. Endoscopic treatment of oesophageal varices.

    PubMed

    Krige, J E; Bornman, P C

    2000-12-01

    Major variceal bleeding is a life-threatening complication of portal hypertension. Therapy for bleeding may be difficult and requires expertise and appropriate facilities. Endoscopic therapy using either injection sclerotherapy or band ligation after adequate resuscitation and diagnostic endoscopy is the preferred first-line treatment. Bleeding not controlled by initial endoscopic therapy requires balloon tamponade followed by repeat variceal ligation or sclerotherapy. Patients who continue to bleed after endoscopic therapy are best treated with percutaneous radiological transjugular intrahepatic portosystemic shunt stent (TIPSS) insertion. After variceal eradication, patients require lifelong surveillance endoscopy and re-obliteration of varices by endoscopic therapy if they recur. Beta-blockers to prevent recurrent bleeding are reserved for selected patients. Patients with severe liver decompensation have a poor prognosis and should be evaluated for liver transplantation. Prophylactic endoscopic therapy in patients who have never bled from varices is contraindicated as it is associated with increased morbidity and mortality. PMID:11424860

  6. Endoscopic treatment of obesity

    PubMed Central

    Swidnicka-Siergiejko, Agnieszka; Wróblewski, Eugeniusz; Dabrowski, Andrzej

    2011-01-01

    BACKGROUND: The increasing incidence of obesity and overweight among children and adolescents will be reflected by the imminent increase in the number of obese patients who require more definitive methods of treatment. There is great interest in new, safe, simple, nonsurgical procedures for weight loss. OBJECTIVE: To provide an overview of new endoscopic methods for the treatment of obesity. METHODS: An English-language literature search on endoscopic interventions, endoscopically placed devices and patient safety was performed in the MEDLINE and Cochrane Library databases. RESULTS: The literature search yielded the following weight loss methods: space-occupying devices (widely used), gastric capacity reduction, modifying gastric motor function and malabsorptive procedures. A commercially available intragastric balloon was the most commonly used device for weight loss. In specific subgroups of patients, it improved quality of life, decreased comorbidities and served as a bridge to surgery. More evidence regarding the potential benefits and safety of other commercially available intragastric balloons is needed to clarify whether they are superior to the most commonly used one. Moreover, early experiences with transoral gastroplasty, the duodenaljejunal bypass sleeve and an adjustable, totally implantable intragastric prosthesis, indicate that they may be viable options for obesity treatment. Other agents, such as botulinum toxin and a device known as the ‘butterfly’, are currently at the experimental stage. CONCLUSION: New endoscopic methods for weight loss may be valuable in the treatment of obesity; however, more clinical experience and technical improvements are necessary before implementing their widespread use. PMID:22059171

  7. Ballooning Interest.

    ERIC Educational Resources Information Center

    Mebane, Robert C.; Rector, Bronwyn

    1991-01-01

    Presents activities that utilize balloons to encourage students to explore questions related to scientific concepts. Concepts explored include light, heat, charged ions, polarization, and the sense of smell. (MDH)

  8. Studies on papillary function and effect of prifinium bromide and other antispasmodics on motility of the papillary region (sphincter of Oddi) in humans.

    PubMed

    Kobayashi, K; Mitani, E; Tatsumi, S; Sasaki, Y; Nakamura, M; Yamada, H

    1985-01-01

    We determined endoscopically the motility of the papillary region in humans, using a pressure sensor devised in our department. The subjects were 184 patients with various diseases. Prifinium bromide and four other antispasmodics were given to 60 of the 184 patients, and their effects were investigated. In 41 (85%) of the 48 patients with chronic gastritis, regular wave patterns were noted. In 35 (85%) of the 41 patients with diseases of the biliary tract and papillary region, in nine (82%) of the 11 patients with pancreatic diseases, and in six (67%) of the nine patients with liver diseases, irregular wave patterns were observed. It was postulated that a high incidence of papillary dysfunction accompanies biliary and pancreatic diseases. Additionally, it was concluded that prifinium bromide has as potent an effect on motility of the papillary region as does a massive dose (40 mg) of hyoscine N-butylbromide. PMID:2859116

  9. Balloon Sculpture

    ERIC Educational Resources Information Center

    Warwick, James F.

    1976-01-01

    For the adventurous teacher and student there is an alternative to the often messy mixing, pouring, casting, cutting, scoring and sanding of plaster of Paris for casting or sculptural projects. Balloon sculpture, devised, designed and shown here by a sculptor/teacher, is an eye appealing sculptural form and holds a strong interest for students.…

  10. Cosmic Balloons

    ERIC Educational Resources Information Center

    El Abed, Mohamed

    2014-01-01

    A team of French high-school students sent a weather balloon into the upper atmosphere to recreate Viktor Hess's historical experiment that demonstrated the existence of ionizing radiation from the sky--later called cosmic radiation. This discovery earned him the Nobel Prize for Physics in 1936.

  11. Cosmic balloons

    NASA Astrophysics Data System (ADS)

    El Abed, Mohamed

    2014-11-01

    A team of French high-school students sent a weather balloon into the upper atmosphere to recreate Viktor Hess’s historical experiment that demonstrated the existence of ionizing radiation from the sky—later called cosmic radiation. This discovery earned him the Nobel Prize for Physics in 1936.

  12. Uterine papillary serous carcinoma.

    PubMed

    Moore, Kathleen N; Fader, Amanda Nickles

    2011-06-01

    Uterine papillary serous carcinoma (UPSC) is a histologic variant of endometrial cancer that accounts for only 10% of new cases of uterine cancer but is responsible for 40% of deaths from the disease. UPSC is an aggressive tumor with a predilection for early spread beyond the uterus. Treatment for UPSC typically entails surgery and in most women is followed by multimodality adjuvant therapy. In this review, we describe the epidemiology, natural history, treatment, and outcome of UPSC. PMID:21508697

  13. Endoscopic management of inflammatory bowel disease strictures

    PubMed Central

    Vrabie, Raluca; Irwin, Gerald L; Friedel, David

    2012-01-01

    Stricture formation is a common complication of Crohn’s disease, occurring in approximately one third of all patients with this condition. While the traditional management of such strictures has been largely surgical, there have been case series going back three decades highlighting the potential role of endoscopic balloon dilation in this clinical setting. This review article summarizes the stricture pathogenesis, focusing on known clinical and genetic risk factors. It then highlights the endoscopic balloon dilation research to date, with particular emphasis on three large recent case series. It concludes by describing the literature consensus regarding specific methodology and presenting avenues for future investigations. PMID:23189221

  14. Endoscopic ultrasound

    MedlinePlus

    Endoscopic ultrasound is a type of imaging test. It is used to see organs in and near the digestive ... Ultrasound is a way to see the inside of the body using high-frequency sound waves. Endoscopic ...

  15. Balloons and Science Kit.

    ERIC Educational Resources Information Center

    Balloon Council, Washington, DC.

    This document provides background information on balloons including: (1) the history of balloons; (2) balloon manufacturing; (3) biodegradability; (4) the fate of latex balloons; and (5) the effect of balloons on the rainforest and sea mammals. Also included as part of this instructional kit are four fun experiments that allow students to…

  16. Congenital duodenal web: successful management with endoscopic dilatation

    PubMed Central

    Poddar, Ujjal; Jain, Vikas; Yachha, Surender Kumar; Srivastava, Anshu

    2016-01-01

    Background and study aims: Congenital duodenal web (CDW) is an uncommon cause of duodenal obstruction and endoscopic balloon dilatation has been reported in just eight pediatric cases to date. Here we are reporting three cases of CDW managed successfully with balloon dilatation. Cases and methods: In 2014 we diagnosed three cases of CDW on the basis of typical radiological and endoscopic findings. Endoscopic balloon dilatation was done under conscious sedation with a through-the-scope controlled radial expansion (CRE) balloon. Results: All three children presented late (median age 8 [range 2 – 9] years) with bilious vomiting, upper abdominal distension, and failure to thrive. One of them had associated Down syndrome and another had horseshoe kidney. In all cases, CDW was observed in the second part of the duodenum beyond the ampulla, causing partial duodenal obstruction. After repeated endoscopic dilatation (2 – 4 sessions), all three patients became asymptomatic. None of the patients experienced complications after balloon dilatation. Conclusions: Duodenal diaphragm should be suspected in patients with abdominal distension with bilious vomiting, even in relatively older children. Endoscopic balloon dilatation is a simple and effective method of treating this condition. PMID:27004237

  17. Anomalous opening of the common bile duct into the duodenal bulb: endoscopic treatment

    PubMed Central

    Disibeyaz, Selcuk; Parlak, Erkan; Cicek, Bahattin; Cengiz, Cem; Kuran, Sedef O; Oguz, Dilek; Güzel, Hakan; Sahin, Burhan

    2007-01-01

    Background Anomalous biliary opening especially the presence of the ampulla of Vater in the duodenal bulb is a very rare phenomenon. We report clinical implications, laboratory and ERCP findings and also therapeutic approaches in 53 cases. Methods The data were collected from the records of 12.158 ERCP. The diagnosis was established as an anomalous opening of the common bile duct (CBD) into the duodenal bulb when there is an orifice observed in the bulb with the absence of a papillary structure at its normal localization and when the CBD is visualized by cholangiography through this orifice without evidence of any other opening. Results A total of 53 cases were recruited. There was an obvious male preponderance (M/F: 49/4). Demographic data and ERCP findings were available for all, but clinical characteristics and laboratory findings could be obtained from 39 patients with full records. Thirty – seven of 39 cases had abdominal pain (95%) and 23 of them (59%) had cholangitis as well. Elevated AP and GGT were found in 97.4% (52/53). History of cholecystectomy was present in 64% of the cases, recurrent cholangitis in 26% and duodenal ulcer in 45%. Normal papilla was not observed in any of the patients and a cleft-like opening was evident instead. The CBD was hook shaped at the distal part that opens to the duodenal bulb. Pancreatic duct (PD) was opening separately into the bulb in all the cases when it was possible to visualize. Dilated CBD in ERCP was evident in 94% and the CBD stone was demonstrated in 51%. PD was dilated in four of 12 (33%) cases. None of them has a history of pancreatitis. Endoscopically, Papillary Balloon Dilatation instead of Sphincterotomy carried out in 19 of 27 patients (70%) with choledocholithiazis. Remaining eight patients had undergone surgery (30%). Clinical symptoms were resolved with medical treatment in 16(32%) patients with dilated CBD but no stone. Perforation and bleeding were occurred only in two patients, which stones extracted

  18. Current status of intragastric balloon for obesity treatment

    PubMed Central

    Kim, Seung Han; Chun, Hoon Jai; Choi, Hyuk Soon; Kim, Eun Sun; Keum, Bora; Jeen, Yoon Tae

    2016-01-01

    Endoscopic bariatric therapy may be a useful alternative to pharmacological treatment for obesity, and it provides greater efficacy with lower risks than do conventional surgical procedures. Among the various endoscopic treatments for obesity, the intragastric balloon is associated with significant efficacy in body weight reduction and relief of comorbid disease symptoms. Anatomically, this treatment is based on gastric space-occupying effects that increase the feeling of satiety and may also affect gut neuroendocrine signaling. The simplicity of the intragastric balloon procedure may account for its widespread role in obesity treatment and its applicability to various degrees of obesity. However, advances in device properties and procedural techniques are still needed in order to improve its safety and cost-effectiveness. Furthermore, verification of the physiological outcomes of intragastric balloon treatment and the clinical predictive factors for treatment responses should be considered. In this article, we discuss the types, efficacy, safety, and future directions of intragastric balloon treatment. PMID:27350727

  19. Giant papillary conjunctivitis.

    PubMed Central

    Donshik, P C

    1994-01-01

    Giant papillary conjunctivitis is a syndrome found frequently as a complication of contact lenses. Many variables can affect the onset and severity of the presenting signs and symptoms. Rigid gas permeable contact lenses appear to result in less severe signs and symptoms, with a longer time before the development of giant papillary conjunctivitis. Nonionic, low-water-content soft contact lenses tend to produce less severe signs and symptoms than ionic, low-water-content soft contact lenses. Enzymatic treatment appears to lessen the severity of signs and symptoms. The association of an allergy appears to play a role in the onset of the severity of the signs and symptoms but does not appear to affect the final ability of the individual to wear contact lenses. Using multiple treatment options, such as changing the polymer to a glyceryl methyl methacrylate or a rigid lens, or utilizing a soft lens on a frequent-replacement basis, can result in a success rate of over 90%. In individuals who still have a return of symptoms, the use of topical mast cell stabilizers or a nonsteroidal anti-inflammatory drug as an adjunctive therapy offers the added possibility of keeping these patients in contact lenses. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 FIGURE 11 A FIGURE 11 B FIGURE 11 C FIGURE 11 D PMID:7886881

  20. Ballooning Then...and Ballooning Now.

    ERIC Educational Resources Information Center

    Journal of Aerospace Education, 1978

    1978-01-01

    Describes the history of hot-air balloon travel, starting with its French origins and continuing through to the 1978 national championship. An address for Balloon Federation of America membership is included. (MA)

  1. Advanced endoscopic imaging to improve adenoma detection

    PubMed Central

    Neumann, Helmut; Nägel, Andreas; Buda, Andrea

    2015-01-01

    Advanced endoscopic imaging is revolutionizing our way on how to diagnose and treat colorectal lesions. Within recent years a variety of modern endoscopic imaging techniques was introduced to improve adenoma detection rates. Those include high-definition imaging, dye-less chromoendoscopy techniques and novel, highly flexible endoscopes, some of them equipped with balloons or multiple lenses in order to improve adenoma detection rates. In this review we will focus on the newest developments in the field of colonoscopic imaging to improve adenoma detection rates. Described techniques include high-definition imaging, optical chromoendoscopy techniques, virtual chromoendoscopy techniques, the Third Eye Retroscope and other retroviewing devices, the G-EYE endoscope and the Full Spectrum Endoscopy-system. PMID:25789092

  2. Double balloon endoscopy in two hundred fifty cases for the diagnosis and treatment of small intestinal disorders.

    PubMed

    Kita, H; Yamamoto, H; Yano, T; Miyata, T; Iwamoto, M; Sunada, K; Arashiro, M; Hayashi, Y; Ido, K; Sugano, K

    2007-04-01

    Double balloon endoscopy is based on a new insertion mode in which two balloons at the distal ends of both an endoscope and an overtube are operated in combination. We have performed 419 enteroscopic examinations in 250 patients using the Fujinon double balloon endoscopy system between September 2000 and October 2005. Total enteroscopy was successfully achieved by the combination of both oral and anal approaches in 55 out of 71 cases in whom total enteroscopy was intended. Of 250 patients, ulcerative and/or erosive lesions were found in 49 cases and tumors/polyps were found in 49 cases. We also found 26 cases of vascular lesion, including angiodysplasia. Endoscopic treatments, including hemostasis using either clipping devices or electro coagulation, polypectomy, endoscopic mucosal resection, balloon dilation, and stent placement was successfully carried out. Double balloon enteroscopy is both feasible and useful technique for the diagnosis as well as treatment of small intestinal disorders. PMID:17450446

  3. NASA Balloon Technology Developments

    NASA Technical Reports Server (NTRS)

    Fairbrother, D. A.

    2004-01-01

    The National Aeronautics and Space Administration (NASA) Balloon Program has been, and will continue to be, committed to improving the capabilities of balloons to support science missions. Fundamental to vehicle improvement is a program of technology development that will enable improved flight performance throughout the next decade. The program s technology thrust areas include: materials, vehicle design & development, structural analysis, operations & support systems, performance modeling and planetary balloons. Building on the foundations of the 18-year research and development program, a technology roadmap has been generated which identifies specific areas of interest to NASA and the vision of future developments. The major components of the roadmap are: vehicle systems, balloon-craft systems, operational and safety support systems, and planetary vehicles. Current technology activities include nanocomposite balloon films, a new balloon designed to lift 3600 kgs to 36 km, a balloon rotation rate study and Mars pumpkin balloon investigations. The technology roadmap, as well as specific projects and recent advancements, will be presented.

  4. Scientific ballooning in Japan

    NASA Astrophysics Data System (ADS)

    Makino, Fumiyoshi

    Activities in scientific ballooning in Japan during 1998-1999 are reported. The total number of scientific balloons flown in Japan in 1998 and 1999 was sixteen, eight flights in each year. The scientific objectives were observations of high energy cosmic electrons, air samplings at various altitudes, monitoring of atmospheric ozone density, Galactic infrared observations, and test flights of new type balloons. Balloon expeditions were conducted in Antarctica by the National Institute of Polar Research, in Russia, in Canada and in India in collaboration with foreign countries' institutes to investigate cosmic rays, Galactic infrared radiation, and Earth's atmosphere. There were three flights in Antarctica, four flights in Russia, three flights in Canada and two flights in India. Four test balloons were flown for balloon technology, which included pumpkin-type super-pressure balloon and a balloon made with ultra-thin polyethylene film of 3.4 μm thickness.

  5. AZD6244 in Treating Patients With Papillary Thyroid Cancer That Did Not Respond to Radioactive Iodine

    ClinicalTrials.gov

    2016-09-02

    Recurrent Thyroid Gland Carcinoma; Stage I Thyroid Gland Papillary Carcinoma; Stage II Thyroid Gland Papillary Carcinoma; Stage III Thyroid Gland Papillary Carcinoma; Stage IV Thyroid Gland Papillary Carcinoma

  6. Diagnostic and Therapeutic Capability of Double-Balloon Enteroscopy in Clinical Practice

    PubMed Central

    Akyuz, Umit; Akyuz, Filiz

    2016-01-01

    Advances in technology have facilitated the common use of small-bowel imaging. Intraoperative enteroscopy was the gold standard method for small-bowel imaging. However, noninvasive capsule endoscopy and invasive balloon enteroscopy are currently the main endoscopic procedures that are routinely used for small-bowel pathologies, and the indications for both techniques are similar. Although obstruction is a contraindication for capsule endoscopy, it is not considered to be problematic for double-balloon enteroscopy. The most important advantage of double-balloon enteroscopy is the applicability of therapeutic interventions during the procedure; however, double-balloon enteroscopy has certain advantages as well as disadvantages. PMID:26950010

  7. Percutaneous Transhepatic Use of a Cutting Balloon in the Treatment of a Benign Common Bile Duct Stricture

    SciTech Connect

    Kakani, Nirmal K.; Puckett, Mark; Cooper, Martin; Watkinson, Anthony

    2006-06-15

    Benign biliary strictures (BBS) are difficult to treat. The majority of them are treated either endoscopically or using percutaneous techniques either with stents or conventional angioplasty balloons. To our knowledge we present the first case of use of a cutting balloon in the treatment of BBS through a percutaneous approach.

  8. Current roles of endoscopy in the management of intraductal papillary mucinous neoplasm of the pancreas.

    PubMed

    Tanaka, Masao

    2015-05-01

    Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is characterized by intraductal papillary proliferation of mucin-producing epithelial cells that exhibit various degrees of dysplasia. IPMN is classified into four histological subtypes (gastric, intestinal, pancreatobiliary, and oncocytic) according to its histomorphological and immunohistochemical characteristics. Endoscopic retrograde cholangiopancreatography plays a crucial role in the evaluation of these features of IPMN. Endoscopic ultrasonography (EUS) has proven to be more sensitive than computed tomography or magnetic resonance imaging for early detection of malignancy. The present review addresses the current roles of endoscopy and related techniques in the management of IPMN. The particular focus is on diagnosing IPMN and malignancy within IPMN, detecting pancreatic cancer concomitant with IPMN, differentiating the epithelial subtypes of IPMN, determining the optimal strategy for the management of branch duct IPMN, and discussing innovative endoscopic technology related to IPMN. The disadvantages of endoscopic examinations of IPMN and different attitudes toward EUS-guided fine-needle aspiration for IPMN between Japan (negative) and other countries (active) are also discussed. PMID:25588761

  9. Current roles of endoscopy in the management of intraductal papillary mucinous neoplasm of the pancreas

    PubMed Central

    2015-01-01

    Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is characterized by intraductal papillary proliferation of mucin‐producing epithelial cells that exhibit various degrees of dysplasia. IPMN is classified into four histological subtypes (gastric, intestinal, pancreatobiliary, and oncocytic) according to its histomorphological and immunohistochemical characteristics. Endoscopic retrograde cholangiopancreatography plays a crucial role in the evaluation of these features of IPMN. Endoscopic ultrasonography (EUS) has proven to be more sensitive than computed tomography or magnetic resonance imaging for early detection of malignancy. The present review addresses the current roles of endoscopy and related techniques in the management of IPMN. The particular focus is on diagnosing IPMN and malignancy within IPMN, detecting pancreatic cancer concomitant with IPMN, differentiating the epithelial subtypes of IPMN, determining the optimal strategy for the management of branch duct IPMN, and discussing innovative endoscopic technology related to IPMN. The disadvantages of endoscopic examinations of IPMN and different attitudes toward EUS‐guided fine‐needle aspiration for IPMN between Japan (negative) and other countries (active) are also discussed. PMID:25588761

  10. NASA balloon technology developments

    NASA Astrophysics Data System (ADS)

    Fairbrother, D. A.

    The National Aeronautics and Space Administration (NASA) Balloon Program has been, and will continue to be, committed to improving the capabilities of balloons to support science missions. Fundamental to vehicle improvement is a program of technology development that will enable improved flight performance throughout the next decade. The program's technology thrust areas include: materials, vehicle design & development, structural analysis, operations & support systems, performance modeling and planetary balloons. Building on the foundations of the 18-year research and development program, a technology roadmap has been generated which identifies specific areas of interest to NASA and the vision of future developments. The major components of the roadmap are: vehicle systems, ballooncraft systems, operational and safety support systems, and planetary vehicles. Current technology activities include nanocomposite balloon films, a new balloon designed to lift 3600 kgs to 36 km, a balloon rotation rate study and Mars pumpkin balloon investigations. The technology roadmap, as well as specific projects and recent advancements, will be presented.

  11. Intraductal Papillary Mucinous Neoplasm of Pancreas

    PubMed Central

    Machado, Norman Oneil; al Qadhi, Hani; al Wahibi, Khalifa

    2015-01-01

    Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are neoplasms that are characterized by ductal dilation, intraductal papillary growth, and thick mucus secretion. This relatively recently defined pathology is evolving in terms of its etiopathogenesis, clinical features, diagnosis, management, and treatment guidelines. A PubMed database search was performed. All the relevant abstracts in English language were reviewed and the articles in which cases of IPMN could be identified were further scrutinized. Information of IPMN was derived, and duplication of information in several articles and those with areas of persisting uncertainties were excluded. The recent consensus guidelines were examined. The reported incidence of malignancy varies from 57% to 92% in the main duct-IPMN (MD-IPMN) and from 6% to 46% in the branch duct-IPMN (BD-IPMN). The features of high-risk malignant lesions that raise concern include obstructive jaundice in a patient with a cystic lesion in the pancreatic head, the findings on radiological imaging of a mass lesion of >30 mm, enhanced solid component, and the main pancreatic duct (MPD) of size ≥10 mm; while duct size 5-9 mm and cyst size <3 mm are considered as “worrisome features.” Magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS) are primary investigations in diagnosing and following up on these patients. The role of pancreatoscopy and the analysis of aspirated cystic fluid for cytology and DNA analysis is still to be established. In general, resection is recommended for most MD-IPMN, mixed variant, and symptomatic BD-IPMN. The 5-year survival of patients after surgical resection for noninvasive IPMN is reported to be at 77-100%, while for those with invasive carcinoma, it is significantly lower at 27-60%. The follow-up of these patients could vary from 6 months to 1 year and would depend on the risk stratification for invasive malignancy and the pathology of the resected specimen. The understanding of

  12. [Endoscopic management of luminal stenosis in inflammatory bowel disease].

    PubMed

    Lorenzo-Zúñiga, Vicente; García-Planella, Esther; Moreno De Vega, Vicente; Domènech, Eugeni; Boix, Jaume

    2012-01-01

    Luminal stenosis is frequent in Crohn's disease (CD) due to transmural involvement. Before any endoscopic treatment, the presence of neoplastic stenosis should always be excluded. Endoscopic balloon dilatation has been used in several series to treat benign stenosis, mainly in CD with involvement of the distal ileon, colon or surgical anastomosis, with success rates of 51% to 85%, although recurrence is high. The concomitant use of injected steroids (triamcinolone) after endoscopic dilatation produces longer-lasting results, but there are few published reports. In patients with luminal stenosis refractory to conventional endoscopy, three emerging techniques may be useful: self-expanding metallic stents, biodegradable endoprostheses and intralesional infliximab injection. PMID:22341673

  13. Paclitaxel-eluting balloon dilation of biliary anastomotic stricture after liver transplantation

    PubMed Central

    Hüsing, Anna; Reinecke, Holger; Cicinnati, Vito R; Beckebaum, Susanne; Wilms, Christian; Schmidt, Hartmut H; Kabar, Iyad

    2015-01-01

    AIM: To investigate the safety and effectiveness of endoscopic therapy with a paclitaxel-eluting balloon (PEB) for biliary anastomotic stricture (AS) after liver transplantation (LT). METHODS: This prospective pilot study enrolled 13 consecutive eligible patients treated for symptomatic AS after LT at the University Hospital of Münster between January 2011 and March 2014. The patients were treated by endoscopic therapy with a PEB and followed up every 8 wk by endoscopic retrograde cholangiopancreatography (ERCP). In cases of re-stenosis, further balloon dilation with a PEB was performed. Follow-up was continued until 24 mo after the last intervention. RESULTS: Initial technical feasibility, defined as successful balloon dilation with a PEB during the initial ERCP procedure, was achieved in 100% of cases. Long-term clinical success (LTCS), defined as no need for further endoscopic intervention for at least 24 mo, was achieved in 12 of the 13 patients (92.3%). The mean number of endoscopic interventions required to achieve LTCS was only 1.7 ± 1.1. Treatment failure, defined as the need for definitive alternative treatment, occurred in only one patient, who developed recurrent stenosis with increasing bile duct dilatation that required stent placement. CONCLUSION: Endoscopic therapy with a PEB is very effective for the treatment of AS after LT, and seems to significantly shorten the overall duration of endoscopic treatment by reducing the number of interventions needed to achieve LTCS. PMID:25624733

  14. Composite encapsulated papillary carcinoma and solid papillary carcinoma.

    PubMed

    Cui, Xiaoyan; Wei, Shi

    2015-03-01

    Encapsulated papillary carcinoma (EPC) and solid papillary carcinoma (SPC) are distinctive variants of intraductal papillary carcinomas, each accounting for <1% of breast carcinomas. Here we report a composite carcinoma consisting of EPC and SPC. A 73-year-old woman was found to have a high density mass in the left breast on mammogram. A biopsy showed intermediate to high grade ductal carcinoma in situ (DCIS). Gross examination of the lumpectomy specimen revealed a solid, multinodular mass. Microscopic examination demonstrated two morphologically distinct intraductal carcinomas intermingled with each other. One had delicate papillae in multi-cystic spaces surrounded by thick fibrous capsule, consistent with EPC. The other had solid tumor nests with delicate fibrovascular cores. The cells were monotonous with round nuclei and salt and pepper-like chromatin, characteristic of SPC. The lack of myoepithelial cells within the papillae and at the periphery of the lesion was confirmed by immunostaining for p63 and CK5/6. Neuroendocrine differentiation of SPC was demonstrated by neuron specific enolase staining. To our knowledge, this is the first reported case of composite EPC and SPC. It raises an interesting question as to a possible common pathway of carcinogenesis of these two rare variants. PMID:25545718

  15. Endoscopic Sinus Surgery

    MedlinePlus

    ... The nasal endoscope is a small, lighted metal telescope placed into the nostril. The endoscope allows the ... sinus surgery involves the use of a small telescope (nasal endoscope) that is inserted through the nostril ...

  16. GHOST balloons around Antarctica

    NASA Technical Reports Server (NTRS)

    Stearns, Charles R.

    1988-01-01

    The GHOST balloon position as a function of time data shows that the atmospheric circulation around the Antarctic Continent at the 100 mb and 200 mb levels is complex. The GHOST balloons supposedly follow the horizontal trajectory of the air at the balloon level. The position of GHOST balloon 98Q for a three month period in 1968 is shown. The balloon moved to within 2 deg of the South Pole on 1 October 1968 and then by 9 December 1968 was 35 deg from the South Pole and close to its position on 1 September 1968. The balloon generally moved from west to east but on two occasions moved in the opposite direction for a few days. The latitude of GHOST balloons 98Q and 149Z which was at 200 mb is given. Both balloons tended to get closer to the South Pole in September and October. Other GHOST balloons at the same pressure and time period may not indicate similar behavior.

  17. NASA Balloon Technology Activities

    NASA Astrophysics Data System (ADS)

    Fairbrother, D. A.

    The National Aeronautics and Space Administration NASA Balloon Program technology development efforts are fundamental to improving the capabilities of the balloon systems better understanding of the flight dynamics and to support the science missions throughout the next decade Building on the foundations of the 20-year research and development program a technology roadmap has been generated which identifies specific areas of interest to NASA and the vision of future developments The major components of the roadmap are vehicle systems ballooncraft systems operational and safety support systems and planetary vehicles Within each of these major components technologies are targeted that will provide both better understanding and foster advancements The Program s technology thrust areas are directed both in broad efforts that touch on a number of the major components as well as specific tasks that address elements within a specific component Advances in vehicle systems have focused on producing better balloon designs This is being attempted through the use of improved inputs into the balloon design process Central to this is an increasing the understanding of materials used to fabricate balloons Testing techniques have been improved with better bi-axial characterization of the balloon materials More realistic radiative properties of the balloon films and components have also been made Analytical assessments of the balloon designs are also key in improving balloon designs These analytical assessments have been accomplished using improving

  18. Kestrel balloon launch system

    SciTech Connect

    Newman, M.J.

    1991-10-01

    Kestrel is a high-altitude, Helium-gas-filled-balloon system used to launch scientific payloads in winds up to 20 knots, from small platforms or ships, anywhere over land or water, with a minimal crew and be able to hold in standby conditions. Its major components consist of two balloons (a tow balloon and a main balloon), the main deployment system, helium measurement system, a parachute recovery unit, and the scientific payload package. The main scope of the launch system was to eliminate the problems of being dependent of launching on long airfield runways, low wind conditions, and long launch preparation time. These objectives were clearly met with Kestrel 3.

  19. Weather Balloon Ascent Rate

    NASA Astrophysics Data System (ADS)

    Denny, Mark

    2016-05-01

    The physics of a weather balloon is analyzed. The surprising aspect of the motion of these balloons is that they ascend to great altitudes (typically 35 km) at a more or less constant rate. Such behavior is not surprising near the ground—say for a helium-filled party balloon rising from street level to the top of the Empire State building—but it is unexpected for a balloon that rises to altitudes where the air is rarefied. We show from elementary physical laws why the ascent rate is approximately constant.

  20. Intraductal papillary neoplasm of the bile duct accompanying biliary mixed adenoneuroendocrine carcinoma.

    PubMed

    Onishi, Ichiro; Kitagawa, Hirohisa; Harada, Kenichi; Maruzen, Syogo; Sakai, Seisyo; Makino, Isamu; Hayashi, Hironori; Nakagawara, Hisatoshi; Tajima, Hidehiro; Takamura, Hiroyuki; Tani, Takashi; Kayahara, Masato; Ikeda, Hiroko; Ohta, Tetsuo; Nakanuma, Yasuni

    2013-05-28

    We present the first case of an intraductal papillary neoplasm of the bile duct (IPNB) accompanying a mixed adenoneuroendocrine carcinoma (MANEC). A 74-year-old woman presented with fever of unknown cause. Laboratory data revealed jaundice and liver injury. Contrast-enhanced computed tomography revealed a 20 mm polypoid tumor in the dilated distal bile duct, which exhibited early enhancement and papillary growth. Upper gastrointestinal endoscopy revealed mucus production from the papilla of Vater, characterized by its protruding and dilated orifice. Endoscopic ultrasonography visualized the polypoid tumor in the distal bile duct, but no invasive region was suggested by diagnostic imaging. Therefore, the initial diagnosis was IPNB. After endoscopic nasobiliary drainage, a pylorus-preserving pancreaticoduodenectomy was performed. Pathological examination of the resected bile duct revealed papillary proliferation of biliary-type cells with nuclear atypia, indicating pancreaticobiliary-type IPNB. In addition, solid portions comprised of tumor cells with characteristic salt-and-pepper nuclei were evident. Immunohistochemistry revealed expression of the neuroendocrine marker synaptophysin in this solid component, diagnosing it as a neuroendocrine tumor (NET). Furthermore, the MIB-1 proliferation index of NET was higher than that of IPNB, and microinvasion of the NET component was found, indicating neuroendocrine carcinoma (NET G3). This unique case of MANEC, comprising IPNB and NET, provides insight into the pathogenesis of biliary NET. PMID:23716999

  1. Intraductal papillary neoplasm of the bile duct accompanying biliary mixed adenoneuroendocrine carcinoma

    PubMed Central

    Onishi, Ichiro; Kitagawa, Hirohisa; Harada, Kenichi; Maruzen, Syogo; Sakai, Seisyo; Makino, Isamu; Hayashi, Hironori; Nakagawara, Hisatoshi; Tajima, Hidehiro; Takamura, Hiroyuki; Tani, Takashi; Kayahara, Masato; Ikeda, Hiroko; Ohta, Tetsuo; Nakanuma, Yasuni

    2013-01-01

    We present the first case of an intraductal papillary neoplasm of the bile duct (IPNB) accompanying a mixed adenoneuroendocrine carcinoma (MANEC). A 74-year-old woman presented with fever of unknown cause. Laboratory data revealed jaundice and liver injury. Contrast-enhanced computed tomography revealed a 20 mm polypoid tumor in the dilated distal bile duct, which exhibited early enhancement and papillary growth. Upper gastrointestinal endoscopy revealed mucus production from the papilla of Vater, characterized by its protruding and dilated orifice. Endoscopic ultrasonography visualized the polypoid tumor in the distal bile duct, but no invasive region was suggested by diagnostic imaging. Therefore, the initial diagnosis was IPNB. After endoscopic nasobiliary drainage, a pylorus-preserving pancreaticoduodenectomy was performed. Pathological examination of the resected bile duct revealed papillary proliferation of biliary-type cells with nuclear atypia, indicating pancreaticobiliary-type IPNB. In addition, solid portions comprised of tumor cells with characteristic salt-and-pepper nuclei were evident. Immunohistochemistry revealed expression of the neuroendocrine marker synaptophysin in this solid component, diagnosing it as a neuroendocrine tumor (NET). Furthermore, the MIB-1 proliferation index of NET was higher than that of IPNB, and microinvasion of the NET component was found, indicating neuroendocrine carcinoma (NET G3). This unique case of MANEC, comprising IPNB and NET, provides insight into the pathogenesis of biliary NET. PMID:23716999

  2. Endoscopic neurosurgery.

    PubMed

    Auer, L M; Holzer, P; Ascher, P W; Heppner, F

    1988-01-01

    This paper describes an ultrasound-guided, laser-assisted, and TV-controlled endoscopic technique which has been used so far in 133 patients for a variety of intracranial lesions. Following CT or MRI image reconstruction, and a decision on the placement of a 1 cm or a 2 cm burrhole, a 1 cm 5.0 mHz or 7.5 mHz intraoperative ultrasound probe is used to direct the endoscope from the burrhole to the target area. A 22.5 cm long rigid endoscope tube with an outer diameter of 6 mm with an inbuilt suction irrigation system, Neodymium Yag laser with 600 micron Quartz glass-fibre and an inlet for various microinstruments is then introduced. The attachment of a TV camera to the ocular lens allows the operator to control further surgical steps in the target area via the TV screen and thus warrants sterility in the operating field. The technique has been used for evacuation of 77 spontaneous intracerebral haematomas (lobar, putaminal, thalamic), 8 traumatic intracerebral haematomas, 13 ventricular haematomas, 8 cerebellar haematomas and 1 brainstem haematoma. Total or subtotal evacuation was achieved in 33% of intracerebral haematomas, removal of more than 50% of the clot in 55%. Twenty-four brain tumours (12 ventricular, 12 cystic cerebral or cerebellar tumours) were operated on for biopsy, evacuation of cyst, resection or removal of the cyst wall and/or laser irradiation of solid tumour or the inner cyst wall of cystic tumours. The complication rate probably related to surgery was 1.6%, morbidity 1.6%, mortality 0%. This high-tec endoscopic technique with its minimal surgical trauma and short operation time can be recommended as a low-risk alternative to conventional neurosurgical techniques. PMID:3278501

  3. Endoscopic Cyclophotocoagulation

    PubMed Central

    Seibold, Leonard K.; SooHoo, Jeffrey R.; Kahook, Malik Y.

    2015-01-01

    In recent years, many new procedures and implants have been introduced as safer alternatives for the surgical treatment of glaucoma. The majority of these advances are implant-based with a goal of increased aqueous drainage to achieve lower intraocular pressure (IOP). In contrast, endoscopic cyclophotocoagulation (ECP) lowers IOP through aqueous suppression. Although ciliary body ablation is a well-established method of aqueous suppression, the novel endoscopic approach presents a significant evolution of this treatment with marked improvement in safety. The endoscope couples a light source, video imaging, and diode laser to achieve direct visualization of the ciliary processes during controlled laser application. The result is an efficient and safe procedure that can achieve a meaningful reduction in IOP and eliminate or reduce glaucoma medication use. From its initial use in refractory glaucoma, the indications for ECP have expanded broadly to include many forms of glaucoma across the spectrum of disease severity. The minimally-invasive nature of ECP allows for easy pairing with phacoemulsification in patients with coexisting cataract. In addition, the procedure avoids implant or device-related complications associated with newer surgical treatments. In this review, we illustrate the differences between ECP and traditional cyclophotocoagulation, then describe the instrumentation, patient selection, and technique for ECP. Finally, we summarize the available clinical evidence regarding the efficacy and safety of this procedure. PMID:25624669

  4. Endoscopic cyclophotocoagulation.

    PubMed

    Seibold, Leonard K; SooHoo, Jeffrey R; Kahook, Malik Y

    2015-01-01

    In recent years, many new procedures and implants have been introduced as safer alternatives for the surgical treatment of glaucoma. The majority of these advances are implant-based with a goal of increased aqueous drainage to achieve lower intraocular pressure (IOP). In contrast, endoscopic cyclophotocoagulation (ECP) lowers IOP through aqueous suppression. Although ciliary body ablation is a well-established method of aqueous suppression, the novel endoscopic approach presents a significant evolution of this treatment with marked improvement in safety. The endoscope couples a light source, video imaging, and diode laser to achieve direct visualization of the ciliary processes during controlled laser application. The result is an efficient and safe procedure that can achieve a meaningful reduction in IOP and eliminate or reduce glaucoma medication use. From its initial use in refractory glaucoma, the indications for ECP have expanded broadly to include many forms of glaucoma across the spectrum of disease severity. The minimally-invasive nature of ECP allows for easy pairing with phacoemulsification in patients with coexisting cataract. In addition, the procedure avoids implant or device-related complications associated with newer surgical treatments. In this review, we illustrate the differences between ECP and traditional cyclophotocoagulation, then describe the instrumentation, patient selection, and technique for ECP. Finally, we summarize the available clinical evidence regarding the efficacy and safety of this procedure. PMID:25624669

  5. Unsuccessful frontal balloon sinuplasty for recurrent sinus barotrauma.

    PubMed

    Andrews, Jamie N; Weitzel, Erik K; Eller, Robert; McMains, Christopher K

    2010-05-01

    The standard of care treatment for diffuse recurrent sinus barotrauma (RSB) is an endoscopic sphenoethmoidectomy with a complete frontal dissection. Successful healing leaves the RSB patient with no ethmoid sinuses and endoscopically patent frontal, sphenoid, and maxillary ostia. In persistent cases, patients with small frontal ostia will go on to require a frontal drillout. Patients presenting for surgical management of RSB generally have minimal sinus disease despite significant symptoms during flight and the prospect of extensive surgical management can be unappealing. With the advent of balloon sinuplasty, military otolaryngologists anticipated this technology would permit therapeutic dilation of sinus ostia without the extensive surgical dissection and prolonged recovery typical for standard of care management. This case report is a cautionary note to the wider flight community to recognize a mechanism for recurrence of the underlying pathology when balloon sinuplasty is used that is not possible after properly performed standard of care sinus surgery for RSB. PMID:20464821

  6. The Japanese Balloon Program

    NASA Astrophysics Data System (ADS)

    Nishimura, J.

    The Japanese scientific ballooning program has been organized by ISAS since the institute was founded in mid 1960s. Since then, the balloon group of ISAS has been engaged in the development of the balloon technologies and scientific observations in collaboration with scientists and engineers in other universities and organizations. Here, I describe several subjects of recent activities, the details of some items will also be reported in the separate papers in this meeting.Preparation of a new mobile receiving station.

  7. Balloons of made of the EVAL (Ethylene-Vinyl-Alcohol) films. EVAL film has specific Infra-red absorption bands, and is expected to be useful for saving the ballast for a long duration flight.
  8. A high altitude balloon with thin polyethylene films achieving at an altitude of above 50km. Further improvement of this type of balloons is continued by inventing how to extrude thin films less than 5 microns of thickness.
  9. Recent achievement of Antarctica Flights under the collaboration of ISAS and National Polar Institute.
  10. Other new efforts to long duration flights such as satellite link boomerang balloon systems and others.
  11. New balloon borne scientific instrumentation for observations of high energy electrons and Anti-protons in cosmic-rays.
  12. The Great Balloon Controversy.

    ERIC Educational Resources Information Center

    Chase, Valerie

    1989-01-01

    Discusses the harmful effects of balloon launches and the dumping of plastic debris into oceans. Cites several examples of plastic materials being discovered inside the bodies of sick and/or dead marine animals. Offers alternative activities to releasing balloons into the atmosphere. (RT)

  13. Clefting in pumpkin balloons

    NASA Astrophysics Data System (ADS)

    Baginski, F.; Schur, W.

    NASA's effort to develop a large payload, high altitude, long duration balloon, the Ultra Long Duration Balloon, focuses on a pumpkin shape super-pressure design. It has been observed that a pumpkin balloon may be unable to pressurize into the desired cyclically symmetric equilibrium configuration, settling into a distorted, undesired stable state instead. Hoop stress considerations in the pumpkin design leads to choosing the lowest possible bulge radius, while robust deployment is favored by a large bulge radius. Some qualitative understanding of design aspects on undesired equilibria in pumpkin balloons has been obtained via small-scale balloon testing. Poorly deploying balloons have clefts, but most gores away from the cleft deploy uniformly. In this paper, we present models for pumpkin balloons with clefts. Long term success of the pumpkin balloon for NASA requires a thorough understanding of the phenomenon of multiple stable equilibria and means for quantitative assessment of measures that prevent their occurrence. This paper attempts to determine numerical thresholds of design parameters that distinguish between properly deploying designs and improperly deploying designs by analytically investigating designs in the vicinity of criticality. Design elements which may trigger the onset undesired equilibria and remedial measures that ensure deployment are discussed.

  14. Modelling Hot Air Balloons.

    ERIC Educational Resources Information Center

    Brimicombe, M. W.

    1991-01-01

    A macroscopic way of modeling hot air balloons using a Newtonian approach is presented. Misleading examples using a car tire and the concept of hot air rising are discussed. Pressure gradient changes in the atmosphere are used to explain how hot air balloons work. (KR)

  15. Mirizzi Syndrome with Endoscopic Ultrasound Image

    PubMed Central

    Rayapudi, K.; Gholami, P.; Olyaee, M.

    2013-01-01

    We describe a 66-year-old Caucasian man with type 1 Mirizzi syndrome diagnosed on endoscopic ultrasound. He presented with acute onset of jaundice, malaise, dark urine over 3–4 days, and was found to have obstructive jaundice on lab testing. CT scan of the abdomen showed intrahepatic biliary ductal dilation, a 1.5 cm common bile duct (CBD) above the pancreas, and possible stones in the CBD, but no masses. Endoscopic retrograde cholangiopancreatography (ERCP) by a community gastroenterologist failed to cannulate the CBD. At the University Center, type 1 Mirizzi syndrome was noted on endoscopic ultrasound with narrowing of the CBD with extrinsic compression from cystic duct stone. During repeat ERCP, the CBD could be cannulated over the pancreatic duct wire. A mid CBD narrowing, distal CBD stones, proximal CBD and extrahepatic duct dilation were noted, and biliary sphincterotomy was performed. A small stone in the distal CBD was removed with an extraction balloon. The cystic duct stone was moved with the biliary balloon into the CBD, mechanical basket lithotripsy was performed and stone fragments were delivered out with an extraction balloon. The patient was seen 7 weeks later in the clinic. Skin and scleral icterus had cleared up and he is scheduled for an elective cholecystectomy. Mirizzi syndrome refers to biliary obstruction resulting from impacted stone in the cystic duct or neck of the gallbladder and commonly presents with obstructive jaundice. Type 1 does not have cholecystocholedochal fistulas, but they present in types 2, 3 and 4. Surgery is the mainstay of therapy. Endoscopic treatment is effective and can also be used as a temporizing measure or definitive treatment in poor surgical risk candidates. PMID:23741207

  16. Low-grade nasopharyngeal papillary adenocarcinoma: a case report and review of the literature

    PubMed Central

    Wang, Xiaoli; Yan, Hongjiang; Luo, Yijun; Fan, Tingyong

    2016-01-01

    Low-grade nasopharyngeal papillary adenocarcinoma is an extremely rare tumor, with only a limited number of cases reported in the literature. Some published studies have paid more attention to the clinicopathological features of nasopharyngeal adenocarcinoma, while little effort has been made to study the optimal therapeutic strategies. We report about a woman diagnosed with low-grade nasopharyngeal papillary adenocarcinoma. She received the treatment approach that combined transnasal endoscopic surgery to remove the lesion with postoperative radiotherapy for nasal cavity. There was no evidence of recurrence after 4 months of surgery, and further follow-up is being continued. Through this example, we wanted to explore the optimal therapeutic strategies for primary nasopharyngeal adenocarcinomas. PMID:27274289

  17. Balloon Devices for Atrial Fibrillation Therapy

    PubMed Central

    Metzner, Andreas; Lin, Tina; Ouyang, Feifan; Kuck, Karl-Heinz

    2015-01-01

    Ablation of atrial fibrillation (AF) is an established treatment option for symptomatic patients refractory to antiarrhythmic medication. In patients with paroxysmal AF, ablation can be offered as first-line therapy when performed in an experienced centre. The accepted cornerstone for all ablation strategies is isolation of the pulmonary veins. However, it is still challenging to achieve contiguous, transmural, permanent lesions using radio-frequency current (RFC) based catheters in conjunction with a three-dimensional mapping system and the learning curve remains long. These limitations have kindled interest in developing and evaluating novel catheter designs that incorporate alternative energy sources. Novel catheters include balloon-based ablation systems, incorporating different energy modalities such as laser (Heartlight™, CardioFocus, Marlborough, MA, US), RFC (Hot Balloon Catheter, Hayama Arrhythmia Institute, Kanagawa, Japan) and cryo-energy (ArcticFront, Medtronic, Inc., Minneapolis, MN, US). While the cryoballoon (CB) and the radiofrequency hot balloon (RHB) are single-shot devices, the endoscopic ablation system (EAS) allows for point-by-point ablation. The CB and EAS are well established as safe, time-efficient and effective ablation tools. Initial studies using the RHB could also demonstrate promising results. However, more data are required. PMID:26835102

  18. Balloon Devices for Atrial Fibrillation Therapy.

    PubMed

    Metzner, Andreas; Wissner, Erik; Lin, Tina; Ouyang, Feifan; Kuck, Karl-Heinz

    2015-05-01

    Ablation of atrial fibrillation (AF) is an established treatment option for symptomatic patients refractory to antiarrhythmic medication. In patients with paroxysmal AF, ablation can be offered as first-line therapy when performed in an experienced centre. The accepted cornerstone for all ablation strategies is isolation of the pulmonary veins. However, it is still challenging to achieve contiguous, transmural, permanent lesions using radio-frequency current (RFC) based catheters in conjunction with a three-dimensional mapping system and the learning curve remains long. These limitations have kindled interest in developing and evaluating novel catheter designs that incorporate alternative energy sources. Novel catheters include balloon-based ablation systems, incorporating different energy modalities such as laser (Heartlight(™), CardioFocus, Marlborough, MA, US), RFC (Hot Balloon Catheter, Hayama Arrhythmia Institute, Kanagawa, Japan) and cryo-energy (ArcticFront, Medtronic, Inc., Minneapolis, MN, US). While the cryoballoon (CB) and the radiofrequency hot balloon (RHB) are single-shot devices, the endoscopic ablation system (EAS) allows for point-by-point ablation. The CB and EAS are well established as safe, time-efficient and effective ablation tools. Initial studies using the RHB could also demonstrate promising results. However, more data are required. PMID:26835102

  19. Balloon Design Software

    NASA Technical Reports Server (NTRS)

    Farley, Rodger

    2007-01-01

    PlanetaryBalloon Version 5.0 is a software package for the design of meridionally lobed planetary balloons. It operates in a Windows environment, and programming was done in Visual Basic 6. By including the effects of circular lobes with load tapes, skin mass, hoop and meridional stress, and elasticity in the structural elements, a more accurate balloon shape of practical construction can be determined as well as the room-temperature cut pattern for the gore shapes. The computer algorithm is formulated for sizing meridionally lobed balloons for any generalized atmosphere or planet. This also covers zero-pressure, over-pressure, and super-pressure balloons. Low circumferential loads with meridionally reinforced load tapes will produce shapes close to what are known as the "natural shape." The software allows for the design of constant angle, constant radius, or constant hoop stress balloons. It uses the desired payload capacity for given atmospheric conditions and determines the required volume, allowing users to design exactly to their requirements. The formulations are generalized to use any lift gas (or mixture of gases), any atmosphere, or any planet as described by the local acceleration of gravity. PlanetaryBalloon software has a comprehensive user manual that covers features ranging from, but not limited to, buoyancy and super-pressure, convenient design equations, shape formulation, and orthotropic stress/strain.

  20. Single balloon enteroscopy: Technical aspects and clinical applications.

    PubMed

    Manno, Mauro; Barbera, Carmelo; Bertani, Helga; Manta, Raffaele; Mirante, Vincenzo Giorgio; Dabizzi, Emanuele; Caruso, Angelo; Pigo, Flavia; Olivetti, Giampiero; Conigliaro, Rita

    2012-02-16

    The small bowel has long been considered a black box for endoscopists because of its long length and the presence of multiple complex loop. Most of the small bowel is inaccessible by traditional endoscopic means. In addition, radiographic studies have significant limitations with regard to diagnostic yield, and surgery is an invasive alternative. This limitation was overcome through the development of balloon enteroscopy that becomes established throughout the world for diagnostic and therapeutic examinations of the small bowel. The single-balloon enteroscope (SBE) system (Olympus, Tokyo, Japan) was introduced into the commercial market in 2007. Several study demonstrated its efficacy and safety. Early reports on the use of single-balloon enteroscopy have suggested a high diagnostic yield and similar therapeutic potential to that of the double-balloon endoscope. SBE is viable technique for in the management of small bowel disease. Technically, it is easy to perform, may be efficient, and in the literature data available, seems to provide high diagnostic and therapeutic yield. PMID:22347529

  21. Endoscopic Microscopy

    PubMed Central

    Sokolov, Konstantin; Sung, Kung-Bin; Collier, Tom; Clark, Anne; Arifler, Dizem; Lacy, Alicia; Descour, Michael; Richards-Kortum, Rebecca

    2002-01-01

    In vivo endoscopic optical microscopy provides a tool to assess tissue architecture and morphology with contrast and resolution similar to that provided by standard histopathology – without need for physical tissue removal. In this article, we focus on optical imaging technologies that have the potential to dramatically improve the detection, prevention, and therapy of epithelial cancers. Epithelial pre-cancers and cancers are associated with a variety of morphologic, architectural, and molecular changes, which currently can be assessed only through invasive, painful biopsy. Optical imaging is ideally suited to detecting cancer-related alterations because it can detect biochemical and morphologic alterations with sub-cellular resolution throughout the entire epithelial thickness. Optical techniques can be implemented non-invasively, in real time, and at low cost to survey the tissue surface at risk. Our manuscript focuses primarily on modalities that currently are the most developed: reflectance confocal microscopy (RCM) and optical coherence tomography (OCT). However, recent advances in fluorescence-based endoscopic microscopy also are reviewed briefly. We discuss the basic principles of these emerging technologies and their current and potential applications in early cancer detection. We also present research activities focused on development of exogenous contrast agents that can enhance the morphological features important for cancer detection and that have the potential to allow vital molecular imaging of cancer-related biomarkers. In conclusion, we discuss future improvements to the technology needed to develop robust clinical devices. PMID:14646041

  22. Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.

    PubMed

    Testoni, Pier Alberto; Mariani, Alberto; Aabakken, Lars; Arvanitakis, Marianna; Bories, Erwan; Costamagna, Guido; Devière, Jacques; Dinis-Ribeiro, Mario; Dumonceau, Jean-Marc; Giovannini, Marc; Gyokeres, Tibor; Hafner, Michael; Halttunen, Jorma; Hassan, Cesare; Lopes, Luis; Papanikolaou, Ioannis S; Tham, Tony C; Tringali, Andrea; van Hooft, Jeanin; Williams, Earl J

    2016-07-01

    that is difficult to cannulate, transpancreatic biliary sphincterotomy should be considered if unintentional insertion of a guidewire into the pancreatic duct occurs (moderate quality evidence, strong recommendation).In patients who have had transpancreatic sphincterotomy, ESGE suggests prophylactic pancreatic stenting (moderate quality evidence, strong recommendation). 6 ESGE recommends that mixed current is used for sphincterotomy rather than pure cut current alone, as there is a decreased risk of mild bleeding with the former (moderate quality evidence, strong recommendation). 7 ESGE suggests endoscopic papillary balloon dilation (EPBD) as an alternative to endoscopic sphincterotomy (EST) for extracting CBD stones < 8 mm in patients without anatomical or clinical contraindications, especially in the presence of coagulopathy or altered anatomy (moderate quality evidence, strong recommendation). 8 ESGE does not recommend routine biliary sphincterotomy for patients undergoing pancreatic sphincterotomy, and suggests that it is reserved for patients in whom there is evidence of coexisting bile duct obstruction or biliary sphincter of Oddi dysfunction (moderate quality evidence, weak recommendation). 9 In patients with periampullary diverticulum (PAD) and difficult cannulation, ESGE suggests that pancreatic duct stent placement followed by precut sphincterotomy or needle-knife fistulotomy are suitable options to achieve cannulation (low quality evidence, weak recommendation).ESGE suggests that EST is safe in patients with PAD. In cases where EST is technically difficult to complete as a result of a PAD, large stone removal can be facilitated by a small EST combined with EPBD or use of EPBD alone (low quality evidence, weak recommendation). 10 For cannulation of the minor papilla, ESGE suggests using wire-guided cannulation, with or without contrast, and sphincterotomy with a pull-type sphincterotome or a needle-knife over a plastic stent (low quality evidence, weak

  23. Refractory Jaundice From Intraductal Papillary Mucinous Neoplasm Treated With Cholangioscopy-Guided Radiofrequency Ablation

    PubMed Central

    Brown, Nicholas G.; Camilo, Joel; McCarter, Martin

    2016-01-01

    Intraductal papillary mucinous neoplasms (IPMNs) are epithelial neoplasms treated with surgical resection when appropriate. We present a 79-year-old man with jandice refractory to endoscopic stenting. Biliary radiofrequency ablation (RFA) with cholangioscopy was used as palliation of obstructive jaundice due to a mucin-producing pancreatic IPMN with fistulous biliary communication. Clinical improvement permitted surgery, and he returned to pre-illness status at 17 months. The use of cholangioscopy in the setting of mucinous filling defects can guide over-the-wire RFA for palliation and may be a bridge to surgery. PMID:27144205

  24. Renal Papillary Necrosis Caused by Protein C Deficiency Leading to Recurrent Hydronephrosis

    PubMed Central

    Olorunnisomo, Vincent; Fowle, Evan James; Modica, Ippolito; Meisels, Ira; Gupta, Mantu

    2016-01-01

    Abstract A patient with history of a solitary functioning kidney and protein C deficiency (PCD) presented with recurrent severe hydronephrosis causing acute kidney injury upon chronic kidney disease. Work-up with endoscopic evaluation revealed renal papillary necrosis (RPN) and sloughed renal papillae to be the true cause of the recurrent obstruction. Pathologic evaluation of the sloughed tissue confirmed the diagnosis of RPN. This is the first case reported in the literature illustrating the unique presentation of RPN in the setting of PCD. PMID:27579411

  25. Renal Papillary Necrosis Caused by Protein C Deficiency Leading to Recurrent Hydronephrosis.

    PubMed

    Chugh, Rohit Kumar; Olorunnisomo, Vincent; Fowle, Evan James; Modica, Ippolito; Meisels, Ira; Gupta, Mantu

    2016-01-01

    A patient with history of a solitary functioning kidney and protein C deficiency (PCD) presented with recurrent severe hydronephrosis causing acute kidney injury upon chronic kidney disease. Work-up with endoscopic evaluation revealed renal papillary necrosis (RPN) and sloughed renal papillae to be the true cause of the recurrent obstruction. Pathologic evaluation of the sloughed tissue confirmed the diagnosis of RPN. This is the first case reported in the literature illustrating the unique presentation of RPN in the setting of PCD. PMID:27579411

  1. Refractory Jaundice From Intraductal Papillary Mucinous Neoplasm Treated With Cholangioscopy-Guided Radiofrequency Ablation.

    PubMed

    Brown, Nicholas G; Camilo, Joel; McCarter, Martin; Shah, Raj J

    2016-04-01

    Intraductal papillary mucinous neoplasms (IPMNs) are epithelial neoplasms treated with surgical resection when appropriate. We present a 79-year-old man with jandice refractory to endoscopic stenting. Biliary radiofrequency ablation (RFA) with cholangioscopy was used as palliation of obstructive jaundice due to a mucin-producing pancreatic IPMN with fistulous biliary communication. Clinical improvement permitted surgery, and he returned to pre-illness status at 17 months. The use of cholangioscopy in the setting of mucinous filling defects can guide over-the-wire RFA for palliation and may be a bridge to surgery. PMID:27144205

  2. The Descending Helium Balloon

    ERIC Educational Resources Information Center

    Helseth, Lars Egil

    2014-01-01

    I describe a simple and fascinating experiment wherein helium leaks out of a rubber balloon, thereby causing it to descend. An estimate of the volumetric leakage rate is made by measuring its rate of descent.

  3. Ballooning Interest in Science.

    ERIC Educational Resources Information Center

    Kim, Hy

    1992-01-01

    Presents an activity in which students construct model hot air balloons to introduce the concepts of convection current, the principles of Charles' gas law, and three-dimensional geometric shapes. Provides construction and launching instructions. (MDH)

  4. NASA Now: Balloon Research

    NASA Video Gallery

    In this NASA Now program, Debbie Fairbrother discusses two types of high-altitude balloons that NASA is using to test scientific instruments and spacecraft. She also talks about the Ideal Gas Law a...

  5. Visualizing balloon stresses

    NASA Astrophysics Data System (ADS)

    Winker, James A.

    1994-02-01

    In a structure as indeterminate as a partially inflalted balloon it is very difficult to determine either the stress at any given point or a stress pattern over an area. Finite element analysis for this purpose is under development, but this will not likely bear fruit for years. This paper describes a process using desktop computers to convert actual experimental stress data into graphic, visual displays. The results provide valuable insight into the nature of balloon stresses.

  6. Determination of balloon drag

    NASA Technical Reports Server (NTRS)

    Conrad, George R.; Robbins, Edward J.

    1991-01-01

    The evolution of an empirical drag relationship that has stimulated rethinking regarding the physics of balloon drag phenomena is discussed. Combined parasitic drag from all sources in the balloon system are estimated to constitute less than 10 percent of the total system drag. It is shown that the difference between flight-determined drag coefficients and those based on the spherical assumption should be related to the square of the Froude number.

  7. Novel Endoscopic Management of Obesity

    PubMed Central

    Dargent, Jerome

    2016-01-01

    Endoscopic procedures have been well-documented in the obesity field, but have not yet reached a sufficient level of evidence as stand-alone methods for treating obesity. It is unclear if they should take over. Although expanding, the array of bariatric surgical techniques does not fully meet the current needs, and there are not enough resources for increasing surgery. Surgery is avoided by a majority of patients, so that less aggressive procedures are necessary. For the time being, relevant endoscopic methods include intra-gastric balloons, gastric partitioning (Endo-plication), and the metabolic field (Endo-barrier). Surgical novelties and basic research are also important contributors owing to their potential combination with endoscopy. Conditions have been listed for implementation of bariatric endoscopy, because innovation is risky, expensive, and faces ethical challenges. A scientific background is being built (e.g., hormonal studies). Some techniques require additional study, while others are not ready but should be priorities. Steps and goals include the search for conceptual similarities and the respect of an ethical frame. Minimally invasive bariatric techniques are not ready for prime time, but they are already being successful as re-do procedures. A time-frame for step-strategies can be defined, and more investments from the industry are mandatory. PMID:26855921

  8. Experimental Papillary Necrosis of the Kidney

    PubMed Central

    Wyllie, R. G.; Hill, G. S.; Murray, G.; Ramsden, P. W.; Heptinstall, R. H.

    1972-01-01

    Reserpine is able to exert a pronounced inhibitory effect on the development of papillary necrosis following the administration of bromoethylamine hydrobromide to the rat. This inhibitory effect has been observed using light microscopy, histochemistry, indigo carmine excretion and urine output. These observations suggest that vasoconstriction may play a significant role in the pathogenesis of papillary necrosis, but the evidence for this is incomplete. ImagesFig 1Fig 2Fig 3Fig 4Fig 5Fig 6 PMID:4114974

  9. Not all occult papillary carcinomas are minimal

    SciTech Connect

    Allo, M.D.; Christianson, W.; Koivunen, D.

    1988-12-01

    Occult papillary carcinomas are characterized as small papillary tumors of less than 1.5 cm in maximum diameter, with or without bulky metastatic deposits in cervical nodes. The primary lesion is usually not palpable, and although the clinical behavior usually follows a benign course, tumors with unfavorable histologic features (invasiveness, multifocality) or extrathyroidal disease or a combination of both may not do so. In this report six cases are presented to illustrate this entity. No patient had a history of irradiation to the head or neck. All had primary lesions smaller than 1.5 cm. None had a palpable nodule or abnormal thyroid scan results, and the diagnosis of thyroid cancer was based on cervical lymph node or lung biopsy specimens, which revealed papillary thyroid cancer. All of the patients underwent total or near-total thyroidectomies and were found to have small, invasive papillary lesions with additional metastases to cervical nodes noted at the time of thyroidectomy. Adjunctive treatment consisted of a 5 mCi iodine-131 scan, ablative iodine-131 therapy, and suppression with L-thyroxine. Although distant metastasis to lung or other organs is uncommon and the mortality rate is low (as in larger papillary cancers), these invasive lesions--despite their small size--have a high propensity for recurrence and should be considered to behave more like encapsulated papillary tumors with extrathyroidal extension than like their small, unencapsulated intrathyroidal counterparts.

  10. Scientific ballooning opportunities

    NASA Astrophysics Data System (ADS)

    Peacock, D.

    The National Science Foundation and the National Aeronautics and Space Administration are exploring the, possibilities of a joint balloon program in Antarctica. Over the years there have been many successful small balloons launched from Antarctica for research on topics such as meteorology, atmospheric chemistry, magnetospheric physics, and astrophysics. Recently, a large balloon (and payload) was successfully launched from McMurdo.In response to this growing interest, NSF hosted a 1-day workshop on Scientific Ballooning in Antarctica on March 27. This was well received, as evidenced by the attendance of some 40-50 scientists. At a follow-up meeting on June 14, 1988, attended by P. Wilkness, Division Director, Polar Programs, NSF, and S. Shawhan, Division Director, Space Physics, NASA, it was decided to solicit community input in the form of brief letters (one or two pages). Therefore if you have aspirations for balloon activities in Antarctica within the next few years, please send a brief description of your plans, including scientific objectives, time frame, launch site(s), logistical requirements, budget estimates (excluding logistics), and special needs, if any. Send this material to J . Lynch, Program Manager, Polar Atmospheric Sciences, Division of Polar Programs, National Science Foundation, 1800 G St., N.W., Washington, DC 20550. Send a copy to S. Shawhan, Director, Space Physics Division, NASA Headquarters, Washington, DC 20546.

  11. Stability of lobed balloons

    NASA Astrophysics Data System (ADS)

    Pagitz, M.; Xu, Y.; Pellegrino, S.

    This paper presents a computational study of the stability of simple lobed balloon structures. The particular structure that is investigated is a stack of pumpkin-shaped envelopes with a common axis of symmetry, and hence forming a kind of lobed cylinder. The number of the pumpkin envelopes is one of the variables that is investigated; a number of shape imperfections are also considered. This lobed cylinder is an axi-symmetric, idealised version of the lobed pumpkin balloons that have occasionally deployed into anomalous, clefted configurations. By studying in detail the behaviour of lobed cylinder we are able to draw some preliminary conclusions about general features of the behaviour of lobed pumpkin balloons.

  12. Universal stratospheric balloon gradiometer

    NASA Astrophysics Data System (ADS)

    Tsvetkov, Yury; Filippov, Sergey; Brekhov, Oleg; Nikolaev, Nikolay

    The study of the interior structure of the Earth and laws of its evolution is one of the most difficult problems of natural science. Among the geophysical fields the anomaly magnetic field is one of the most informational in questions of the Earth’s crust structure. Many important parameters of an environment are expedient for measuring at lower altitudes, than satellite ones. So, one of the alternatives is stratospheric balloon survey. The balloon flight altitudes cover the range from 20 to 50 km. At such altitudes there are steady zone air flows due to which the balloon flight trajectories can be of any direction, including round-the-world (round-the-pole). For investigation of Earth's magnetic field one of the examples of such sounding system have been designed, developed and maintained at IZMIRAN and MAI during already about 25 years. This system consists of three instrumental containers uniformly placed along a vertical 6 km line. Up today this set has been used only for geomagnetic purposes. So we describe this system on example of the measuring of the geomagnetic field gradient. System allows measuring a module and vertical gradient of the geomagnetic field along the whole flight trajectory and so one’s name is - stratospheric balloon magnetic gradiometer (SMBG). The GPS-receivers, located in each instrumental container, fix the flight coordinates to within several tens meters. Process of SBMG deployment, feature of the exit of rope from the magazine at the moment of balloon launching has been studied. Used magazine is cellular type. The hodograph of the measuring base of SBMG and the technique of correction of the deviations of the measuring base from the vertical line (introduction of the amendments for the deviation) during the flight have been investigated. It is shown that estimation of the normal level of values of the vertical gradient of the geomagnetic field is determined by the accuracy of determining the length of the measuring base SBMG

  13. Balloon gondola diagnostics package

    NASA Technical Reports Server (NTRS)

    Cantor, K. M.

    1986-01-01

    In order to define a new gondola structural specification and to quantify the balloon termination environment, NASA developed a balloon gondola diagnostics package (GDP). This addition to the balloon flight train is comprised of a large array of electronic sensors employed to define the forces and accelerations imposed on a gondola during the termination event. These sensors include the following: a load cell, a three-axis accelerometer, two three-axis rate gyros, two magnetometers, and a two axis inclinometer. A transceiver couple allows the data to be telemetered across any in-line rotator to the gondola-mounted memory system. The GDP is commanded 'ON' just prior to parachute deployment in order to record the entire event.

  14. Launching Garbage-Bag Balloons.

    ERIC Educational Resources Information Center

    Kim, Hy

    1997-01-01

    Presents a modification of a procedure for making and launching hot air balloons made out of garbage bags. Student instructions for balloon construction, launching instructions, and scale diagrams are included. (DDR)

  15. BARREL Team Launching 20 Balloons

    NASA Video Gallery

    A movie made by the NASA-Funded Balloon Array for Radiation belt Relativistic Electron Losses, or BARREL, team on their work launching 20 balloons in Antarctica during the Dec. 2013/Jan. 2014 campa...

  16. Treatment of chronic frontal sinusitis with difficult anatomy: A hybrid balloon technique in four cases

    PubMed Central

    Fleischman, Gitanjali M.; Miller, Justin D.; Kim, Grace G.; Zanation, Adam M.

    2014-01-01

    The presence of frontal cells poses unique challenges when using endoscopic approaches. This study describes the use of a balloon dilation system as an aid for functional endoscopic sinus surgery (FESS) to access the frontal sinus in cases that would traditionally require open approaches. We present a case series of four patients with chronic rhinosinusitis refractive to medical management who underwent FESS with the aid of a balloon dilation system at a tertiary referral center. All patients had variant forms of frontal sinus anatomy. Surgical techniques will be described and use of the balloon system will be reviewed. All patients (aged 13–68 years) successfully underwent fontal sinusotomies with the assistance of a balloon dilation system, which was used in a variety of ways: to dilate the narrow infundibulum of a high intersinus septal cell, to remove an anteriorly located type III frontal sinus cell, to expand the natural frontal ostium in the presence of excessive agger nasi pneumatization, and to remove a type IV frontal sinus cell. All patients were spared an osteoplastic flap or trephination, and there were no intraoperative complications. No postoperative bleeding, infection, or cerebral spinal fluid leaks were reported. Balloon dilation in combination with standard frontal sinus dissection techniques may be beneficial for a select group of patients with complex frontal anatomy. In this series of patients, the balloon dilation system was used as a tool during FESS and eliminated the need for open approaches. PMID:25565046

  17. Balloon-Borne Polarimetry

    NASA Astrophysics Data System (ADS)

    Rust, D. M.; Murphy, G.; Strohbehn, K.; Keller, C. U.

    1996-03-01

    For about two weeks in 1995, the balloon-borne Flare Genesis Experiment will continuously observe the Sun well above the turbulent, image-blurring layers of the Earth's atmosphere. The polarization-free 80 cm telescope will supply images to a liquid-crystal based vector magnetograph, which will measure magnetic features at a resolution of 0.2 arcsec. An electrically tunable lithium-niobate Fabry-Perot provides a spectral resolution of about 0.015 nm. In a follow-up series of Antarctic balloon flights, the Flare Genesis Experiment (FGE) will provide unprecedented details about sunspots, flares, magnetic elements, filaments, and the quiet solar atmosphere.

  18. Balloon borne Infrared Surveys

    NASA Astrophysics Data System (ADS)

    Lubin, Philip M.

    2015-08-01

    We report on modeling of a balloon borne mission to survey the 1-5 micron region with sensitivity close to the zodiacal light limits in portions of this band. Such a survey is compelling for numerous science programs and is complimentary to the upcoming Euclid, WFIRST and other orbital missions. Balloons borne missions offer much lower cost access and rapid technological implementation but with much less exposure time and increased backgrounds. For some science missions the complimentary nature of these is extremely useful. .

  19. JACEE long duration balloon flights

    SciTech Connect

    Burnett, T.; Iwai, J.; Lord, J.J.; Strausz, S.; Wilkes, R.J. ); Dake, S.; Oda, H. ); Miyamura, O. ); Fuki, M. ); Jones, W.V. ); Gregory, J.; Hayashi, T.; Takahashi, U. ); Tominaga,

    1989-01-01

    JACEE balloon-borne emulsion chamber detectors are used to observe the spectra and interactions of cosmic ray protons and nuclei in the energy range 1-100A TeV. Experience with long duration mid-latitude balloon flights and characteristics of the detector system that make it ideal for planned Antarctic balloon flights are discussed. 5 refs., 2 figs.

  20. A case of mixed adenoneuroendocrine carcinoma of the gallbladder arising from an intracystic papillary neoplasm associated with pancreaticobiliary maljunction.

    PubMed

    Meguro, Yoshiyuki; Fukushima, Noriyoshi; Koizumi, Masaru; Kasahara, Naoya; Hydo, Masanobu; Morishima, Kazue; Sata, Naohiro; Lefor, Alan T; Yasuda, Yoshikazu

    2014-09-01

    A 54-year-old Japanese woman was referred with a gallbladder tumor. Based on the results of the computed tomography scan, endoscopic retrograde cholangiopancreatography, and magnetic resonance cholangiopancreatography, a mucin-producing neoplasm of the gallbladder associated with pancreaticobiliary maljunction was diagnosed. Extended cholecystectomy, extrahepatic bile duct resection, and choledochojejunostomy were performed, and she remains free of recurrence 24 months after resection. Histopathological examination revealed that the papillary component of the lesion was an intracystic papillary neoplasm with diverse characteristics of pancreaticobiliary epithelium and intestinal epithelium including mucin. In this component, most of the papillary lesion was a high-grade intraepithelial neoplasm, but also showed slight invasion into the muscular layer. The nodular component consisted of both poorly differentiated biliary type adenocarcinoma and large cell neuroendocrine carcinoma. We report a rare case of a mixed adenoneuroendocrine carcinoma arising from an intracystic papillary neoplasm associated with pancreaticobiliary maljunction. As for the histogenesis of this tumor, based on the histopathologic appearance, transdifferentiation from poorly differentiated biliary type adenocarcinoma to large cell neuroendocrine carcinoma is considered the most possible histogenesis of this tumor. PMID:25146100

  1. Scientific balloons: historical remarks.

    NASA Astrophysics Data System (ADS)

    Ubertini, P.

    The paper is an overview of the Human attempt to fly, from the myth of Daedalus and his son Icarus to the first "aerostatic" experiment by Joseph-Michel and Jaques-Etienne Montgolfier. Then, via a jump of about 200 years, we arrive to the era of the modern stratospheric ballooning that, from the beginning of the last century, have provided a unique flight opportunity for aerospace experiments. In particular, the Italian scientific community has employed stratospheric balloons since the '50s for cosmic rays and high energy astrophysical experiments with initial launches performed from Cagliari Helmas Airport (Sardinia). More recently an almost ideal location was found in the area of Trapani-Milo (Sicily, Italy), were an old abandoned airport was refurbished to be used as a new launch site that became operative at the beginning of the '70s. Finally, we suggest a short reminiscence of the first transatlantic experiment carried out on August 1975 in collaboration between SAS-CNR (Italy) and NSBF-NASA (USA). The reason why the Long Duration Balloon has been recently re-oriented in a different direction is analysed and future perspectives discussed. Finally, the spirit of the balloon launch performed by the Groups lead by Edoardo Amaldi, Livio Scarsi and other Italian pioneers, with payloads looking like "refrigerators" weighting a few tens of kg is intact and the wide participation to the present Workshop is the clear demonstration.

  2. Particle Astrophysics Using Balloons

    NASA Astrophysics Data System (ADS)

    Seo, E. S.

    Cosmic rays, energetic particles coming from outer space, bring us information about the physical processes that accelerate particles to relativistic energies, about the effects of those particles in driving dynamical processes in our Galaxy, and about the distribution of matter and fields in interstellar space. Cosmic rays were discovered in the early twentieth century using a balloon-borne electroscope. Balloons are currently being used for answering fundamental questions about the cosmos: (1) Is the Universe symmetric, and if so where is the antimatter? (2) What is the dark matter? (3) How do cosmic rays get their enormous energies? (4) Can the entire energy spectrum of cosmic rays result from a single acceleration mechanism? (5) Are supernovae really the sources of cosmic rays? (6) What is the history of cosmic rays in the Galaxy? (7) What is the origin of the "knee" in the cosmic ray energy spectrum? etc. The status of results from past balloon-borne measurements and expected results from ongoing and planned future balloon-borne particle astrophysics experiments will be reviewed.

  3. Renal Papillary Necrosis: Role of Radiology

    PubMed Central

    Pandya, Vaidehi K.

    2016-01-01

    Renal Papillary Necrosis (RPN) is idefined as Ischemic necrobiosis of the papilla in the medulla of the kidneys. Variety of etiological factors are recognized which cause papillary necrosis, such as analgesic nephropathy, diabetes mellitus, urinary obstruction and sickle cell haemoglobinopathy. The early diagnosis of RPN is important to improve prognosis and reduce morbidity. Radiological Imaging offers early diagnosis and can guide prompt treatment of papillary necrosis and can minimize a decline in renal function. Here we report three cases of RPN with typical imaging findings. One of them was diabetic and hypertensive female with recurrent Urinary tract Infections and other was a male with no known co-morbidity. Both of them were diagnosed to have renal papillary necrosis on CT scan and were managed operatively and conservatively, respectively. Third case was a healthy female being investigated to be renal donor for her son. Here RPN was an incidental finding and was treated conservatively. Thus CT scan could detect it pre-operatively and complications due to transplantation of a kidney with papillary necrosis were avoided. So, we want to emphasize the importance of Radiology, particularly CT scanning in detection of RPN and to guide early and prompt treatment. PMID:26894147

  4. Flow Past a Descending Balloon

    NASA Technical Reports Server (NTRS)

    Baginski, Frank

    2001-01-01

    In this report, we present our findings related to aerodynamic loading of partially inflated balloon shapes. This report will consider aerodynamic loading of partially inflated inextensible natural shape balloons and some relevant problems in potential flow. For the axisymmetric modeling, we modified our Balloon Design Shape Program (BDSP) to handle axisymmetric inextensible ascent shapes with aerodynamic loading. For a few simple examples of two dimensional potential flows, we used the Matlab PDE Toolbox. In addition, we propose a model for aerodynamic loading of strained energy minimizing balloon shapes with lobes. Numerical solutions are presented for partially inflated strained balloon shapes with lobes and no aerodynamic loading.

  5. Endoscopic vacuum-assisted closure with sponge for esophagotracheal fistula after esophagectomy.

    PubMed

    Lee, Hyun Jik; Lee, Hyuk

    2015-04-01

    We experienced a case of endoscopic vacuum-assisted closure with sponge for esophagotracheal fistula diagnosed after esophagectomy due to squamous cell esophageal cancer. The patient, who had undergone a robotic-assisted thoracoscopic esophagectomy and esophageal reconstruction of the stomach, was referred for the management of esophagotracheal fistula. Diagnostic esophagogastroduodenoscopy and imaging studies were performed, and they indicated anastomotic leakage with esophagotracheal fistula. The patient was treated by the endoscopic placement of full-covered self-expanding metal stents, but the fistula persisted. Then, we applied a size-adjusted sponge endoscopically with continuous suction by a vacuum system in the fistula lesion. Complete closure was achieved without any procedure-related complications. After 40 days, symptomatic esophageal stricture was detected and treated successfully with endoscopic balloon dilation. Endoscopic vacuum-assisted closure with a sponge might be an adequate alternative treatment option for esophageal stenting for esophagotracheal fistula after esophagectomy. PMID:25799256

  6. High grade anorectal stricture complicating Crohn's disease: endoscopic treatment using insulated-tip knife

    PubMed Central

    Chon, Hyung Ku; Shin, Ik Sang; Kim, Sang Wook

    2016-01-01

    Endoscopic treatments have emerged as an alternative to surgery, in the treatment of benign colorectal stricture. Unlike endoscopic balloon dilatation, there is limited data on endoscopic electrocautery incision therapy for benign colorectal stricture, especially with regards to safety and long-term patency. We present a case of a 29-year-old female with Crohn's disease who had difficulty in defecation and passing thin stools. A pelvic magnetic resonance imaging scan, gastrograffin enema, and sigmoidoscopy showed a high-grade anorectal stricture. An endoscopic insulated-tip knife incision was successfully performed to resolve the problem. From our experience, we suggest that endoscopic insulated-tip knife treatment may be a feasible and effective modality for patients with short-segment, very rigid, fibrotic anorectal stricture. PMID:27433152

  7. High grade anorectal stricture complicating Crohn's disease: endoscopic treatment using insulated-tip knife.

    PubMed

    Chon, Hyung Ku; Shin, Ik Sang; Kim, Sang Wook; Lee, Soo Teik

    2016-07-01

    Endoscopic treatments have emerged as an alternative to surgery, in the treatment of benign colorectal stricture. Unlike endoscopic balloon dilatation, there is limited data on endoscopic electrocautery incision therapy for benign colorectal stricture, especially with regards to safety and long-term patency. We present a case of a 29-year-old female with Crohn's disease who had difficulty in defecation and passing thin stools. A pelvic magnetic resonance imaging scan, gastrograffin enema, and sigmoidoscopy showed a high-grade anorectal stricture. An endoscopic insulated-tip knife incision was successfully performed to resolve the problem. From our experience, we suggest that endoscopic insulated-tip knife treatment may be a feasible and effective modality for patients with short-segment, very rigid, fibrotic anorectal stricture. PMID:27433152

  8. Endoscopic retrograde cholangiopancreatography in ruptured liver hydatid cyst.

    PubMed

    Borahma, Mohamed; Afifi, Rajaa; Benelbarhdadi, Imane; Ajana, Fatima Zahra; Essamri, Wafaa; Essaid, Abdellah

    2015-07-01

    One of the most common and serious complications of hepatic hydatid cyst disease is communication between the cyst and the biliary tree. Surgical management of biliary fistula is associated with high morbidity and mortality. We retrospectively reviewed the effectiveness of endoscopic treatment of ruptured hydatid cyst into intrahepatic bile ducts. Diagnosis of intrabiliary rupture of hydatid cyst was mostly suspected by acute cholangitis, jaundice, pain, and/or persistent external biliary fistula after surgery. The diagnosis was confirmed by radiology and endoscopic retrograde cholangiopancreatography (ERCP) findings. We retrospectively reviewed clinical, laboratory, imagery, and ERCP findings for all patients. The therapeutic methods performed were endoscopic sphincterotomy, extraction by balloon or Dormia basket, stenting, or nasobiliary drainage. Sixteen patients with ruptured hepatic hydatid cyst into bile ducts were seen in 9 years. Nine of 16 patients had a surgical history of hepatic hydatid cyst and three patients had a percutanous treatment history. We carried out ERCP with sphincterotomy and extraction of hydatid materials (extraction balloon n = 11; Dormia basket n = 5) or biliary drainage (nasobiliary drainage n = 1; biliary stenting n = 1). The fistula healed in 80 % of patients with a median time of 6 weeks [range, 1-12] after endoscopic treatment. ERCP was an effective method of treatment for hepatic hydatid cyst with biliary fistula. PMID:26345677

  9. Endoscopic Evaluation of Swallowing (Endoscopy)

    MedlinePlus

    ... the Public / Speech, Language and Swallowing / Swallowing Endoscopic Evaluation of Swallowing (Endoscopy) Do you have problems swallowing? ... Some names you might hear are: Endoscopy Endoscopic Evaluation of swallowing FEES (Fiberoptic Endoscopic Evaluation of Swallowing) ...

  10. Review of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography using several endoscopic methods in patients with surgically altered gastrointestinal anatomy

    PubMed Central

    Shimatani, Masaaki; Takaoka, Makoto; Tokuhara, Mitsuo; Miyoshi, Hideaki; Ikeura, Tsukasa; Okazaki, Kazuichi

    2015-01-01

    The endoscopic approach for biliary diseases in patients with surgically altered gastrointestinal anatomy (SAGA) had been generally deemed impractical. However, it was radically made feasible by the introduction of double balloon endoscopy (DBE) that was originally developed for diagnosis and treatments for small-bowel diseases. Followed by the subsequent development of single-balloon endoscopy (SBE) and spiral endoscopy (SE), interventions using several endoscopes for biliary disease in patients with SAGA widely gained an acceptance as a new modality. Many studies have been made on this new technique. Yet, some problems are to be solved. For instance, the mutual unavailability among devices due to different working lengths and channels, and unestablished standardization of procedural techniques can be raised. Additionally, in an attempt to standardize endoscopic procedures, it is important to evaluate biliary cannulating methods by case with existence of papilla or not. A full comprehension of the features of respective scope types is also required. However there are not many papers written as a review. In our manuscript, we would like to evaluate and make a review of the present status of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography applying DBE, SBE and SE for biliary diseases in patients with SAGA for establishment of these modalities as a new technology and further improvement of the scopes and devices. PMID:26078830

  11. Vega balloon meteorological measurements

    NASA Technical Reports Server (NTRS)

    Crisp, D.; Ingersoll, A. P.; Hildebrand, C. E.; Preston, R. A.

    1990-01-01

    The Vega balloons obtained in situ measurements of pressure, temperature, vertical winds, cloud density, ambient illumination, and the frequency of lightning during their flights in the Venus middle cloud layer. The Vega measurements were used to develop a comprehensive description of the meteorology of the Venus middle cloud layer. The Vega measurements provide the following picture: large horizontal temperature gradients near the equator, vigorous convection, and weather conditions that can change dramatically on time scales as short as one hour.

  12. Role of Balloon-Sheathed Intraductal Ultrasonography for Patients with Extensive Pneumobilia

    PubMed Central

    Kim, Ha-Na; Park, Chang-Hwan; Cho, Eun-Ae; Rew, Soo-Jung; Park, In-Hyung; Lim, Sung-Uk; Jun, Chung-Hwan; Park, Seon-Young; Kim, Hyun-Soo; Choi, Sung-Kyu

    2015-01-01

    Intraductal ultrasonography (IDUS) is one of the most useful diagnostic tools for various extrahepatic biliary diseases. However, conventional IDUS has some limitations in providing accurate cross-sectional imaging of the bile duct in patients with extensive pneumobilia. Using a balloon-sheathed catheter, the US system (balloon-sheathed IDUS) can overcome these limitations. Sixteen patients underwent balloon-sheathed IDUS during endoscopic retrograde cholangiography. The balloon-sheathed IDUS was inserted via a transpapillary route when visualization of the bile duct with conventional IDUS was distorted by extensive pneumobilia. The patient group had a mean age of 65.5 years, and 56.3% (9/16) were male. The balloon-sheathed IDUS permitted successful visualization of the bile duct in all patients, regardless of the extent of pneumobilia. Using this system, remnant common bile duct stones were detected in five patients (31.3%), and cholangiocarcinoma was detected in one patient (6.3%). The balloon-sheath IDUS aided in stone sweeping. No significant complications, including bleeding, perforation, or pancreatitis, occurred in any of the patients. The balloon-sheathed catheter US system was useful and safe for biliary IDUS in patients with extensive pneumobilia. PMID:26033684

  13. Endoscopic assessment of primary sclerosing cholangitis.

    PubMed

    De Vries, Boudewijn; Weersma, Rinse K

    2016-03-01

    Primary sclerosing cholangitis (PSC) is a rare chronic liver disease of unknown etiology for which the only known curative treatment is liver transplantation. The disease is defined by progressive inflammation and fibrosis of the bile ducts, causing biliary strictures and cholestasis. Common complications of the disease are the presence of biliary lithiasis requiring stone extraction, and development of dominant bile duct strictures requiring balloon dilatation and stent placement through endoscopic retrograde cholangiopancreatography. The increased development of cholangiocarcinoma is a dreaded complication in PSC, as it is often detected in an advanced stage and is associated with a poor prognosis. Several endoscopic techniques, including endoscopic ultrasound, confocal laser endomicroscopy and peroral cholangioscopy are applied in the management of PSC and detection of cholangiocarcinoma. Tissue sampling through different types of biopsies and biliary brush combined with fluorescence in situ hybridization are used to differentiate benign dominant strictures from biliary neoplasia. Nonetheless early detection of cholangiocarcinoma in PSC remains a clinical challenge requiring a specialized diagnostic workup. The aim of this review is to discuss the role of diagnostic and therapeutic endoscopy in management of PSC, providing an overview of current literature. PMID:26446685

  14. Gallstone Ileus following Endoscopic Stone Extraction

    PubMed Central

    Wakui, Noritaka; Asai, Yasutsugu; Dan, Nobuhiro; Takeda, Yuki; Ueki, Nobuo; Otsuka, Takahumi; Oba, Nobuyuki; Nisinakagawa, Shuta; Kojima, Tatsuya

    2014-01-01

    An 85-year-old woman was an outpatient treated at Tokyo Rosai Hospital for cirrhosis caused by hepatitis B. She had previously been diagnosed as having common bile duct stones, for which she underwent endoscopic retrograde cholangiopancreatography (ERCP). However, as stone removal was unsuccessful, a plastic stent was placed after endoscopic sphincterotomy. In October 2012, the stent was replaced endoscopically because she developed cholangitis due to stent occlusion. Seven days later, we performed ERCP to treat recurring cholangitis. During the procedure, the stone was successfully removed by a balloon catheter when cleaning the common bile duct. The next day, the patient developed abdominal pain, abdominal distension, and nausea and was diagnosed as having gallstone ileus based on abdominal computed tomography (CT) and abdominal ultrasonography findings of an incarcerated stone in the terminal ileum. Although colonoscopy was performed after inserting an ileus tube, no stone was visible. Subsequent CT imaging verified the disappearance of the incarcerated stone from the ileum, suggesting that the stone had been evacuated naturally via the transanal route. Although it is extremely rare for gallstone ileus to develop as a complication of ERCP, physicians should be aware of gallstone ileus and follow patients carefully, especially after removing huge stones. PMID:25328725

  15. Intraductal papillary mucinous neoplasm of the bile duct with gastric and duodenal fistulas

    PubMed Central

    Hong, Man Yong; Yu, Dong Wook; Hong, Seung Goun

    2014-01-01

    Intraductal papillary mucinous neoplasm (IPMN) of the bile duct is still rare and not yet understood despite of its increased incidence and similar clinicopathologic characteristics compared with IPMN of the pancreas. The fistula formation into other organs can occur in IPMN, especially the pancreatic type. To our knowledge, only two cases of IPMN of the bile duct with a choledochoduodenal fistula were reported and we have recently experienced a case of IPMN of the bile duct penetrating into two neighboring organs of the stomach and duodenum presenting with abdominal pain and jaundice. Endoscopy showed thick mucin extruding from two openings of the fistulas. Endoscopic suction of thick mucin using direct peroral cholangioscopy with ultra-slim endoscope through choledochoduodenal fistula was very difficult and ineffective because of very thick mucin and next endoscopic suction through the stent after prior insertion of biliary metal stent into choledochogastric fistula also failed. Pathologic specimen obtained from the proximal portion of the choledochogastric fistula near left intrahepatic bile duct through the metal stent showed a low grade adenoma. The patient declined the surgical treatment due to her old age and her abdominal pain with jaundice was improved after percutaneous transhepatic biliary drainage with the irrigation of N-acetylcysteine three times daily for 10 d. PMID:25031793

  16. Popping a balloon with spaghetti

    NASA Astrophysics Data System (ADS)

    Planinšič, Gorazd; Etkina, Eugenia

    2015-05-01

    Imagine a balloon sitting on a tabletop. The balloon is free to move. You take one uncooked spaghetti noodle. Can you pop the balloon with this spaghetti? If you try, you will quickly see that you cannot [Fig. 1(a)]. You might think that the reason for the failure is the movement of the balloon. As it is not supported by anything, it moves away the moment you touch it with the spaghetti. But you also observe that the noodle breaks. Are these the explanations of your lack of success? To test both explanations of the balloon popping failure, the movement of the balloon (E1) and breaking of the spaghetti noodle (E2), we will perform testing experiments.

  17. Optimum designs for superpressure balloons

    NASA Astrophysics Data System (ADS)

    Smith, M. S.; Rainwater, E. L.

    2004-01-01

    The elastica shape is now well known to be the best basic shape for superpressure balloon design. This shape, also known as the pumpkin, or natural shape for balloons, has been well understood since the early 1900s when it was applied to the determination of the shape of descending parachutes. The elastica shape was also investigated in the 1950s when high strength films were used to produce superpressure cylinder balloons. The need for uniform stress distribution in shells of early superpressure balloons led to a long period of the development of spherical superpressure balloons. Not until the late 1970s was the elastica shape revisited for the purpose of the producing superpressure balloons. This paper will review various development efforts in the field of superpressure design and will elaborate on the current state-of-the-art with suggestions for future developments.

  18. Papillary Tumor of the Temporal Bone

    PubMed Central

    Schick, Bernhard; Kronsbein, Hartmut; Kahle, Gabriele; Prescher, Andreas; Draf, Wolfgang

    2001-01-01

    Papillary tumors of the middle and inner ear have been interpreted histogenetically in many ways. In 1989 Heffner proposed the endolymphatic sac epithelium as a possible origin. These rare tumors are clinically aggressive and can cause extensive temporal bone destruction. Because of this behavior, endolymphatic sac tumors (ELST) were classified as low-grade adenocarcinomas, although metastasis has not yet been documented. Two papillary neoplasms of the temporal bone are presented, which we believe are examples of adenomatous tumors arising from the epithelium of the endolymphatic sac. One was associated with a pituitary adenoma. A third case of a papillary middle ear neoplasm is described that shows histologic features similar to the other two, but it was located in the tympanum and had no connection to the endolymphatic sac. This report focuses on clinical, radiologic, and histologic findings of papillary tumors of the temporal bone with additional emphasis on modern concepts of histogenesis and aspects of differential diagnosis. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5 PMID:17167601

  19. Cleft formation in pumpkin balloons

    NASA Astrophysics Data System (ADS)

    Baginski, Frank E.; Brakke, Kenneth A.; Schur, Willi W.

    NASA’s development of a large payload, high altitude, long duration balloon, the Ultra Long Duration Balloon, centers on a pumpkin shape super-pressure design. Under certain circumstances, it has been observed that a pumpkin balloon may be unable to pressurize into the desired cyclically symmetric equilibrium configuration, settling into a distorted, undesired state instead. Success of the pumpkin balloon for NASA requires a thorough understanding of the phenomenon of multiple stable equilibria and developing of means for the quantitative assessment of design measures that prevent the occurrence of undesired equilibrium. In this paper, we will use the concept of stability to classify cyclically symmetric equilibrium states at full inflation and pressurization. Our mathematical model for a strained equilibrium balloon, when applied to a shape that mimics the Phase IV-A balloon of Flight 517, predicts instability at float. Launched in Spring 2003, this pumpkin balloon failed to deploy properly. Observations on pumpkin shape type super-pressure balloons that date back to the 1980s suggest that within a narrowly defined design class of pumpkin shape super-pressure balloons where individual designs are fully described by the number of gores ng and by a single measure of the bulging gore shape, the designs tend to become more vulnerable with the growing number of gores and with the diminishing size of the bulge radius rB Weight efficiency considerations favor a small bulge radius, while robust deployment into the desired cyclically symmetrical configuration becomes more likely with an increased bulge radius. In an effort to quantify this dependency, we will explore the stability of a family of balloon shapes parametrized by (ng, rB) which includes a design that is very similar, but not identical, to the balloon of Flight 517. In addition, we carry out a number of simulations that demonstrate other aspects related to multiple equilibria of pumpkin balloons.

  20. Breakthrough in Mars balloon technology

    NASA Astrophysics Data System (ADS)

    Kerzhanovich, V. V.; Cutts, J. A.; Cooper, H. W.; Hall, J. L.; McDonald, B. A.; Pauken, M. T.; White, C. V.; Yavrouian, A. H.; Castano, A.; Cathey, H. M.; Fairbrother, D. A.; Smith, I. S.; Shreves, C. M.; Lachenmeier, T.; Rainwater, E.; Smith, M.

    2004-01-01

    Two prototypes of Mars superpressure balloons were flight tested for aerial deployment and inflation in the Earth's stratosphere in June, 2002. One was an 11.3 m diameter by 6.8 m high pumpkin balloon constructed from polyethylene film and Zylon (PBO) tendons, the second was a 10 m diameter spherical balloon constructed from 12 μm thick Mylar film. Aerial deployment and inflation occurred under parachute descent at 34 km altitude, mimicing the dynamic pressure environment expected during an actual Mars balloon mission. Two on-board video cameras were used on each flight to provide real-time upward and downward views of the flight train. Atmospheric pressure and temperature were also recorded. Both prototypes successfully deployed from their storage container during parachute descent at approximately 40 m/s. The pumpkin balloon also successfully inflated with a 440 g charge of helium gas injected over a 1.5-min period. Since the helium inflation system was deliberately retained after inflation in this test, the pumpkin balloon continued to fall to the ocean where it was recovered for post-flight analysis. The less robust spherical balloon achieved only a partial (~70%) inflation before a structural failure occurred in the balloon film resulting in the loss of the vehicle. This structural failure was diagnosed to result from the vigorous oscillatory motion of the partially inflated balloon, possibly compounded by contact between the balloon film and an instrumentation box above it on the flight train. These two flights together represent significant progress in the development of Mars superpressure balloon technology and pave the way for future flight tests that will include post-deployment flight of the prototype balloons at a stable altitude.

  1. Endoscopic pyloroplasty for severe gastric outlet obstruction due to alkali ingestion in a child.

    PubMed

    Dehghani, Seyed Mohsen; Aldaghi, Mitra; Javaherizadeh, Hazhir

    2016-01-01

    A common belief is that alkali ingestion causes severe esophageal damage and limited gastric injury due to the buffering action of acid. Gastric injury has been observed in patients who ingested alkali. Gastric outlet obstruction (GOO) secondary to caustic ingestion occurs due to fibrosis after resolution of the acute injury and inflammation, most commonly 6 to 12 weeks after initial ingestion. The traditional treatment for GOO related to ingestion of corrosive agents is surgery. Experience with endoscopic balloon dilation of corrosive-induced GOO is limited in children. This is the first report of endoscopic pyloroplasty in a child with GOO due to caustic alkalis ingestion that was treated with balloon dilation (using TTS balloon ranging from 6-15 mm) in Iran. Four dilation sessions were required for symptomatic relief of dysphagia. After one year of follow up, weight gain was normal. PMID:26744617

  2. Endoscopic pyloroplasty for severe gastric outlet obstruction due to alkali ingestion in a child

    PubMed Central

    Dehghani, Seyed Mohsen; Aldaghi, Mitra; Javaherizadeh, Hazhir

    2016-01-01

    A common belief is that alkali ingestion causes severe esophageal damage and limited gastric injury due to the buffering action of acid. Gastric injury has been observed in patients who ingested alkali. Gastric outlet obstruction (GOO) secondary to caustic ingestion occurs due to fibrosis after resolution of the acute injury and inflammation, most commonly 6 to 12 weeks after initial ingestion. The traditional treatment for GOO related to ingestion of corrosive agents is surgery. Experience with endoscopic balloon dilation of corrosive-induced GOO is limited in children. This is the first report of endoscopic pyloroplasty in a child with GOO due to caustic alkalis ingestion that was treated with balloon dilation (using TTS balloon ranging from 6-15 mm) in Iran. Four dilation sessions were required for symptomatic relief of dysphagia. After one year of follow up, weight gain was normal. PMID:26744617

  3. Next Generation Balloon Performance Model

    NASA Astrophysics Data System (ADS)

    Pankine, A.; Nock, K.; Heun, M.; Schlaifer, S.

    Global Aerospace Corporation is developing a new trajectory and performance modeling tool for Earth and Planetary Balloons, called Navajo. This tool will advance the state of the art for balloon performance models and assist NASA and commercial balloon designers, campaign and mission planners, and flight operations staff by providing high-accuracy vertical and horizontal trajectory predictions. Nothing like Navajo currently exists. The Navajo design integrates environment, balloon (or Lighter Than Air - LTA), gondola (for ballast and communications), and trajectory control system submodels to provide rapid and exhaustive evaluation of vertical and horizontal balloon and LTA vehicle trajectories. The concept utilizes an extensible computer application architecture to permit definit ion of additional flight system components and environments. The Navajo architecture decouples the balloon performance and environment models so that users can swap balloon and environment models easily and assess the capabilities of new balloon technologies in a variety of environments. The Navajo design provides integrated capabilities for safety analysis for Earth balloon trajectories, and utilize improved thermal models. We report on our progress towards the development of Navajo.

  4. Microgravity Experiment System Using Balloon

    NASA Astrophysics Data System (ADS)

    Sawai, Shujiro; Hashimoto, Tatsuaki; Sawai, Shujiro; Sakai, Shin'ichiro; Bando, Nobutaka; Kobayashi, Hiroaki; Fujita, Kazuhisa; Inatomi, Yuko; Ishikawa, Takehiko; Yoshimitsu, Tetsuo; Saito, Yoshitaka

    Balloon based system to conduct microgravity experiment was developed. This system consists of high altitude balloon, Microgravity Operation Unit for Scientific Experiment (MOUSE), and Balloon based Operation Vehicle (BOV). BOV drops from the balloon. But due to the residual air drag, BOV do not fall freely. So, MOUSE floats freely inside BOV body. BOV itself is controlled not to collide to MOUSE, and it makes the residual gravity negligible inside MOUSE. Authors have conducted the flight campaign twice to show the feasibility of this microgravity experiment system.

  5. Tricuspid balloon valvuloplasty: a more simplified approach using inoue balloon.

    PubMed

    Patel, T M; Dani, S I; Shah, S C; Patel, T K

    1996-01-01

    We report a more simplified technique of the balloon tricuspid valvuloplasty using inoue balloon set in a patient suffering from severe rheumatic tricuspid stenosis. We believe that this technique may be useful in a difficult case of tricuspid valvuloplasty. PMID:8770490

  6. Ballooning Comes of Age: Make Your Own Balloon.

    ERIC Educational Resources Information Center

    Eckford, Jim

    1983-01-01

    Provides instructions for building a working model of a hot-air balloon, offering suggestions for a successful flight. Indicates that children can be involved in the projects, for example, by filling in colors in the panels of a balloon drawing. (JN)

  7. Evaluation of radiation exposure dose at double-balloon endoscopy for the patients with small bowel disease

    PubMed Central

    Nagura, Asuka; Nakamura, Masanao; Watanabe, Osamu; Yamamura, Takeshi; Funasaka, Kohei; Ohno, Eizaburo; Miyahara, Ryoji; Kawashima, Hiroki; Koyama, Shuji; Hinami, Tomoki; Goto, Hidemi; Hirooka, Yoshiki

    2016-01-01

    ABSTRACT Double-balloon endoscopy (DBE) is useful for the diagnosis and treatment of small bowel diseases. Although fluoroscopy is used to confirm the position of endoscope at DBE, the endoscopist does not have the knowledge with regard to the radiation exposure dose. In this study, we evaluated the absorbed dose during DBE in patients with suspected or established small bowel diseases. This was a retrospective study in which the estimated fluoroscopic radiation absorbed doses loaded on the small bowel and skin were determined according to the data of the referential X-ray experiment with a human body phantom. The subjects were 415 DBEs preformed in total. The mean small bowel absorbed doses on antegrade and retrograde DBEs were 42.2 and 53.8 mGy, respectively, showing that the organ dose applied in retrograde DBE was significantly higher (P<0.0001). The mean skin absorbed doses of them were 79.2 and 101.0 mGy, respectively, showing that the dose was also significantly higher on retrograde DBE (P<0.0001). Of 27 cases who were applied endoscopic balloon dilation, the mean fluoroscopy time was 16.0 minutes, and mean small bowel and skin absorbed doses were 121.9 and 228.9 mGy, respectively. In conclusion, endoscopist should be careful for reducing the organ exposure dose at DBE, particularly for the lower abdominal region. Abbreviations: Double-balloon enteroscopy (DBE), endoscopic balloon dilation (EBD), endoscopic mucosal resection (EMR), double-balloon endoscopic retrograde cholangiopancreatography (DBERCP), percutaneous coronary intervention (PCI) PMID:27578908

  8. Endoscopic Devices for Obesity.

    PubMed

    Sampath, Kartik; Dinani, Amreen M; Rothstein, Richard I

    2016-06-01

    The obesity epidemic, recognized by the World Health Organization in 1997, refers to the rising incidence of obesity worldwide. Lifestyle modification and pharmacotherapy are often ineffective long-term solutions; bariatric surgery remains the gold standard for long-term obesity weight loss. Despite the reported benefits, it has been estimated that only 1% of obese patients will undergo surgery. Endoscopic treatment for obesity represents a potential cost-effective, accessible, minimally invasive procedure that can function as a bridge or alternative intervention to bariatric surgery. We review the current endoscopic bariatric devices including space occupying devices, endoscopic gastroplasty, aspiration technology, post-bariatric surgery endoscopic revision, and obesity-related NOTES procedures. Given the diverse devices already FDA approved and in development, we discuss the future directions of endoscopic therapies for obesity. PMID:27115879

  9. Endoscopic Skull Base Surgery

    PubMed Central

    Senior, Brent A

    2008-01-01

    Endoscopic skull base surgery has undergone rapid advancement in the past decade moving from pituitary surgery to suprasellar lesions and now to a myriad of lesions extending from the cribriform plate to C2 and laterally out to the infratemporal fossa and petrous apex. Evolution of several technological advances as well as advances in understanding of endoscopic anatomy and the development of surgical techniques both in resection and reconstruction have fostered this capability. Management of benign disease via endoscopic methods is largely accepted now but more data is needed before the controversy on the role of endoscopic management of malignant disease is decided. Continued advances in surgical technique, navigation systems, endoscopic imaging technology, and robotics assure continued brisk evolution in this expanding field. PMID:19434274

  10. Telescope Systems for Balloon-Borne Research

    NASA Technical Reports Server (NTRS)

    Swift, C. (Editor); Witteborn, F. C. (Editor); Shipley, A. (Editor)

    1974-01-01

    The proceedings of a conference on the use of balloons for scientific research are presented. The subjects discussed include the following: (1) astronomical observations with balloon-borne telescopes, (2) orientable, stabilized balloon-borne gondola for around-the-world flights, (3) ultraviolet stellar spectrophotometry from a balloon platform, (4) infrared telescope for balloon-borne infrared astronomy, and (5) stabilization, pointing, and command control of balloon-borne telescopes.

  11. 026. Papillary adenoma of the lung: a case report

    PubMed Central

    Baliaka, Aggeliki; Tryfon, Stavros; Papaemmanouil, Styliani; Cheva, Angeliki; Papastergiou, Christos; Sakkas, Leonidas

    2015-01-01

    Background Papillary adenoma of the lung is a rare neoplasm with only 24 cases reported in the current literature. It occurs in individuals range in age, from 7-60 years with a male predominance and is usually detected incidentally on chest radiographs. Objective The report of a rare case of pulmonary papillary adenoma. Methods A 70-year-old male presented to our Hospital with cough and expectoration. The chest radiological examination demonstrated a nodular shadow two cm in size at the upper lobe of the left lung. Bronchoscopic lung biopsy was performed and the tissue sample was sent for histological examination. Results Pathology examination revealed a lesion consisting of a papillary growth pattern of cuboidal to columnar, ciliated epithelial cells lining the surface of fibrovascular cores. Occasional eosinophilic intranuclear inclusions were noted, but nuclear atypia or mitosis were almost absent. The histological features were consistent with pulmonary papillary adenoma. Conclusions Papillary adenoma of the lung is a benign, circumscribed papillary neoplasm (WHO 2004). Its rarity and shared histologic features of other benign and malignant tumors, such as alveolar adenoma, papillary adenocarcinomas including metastatic thyroid carcinoma, bronchoalveolar carcinoma and papillary carcinoid tumor, demand special attention for diagnosis. In our case, the pathologic criteria, such as papillary growth pattern and cytologic features, were sufficient to confirm the diagnosis of papillary adenoma of the lung.

  12. Balloon dilatation for male urethral strictures “revisited”

    PubMed Central

    Vyas, Jigish B.; Ganpule, Arvind P.; Muthu, Veermani; Sabnis, Ravindra B.; Desai, Mahesh R.

    2013-01-01

    Aims: To analyze the results of balloon dilatation for short segment male urethral strictures. Materials and Methods: Retrospective analysis was done of 120 patients undergoing urethral balloon dilatation since January 2004 to January 2012. The inclusion criteria for analysis was a short segment (less than 1.5 cm) stricture, exclusion criteria were pediatric, long (more than 1.5 cm), traumatic, malignant strictures. The parameters analyzed included presentation of patients, ascending urethrogram (AUG) and descending urethrogram findings, pre- and postoperative International prostate symptoms score (IPSS), uroflowmetry (Qmax), and post-void residue (PVR). Need for self calibration/ancillary procedures were assessed. Failure was defined as requirement for a subsequent endoscopic or open surgery. A urethral balloon catheter (Cook Urological, Spencer, Indiana) is passed over a guide wire after on table AUG and inflated till 180 psi for 5 minutes under fluoroscopy till waist disappears. Dilatation is followed by insertion of a Foley catheter. Patients were followed up at 1, 3, and 6 months. Results: Mean age was 49.86 years. Mean follow-up was 6 (2–60) months. IPSS improved from 21.6 preoperative to 5.6 postoperatively. Qmax increased from 5.7 to 19.1 and PVR decreased from 90.2 to 28.8 (P < 0.0001*) postoperatively. At 1, 3, and at 6 monthly follow-up, 69.2% (n = 82) patients were asymptomatic. Conclusions: Balloon dilation is a safe, well-tolerated procedure with minimal complications. Further randomized studies comparing balloon dilatation with direct internal visual urethrotomy are warranted. PMID:24311903

  13. [BALLOON DILATATION IN COMBINATION WITH A DOSED PAPILLOTOMY IN THE TREATMENT OF DIFFICULT FORMS OF CHOLEDOCHOLITHIASIS].

    PubMed

    Shapovalova, E I; Grubnik, V V; Tkachenko, A I; Gerasimov, D V; Romak, R P

    2016-04-01

    Results of treatment was studied in 2008 - 2015 yrs in 57 patients, suffering "difficult stones" (choledocholithiasis), in whom a dosed papillotomy in combination with the balloon dilatation. The advantages of application of combined dosed endoscopic papillosphincterotomy and balloon dilatation, comparing with complete endoscopic papillosphincterotomy, while treating "difficult stones" of common biliary duct, were established. Application of the procedure have guaranteed a good access through the duodenal papilla magna and have permitted to perform the calculi extraction in a less traumatic way, what have promoted its function preservation, and reduction of a postoperative complications rate, the patients' stationary treatment duration, and the remote complications rate. Using questionnaire SF-36, the quality of life was analyzed in patients, in whom in remote period the duodenal papilla magna function was preserved. PMID:27434947

  14. Current status of single-balloon enteroscopy: Insertability and clinical applications

    PubMed Central

    Kawamura, Takuji; Uno, Koji; Tanaka, Kiyohito; Yasuda, Kenjiro

    2015-01-01

    The single-balloon enteroscopy (SBE) system was launched in 2007, proposed as a simpler method than double-balloon enteroscopy (DBE). Controversy surrounds whether the SBE system has the same insertability as DBE. However, many methods have been proposed to improve the depth of insertion with the SBE system, involving several techniques and endoscopic accessories. SBE is used for investigating not only small bowel diseases, but also diseases of the pancreatobiliary and colonic structures. SBE is a necessary advancement for many endoscopic procedures and applications in modern clinical practice. In our review, we summarized the current literature concerning the insertability of SBE and described the technical aspects of improving the rate of deep insertion in SBE procedures. In addition, the recent applications of SBE to diseases besides those of the small bowel are described. PMID:25610535

  15. Endoscopic Management of Bile Leakage after Liver Transplantation

    PubMed Central

    Oh, Dongwook; Lee, Sung Koo; Song, Tae Jun; Park, Do Hyun; Lee, Sang Soo; Seo, Dong-Wan; Kim, Myung-Hwan

    2015-01-01

    Background/Aims Endoscopic retrograde cholangiopancreatography (ERCP) can be an effective treatment for bile leakage after liver transplantation. We evaluated the efficacy of endoscopic treatment in liver transplantation in patients who developed bile leaks. Methods Forty-two patients who developed bile leaks after liver transplantation were included in the study. If a bile leak was observed on ERCP, a sphincterotomy was performed, and a nasobiliary catheter was then inserted. If a bile leak was accompanied by a bile duct stricture, either the stricture was dilated with balloons, followed by nasobiliary catheter insertion across the bile duct stricture, or endoscopic retrograde biliary drainage was performed. Results In the bile leakage alone group (22 patients), endoscopic treatment was technically successful in 19 (86.4%) and clinically successful in 17 (77.3%) cases. Among the 20 patients with bile leaks with bile duct strictures, endoscopic treatment was technically successful in 13 (65.0%) and clinically successful in 10 (50.0%) cases. Among the 42 patients who underwent ERCP, technical success was achieved in 32 (76.2%) cases and clinical success was achieved in 27 (64.3%) cases. Conclusions ERCP is an effective and safe therapeutic modality for bile leaks after liver transplantation. ERCP should be considered as an initial therapeutic modality in post-liver transplantation patients. PMID:25717048

  16. Dual Balloon-Occluded Retrograde Transvenous Obliteration of Gastric Varix Draining into the Left Adrenal Vein and Left Inferior Phrenic Vein

    SciTech Connect

    Nishida, Norifumi Ninoi, Teruhisa; Kitayama, Toshiaki; Yamamoto, Akira; Sakai, Yukimasa; Sato, Kimihiko; Hamuro, Masao; Nakamura, Kenji; Inoue, Yuichi; Yamada, Ryusaku

    2004-09-15

    A 66-year-old woman with a gastric varix, draining into a dilated left adrenal vein and a left inferior phrenic vein, was treated with dual balloon-occluded retrograde transvenous obliteration (B-RTO). Under balloon occlusion of the left adrenal vein and the left inferior phrenic vein, retrograde injection of a sclerosant (5% ethanolamine oleate) into the gastric varix was performed. Two weeks later, disappearance of flow in the gastric varix was confirmed on endoscopic ultrasound examination.

  17. A Methane Balloon Inflation Chamber

    ERIC Educational Resources Information Center

    Czerwinski, Curtis J.; Cordes, Tanya J.; Franek, Joe

    2005-01-01

    The various equipments, procedure and hazards in constructing the device for inflating a methane balloon using a standard methane outlet in a laboratory are described. This device is fast, safe, inexpensive, and easy to use as compared to a hydrogen gas cylinder for inflating balloons.

  18. Aerodynamics of a Party Balloon

    ERIC Educational Resources Information Center

    Cross, Rod

    2007-01-01

    It is well-known that a party balloon can be made to fly erratically across a room, but it can also be used for quantitative measurements of other aspects of aerodynamics. Since a balloon is light and has a large surface area, even relatively weak aerodynamic forces can be readily demonstrated or measured in the classroom. Accurate measurements…

  19. Current applications of endoscopic suturing

    PubMed Central

    Stavropoulos, Stavros N; Modayil, Rani; Friedel, David

    2015-01-01

    Endoscopic suturing had previously been considered an experimental procedure only performed in a few centers and often by surgeons. Now, however, endoscopic suturing has evolved sufficiently to be easily implemented during procedures and is more commonly used by gastroenterologists. We have employed the Apollo OverStitch suturing device in a variety of ways including closure of perforations, closure of full thickness defects in the gastrointestinal wall created during endoscopic full thickness resection, closure of mucosotomies during peroral endoscopic myotomy, stent fixation, fistula closure, post endoscopic submucosal dissection, endoscopic mucosal resection and Natural Orifice Transluminal Endoscopic Surgery defect closures, post-bariatric surgery gastrojejunal anastomosis revision and primary sleeve gastroplasty. PMID:26191342

  20. Scientific Balloons for Venus Exploration

    NASA Astrophysics Data System (ADS)

    Cutts, James; Yavrouian, Andre; Nott, Julian; Baines, Kevin; Limaye, Sanjay; Wilson, Colin; Kerzhanovich, Viktor; Voss, Paul; Hall, Jeffery

    Almost 30 years ago, two balloons were successfully deployed into the atmosphere of Venus as an element of the VeGa - Venus Halley mission conducted by the Soviet Union. As interest in further Venus exploration grows among the established planetary exploration agencies - in Europe, Japan, Russia and the United States, use of balloons is emerging as an essential part of that investigative program. Venus balloons have been proposed in NASA’s Discovery program and ESA’s cosmic vision program and are a key element in NASA’s strategic plan for Venus exploration. At JPL, the focus for the last decade has been on the development of a 7m diameter superpressure pressure(twice that of VeGa) capable of carrying a 100 kg payload (14 times that of VeGA balloons), operating for more than 30 days (15 times the 2 day flight duration of the VeGa balloons) and transmitting up to 20 Mbit of data (300 times that of VeGa balloons). This new generation of balloons must tolerate day night transitions on Venus as well as extended exposure to the sulfuric acid environment. These constant altitude balloons operating at an altitude of about 55 km on Venus where temperatures are benign can also deploy sondes to sound the atmosphere beneath the probe and deliver deep sondes equipped to survive and operate down to the surface. The technology for these balloons is now maturing rapidly and we are now looking forward to the prospects for altitude control balloons that can cycle repeatedly through the Venus cloud region. One concept, which has been used for tropospheric profiling in Antarctica, is the pumped-helium balloon, with heritage to the anchor balloon, and would be best adapted for flight above the 55 km level. Phase change balloons, which use the atmosphere as a heat engine, can be used to investigate the lower cloud region down to 30 km. Progress in components for high temperature operation may also enable investigation of the deep atmosphere of Venus with metal-based balloons.

  1. The Venus Balloon Project

    NASA Technical Reports Server (NTRS)

    Stelzried, C. T.; Preston, R. A.; Hildebrand, C. E.; Wilcher, J. H.; Ellis, J.

    1986-01-01

    On June 11 and 15, 1985, two instrumental balloons were released from the Soviet VEGA 1 and VEGA 2 spacecraft and deployed in the atmosphere of Venus. The VEGA probes flew by the planet on their way to a rendezvous with comet Halley in March 1986. Drifting with the wind at altitudes of 54 km, the balloons traveled one-third of the way around the planet during their 46-hour lifetimes. Sensors on-board the gondolas made periodic measurements of pressure, temperature, vertical wind velocity, cloud particle density, ambient light level, and frequency of lightning. The data were transmitted to Earth and received at the Deep Space Network (DSN) 64-m stations and at several large antennas in the USSR. Approximately 95 percent of the telemetry data were successfully decoded at the DSN complexes and in the Soviet Union, and were provided to the international science team for analysis. Very Long Baseline Interferometry (VLBI) data were acquired by 20 radio observatories around the world for the purpose of monitoring the Venus winds. The DSN 64-m subnet was part of a 15-station VLBI network organized by the Centre National d'Etudes Spatiales (CNES) of France. In addition, five antennas of the Soviet network participated. VLBI data from the CNES network are currently being processed at the Jet Propulsion Laboratory.

  2. Nationwide Eclipse Ballooning Project

    NASA Astrophysics Data System (ADS)

    Colman Des Jardins, Angela; Berk Knighton, W.; Larimer, Randal; Mayer-Gawlik, Shane; Fowler, Jennifer; Harmon, Christina; Koehler, Christopher; Guzik, Gregory; Flaten, James; Nolby, Caitlin; Granger, Douglas; Stewart, Michael

    2016-05-01

    The purpose of the Nationwide Eclipse Ballooning Project is to make the most of the 2017 rare eclipse event in four main areas: public engagement, workforce development, partnership development, and science. The Project is focused on two efforts, both student-led: online live video of the eclipse from the edge of space and the study of the atmospheric response to the eclipse. These efforts, however, involving more than 60 teams across the US, are challenging in many ways. Therefore, the Project is leveraging the NASA Space Grant and NOAA atmospheric science communities to make it a success. The first and primary topic of this poster is the NASA Space Grant supported online live video effort. College and high school students on 48 teams from 31 states will conduct high altitude balloon flights from 15-20 locations across the 8/21/2017 total eclipse path, sending live video and images from near space to a national website. Video and images of a total solar eclipse from near space are fascinating and rare. It’s never been done live and certainly not in a network of coverage across a continent. In addition to the live video to the web, these teams are engaged in several other science experiments as secondary payloads. We also briefly highlight the eclipse atmospheric science effort, where about a dozen teams will launch over one hundred radiosondes from across the 2017 path, recording an unprecedented atmospheric data sample. Collected data will include temperature, density, wind, humidity, and ozone measurements.

  3. Free boundary ballooning mode representation

    SciTech Connect

    Zheng, L. J.

    2012-10-15

    A new type of ballooning mode invariance is found in this paper. Application of this invariance is shown to be able to reduce the two-dimensional problem of free boundary high n modes, such as the peeling-ballooning modes, to a one-dimensional problem. Here, n is toroidal mode number. In contrast to the conventional ballooning representation, which requires the translational invariance of the Fourier components of the perturbations, the new invariance reflects that the independent solutions of the high n mode equations are translationally invariant from one radial interval surrounding a single singular surface to the other intervals. The conventional ballooning mode invariance breaks down at the vicinity of plasma edge, since the Fourier components with rational surfaces in vacuum region are completely different from those with rational surfaces in plasma region. But, the new type of invariance remains valid. This overcomes the limitation of the conventional ballooning mode representation for studying free boundary modes.

  4. Rare condition of needle tract seeding after EUS-guided FNA for intraductal papillary mucinous carcinoma

    PubMed Central

    Yamabe, Akane; Irisawa, Atsushi; Shibukawa, Goro; Hoshi, Koki; Fujisawa, Mariko; Igarashi, Ryo; Sato, Ai; Maki, Takumi; Hojo, Hiroshi

    2016-01-01

    Background and study aims: We report on a 75-year-old man who was admitted due to pancreatic cystic lesion accompanied by a solid mass with liver metastasis. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was performed on the solid mass, and pathological findings revealed the lesion to be an adenocarcinoma diagnosed as intraductal papillary mucinous carcinoma (IPMC). Approximately 3 months after, a cystic subepithelial lesion appeared in the posterior gastric wall where the EUS-FNA had been performed. We performed EUS-FNA again, which revealed that the cystic mass was IPMC with pathology similar to the original lesion. This is a rare case demonstrating needle tract seeding of EUS-FNA for IPMC.

  5. Mars Balloon Flight Test Results

    NASA Technical Reports Server (NTRS)

    Hall, Jeffery L.; Pauken, Michael T.; Kerzhanovich, Viktor V.; Walsh, Gerald J.; Kulczycki, Eric A.; Fairbrother, Debora; Shreves, Chris; Lachenmeier, Tim

    2009-01-01

    This paper describes a set of four Earth atmosphere flight test experiments on prototype helium superpressure balloons designed for Mars. Three of the experiments explored the problem of aerial deployment and inflation, using the cold, low density environment of the Earth's stratosphere at an altitude of 30-32 km as a proxy for the Martian atmosphere. Auxiliary carrier balloons were used in three of these test flights to lift the Mars balloon prototype and its supporting system from the ground to the stratosphere where the experiment was conducted. In each case, deployment and helium inflation was initiated after starting a parachute descent of the payload at 5 Pa dynamic pressure, thereby mimicking the conditions expected at Mars after atmospheric entry and high speed parachute deceleration. Upward and downward looking video cameras provided real time images from the flights, with additional data provided by onboard temperature, pressure and GPS sensors. One test of a 660 cc pumpkin balloon was highly successful, achieving deployment, inflation and separation of the balloon from the flight train at the end of inflation; however, some damage was incurred on the balloon during this process. Two flight tests of 12 m diameter spherical Mylar balloons were not successful, although some lessons were learned based on the failure analyses. The final flight experiment consisted of a ground-launched 12 m diameter spherical Mylar balloon that ascended to the designed 30.3 km altitude and successfully floated for 9.5 hours through full noontime daylight and into darkness, after which the telemetry system ran out of electrical power and tracking was lost. The altitude excursions for this last flight were +/-75 m peak to peak, indicating that the balloon was essentially leak free and functioning correctly. This provides substantial confidence that this balloon design will fly for days or weeks at Mars if it can be deployed and inflated without damage.

  6. Intraductal Oncocytic Papillary Neoplasms of the Pancreas.

    PubMed

    Kallen, Michael E; Naini, Bita V

    2016-09-01

    Intraductal oncocytic papillary neoplasms (IOPNs) are cystic neoplasms with intraductal growth and complex papillae composed of oncocytic cells. IOPNs have been reported both in the pancreas and biliary tree, and are most likely closely related in these 2 locations. In the pancreas, these rare tumors are now considered 1 of the 4 histologic subtypes of intraductal papillary mucinous neoplasm (IPMN). Significant differences in histology, immunophenotype, and molecular genetics have been reported between IOPNs and other IPMN subtypes. However, there are limited data regarding the clinical behavior and prognosis of IOPNs in comparison to other subtypes of IPMN. We review features of pancreatic IOPNs and discuss the differential diagnosis of other intraductal lesions in the pancreas. PMID:27575268

  7. Aortic valve repair for papillary fibroelastoma.

    PubMed

    Di Marco, Luca; Al-Basheer, Amin; Glineur, David; Oppido, Guido; Di Bartolomeo, Roberto; El-Khoury, Gebrine

    2006-05-01

    We report the case of aortic valve-papillary fibroelastoma in a 66-year-old Belgian woman with a previous single episode of cerebral transient ischemic attack. Transthoracic two-dimensional echocardiography revealed a small mass adherent to the noncoronary cusp of the valve, which was confirmed by transesophageal echocardiography. Indication for surgery was performed because of a previous cerebral transient ischemic attack and for its potential risk of cerebral and coronary embolization. Surgical excision of the mass was performed with the need for glutaraldehyde-treated autologous pericardial patch repair of the aortic cusp. Intraoperative and postoperative transesophageal echocardiography both showed the valve to be competent. Postoperative recovery was uneventful. After a review of the literature, we conclude that, even if asymptomatic, and independent of their size, aortic valve papillary fibroelastomas justify surgical excision for their potential to systemic embolization. Moreover, we believe that a valve-sparing approach might be feasible with no recurrence after complete excision. PMID:16645416

  8. Papillary tumor of the pineal region in a 15-month-old boy.

    PubMed

    Li, Jessica; Recinos, Pablo F; Orr, Brent A; Burger, Peter C; Jallo, George I; Recinos, Violette Renard

    2011-05-01

    The papillary tumor of the pineal region (PTPR) is a distinct entity that is particularly rare in the pediatric population. The authors document the youngest reported patient with this clinicopathological entity to date. A case of PTPR in a 15-month-old boy is described. Initially thought to be a tectal glioma, the tumor was later identified as a pineal region tumor after demonstrating growth on routine imaging. Diagnosis of PTPR was established by histopathological evaluation of biopsy samples, which revealed papillary, cystic, and solid tumor components. The patient's postoperative course was complicated by tumor growth despite several debulking procedures and chemotherapy, as well as persistent hydrocephalus requiring 2 endoscopic third ventriculostomies and eventual ventriculoperitoneal shunt placement. After a 15-month follow-up period, the patient has received proton-beam therapy and has a stable tumor size. The PTPR is a recently described tumor of the CNS that must be included in the differential diagnosis of pineal region masses. The biological behavior, prognosis, and appropriate treatment of PTPR have yet to be fully defined. PMID:21529195

  9. Spread of Intraductal Papillary Neoplasm Arising from the Cystic Duct of the Biliary Tree

    PubMed Central

    Kadowaki, Yoshihiko; Yokota, Yuki; Komoto, Satoshi; Kubota, Nobuhito; Okamoto, Takahiro; Ishido, Nobuhiro; Okino, Tsuyoshi

    2016-01-01

    Intraductal papillary neoplasm of the bile duct (IPNB) is a variant type of the bile duct carcinoma characterized by intraductal growth. IPNB is also recognized as a precursor of invasive carcinoma. We describe herein an extremely rare case of IPNB arising from the cystic duct. A 68-year-old man was admitted to our hospital for investigation of epigastralgia and abnormal levels of biliary tract enzyme. Computed tomography and magnetic resonance imaging showed a mass lesion spreading from the cystic duct to the upper-middle bile duct. Endoscopic retrograde cholangiography demonstrated diffuse duct dilation with a grossly visible intraductal mass and amorphous blobs, suggesting the presence of mucobilia or scattered tumors. We performed extrahepatic bile duct resection with lymphadenectomy. Macroscopically, a friable papillary tumor originated from the cystic duct grows intraluminally into the bile duct. Pathologically, the tumor was found to be intramucosal adenocarcinoma spreading to the whole extrahepatic bile duct, which was compatible with IPNB. We should discuss the features and progression processes of IPNB through this precious case.

  10. Cardiac papillary fibroelastoma presenting as acute stroke

    PubMed Central

    Abbasi, Atif Saleem; Da Costa, Mark; Hennessy, Terry; Kiernan, Thomas John

    2013-01-01

    We present a case of a young woman who was initially diagnosed with acute stroke with no obvious risk factors. Preliminary investigation with transthoracic echocardiography and subsequent advanced imaging with transoesophageal echocardiography suggested the diagnosis of a benign cardiac tumour on the anterior leaflet of mitral valve. The patient underwent urgent surgical resection. Histology confirmed the diagnosis of cardiac papillary fibroelastoma. She made complete clinical recovery with no recurrence of symptoms. PMID:23761612

  11. [A case of peritoneal serous papillary carcinoma].

    PubMed

    Takeuchi, Nobuhiro; Sakata, Yoshio; Nishida, Yu; Nomura, Yusuke; Makino, Tetsuya; Maeda, Tetsuo; Tada, Hidetoshi; Kimoto, Takeo; Ueno, Sayaka; Fujiwara, Kiyoshi

    2011-08-01

    A 65-year-old female was admitted to our hospital with abdominal distension. Abdominal CT and MRI revealed massive ascites and an omental cake, but the ovaries were of normal size. After an omentum biopsy was performed during open abdominal surgery, she was diagnosed as peritoneal serous papillary adenocarcinoma. After 6 courses of chemotherapy with paclitaxel and carboplatin, the massive ascites totally disappeared, and a second look operation could be performed. She is still alive with no sign of recurrence. PMID:21829076

  12. Determinants of papillary cancer of the thyroid

    SciTech Connect

    Wingren, G.; Hatschek, T.; Axelson, O. )

    1993-10-01

    Determinants of papillary thyroid cancer were evaluated in a questionnaire-based case-control study from southeastern Sweden. A total of 104 cases, diagnosed from 1977 to 1987, and 387 randomly selected controls were included in the analyses. Female subjects with papillary cancer reported a work history as dentists/dental assistants, telephone operators, teachers, and day nursery personnel, and an occupational contact with chemicals and video display terminals more often than did controls. The 11 male cases more often reported working as mechanics and metal workers and having occupational contact with solvents. Other factors associated with increased risk for female papillary cancer were having private well water at the birth address; leisure time exposure to combustion smoke; low intake of cruciferous vegetables and seafood; and a family history of goiter, heart disease, biliary disorder, or female genital cancer. Diagnostic radiographic examinations, especially to the head, neck, or upper back/chest area, or repeated dental examinations, were also found to be associated with this form of cancer. With regard to the possible influence from hormonal factors among women less than age 50 years at time of diagnosis, an increased risk was found for a pregnancy soon after puberty. Tendencies toward a decreasing risk with increasing age at first pregnancy as well as an increasing risk with increasing number of pregnancies were found as well. Multiparity seemed to potentiate the effect from prior radiographic examinations.

  13. Robotic Excision of a Papillary Fibroelastoma of the Mitral Chordae.

    PubMed

    Arsalan, Mani; Smith, Robert L; Squiers, John J; Wang, Alex; DiMaio, J Michael; Mack, Michael J

    2016-06-01

    Papillary fibroelastomas of the mitral chordae tendineae are rare, primary benign tumors. They are either incidentally diagnosed during echocardiography or discovered after transient ischemic attack, stroke, or myocardial infarction. Removal of papillary fibroelastomas should be considered, given the increased risk for embolization causing cerebrovascular accident or mortality in patients with echocardiographic evidence of papillary fibroelastoma not undergoing surgical procedures. Although fibroelastoma removal can be performed in most cases without disrupting mitral valve competency, sternotomy and minithoracotomy are the typical approaches for excision. Herein, we report the first robotic excision of a mitral chord papillary fibroelastoma. PMID:27211977

  14. Papillary cystadenoma of anterior one-third of the tongue

    PubMed Central

    Ananthaneni, Anu Radha; Namala, Srilekha; G, Vijay Srinivas; HK, Puneeth

    2014-01-01

    Papillary cystadenoma is an unusual benign cystic neoplasm with cystic spaces of diverse sizes and intraluminal papillary projections histologically, which is commonly seen in the lips, cheek and palate. We report a case of papillary cystadenoma in a 40-year-old man on the anterior one-third of the tongue with classical histological features. The paper highlights the rarity of the site of occurrence with emphasis on differential diagnosis and the need for considering papillary cystadenoma when benign cystic lesions are encountered in the anterior one-third of the tongue. PMID:25063316

  15. Stability of Lobed Balloons

    NASA Technical Reports Server (NTRS)

    Ball, Danny (Technical Monitor); Pagitz, M.; Pellegrino, Xu S.

    2004-01-01

    This paper presents a computational study of the stability of simple lobed balloon structures. Two approaches are presented, one based on a wrinkled material model and one based on a variable Poisson s ratio model that eliminates compressive stresses iteratively. The first approach is used to investigate the stability of both a single isotensoid and a stack of four isotensoids, for perturbations of in.nitesimally small amplitude. It is found that both structures are stable for global deformation modes, but unstable for local modes at su.ciently large pressure. Both structures are stable if an isotropic model is assumed. The second approach is used to investigate the stability of the isotensoid stack for large shape perturbations, taking into account contact between di.erent surfaces. For this structure a distorted, stable configuration is found. It is also found that the volume enclosed by this con.guration is smaller than that enclosed by the undistorted structure.

  16. Balloon catheter coronary angioplasty

    SciTech Connect

    Angelini, P.

    1987-01-01

    The author has produced a reference and teaching book on balloon angioplasty. Because it borders in surgery and is performed on an awake patient without circulatory assistance, it is a complex and demanding procedure that requires thorough knowledge before it is attempted. The text is divided into seven sections. The first section describes coronary anatomy and pathophysiology, defines the objectives and mechanisms of the procedure and lists four possible physiologic results. The next section describes equipment in the catheterization laboratory, catheters, guidewires and required personnel. The following section is on the procedure itself and includes a discussion of examination, testing, technique and follow-up. The fourth section details possible complications that can occur during the procedure, such as coronary spasms, occlusion, thrombosis, perforations and ruptures, and also discusses cardiac surgery after failed angioplasty. The fifth section details complex or unusual cases that can occur. The sixth and seventh sections discuss radiation, alternative procedures and the future of angioplasty.

  17. Hot-Air Ballooning in Physics Teaching.

    ERIC Educational Resources Information Center

    Haugland, Ole Anton

    1991-01-01

    Describes the modern hot-air balloon and the physics of ballooning. Proposes that students construct their own hot-air balloon and presents an experiment calculating the time needed for a balloon to rise to the ceiling of a gymnasium. (MDH)

  18. Endoscopic treatment of gastroparesis

    PubMed Central

    McCarty, Thomas R; Rustagi, Tarun

    2015-01-01

    Gastroparesis has traditionally been a largely medically managed disease with refractory symptoms typically falling under the umbrella of the surgical domain. Surgical options include, but are not limited to, gastrostomy, jejunostomy, pyloromyotomy, or pyloroplasty, and the Food and Drug Administration approved gastric electrical stimulation implantation. Endoscopic management of gastroparesis most commonly involves intrapyloric botulinum toxin injection; however, there exists a variety of endoscopic approaches on the horizon that have the potential to radically shift standard of care. Endoscopic management of gastroparesis seeks to treat delayed gastric emptying with a less invasive approach compared to the surgical approach. This review will serve to highlight such innovative and potentially transformative, endoscopic interventions available to gastroenterologists in the management of gastroparesis. PMID:26078560

  19. Understanding EUS (Endoscopic Ultrasonography)

    MedlinePlus

    ... Certification (MOC) Course Calendar GI Outlook (GO) Practice Management Conference Endoscopic Learning Library IT&T Hands-On Training Training and ... ASGE Endorsed Activities Ambassador Program Trainee Resources Traveling Learning ... MANAGEMENT GI Outlook (GO) Practice Management Conference Featured Courses ...

  20. Asian perspective on endoscopic thyroidectomy -- a review of 193 cases.

    PubMed

    Shimizu, Kazuo; Tanaka, Shigeo

    2003-04-01

    Endoscopic surgery has become widely used, so much so that recent technical and mechanical advances have led to "endoscopic surgery" being synonymous with "minimally invasive surgery". In particular, endoscopic thyroid surgery has developed rapidly and been increasingly refined in recent years. The incidence of thyroid diseases is markedly higher in women than in men, and operations for these diseases result in a scar on the anterior neck that is exposed when open-necked clothing is worn. Therefore, a technique for endoscopic endocrine neck surgery that results in a better cosmetic appearance is desirable. We have developed a totally gasless endoscopic surgical technique using an anterior neck-skin lifting method for thyroid and parathyroid diseases. This technique is called the video-assisted neck surgery (VANS) method. Since our original report, we have treated more than 200 cases of thyroid and parathyroid disease using this technique. In cases of benign thyroid tumours, near total lobectomy was the most common procedure followed by total lobectomy. The maximum resected tumour size was 7.4 cm in diameter. For malignant tumours, the indication for the VANS method was limited to thyroid papillary microcarcinomas measuring less than 1 cm in diameter. Total lobectomy and prophylactic neck dissection were performed in all 10 of these cases. A subtotal thyroidectomy was performed for only a few cases of Graves' disease. The operating time and the amount of bleeding were statistically significantly reduced, as the surgeon gained experience with the technique. In conclusion, the VANS method is a feasible, practical and safe procedure, with excellent cosmetic benefits. PMID:12732493

  1. Structure variations of pumpkin balloon

    NASA Astrophysics Data System (ADS)

    Yajima, N.; Izutsu, N.; Honda, H.

    A robed pumpkin balloon by 3-D gore design concept is recognized as a basic form for a super -pressure balloon. This paper deals with an extension of this design concept for other large pressurized membrane structures, such as a stratospheric airship and a balloon of which volume is controllable. The structural modifications are performed by means of additional ropes or poles. When the original pumpkin shape is modified for those systems, superior characteristics of 3-D gore design, those are large bulges with a small local radius and unidirectional film tension, should be maintained. Improved design methods which are adequate for the above subjects will be discussed in detail.

  2. Endoscopic Techniques in Tympanoplasty.

    PubMed

    Anzola, Jesus Franco; Nogueira, João Flávio

    2016-10-01

    The endoscope has transformed the way we observe, understand, and treat chronic ear disease. Improved view, exclusive transcanal techniques, assessment of ventilation routes and mastoid tissue preservation have led to decreased morbidity and functional enhancement of minimally invasive reconstruction of the middle ear. The philosophical identity of endoscopic ear surgery is evolving; new research, long-term results, and widespread acknowledgement of its postulates will undoubtedly define its role in otology. PMID:27565390

  3. Standardized endoscopic reporting.

    PubMed

    Aabakken, Lars; Barkun, Alan N; Cotton, Peter B; Fedorov, Evgeny; Fujino, Masayuki A; Ivanova, Ekaterina; Kudo, Shin-Ei; Kuznetzov, Konstantin; de Lange, Thomas; Matsuda, Koji; Moine, Olivier; Rembacken, Björn; Rey, Jean-Francois; Romagnuolo, Joseph; Rösch, Thomas; Sawhney, Mandeep; Yao, Kenshi; Waye, Jerome D

    2014-02-01

    The need for standardized language is increasingly obvious, also within gastrointestinal endoscopy. A systematic approach to the description of endoscopic findings is vital for the development of a universal language, but systematic also means structured, and structure is inherently a challenge when presented as an alternative to the normal spoken word. The efforts leading to the "Minimal Standard Terminology" (MST) of gastrointestinal endoscopy offer a standardized model for description of endoscopic findings. With a combination of lesion descriptors and descriptor attributes, this system gives guidance to appropriate descriptions of lesions and also has a normative effect on endoscopists in training. The endoscopic report includes a number of items not related to findings per se, but to other aspects of the procedure, formal, technical, and medical. While the MST sought to formulate minimal lists for some of these aspects (e.g. indications), they are not all well suited for the inherent structure of the MST, and many are missing. Thus, the present paper offers a recommended standardization also of the administrative, technical, and other "peri-endoscopic" elements of the endoscopic report; important also are the numerous quality assurance initiatives presently emerging. Finally, the image documentation of endoscopic findings is becoming more obvious-and accessible. Thus, recommendations for normal procedures as well as for focal and diffuse pathology are presented. The recommendations are "minimal," meaning that expansions and subcategories will likely be needed in most centers. Still, with a stronger common grounds, communication within endoscopy will still benefit. PMID:24329727

  4. Endoscopic video manifolds.

    PubMed

    Atasoy, Selen; Mateus, Diana; Lallemand, Joe; Meining, Alexander; Yang, Guang-Zhong; Navab, Nassir

    2010-01-01

    Postprocedural analysis of gastrointestinal (GI) endoscopic videos is a difficult task because the videos often suffer from a large number of poor-quality frames due to the motion or out-of-focus blur, specular highlights and artefacts caused by turbid fluid inside the GI tract. Clinically, each frame of the video is examined individually by the endoscopic expert due to the lack of a suitable visualisation technique. In this work, we introduce a low dimensional representation of endoscopic videos based on a manifold learning approach. The introduced endoscopic video manifolds (EVMs) enable the clustering of poor-quality frames and grouping of different segments of the GI endoscopic video in an unsupervised manner to facilitate subsequent visual assessment. In this paper, we present two novel inter-frame similarity measures for manifold learning to create structured manifolds from complex endoscopic videos. Our experiments demonstrate that the proposed method yields high precision and recall values for uninformative frame detection (90.91% and 82.90%) and results in well-structured manifolds for scene clustering. PMID:20879345

  5. Endoscopic Treatment of Biliary Stenosis in Patients with Alveolar Echinococcosis – Report of 7 Consecutive Patients with Serial ERC Approach

    PubMed Central

    Stojkovic, Marija; Junghanss, Thomas; Veeser, Mira; Weber, Tim F.; Sauer, Peter

    2016-01-01

    Background and Aims Biliary vessel pathology due to alveolar echicococcosis (AE) results in variable combinations of stenosis, necrosis and inflammation. Modern management strategies for patients with cholestasis are desperately needed. The aim is proof of principle of serial ERC (endoscopic retrograde cholangiography) balloon dilation for AE biliary pathology. Methods Retrospective case series of seven consecutive patients with AE-associated biliary pathology and ERC treatment in an interdisciplinary endoscopy unit at a University Hospital which hosts a national echinococcosis treatment center. The AE patient cohort consists of 106 patients with AE of the liver of which 13 presented with cholestasis. 6/13 received bilio-digestive anastomosis and 7/13 patients were treated by ERC and are reported here. Biliary stricture balloon dilation was performed with 18-Fr balloons at the initial and with 24-Fr balloons at subsequent interventions. If indicated 10 Fr plastic stents were placed. Results Six patients were treated by repeated balloon dilation and stenting, one by stenting only. After an acute phase of 6 months with repeated balloon dilation, three patients showed “sustained clinical success” and four patients “assisted therapeutic success,” of which one has not yet reached the six month endpoint. In one patient, sustained success could not be achieved despite repeated insertion of plastic stents and balloon dilation, but with temporary insertion of a fully covered self-expanding metal stent (FCSEMS). There was no loss to follow up. No major complications were observed. Conclusions Serial endoscopic dilation is a standard tool in the treatment of benign biliary strictures. Serial endoscopic intervention with balloon dilation combined with benzimidazole treatment can re-establish and maintain biliary duct patency in AE associated pathology and probably contributes to avoid or postpone bilio-digestive anastomosis. This approach is in accordance with current

  6. Coronary artery balloon angioplasty - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100160.htm Coronary artery balloon angioplasty - series To use the sharing features ... out of 9 Normal anatomy Overview The coronary arteries supply blood to the heart muscle. The right ...

  7. Endoscopic extraperitoneal repair of a Grynfeltt hernia.

    PubMed

    Postema, R R; Bonjer, H J

    2002-04-01

    There are three types of lumbar hernia: congenital, acquired, and incisional hernias. Acquired hernia can appear in two forms: the inferior (Petit) type and the superior type, first described by Grynfeltt in 1866. We report endoscopic extraperitoneal repair of a Grynfeltt hernia. A 46-year-old woman presented with a painful swelling in the left lumbar region that had caused her increasing discomfort. The diagnosis of Grynfeltt's hernia was made, and she underwent surgery. With the patient in a left-side decubitus position, access to the extraperitoneal space was gained by inserting a 10-mm inflatable balloon trocar just anteriorly to the midaxillary line between the 12th rib and the superior iliac crest through a muscle-splitting incision into the extraperitoneal space. After the balloon trocar had been removed a blunt-tip trocar was inserted. Using two 5-mm trocars, one above and another below the 10-mm port in the midaxillary line, the hernia could be reduced. A polypropylene mesh graft was introduced through the 10-mm trocar and tacked with spiral tackers. The patient could be discharged the next day after requiring only minimal analgesics. At this writing, 2 (1/2) years after the operation, there is no sign of recurrence. This Grynfeltt hernia could safely be treated using the extraperitoneal approach, which obviates opening and closing the peritoneum, thereby reducing operative time and possibly postoperative complications. PMID:11972231

  8. Feasibility Study of Eval Balloons

    NASA Astrophysics Data System (ADS)

    Saito, Yoshitaka; Kamioka, Eiji; Toriumi, Michihiko; Matsuzaka, Yukihiko; Namiki, Michiyoshi; Izutsu, Naoki; Ohta, Shigco; Yamagami, Takamasa; Nishimura, Jun; Matsushima, Kiyoho

    For a new balloon material, we have been studying the properties of an EVAL (Ethylene-Vinyl-ALcohol) film during a part of few years. The EVAL film is a product of Kurare Plastic Company, and has mechanical properties similar to that of a Mylar film. Besides this strong mechanical strength. we found that the EVAL film has several characteristics which seems to be suitable for the balloon material. Those are:

  9. Sandwiched EVAL films laminated by polyethylene films can be heat-sealed,
  10. Gas leakage through the EVAL film is extremely low, and for Helium gas, it is almost 100 times less than that of a Mylar film.
  11. The EVAL film is transparent in the optical band. while it efficiently absorbs the infrared radiation from the earth.In 1997, we have carried out a test flight from the Sanriku Balloon Center using a small balloon with a volume of 1000 m3. The balloon reached an altitude of 22 km successfully and showed a maximum burst pressure of 2.1 g/cm2.In this paper, basic properties of the EVAL film and performance of the test balloon are described

  12. Per-oral endoscopic myotomy: emerging indications and evolving techniques.

    PubMed

    Minami, Hitomi; Inoue, Haruhiro; Haji, Amyn; Isomoto, Hajime; Urabe, Shigetoshi; Hashiguchi, Keiichi; Matsushima, Kayoko; Akazawa, Yuko; Yamaguchi, Naoyuki; Ohnita, Ken; Takeshima, Fuminao; Nakao, Kazuhiko

    2015-01-01

    Esophageal achalasia is a benign esophageal motility disorder resulting from an impaired relaxation of the lower esophageal sphincter. The principles of treatment involve disruption of the sphincter at the esophagogastric junction. Treatment techniques include balloon dilatation, botulinum toxin injection, and surgical myotomy. In 2008, per-oral endoscopic myotomy (POEM) was introduced by Inoue et al. as an endoscopic myotomy with no skin incision. The procedure has been well accepted and widely applied owing to its minimal invasiveness and high cure rates. Moreover, there have been discussions on wider indications for POEM and new technical developments have been reported. The present article reviews the historical background and present status of POEM, as well as future prospects for its application in the treatment of esophageal achalasia. PMID:25040806

  13. [Macroscopic and pathohistological investigation of endarterial plaque after intraoperative balloon dilatation of the carotid artery during carotid endarterectomy].

    PubMed

    Nishida, M; Shima, T; Okada, Y; Yamane, K; Hatayama, T; Yamanaka, C; Toyota, A; Nishida, T

    1998-12-01

    Twelve patients associated with stenosis of the extracranial carotid artery underwent intraluminal balloon dilatation during carotid endarterectomy (CEA). There were 11 men and 1 woman, and age ranged from 56 to 73 years old. The rate of stenosis, shown by angiography, in each patient was from 60 to 85% in width. After securing carotid blood flow by a T-shaped shunt tube, a balloon catheter was inserted from the exposed common carotid artery into the internal carotid artery. The balloon was inflated three or four times with 2.5-3.5 atm. for 30-40 seconds. Immediately after balloon dilatation, endoscopic investigation was performed (Wolf; hard type endoscope, 2.7 mm diameter). Then CEA was performed using the usual procedure. The removed endarterial plaque was investigated pathohistologically. In macroscopic and endoscopic findings, there were 6 patients with mural thrombosis, 4 patients with laceration of the intima, and one patient with outflow of atheroma from the intima. Only 3 patients had increase in lumen after balloon dilatation. In pathohistological appearance, all patients had a moderate degree of fibrosis, calcification, and atheroma in the cross section of the plaque. Ten patients had intramural hemorrhage. Three typical patients were revealed by the use of angiographical, ultrasonographical, endoscopic, and pathohistological presentation. Case 10 showed laceration of the intima by balloon dilatation, and had moderate increase in lumen size macroscopically and endoscopically. There were moderate cases of fibrosis, calcification, atheroma, and intramural hemorrhage. Dilatation of the lumen seemed to be accomplished by a decrease in thickness of the atheroma and intramural hemorrhage. Case 8 demonstrated an increase in lumen size, but also laceration of the intima and outflow of atheroma from the arterial wall. There were much atheroma and large intramural hemorrhage in the intima, which might become a source of enbolism. Case 7 revealed no laceration of

  14. Jackhammer esophagus: high-resolution manometry and therapeutic approach using peroral endoscopic myotomy (POEM).

    PubMed

    Kandulski, A; Fuchs, K-H; Weigt, J; Malfertheiner, P

    2016-08-01

    We present the first report on peroral endoscopic myotomy (POEM) in the treatment of jackhammer esophagus. A 34-year-old female patient was newly diagnosed with a jackhammer esophagus. After failure of medical treatment, the patient underwent POEM procedure for myotomy of the spastic segment. Postoperatively, a mild emphysema and pneumothorax occurred that required drainage and antibiotic therapy until full recovery. Discharge was possible after 5 days. Six months later, she presented with recurrent but mild pain due to a remnant spastic segment proximal to the myotomy. Endoscopic balloon dilation was performed twice within 6 weeks with full symptomatic relief of pain and mild symptoms of dysphagia. PMID:24460870

  15. Clinical management of uterine papillary serous carcinoma.

    PubMed

    Roelofsen, Thijs; van Ham, Maaike A; de Hullu, Joanne A; Massuger, Leon F

    2011-01-01

    Uterine papillary serous carcinoma (UPSC) is an aggressive variant of endometrial cancer. Owing to its rarity, most clinicians are unfamiliar with the clinical aspects and management of UPSC. Furthermore, little prospective evidence exists regarding how best to treat this subset of patients. In anticipation of prospective clinical trials, this article summarizes the latest results of various clinical management options in the different substages of UPSC, with a special focus on the effects of cytoreductive surgery, comprehensive surgical staging and different adjuvant treatment options in relation to recurrence rate and survival outcome. PMID:21166512

  16. Sparse aperture endoscope

    DOEpatents

    Fitch, J.P.

    1999-07-06

    An endoscope is disclosed which reduces the volume needed by the imaging part, maintains resolution of a wide diameter optical system, while increasing tool access, and allows stereographic or interferometric processing for depth and perspective information/visualization. Because the endoscope decreases the volume consumed by imaging optics such allows a larger fraction of the volume to be used for non-imaging tools, which allows smaller incisions in surgical and diagnostic medical applications thus produces less trauma to the patient or allows access to smaller volumes than is possible with larger instruments. The endoscope utilizes fiber optic light pipes in an outer layer for illumination, a multi-pupil imaging system in an inner annulus, and an access channel for other tools in the center. The endoscope is amenable to implementation as a flexible scope, and thus increases it's utility. Because the endoscope uses a multi-aperture pupil, it can also be utilized as an optical array, allowing stereographic and interferometric processing. 7 figs.

  17. Sparse aperture endoscope

    DOEpatents

    Fitch, Joseph P.

    1999-07-06

    An endoscope which reduces the volume needed by the imaging part thereof, maintains resolution of a wide diameter optical system, while increasing tool access, and allows stereographic or interferometric processing for depth and perspective information/visualization. Because the endoscope decreases the volume consumed by imaging optics such allows a larger fraction of the volume to be used for non-imaging tools, which allows smaller incisions in surgical and diagnostic medical applications thus produces less trauma to the patient or allows access to smaller volumes than is possible with larger instruments. The endoscope utilizes fiber optic light pipes in an outer layer for illumination, a multi-pupil imaging system in an inner annulus, and an access channel for other tools in the center. The endoscope is amenable to implementation as a flexible scope, and thus increases the utility thereof. Because the endoscope uses a multi-aperture pupil, it can also be utilized as an optical array, allowing stereographic and interferometric processing.

  18. Aggressive papillary adenocarcinoma on atypical localization

    PubMed Central

    Balci, Mecdi Gurhan; Tayfur, Mahir; Deger, Ayse Nur; Cimen, Orhan; Eken, Huseyin

    2016-01-01

    Abstract Introduction: Aggressive digital papillary adenocarcinoma (ADPA) is a rare sweat gland tumor that is found on the fingers, toes, and the digits. To date, <100 cases have been reported in the literature. Apart from 1 case reported in the thigh, all of them were on digital or nondigital acral skin. Case presentation: A 67-year-old Caucasian woman was admitted to the hospital due to a mass on the scalp. This lesion was present for almost a year. It was a semimobile cyctic mass that elevated the scalp. There was no change in the skin color. Its dimensions were 1.5 × 1 × 0.6 cm. The laboratory, clinic, and radiologic findings (head x-ray) of the patient were normal. It was evaluated as a benign lesion such as lipoma or epidermal cyst by a surgeon due to a small semimobile mass and no erosion of the skull. It was excised by a local surgery excision. The result of the pathologic examination was aggressive papillary adenocarcinoma. This diagnosis is synonymous with ADPA. Conclusion: In our case, localization was scalp. This localization is the first for this tumor in the literature. In addition, another atypical localization of this tumor (ADPA) is thigh in the literature. This case was presented due to both the rare and atypical localizations. That is why, in our opinion, revision of “digital” term in ADPA is necessary due to seem in atypical localizations like thigh and scalp. PMID:27428196

  19. Immunophenotypic and genomic characterisation of papillary carcinomas of the breast

    PubMed Central

    Lacroix-Triki, Magali; Lambros, Maryou B; MacKay, Alan; A’Hern, Roger; Gauthier, Arnaud; Pawar, Vidya; Colombo, Pierre-Emanuel; Daley, Frances; Natrajan, Rachael; Ward, Eric; MacGrogan, Gaëtan; Arbion, Flavie; Michenet, Patrick; Weigelt, Britta; Vincent-Salomon, Anne; Reis-Filho, Jorge S

    2016-01-01

    Papillary carcinomas are a special histological type of breast cancer, and have a relatively good outcome. We characterised the genomic and phenotypic characteristics of papillary carcinomas, and to determine whether they would constitute an entity distinct from grade- and oestrogen receptor (ER)-matched invasive ductal carcinomas of no special type (IDC-NSTs). The phenotype of 63 papillary carcinomas of the breast and grade- and ER-matched IDC-NSTs was determined by immunohistochemistry. DNA of sufficient quality was extracted from 49 microdissected papillary carcinomas and 49 microdissected grade- and ER-matched IDC-NSTs. These samples were subjected to high-resolution microarray-based comparative genomic hybridisation (aCGH) and MassARRAY Sequenom sequencing analysis of 19 known oncogenes. Papillary carcinomas were predominantly of low histological grade, expressed immunohistochemical markers consistent with a luminal phenotype, and a lower rate of lymph node metastasis and p53 expression than grade- and ER-matched IDC-NSTs. Papillary carcinomas displayed less genomic aberrations than grade- and ER-matched IDC-NSTs; however the patterns of gene copy number aberrations found in papillary carcinomas were similar to those of ER- and grade-matched IDC-NSTs, including 16q losses. Furthermore, PIK3CA mutations were found in 43% and 29% of papillary carcinomas and grade- and ER-matched IDC-NSTs respectively. The genomic profiles of encapsulated, solid and invasive papillary carcinomas, the three morphological subtypes, were remarkably similar. Our results demonstrate that papillary carcinomas are a homogeneous special histological type of breast cancer. The similarities in the genomic profiles of papillary carcinomas and grade- and ER-matched IDC-NSTs suggest that papillary carcinomas may be best positioned as part of the spectrum of ER-positive breast cancers rather than as a distinct entity. Furthermore, the good prognosis of papillary carcinomas may stem from the

  20. Transvaginal endoscopic appendectomy.

    PubMed

    Shin, Eung Jin; Jeong, Gui Ae; Jung, Jun Chul; Cho, Gyu Seok; Lim, Chul Wan; Kim, Hyung Chul; Song, Ok Pyung

    2010-12-01

    Since Kalloo and colleagues first reported the feasibility and safety of a peroral transgastric approach in the porcine model in 2004, various groups have reported more complex natural orifice transluminal endoscopic surgery (NOTES) procedures, such as the cholecystectomy, splenectomy and liver biopsy, in the porcine model. Natural orifice access to the abdominal cavity, such as transgastric, transvesical, transcolonic, and transvaginal, has been described. Although a novel, minimally invasive approach to the abdominal cavity is a peroral endoscopic transgastric approach, there are still some challenging issues, such as the risk of infection and leakage, and the method of gastric closure. Hybrid-NOTES is an ideal first step in humans. Human hybrid transvaginal access has been used for years by many surgeons for diagnostic and therapeutic purposes. Here, we report a transvaginal flexible endoscopic appendectomy, with a 5-mm umbilical port using ultrasonic scissors in a 74-year-old woman with acute appendicitis. PMID:21221245

  21. Technicalities of endoscopic biopsy.

    PubMed

    Tytgat, G N; Ignacio, J G

    1995-11-01

    Despite the wealth of biopsy forceps currently available, it is obvious that there are sufficient drawbacks and shortcomings to reconsider the overall design of the endoscopic biopsy depth, the short lifespan of reusable forceps, damage to the working channel, excessive time consumption, cleaning and disinfection difficulties, etc. Improvements should be possible that approach the same degree of sophistication as is currently available in endoscopic equipment. Fully-automated, repetitive, quickly targeted biopsy sampling should be possible, but it will require the utmost technical ingenuity and expertise to achieve. PMID:8903983

  22. Endoscopic Facial Nerve Surgery.

    PubMed

    Marchioni, Daniele; Soloperto, Davide; Rubini, Alessia; Nogueira, João Flávio; Badr-El-Dine, Mohamed; Presutti, Livio

    2016-10-01

    Tympanic facial nerve segment surgery has been traditionally performed using microscopic approaches, but currently, exclusive endoscopic approaches have been performed for traumatic, neoplastic, or inflammatory diseases, specially located at the geniculate ganglion, greater petrosal nerve, and second tract of the facial nerve, until the second genu. The tympanic segment of the facial nerve can be reached and visualized using an exclusive transcanal endoscopic approach, even in poorly accessible regions such as the second genu and geniculate ganglion, avoiding mastoidectomy, bony demolition, and meningeal or cerebral lobe tractions, with low complication rates using a minimally invasive surgical route. PMID:27468633

  23. Endoscopic Sedation: Medicolegal Considerations.

    PubMed

    Kralios, Andreas A; Feld, Kayla A; Feld, Andrew D

    2016-07-01

    Goals of endoscopic sedation are to provide patients with a successful procedure, and ensure that they remain safe and are relieved from anxiety and discomfort; agents should provide efficient, appropriate sedation and allow patients to recover rapidly. Sedation is usually safe and effective; however, complications may ensue. This paper outlines some medicolegal aspects of endoscopic sedation, including informed consent, possible withdrawal of consent during the procedure, standard of care for monitoring sedation, use of anesthesia personnel to deliver sedation, and new agents and devices. PMID:27372770

  1. The challenge to balloon science

    NASA Astrophysics Data System (ADS)

    Jones, W. Vernon

    A thorough review of the NASA balloon program in 1995 confirmed both the inherent importance of balloon science investigations and their value for developing technology for future space missions. A follow-on study in 1996 looked into restructuring the entire suborbital program, in order to find more efficient and effective ways of doing business. These studies were mandated by the adverse impact of NASA's declining budgets and work force constraints on all aspects of space research. The challenge is to accomplish more with less. The balloon program began stepping up to this challenge several years ago with the advent of 10 - 20 day long-duration flights in Antarctica. We must now push ahead with enhanced flight capabilities and with new science instrument technologies, as we forge alliances with other modes of low-cost access to space. Specifically, the development of sealed superpressure balloons could extend flight duration by another order of magnitude, to about 100 days, making ballooning even more competitive with space missions.

  2. Outcomes Following Endoscopic Stapes Surgery.

    PubMed

    Hunter, Jacob B; Rivas, Alejandro

    2016-10-01

    There are limited studies describing the surgical and hearing outcomes following endoscopic stapes surgeries, despite the burgeoning interest and excitement in endoscopic ear surgery. Current studies have demonstrated that endoscopic stapes surgery is safe and has similar audiologic outcomes when compared with microscopic stapes procedures. However, preliminary studies show decreased postoperative pain in endoscopic cases compared with microscopic controls. In regards to possible endoscopic advantages, these few studies demonstrate mixed results when comparing the need to remove the bony medial external auditory canal wall to improve visualization and access to the oval window niche. PMID:27565387

  3. Conservative approach in Peutz-Jeghers syndrome: Single-balloon enteroscopy and small bowel polypectomy

    PubMed Central

    Torroni, Filippo; Romeo, Erminia; Rea, Francesca; Angelis, Paola De; Foschia, Francesca; Faraci, Simona; Abriola, Giovanni Federici di; Contini, Anna Chiara; Caldaro, Tamara; Dall’Oglio, Luigi

    2014-01-01

    AIM: To assess the usefulness of the balloon assisted enteroscopy in preventing surgical intervention in patients with Peutz-Jeghers syndrome (PJS) having a small bowel large polyps. METHODS: Seven consecutive asymptomatic pts (age 15-38 years) with PJS have been collected; six underwent polypectomy using single balloon enteroscopy (Olympus SIF Q180) with antegrade approach using push and pull technique. SBE system consists of the SIF-Q180 enteroscope, an overtube balloon control unit (OBCU Olympus Balloon Control Unit) and a disposable silicone splinting tube with balloon (ST-SB1). All procedures were performed under general anesthesia. Previously all pts received wireless capsule endoscopy (WCE). Prophylactic polypectomy was reserved mainly in pts who had polyps > 15 mm in diameter. The balloon is inflated and deflated by a balloon control unit with a safety pressure setting range from -6.0 kPa to +5.4 kPa. Informed consent has been obtained from pts or parents for each procedure. RESULTS: Six pts underwent polypectomy of small bowel polyps; in 5 pts a large polyp > 15 mm (range 20-50 mm in diameter) was resected; in 1 patient with WCE negative, SBE was performed for previous surgical resection of gastrointestinal stromal tumors. In 2 pts endoscopic clips were placed due to a polypectomy. No surgical complication have been reported. SBE with resection of small bowel large polyps in PJS pts was useful to avoid gastrointestinal bleeding and emergency laparotomy due to intestinal intussusceptions. No gastrointestinal tumors were found in subsequent enteroscopic surveillance in all seven pts. In order surveillance, all pts received WCE, upper endoscopy, ileocolonoscopy every 2 years. No pts had extraintestinal malignant lesions. SBE was performed when WCE was positive for significant polyps (> 15 mm). CONCLUSION: The effective of prophylactic polypectomy of small bowel large polyps (> 15 mm) could be the first line treatment for conservative approach in management of

  4. Structure variations of pumpkin balloon

    NASA Astrophysics Data System (ADS)

    Yajima, N.; Izutsu, N.; Honda, H.

    2004-01-01

    A lobed pumpkin balloon by 3-D gore design concept is recognized as a basic form for a super-pressure balloon. This paper deals with extensions of this design concept for other large pressurized membrane structures, such as a stratospheric airship and a balloon of which volume is controllable. The structural modifications are performed by means of additional ropes, belts or a strut. When the original pumpkin shape is modified by these systems, the superior characteristics of the 3-D gore design, incorporating large bulges with a small local radius and unidirectional film tension, should be maintained. Improved design methods which are adequate for the above subjects will be discussed in detail. Application for ground structures are also mentioned.

  5. Balloon Exoplanet Nulling Interferometer (BENI)

    NASA Technical Reports Server (NTRS)

    Lyon, Richard G.; Clampin, Mark; Woodruff, Robert A.; Vasudevan, Gopal; Ford, Holland; Petro, Larry; Herman, Jay; Rinehart, Stephen; Carpenter, Kenneth; Marzouk, Joe

    2009-01-01

    We evaluate the feasibility of using a balloon-borne nulling interferometer to detect and characterize exosolar planets and debris disks. The existing instrument consists of a 3-telescope Fizeau imaging interferometer with 3 fast steering mirrors and 3 delay lines operating at 800 Hz for closed-loop control of wavefront errors and fine pointing. A compact visible nulling interferometer is under development which when coupled to the imaging interferometer would in-principle allow deep suppression of starlight. We have conducted atmospheric simulations of the environment above 100,000 feet and believe balloons are a feasible path forward towards detection and characterization of a limited set of exoplanets and their debris disks. Herein we will discuss the BENI instrument, the balloon environment and the feasibility of such as mission.

  6. Yellow Balloon in a Briar Patch.

    ERIC Educational Resources Information Center

    Cooper, Frank; Fitzmaurice, Robert W.

    1978-01-01

    As part of a meteorology unit, sixth grade science students launched helium balloons with attached return postcards. This article describes Weather Service monitoring of the balloons and postcard return results. (MA)

  7. Tensile set behavior of Foley catheter balloons.

    PubMed

    Joseph, R; Ramesh, P; Sivakumar, R

    1999-01-01

    The removal of indwelling urinary balloon catheters from patients is usually associated with many problems. The problems such as balloon deflation failure; encrustations on balloons, eyes, and lumen; and catheter associated infections are widely discussed in the literature. The tensile set exhibited by the catheter balloon material could also play a role and further complicate the removal process. This article addresses this issue by comparing the tensile set behavior of the balloon material from three commercially available Foley catheters. The balloon materials were subjected to aging in synthetic urine at 37 degrees C for 28 days to simulate clinical conditions. The deflation time of catheter balloons aged in similar conditions were also measured. It was found that different brands of catheters exhibited statistically significant differences in their properties. The tensile set data of the aged samples could be correlated with the deflation time of the balloons. The clinical significance of the tensile set is also highlighted. PMID:10029146

  8. NASA Aeronautics Showcased at Balloon Fiesta

    NASA Video Gallery

    Visitors at the 2010 International Balloon Fiesta in Albuquerque, N.M., got visual stimulation from hundreds of colorful hot-air balloons soaring skyward, but also learned about NASA's aeronautics ...

  9. Status of the NASA Balloon Program

    NASA Technical Reports Server (NTRS)

    Needleman, H. C.; Nock, R. S.; Bawcom, D. W.

    1993-01-01

    The NASA Balloon Program (BP) is examined in an overview of design philosophy, R&D activities, flight testing, and the development of a long-duration balloon for Antarctic use. The Balloon Recovery Program was developed to qualify the use of existing films and to design improved materials and seals. Balloon flights are described for studying the supernova SN1987a, and systems were developed to enhance balloon campaigns including mobile launch vehicles and tracking/data-acquisition systems. The technical approach to long-duration ballooning is reviewed which allows the use of payloads of up to 1350 kg for two to three weeks. The BP is responsible for the development of several candidate polyethylene balloon films as well as design/performance standards for candidate balloons. Specific progress is noted in reliability and in R&D with respect to optimization of structural design, resin blending, and extrusion.

  10. The EUSO-Balloon pathfinder

    NASA Astrophysics Data System (ADS)

    Adams, J. H.; Ahmad, S.; Albert, J.-N.; Allard, D.; Anchordoqui, L.; Andreev, V.; Anzalone, A.; Arai, Y.; Asano, K.; Ave Pernas, M.; Baragatti, P.; Barrillon, P.; Batsch, T.; Bayer, J.; Bechini, R.; Belenguer, T.; Bellotti, R.; Belov, K.; Berlind, A. A.; Bertaina, M.; Biermann, P. L.; Biktemerova, S.; Blaksley, C.; Blanc, N.; Błȩcki, J.; Blin-Bondil, S.; Blümer, J.; Bobik, P.; Bogomilov, M.; Bonamente, M.; Briggs, M. S.; Briz, S.; Bruno, A.; Cafagna, F.; Campana, D.; Capdevielle, J.-N.; Caruso, R.; Casolino, M.; Cassardo, C.; Castellinic, G.; Catalano, C.; Catalano, G.; Cellino, A.; Chikawa, M.; Christl, M. J.; Cline, D.; Connaughton, V.; Conti, L.; Cordero, G.; Crawford, H. J.; Cremonini, R.; Csorna, S.; Dagoret-Campagne, S.; de Castro, A. J.; De Donato, C.; de la Taille, C.; De Santis, C.; del Peral, L.; Dell'Oro, A.; De Simone, N.; Di Martino, M.; Distratis, G.; Dulucq, F.; Dupieux, M.; Ebersoldt, A.; Ebisuzaki, T.; Engel, R.; Falk, S.; Fang, K.; Fenu, F.; Fernández-Gómez, I.; Ferrarese, S.; Finco, D.; Flamini, M.; Fornaro, C.; Franceschi, A.; Fujimoto, J.; Fukushima, M.; Galeotti, P.; Garipov, G.; Geary, J.; Gelmini, G.; Giraudo, G.; Gonchar, M.; González Alvarado, C.; Gorodetzky, P.; Guarino, F.; Guzmán, A.; Hachisu, Y.; Harlov, B.; Haungs, A.; Hernández Carretero, J.; Higashide, K.; Ikeda, D.; Ikeda, H.; Inoue, N.; Inoue, S.; Insolia, A.; Isgrò, F.; Itow, Y.; Joven, E.; Judd, E. G.; Jung, A.; Kajino, F.; Kajino, T.; Kaneko, I.; Karadzhov, Y.; Karczmarczyk, J.; Karus, M.; Katahira, K.; Kawai, K.; Kawasaki, Y.; Keilhauer, B.; Khrenov, B. A.; Kim, J.-S.; Kim, S.-W.; Kim, S.-W.; Kleifges, M.; Klimov, P. A.; Kolev, D.; Kreykenbohm, I.; Kudela, K.; Kurihara, Y.; Kusenko, A.; Kuznetsov, E.; Lacombe, M.; Lachaud, C.; Lee, J.; Licandro, J.; Lim, H.; López, F.; Maccarone, M. C.; Mannheim, K.; Maravilla, D.; Marcelli, L.; Marini, A.; Martinez, O.; Masciantonio, G.; Mase, K.; Matev, R.; Medina-Tanco, G.; Mernik, T.; Miyamoto, H.; Miyazaki, Y.; Mizumoto, Y.; Modestino, G.; Monaco, A.; Monnier-Ragaigne, D.; Morales de los Ríos, J. A.; Moretto, C.; Morozenko, V. S.; Mot, B.; Murakami, T.; Murakami, M. Nagano; Nagata, M.; Nagataki, S.; Nakamura, T.; Napolitano, T.; Naumov, D.; Nava, R.; Neronov, A.; Nomoto, K.; Nonaka, T.; Ogawa, T.; Ogio, S.; Ohmori, H.; Olinto, A. V.; Orleański, P.; Osteria, G.; Panasyuk, M. I.; Parizot, E.; Park, I. H.; Park, H. W.; Pastircak, B.; Patzak, T.; Paul, T.; Pennypacker, C.; Perez Cano, S.; Peter, T.; Picozza, P.; Pierog, T.; Piotrowski, L. W.; Piraino, S.; Plebaniak, Z.; Pollini, A.; Prat, P.; Prévôt, G.; Prieto, H.; Putis, M.; Reardon, P.; Reyes, M.; Ricci, M.; Rodríguez, I.; Rodríguez Frías, M. D.; Ronga, F.; Roth, M.; Rothkaehl, H.; Roudil, G.; Rusinov, I.; Rybczyński, M.; Sabau, M. D.; Sáez-Cano, G.; Sagawa, H.; Saito, A.; Sakaki, N.; Sakata, M.; Salazar, H.; Sánchez, S.; Santangelo, A.; Santiago Crúz, L.; Sanz Palomino, M.; Saprykin, O.; Sarazin, F.; Sato, H.; Sato, M.; Schanz, T.; Schieler, H.; Scotti, V.; Segreto, A.; Selmane, S.; Semikoz, D.; Serra, M.; Sharakin, S.; Shibata, T.; Shimizu, H. M.; Shinozaki, K.; Shirahama, T.; Siemieniec-Oziȩbło, G.; Silva López, H. H.; Sledd, J.; Słomińska, K.; Sobey, A.; Sugiyama, T.; Supanitsky, D.; Suzuki, M.; Szabelska, B.; Szabelski, J.; Tajima, F.; Tajima, N.; Tajima, T.; Takahashi, Y.; Takami, H.; Takeda, M.; Takizawa, Y.; Tenzer, C.; Tibolla, O.; Tkachev, L.; Tokuno, H.; Tomida, T.; Tone, N.; Toscano, S.; Trillaud, F.; Tsenov, R.; Tsunesada, Y.; Tsuno, K.; Tymieniecka, T.; Uchihori, Y.; Unger, M.; Vaduvescu, O.; Valdés-Galicia, J. F.; Vallania, P.; Valore, L.; Vankova, G.; Vigorito, C.; Villaseñor, L.; von Ballmoos, P.; Wada, S.; Watanabe, J.; Watanabe, S.; Watts, J.; Weber, M.; Weiler, T. J.; Wibig, T.; Wiencke, L.; Wille, M.; Wilms, J.; Włodarczyk, Z.; Yamamoto, T.; Yamamoto, Y.; Yang, J.; Yano, H.; Yashin, I. V.; Yonetoku, D.; Yoshida, K.; Yoshida, S.; Young, R.; Zotov, M. Yu.; Zuccaro Marchi, A.

    2015-11-01

    EUSO-Balloon is a pathfinder for JEM-EUSO, the Extreme Universe Space Observatory which is to be hosted on-board the International Space Station. As JEM-EUSO is designed to observe Ultra-High Energy Cosmic Rays (UHECR)-induced Extensive Air Showers (EAS) by detecting their ultraviolet light tracks "from above", EUSO-Balloon is a nadir-pointing UV telescope too. With its Fresnel Optics and Photo-Detector Module, the instrument monitors a 50 km2 ground surface area in a wavelength band of 290-430 nm, collecting series of images at a rate of 400,000 frames/sec. The objectives of the balloon demonstrator are threefold: a) perform a full end-to-end test of a JEM-EUSO prototype consisting of all the main subsystems of the space experiment, b) measure the effective terrestrial UV background, with a spatial and temporal resolution relevant for JEM-EUSO. c) detect tracks of ultraviolet light from near space for the first time. The latter is a milestone in the development of UHECR science, paving the way for any future space-based UHECR observatory. On August 25, 2014, EUSO-Balloon was launched from Timmins Stratospheric Balloon Base (Ontario, Canada) by the balloon division of the French Space Agency CNES. From a float altitude of 38 km, the instrument operated during the entire astronomical night, observing UV-light from a variety of ground-covers and from hundreds of simulated EASs, produced by flashers and a laser during a two-hour helicopter under-flight.

  11. Papillary carcinoma in ectopic thyroid detected by Tl-201 scintigraphy

    SciTech Connect

    Michigishi, T.; Mizukami, Y.; Mura, T.; Nomura, T.; Watanabe, K.; Tonami, N.; Hisada, K. )

    1991-05-01

    A 37-year-old man with papillary carcinoma in an ectopic thyroid is presented. Excisional biopsy revealed the cervical mass to be a metastasis from thyroid cancer. X-ray, ultrasonography, and computed tomography, however, failed to identify the primary tumor in the thyroid. Incidental TI-201 uptake was noted in the midline of the anterior neck, and a palpable nodule was discovered in this area. Fine needle aspiration cytology demonstrated Class V papillary adenocarcinoma, and subsequent surgery confirmed a papillary carcinoma in the ectopic thyroid. This case suggests the usefulness of TI-201 scintigraphy for the detection of ectopic thyroid malignancy.

  12. Intracystic Papillary Carcinoma of the Breast in a Male Patient

    PubMed Central

    Hu, Zishuo Ian; Liu, Chengbao; Fisher, Paul R.; Cohen, Jules A.

    2016-01-01

    We report a case of intracystic papillary carcinoma of the right breast in a 59-year old man presenting with bloody nipple discharge for 1 week prior to presentation. Mammography, ultrasonography, and core needle aspiration were consistent with intracystic papillary carcinoma. The patient underwent right simple mastectomy. Pathology was also consistent with low grade intracystic papillary carcinoma. The 21-gene assay revealed a recurrence score of 0, corresponding to a 3% risk of distant recurrence at 10 years. A patient did not receive chemotherapy or post-mastectomy radiotherapy. The patient was placed on tamoxifen and has been free of disease to date. PMID:27134706

  13. [Viscoelastic properties of relaxed papillary muscle at physiological hypertrophy].

    PubMed

    Smoliuk, L T; Lisin, R V; Kuznetsov, D A; Protsenko, Iu L

    2012-01-01

    Viscoelastic properties of relaxed rat papillary muscles at physiological hypertrophy (intensive swimming for 5 weeks) have been obtained. It has been ascertained that viscoelastic properties of hypertrophied muscles are not significantly distinguished from those of control papillary muscles. A three-dimensional model of myocardial fascicle has been verified in compliance with experimental data of biomechanical tests of hypertrophied muscles. Elastic and viscous parameters of structural elements of the model negligibly differ from the parameters of the model of a control muscle. It is shown that physiological hypertrophy has a slight influence on viscoelastic properties of papillary muscles. PMID:23035537

  14. Double papillary fibroelastoma: beautiful, innocent flowers in the left heart.

    PubMed

    Floria, Mariana; Gerard, Marina; Louagie, Yves; Weynand, Birgit; Schroeder, Erwin

    2014-01-01

    Papillary fibroelastoma is a rare, benign tumor, and multiple papillary fibroelastomas are even more uncommon. In an asymptomatic patient scheduled for carotid endarterectomy, transthoracic echocardiography discovered a fibroelastoma on the mitral valve. Then, transesophageal echocardiography showed another fibroelastoma on the aortic valve. Because he also needed a right coronary artery bypass, the patient underwent surgical excision of both masses. Fibroelastomas are not always as innocent as they seem, and surgical excision is necessary because of their potential for systemic or coronary embolization. Transoesophageal echocardiography may improve the diagnosis of multiple papillary fibroelastomas. PMID:24796685

  15. Cooling balloons with liquid nitrogen

    NASA Astrophysics Data System (ADS)

    Moreno, A. J.; Ferrari, H.; Bekeris, V.

    2010-12-01

    We present an undergraduate level experiment in which the radius of a rubber balloon is measured as it is cooled with liquid nitrogen. For balloons filled with simple gases that condense at liquid nitrogen temperatures, we found that the volume decreases linearly with time. We compared our measurements with a simplified model based on elementary kinetic theory and thermodynamics that explains this behavior. Students are encouraged to test the validity of the model by repeating the experiment using gas mixtures and gases that do not condense at liquid nitrogen temperatures.

  16. Papillary serous carcinoma of the peritoneal surface: matched-case comparison with papillary serous ovarian carcinoma.

    PubMed

    Killackey, M A; Davis, A R

    1993-11-01

    Between 1984 and 1991, 199 patients underwent laparotomy for epithelial "ovarian" malignancy. In 29 cases (15%) normal-sized ovaries (< 4 cm in diameter) with minimal invasion by papillary serous carcinoma were found. This entity in the setting of peritoneal carcinomatosis has been previously described and is reported here as papillary serous cancer of the peritoneal surface (PSPS). The clinical, surgical, and pathologic features of PSPS are compared with a group of age-, grade-, and stage-matched cases with papillary serous ovarian carcinomas (PSOC). PSPS was also characterized by ascites (mean = 3036 cc), malignant washings (91%), and omental involvement with bulky infiltration and/or multiple tumor nodules (96%). Mean cytoreduction in the PSPS group was 65.5% compared to 79% in the PSOC group (P = 0.049). Patients received combination chemotherapy with platinum-based regimens. In general, there was a poor response to treatment with a disease-free interval of 3.4 and median survival time of 19 months in PSPS compared to 11.7 and 31 months in the PSOC patients. Patients with PSPS have more limited cytoreduction, shorter disease-free interval, and shorter overall survival time. Such differences prompt re-evaluation of treatment modalities for PSPS and recognition that this is a condition distinct from PSOC. PMID:8276289

  17. Endoscopic Optical Coherence Tomography

    NASA Astrophysics Data System (ADS)

    Zhou, Chao; Fujimoto, James G.; Tsai, Tsung-Han; Mashimo, Hiroshi

    New gastrointestinal (GI) cancers are expected to affect more than 290,200 new patients and will cause more than 144,570 deaths in the United States in 2013 [1]. When detected and treated early, the 5-year survival rate for colorectal cancer increases by a factor of 1.4 [1]. For esophageal cancer, the rate increases by a factor of 2 [1]. The majority of GI cancers begin as small lesions that are difficult to identify with conventional endoscopy. With resolutions approaching that of histopathology, optical coherence tomography (OCT) is well suited for detecting the changes in tissue microstructure associated with early GI cancers. Since the lesions are not endoscopically apparent, however, it is necessary to survey a relatively large area of the GI tract. Tissue motion is another limiting factor in the GI tract; therefore, in vivo imaging must be performed at extremely high speeds. OCT imaging can be performed using fiber optics and miniaturized lens systems, enabling endoscopic OCT inside the human body in conjunction with conventional video endoscopy. An OCT probe can be inserted through the working channel of a standard endoscope, thus enabling depth-resolved imaging of tissue microstructure in the GI tract with micron-scale resolution simultaneously with the endoscopic view (Fig. 68.1).

  18. Evolving endoscopic surgery.

    PubMed

    Sakai, Paulo; Faintuch, Joel

    2014-06-01

    Since the days of Albukasim in medieval Spain, natural orifices have been regarded not only as a rather repugnant source of bodily odors, fluids and excreta, but also as a convenient invitation to explore and treat the inner passages of the organism. However, surgical ingenuity needed to be matched by appropriate tools and devices. Lack of technologically advanced instrumentation was a strong deterrent during almost a millennium until recent decades when a quantum jump materialized. Endoscopic surgery is currently a vibrant and growing subspecialty, which successfully handles millions of patients every year. Additional opportunities lie ahead which might benefit millions more, however, requiring even more sophisticated apparatuses, particularly in the field of robotics, artificial intelligence, and tissue repair (surgical suturing). This is a particularly exciting and worthwhile challenge, namely of larger and safer endoscopic interventions, followed by seamless and scarless recovery. In synthesis, the future is widely open for those who use together intelligence and creativity to develop new prototypes, new accessories and new techniques. Yet there are many challenges in the path of endoscopic surgery. In this new era of robotic endoscopy, one will likely need a virtual simulator to train and assess the performance of younger doctors. More evidence will be essential in multiple evolving fields, particularly to elucidate whether more ambitious and complex pathways, such as intrathoracic and intraperitoneal surgery via natural orifice transluminal endoscopic surgery (NOTES), are superior or not to conventional techniques. PMID:24628672

  19. Therapeutic Armamentarium for Stricturing Crohn's Disease: Medical Versus Endoscopic Versus Surgical Approaches.

    PubMed

    Bharadwaj, Shishira; Fleshner, Phillip; Shen, Bo

    2015-09-01

    One-third of patients with Crohn's disease (CD) present as stricturing phenotype characterized by progressive luminal narrowing and obstructive symptoms. The diagnosis and management of these patients have been intriguing and challenging. Immunomodulators and biologics have been successfully used in treating inflammatory and fistulizing CD. There are issues of efficacy and safety of biological agents in treating strictures in CD. Rapid mucosal healing from potent biological agents may predispose patients to the development of new strictures or worsening of existing strictures. On the other hand, strictures constitute one-fifth of the reasons for surgery in patients with CD. Disease recurrence is common at or proximal to the anastomotic site with the majority of these patients developing new endoscopic lesions within 1 year of surgery. The progressive nature of the disease with repetitive cycle of inflammation and stricture formation results in repeated surgery, with a risk of small bowel syndrome. There is considerable quest for bowel conserving endoscopic and surgical strategies. Endoscopic balloon dilation and stricturoplasty have emerged as valid alternatives to resection. Endoscopic balloon dilation has been shown to be feasible, safe, and effective for the short primary or anastomotic strictures. However, repeated dilations are often needed, and long-term outcomes of endoscopic balloon dilation remain to be investigated. The introduction of stricturoplasty has added another dimension to bowel saving strategy. Although postoperative recurrence rate after stricturoplasty is comparable with surgical resection, there are concerns for increased risk of malignancy in preserved bowel. Laparoscopic surgery has widely been performed with similar outcomes to open approach with fewer complications, quicker recovery, better cosmesis, and lower cost. All of these issues should be considered by physicians involved in the management of patients with stricturing CD. PMID

  20. Automated endoscope reprocessors.

    PubMed

    Desilets, David; Kaul, Vivek; Tierney, William M; Banerjee, Subhas; Diehl, David L; Farraye, Francis A; Kethu, Sripathi R; Kwon, Richard S; Mamula, Petar; Pedrosa, Marcos C; Rodriguez, Sarah A; Wong Kee Song, Louis-Michel

    2010-10-01

    The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, with a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases data from randomized, controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through February 2010 for articles related to automated endoscope reprocessors, using the words endoscope reprocessing, endoscope cleaning, automated endoscope reprocessors, and high-level disinfection. Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment. PMID:20883843

  1. Proteomic Profiling of Thyroid Papillary Carcinoma

    PubMed Central

    Ban, Yoshiyuki; Yamamoto, Gou; Takada, Michiya; Hayashi, Shigeo; Ban, Yoshio; Shimizu, Kazuo; Akasu, Haruki; Igarashi, Takehito; Bando, Yasuhiko; Tachikawa, Tetsuhiko; Hirano, Tsutomu

    2012-01-01

    Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy. We performed shotgun liquid chromatography (LC)/tandem mass spectrometry (MS/MS) analysis on pooled protein extracts from patients with PTC and compared the results with those from normal thyroid tissue validated by real-time (RT) PCR and immunohistochemistry (IHC). We detected 524 types of protein in PTC and 432 in normal thyroid gland. Among these proteins, 145 were specific to PTC and 53 were specific to normal thyroid gland. We have also identified two important new markers, nephronectin (NPNT) and malectin (MLEC). Reproducibility was confirmed with several known markers, but the one of two new candidate markers such as MLEC did not show large variations in expression levels. Furthermore, IHC confirmed the overexpression of both those markers in PTCs compared with normal surrounding tissues. Our protein data suggest that NPNT and MLEC could be a characteristic marker for PTC. PMID:22518348

  2. Alternative endoscopic management in the treatment of urethral strictures.

    PubMed

    Niesel, T; Moore, R G; Alfert, H J; Kavoussi, L R

    1995-02-01

    Advances in endoscopic instrumentation and techniques have expanded our armamentarium for safe and effective treatment of urethral strictures. Endoscopic incision or dilation should remain the preferred treatment for uncomplicated primary strictures. Balloon dilation can be useful in the treatment of dense strictures. Incision using laser energy has yet to provide better results than procedures employing a cold knife. As such, it would be difficult to justify the added expense of laser urethrotomy. Endoscopic placement of free skin grafts into the bed of the urethra after transurethral resection or deep incision of the stricture is a novel approach that has shown a great deal of promise. Endourethroplasty is a reasonable alternative to open urethroplasty when treating long strictures, as more than 90% of the reported patients have had a successful outcome with no recurrence. However, larger experience with this procedure is necessary to verify its efficacy and for greater acceptance. The placement of indwelling stents is another new promising treatment option. Overall short-term success rates range from 75% to 100%, but the follow-up period is short, and little is known about the long-term risks of an indwelling foreign body in the urethra. Endoscopic incision via "cut-to-the-light" or "core-through" procedures is an excellent alternative in patients with obliterative strictures. Data from several centers reveal that the majority of patients gain relief of obstruction while maintaining continence and erectile potency. However, at least 25% of these patients will need further endoscopic management to maintain urethral patency. PMID:7780428

  3. Adrenal Metastasis from Uterine Papillary Serous Carcinoma

    PubMed Central

    Lubana, Sandeep Singh; Singh, Navdeep; Tuli, Sandeep S.; Seligman, Barbara

    2016-01-01

    Patient: Female, 60 Final Diagnosis: UPSC with adrenal metastasis Symptoms: Post menopausal bleeding Medication: — Clinical Procedure: Adrenalectomy Specialty: Oncology Objective: Rare disease Background: Uterine papillary serous carcinoma (UPSC) is a highly malignant form of endometrial cancer with a high propensity for metastases and recurrences even when there is minimal or no myometrial invasion. It usually metastasizes to the pelvis, retroperitoneal lymph nodes, upper abdomen, and peritoneum. However, adrenal metastases from UPSC is extremely rare. Here, we present a case of UPSC with adrenal metastasis that occurred 6 years after the initial diagnosis. Case Report: A 60-year-old woman previously diagnosed with uterine papillary serous carcinoma at an outside facility presented in September of 2006 with postmenopausal bleeding. She underwent comprehensive surgical staging with FIGO (International Federation of Gynecology and Obstetrics) stage 2. Post-operatively, the patient was treated with radiation and chemotherapy. The treatment was completed in April of 2007. The patient had no evidence of disease until July 2009 when she was found to have a mass highly suspicious for malignancy. Subsequently, she underwent right upper lobectomy. The morphology of the carcinoma was consistent with UPSC. She refused chemotherapy due to a previous history of chemotherapy-induced neuropathy. The patient was followed up with regular computed tomography (CT) scans. In October 2012 a new right adrenal nodule was seen on CT, which showed intense metabolic uptake on positron emission tomography (PET)/CT scan. The patient underwent right adrenalectomy. Pathology of the surgical specimen was consistent with UPSC. Conclusions: UPSC is an aggressive variant of endometrial cancer associated with high recurrence rate and poor prognoses. Long-term follow-up is needed because there is a possibility of late metastases, as in this case. PMID:27117594

  4. Adrenal Metastasis from Uterine Papillary Serous Carcinoma.

    PubMed

    Singh Lubana, Sandeep; Singh, Navdeep; Tuli, Sandeep S; Seligman, Barbara

    2016-01-01

    BACKGROUND Uterine papillary serous carcinoma (UPSC) is a highly malignant form of endometrial cancer with a high propensity for metastases and recurrences even when there is minimal or no myometrial invasion. It usually metastasizes to the pelvis, retroperitoneal lymph nodes, upper abdomen, and peritoneum. However, adrenal metastases from UPSC is extremely rare. Here, we present a case of UPSC with adrenal metastasis that occurred 6 years after the initial diagnosis. CASE REPORT A 60-year-old woman previously diagnosed with uterine papillary serous carcinoma at an outside facility presented in September of 2006 with postmenopausal bleeding. She underwent comprehensive surgical staging with FIGO (International Federation of Gynecology and Obstetrics) stage 2. Post-operatively, the patient was treated with radiation and chemotherapy. The treatment was completed in April of 2007. The patient had no evidence of disease until July 2009 when she was found to have a mass highly suspicious for malignancy. Subsequently, she underwent right upper lobectomy. The morphology of the carcinoma was consistent with UPSC. She refused chemotherapy due to a previous history of chemotherapy-induced neuropathy. The patient was followed up with regular computed tomography (CT) scans. In October 2012 a new right adrenal nodule was seen on CT, which showed intense metabolic uptake on positron emission tomography (PET)/CT scan. The patient underwent right adrenalectomy. Pathology of the surgical specimen was consistent with UPSC. CONCLUSIONS UPSC is an aggressive variant of endometrial cancer associated with high recurrence rate and poor prognoses. Long-term follow-up is needed because there is a possibility of late metastases, as in this case. PMID:27117594

  5. Comparison of different methods for endoscopic hemostasis of bleeding canine esophageal varices.

    PubMed

    Jensen, D M; Silpa, M L; Tapia, J I; Beilin, D B; Machicado, G A

    1983-06-01

    Despite advances in the therapy of acute esophageal variceal hemorrhage, morbidity and mortality remain high. Continued severe variceal hemorrhage remains a major clinical problem in poor risk patients who cannot tolerate emergency surgery for hemostasis. Several endoscopic hemostatic methods might be effective for variceal hemostasis, but they have not been systematically evaluated. Using a reproducible canine model of esophageal varices, several hemostatic modalities were tested and compared to determine which were most effective in stopping variceal bleeding. Methods tested were endoscopic sclerotherapy, organ laser, neodymium-yttrium-aluminum-garnet laser, monopolar electro-coagulation, bipolar electrocoagulation, ferromagnetic tamponade, and endoscopic heater probe. Both neodymium-yttrium-aluminum-garnet laser and endoscopic sclerotherapy provided reliable hemostasis in acutely bleeding canine varices. Large heater probe controlled bleeding 50% of the time, and all the other methods stopped bleeding in less than half the trials. Rebleeding after balloon inflation proximal to the coagulated bleeding site did not occur with neodymium-yttrium-aluminum-garnet laser or endoscopic sclerotherapy-treated varices but did occur with the other methods. The principal differences between neodymium-yttrium-aluminum-garnet laser and endoscopic sclerotherapy were the ease of application of neodymium-yttrium-aluminum-garnet laser, the higher frequency of esophageal ulcers or erosions with neodymium-yttrium-aluminum-garnet laser, and the lack of variceal obliteration with neodymium-yttrium-aluminum-garnet laser. PMID:6341157

  6. Urinary and renal papillary solutes during cyclooxygenase inhibition with ibuprofen

    SciTech Connect

    Passmore, J.C.; Hartupee, D.A.; Jackson, B.A.

    1987-12-01

    We investigated the mechanisms by which prostaglandin synthetase (cyclooxygenase) inhibitors cause antidiuresis and antinatriuresis in anesthetized dogs. Cyclooxygenase inhibition with ibuprofen caused an increased total solute (Na+, K+, and urea) concentration in the renal papilla. Xenon 133 washout studies revealed no change in medullary blood flow. Ibuprofen induced a 147% increase in papillary Na+ concentration, while increasing urea and K+ only 98% and 35%, respectively, suggesting that a Na+ reabsorption mechanism rather than decreased papillary blood flow was responsible for a majority of the increased papillary solute concentration. A decrease in the excretion of Na+, but not of K+ or urea, in treated dogs further implies increased Na+ reabsorption. Thus, it appears that cyclooxygenase inhibition increases papillary solute concentration primarily by increasing Na+ transport into the papilla.

  7. A Case of Post Myocardial Infarction Papillary Muscle Rupture.

    PubMed

    Anuwatworn, Amornpol; Milnes, Christopher; Kumar, Vishesh; Raizada, Amol; Nykamp, Verlyn; Stys, Adam

    2016-06-01

    Papillary muscle rupture is a rare, life-threatening post myocardial infarction mechanical complication. Without surgical intervention, prognosis is very poor. Clinicians need to recognize this complication early, as prompt therapy is crucial. We present a case of inferior ST elevation myocardial infarction complicated by posteromedial papillary muscle rupture resulting in severe acute mitral regurgitation (flail anterior mitral leaflet), acute pulmonary edema and cardiogenic shock. In our patient, a new mitral regurgitation murmur suggested this mechanical complication. Complete disruption of papillary muscle was visualized by transesophageal echocardiography. This case illustrates the importance of good physical examination for early diagnosis of papillary muscle rupture, so that life-saving treatment can be administered without delay. PMID:27443107

  8. Laser welding of balloon catheters

    NASA Astrophysics Data System (ADS)

    Flanagan, Aidan J.

    2003-03-01

    The balloon catheter is one of the principal instruments of non-invasive vascular surgery. It is used most commonly for angioplasty (and in recent years for delivering stents) at a multitude of different sites in the body from small arteries in the heart to the bilary duct. It is composed of a polymer balloon that is attached to a polymer shaft at two points called the distal and proximal bonds. The diverse utility of balloon catheters means a large range of component sizes and materials are used during production; this leads to a complexity of bonding methods and technology. The proximal and distal bonds have been conventionally made using cyanoacrylate or UV curing glue, however with performance requirements of bond strength, flexibility, profile, and manufacturing costs these bonds are increasingly being made by welding using laser, RF, and Hot Jaw methods. This paper describes laser welding of distal and proximal balloon bonds and details beam delivery, bonding mechanisms, bond shaping, laser types, and wavelength choice.

  9. Simulating clefts in pumpkin balloons

    NASA Astrophysics Data System (ADS)

    Baginski, Frank; Brakke, Kenneth

    2010-02-01

    The geometry of a large axisymmetric balloon with positive differential pressure, such as a sphere, leads to very high film stresses. These stresses can be significantly reduced by using a tendon re-enforced lobed pumpkin-like shape. A number of schemes have been proposed to achieve a cyclically symmetric pumpkin shape, including the constant bulge angle (CBA) design, the constant bulge radius (CBR) design, CBA/CBR hybrids, and NASA’s recent constant stress (CS) design. Utilizing a hybrid CBA/CBR pumpkin design, Flight 555-NT in June 2006 formed an S-cleft and was unable to fully deploy. In order to better understand the S-cleft phenomenon, a series of inflation tests involving four 27-m diameter 200-gore pumpkin balloons were conducted in 2007. One of the test vehicles was a 1/3-scale mockup of the Flight 555-NT balloon. Using an inflation procedure intended to mimic ascent, the 1/3-scale mockup developed an S-cleft feature strikingly similar to the one observed in Flight 555-NT. Our analysis of the 1/3-scale mockup found it to be unstable. We compute asymmetric equilibrium configurations of this balloon, including shapes with an S-cleft feature.

  10. Global electrodynamics from superpressure balloons

    NASA Technical Reports Server (NTRS)

    Holzworth, R. H.; Hu, H.

    1995-01-01

    Electric field and conductivity measurements in the stratosphere between November 1992 and March 1993 have been made using superpressure balloons in the southern hemisphere. Over 400 payload-days of data have been made during a record setting experiment called ELBBO (Extended Life Balloon Borne Observatories). This experiment resulted in 4 flights aloft simultaneously for over 2 months including one flight which lasted over 4 months. Electrodynamical coupling between the atmosphere and ionosphere is studied using the measured electric fields, and a simple empirical model of the stratospheric conductivity. Altitude profiles of conductivity have been obtained from several superpressure balloon flights using the large end-of-flight altitude swings on the last few days of each flight (as the balloon begins to loose superpressure). Coupling between the fields and atmospheric inertial waves has been observed. Effects and dynamics of the global circuit suggest that standard models are missing significant phenomena. Large scale ionospheric convection activity has been studied from the polar cap to the middle latitudes. Cusp latitude fields have been continuously measured for many days in a row.

  11. Balloon atmospheric propagation experiment measurements

    NASA Technical Reports Server (NTRS)

    Minott, P. O.

    1973-01-01

    High altitude balloon measurements on laser beam fading during propagation through turbulent atmosphere show that a correlation between fading strength and stellar scintillation magnitudes exists. Graphs for stellar scintillation as a function of receiver aperture are used to predict fading bit error rates for neodymium-yag laser communication system.

  12. Stability of the pumpkin balloon

    NASA Astrophysics Data System (ADS)

    Baginski, Frank

    A large axisymmetric balloon with positive differential pressure, e.g., a sphere, leads to high film stresses. These can be significantly reduced by using a lobed pumpkin-like shape re-enforced with tendons. A number of schemes have been proposed to achieve a cyclically symmetric pumpkin-shape at full inflation, including the constant bulge angle (CBA) design and the constant bulge radius (CBR) design. The authors and others have carried out stability studies of CBA and CBR designs and found instabilities under various conditions. While stability seems to be a good indicator of deployment problems for large balloons under normal ascent conditions, one cannot conclude that a stable design will deploy reliably. Nevertheless, stability analysis allows one to quantify certain deployment characteristics. Ongoing research by NASA's Balloon Program Office utilizes a new design approach developed by Rodger Farley, NASA/GSFC, that takes into account film and tendon strain. We refer to such a balloon as a constant stress (CS) pumpkin design. In June 2006, the Flight 555-NT balloon (based on a hybrid CBR/CBA design) developed an S-cleft and did not deploy. In order to understand the S-cleft phenomena and study a number of aspects related to the CS-design, a series of inflation tests were conducted at TCOM, Elizabeth City, NC in 2007. The test vehicles were 27 meter diameter pumpkins distinguished by their respective equatorial bulge angles (BA). For example, BA98 indicates an equatorial bulge angle of 98° . BA90, BA55, and BA00 are similarly defined. BA98 was essentially a one-third scale version of of the Flight 555 balloon (i.e., 12 micron film instead of 38.1 micron, mini-tendons, etc.). BA90 and BA55 were Farley CS-designs. BA00 was derived from the BA55 design so that a flat chord spanned adjacent tendons. In this paper, we will carry out stability studies of BA98, BA90, BA55, and BA00. We discuss the deployment problem of pumpkin balloons in light of 2007 inflation

  13. Familial Adenomatous Polyposis-Associated Papillary Thyroid Cancer

    PubMed Central

    Abdullah Suhaimi, Shahrun Niza; Nazri, Nadzrin; Nani Harlina, Mat Latar; Md. Isa, Nurismah; Muhammad, Rohaizak

    2015-01-01

    Papillary thyroid carcinoma (PTC) associated with familial adenomatous polyposis (FAP) is rare. It is usually associated with the cribriform-morular variant of PTC, with unusual patterns on detailed histology examination. This variant is known to have a good prognosis. Papillary thyroid carcinoma associated with FAP commonly occurs in females in their 30s and rarely in the elderly. We report a case of a 69-year-old female presenting with thyroid swelling and a history of FAP. PMID:26715910

  14. Sonographic findings of an ovarian serous surface papillary borderline tumor.

    PubMed

    Kwon, Yohan; Park, Sung Bin; Lee, Jong Beum; Park, Hyun Jeong

    2013-01-01

    Sonographic findings of a serous surface papillary borderline tumor of the ovary have rarely been reported in the English literature. Here, we describe a case of serous surface papillary borderline tumor, which was depicted on gray-scale and Doppler ultrasonography as smoothly lobulated and polypoid heterogeneous echoic bilateral adnexal masses encased or surrounded by what was presumed to be normal-appearing ovarian follicles with increased vascular flow. PMID:23938140

  15. [Endoscopic Therapy for Esophageal Cancer].

    PubMed

    Sakai, Makoto; Kuwano, Hiroyuki

    2016-07-01

    Endoscopic treatment for esophageal neoplasms includes endoscopic resection, argon plasma coagulation(APC), photodynamic therapy( PDT) and stent placement. Endoscopic resection is widely used as an effective, less invasive treatment for superficial esophageal carcinoma in Japan. APC is considered to be safe and effective treatment for superficial esophageal carcinoma which cannot be resected endoscopically because of severe comorbidities, as well as for local recurrence after endoscopic resection or chemoradiotherapy. PDT is thought to be an effective option as salvage treatment for local failure after chemoradiotherapy. Stent placement mainly using self-expanding metallic stents have been used as a minimally invasive and effective modality for the palliative treatment of malignant esophageal obstruction. Endoscopic treatment is expected to have more important role in the treatment of esophageal neoplasms in the future. PMID:27440040

  16. Urgent double balloon endoscopy provides higher yields than non-urgent double balloon endoscopy in overt obscure gastrointestinal bleeding

    PubMed Central

    Aniwan, Satimai; Viriyautsahakul, Vichai; Rerknimitr, Rungsun; Angsuwatcharakon, Phonthep; Kongkam, Pradermchai; Treeprasertsuk, Sombat; Kullavanijaya, Pinit

    2014-01-01

    Background and study aims: In overt obscure gastrointestinal bleeding (OV), double balloon endoscopy (DBE) is recommended as one of the most important investigations as it can provide both diagnosis and treatment. However, there is no set standard on the timing of DBE in OV. The aim of this study was to compare the diagnostic and therapeutic yields between urgent and non-urgent DBE in patients with OV. Patients and methods: Between January 2006 and February 2013, 120 patients with OV who underwent DBE were retrospectively reviewed. An urgent DBE was defined as DBE performed within 72 h from the last visible gastrointestinal bleeding (n = 74) whereas a non-urgent DBE was defined as DBE performed after 72 h (n = 46). Diagnostic yields, therapeutic impact and clinical outcomes were evaluated. Results: Diagnostic yield in urgent DBE was significantly higher than that in non-urgent DBE (70 % versus 30 %; P < 0.05). Urgent DBE offered significantly more therapies including endoscopic, angiographic embolization, and surgery than non-urgent DBE (54 % versus 15 %; P < 0.001). Endoscopic therapy was performed in 43 % of urgent-DBE patients whereas only 13 % of patients in the other group received endoscopic therapy (P < 0.01). In patients with identified bleeding sources, the rebleeding rate was lower in patients who underwent urgent DBE than in those who underwent non-urgent DBE (10 % versus 29 %, NS). Conclusions: Regarding diagnostic and therapeutic impacts in OV, our retrospective study showed that urgent DBE is better than non-urgent DBE. The recurrent bleeding rate in patients undergoing urgent DBE tended to be lower. PMID:26135267

  17. Endoscopic Gastrointestinal Laser Therapy

    PubMed Central

    Buchi, Kenneth N.

    1985-01-01

    The development of flexible fibers for the delivery of laser energy led to the first endoscopic laser applications in humans in the early 1970s. Since that time, much has been learned about applications throughout the gastrointestinal tract. The risks appear to be minimal. The coagulative effect of laser energy is used to treat gastrointestinal hemorrhage and small, benign mucosal lesions. The ablative effect of the Nd:YAG laser on tissue is used for palliative therapy for malignant gastrointestinal disorders and incisional therapy for anatomic lesions such as strictures or cysts. New laser modalities that potentially can be tuned throughout large segments of the electromagnetic spectrum, new fiber-optic delivery systems with specialized tips and new methods of sensitizing tissue to laser energy all indicate that the endoscopic laser should continue to have many new and innovative applications. ImagesFigure 1.Figure 2.Figure 3. PMID:3911589

  18. Endoscopic incisional therapy for benign esophageal strictures: Technique and results

    PubMed Central

    Samanta, Jayanta; Dhaka, Narendra; Sinha, Saroj Kant; Kochhar, Rakesh

    2015-01-01

    Benign esophageal strictures refractory to the conventional balloon or bougie dilatation may be subjected to various adjunctive modes of therapy, one of them being endoscopic incisional therapy (EIT). A proper delineation of the stricture anatomy is a prerequisite. A host of electrocautery and mechanical devices may be used, the most common being the use of needle knife, either standard or insulated tip. The technique entails radial incision and cutting off of the stenotic rim. Adjunctive therapies, to prevent re-stenosis, such as balloon dilatation, oral or intralesional steroids or argon plasma coagulation can be used. The common strictures where EIT has been successfully used are Schatzki’s rings (SR) and anastomotic strictures (AS). Short segment strictures (< 1 cm) have been found to have the best outcome. When compared with routine balloon dilatation, EIT has equivalent results in treatment naïve cases but better long term outcome in refractory cases. Anecdotal reports of its use in other types of strictures have been noted. Post procedure complications of EIT are mild and comparable to dilatation therapy. As of the current evidence, incisional therapy can be used for management of refractory AS and SR with relatively short stenosis (< 1 cm) with good safety profile and acceptable long term patency. PMID:26722613

  19. Endoscopic incisional therapy for benign esophageal strictures: Technique and results.

    PubMed

    Samanta, Jayanta; Dhaka, Narendra; Sinha, Saroj Kant; Kochhar, Rakesh

    2015-12-25

    Benign esophageal strictures refractory to the conventional balloon or bougie dilatation may be subjected to various adjunctive modes of therapy, one of them being endoscopic incisional therapy (EIT). A proper delineation of the stricture anatomy is a prerequisite. A host of electrocautery and mechanical devices may be used, the most common being the use of needle knife, either standard or insulated tip. The technique entails radial incision and cutting off of the stenotic rim. Adjunctive therapies, to prevent re-stenosis, such as balloon dilatation, oral or intralesional steroids or argon plasma coagulation can be used. The common strictures where EIT has been successfully used are Schatzki's rings (SR) and anastomotic strictures (AS). Short segment strictures (< 1 cm) have been found to have the best outcome. When compared with routine balloon dilatation, EIT has equivalent results in treatment naïve cases but better long term outcome in refractory cases. Anecdotal reports of its use in other types of strictures have been noted. Post procedure complications of EIT are mild and comparable to dilatation therapy. As of the current evidence, incisional therapy can be used for management of refractory AS and SR with relatively short stenosis (< 1 cm) with good safety profile and acceptable long term patency. PMID:26722613

  20. Cyst infection of intraductal papillary mucinous neoplasms of the pancreas: management of a rare complication: report of 2 cases.

    PubMed

    Watanabe, Kenji; Karasaki, Hidenori; Mizukami, Yusuke; Kawamoto, Toru; Kono, Toru; Imai, Koji; Einama, Takahiro; Taniguchi, Masahiko; Kohgo, Yutaka; Furukawa, Hiroyuki

    2014-04-01

    The purpose of this study was to describe the cyst infection of intraductal papillary mucinous neoplasm in 2 patients. The patients were 62- and 74-year-old men. The initial symptom was acute febrile abdominal pain. Laboratory tests revealed severe infection (C-reactive protein concentrations were 23.3 µg/mL in patient 1 and 22.3 µg/mL in patient 2) and multilocular cystic masses (the diameters were 70 mm in patient 1 and 50 mm in patient 2) at the pancreatic head that involved peripancreatic vessels were demonstrated by computed tomography. Laboratory and radiographic findings were markedly improved by endoscopic transpapillary drainage. The enteric bacteria were detected in the drainage specimens. Curative resection was achieved, and histological findings indicated a carcinoma in situ in patient 1 and an invasive carcinoma in patient 2. Neither hyperamylasemia nor histological fat necrosis, frequently observed in acute pancreatitis, was evident. Both patients were free from recurrence after surgery (17 months in patient 1, and 18 months in patient 2). Cyst infection is an unknown complication of intraductal papillary mucinous neoplasm. Transpapillary drainage is highly recommended as an initial intervention. It is difficult to distinguish between cyst infection and unresectable invasive carcinoma with imaging modalities; however, surgical intervention after drainage may contribute to long-term survival. PMID:24622083

  1. Decitabine in Treating Patients With Metastatic Papillary Thyroid Cancer or Follicular Thyroid Cancer Unresponsive to Iodine I 131

    ClinicalTrials.gov

    2014-08-20

    Recurrent Thyroid Cancer; Stage IVA Follicular Thyroid Cancer; Stage IVA Papillary Thyroid Cancer; Stage IVB Follicular Thyroid Cancer; Stage IVB Papillary Thyroid Cancer; Stage IVC Follicular Thyroid Cancer; Stage IVC Papillary Thyroid Cancer

  2. Endoscopic and Microscopic Microvascular Decompression.

    PubMed

    Piazza, Matthew; Lee, John Y K

    2016-07-01

    The introduction of the endoscope into the neurosurgeon's armamentarium has revolutionized ventral and anterior skull-base surgery and, more recently, has been used in the surgical treatment of cerebellopontine angle (CPA) pathology. The utilization of the endoscope in microvascular decompression (MVD) for trigeminal neuralgia and other associated cranial nerve hyperactivity syndromes allows for unparalleled panoramic views and illumination of the neurovascular structures within the CPA and identification of vessel-nerve contact traditionally unseen using the microscope. In this article, the technical advantages and challenges of using the endoscope for MVD, operative technique, and patient outcomes of endoscopic MVD are discussed. PMID:27324997

  3. [Endoscopic interventions in pulmonology].

    PubMed

    Gompelmann, D; Herth, F J F

    2016-08-01

    Bronchoscopy plays a significant role in the diagnosis and treatment of pulmonary diseases. Hemoptysis, or central airway obstruction, is a common indication for interventional bronchoscopy. In addition, the treatment of early lung cancer is the domain of bronchoscopy in inoperable patients. In recent years, endoscopic techniques have also been established as new therapeutic options in advanced chronic obstructive pulmonary disease and uncontrolled bronchial asthma. PMID:27351790

  4. Fluorescence endoscopic video system

    NASA Astrophysics Data System (ADS)

    Papayan, G. V.; Kang, Uk

    2006-10-01

    This paper describes a fluorescence endoscopic video system intended for the diagnosis of diseases of the internal organs. The system operates on the basis of two-channel recording of the video fluxes from a fluorescence channel and a reflected-light channel by means of a high-sensitivity monochrome television camera and a color camera, respectively. Examples are given of the application of the device in gastroenterology.

  5. Endoscopic ultrasound-guided drainage of pancreatic fluid collections

    PubMed Central

    Fabbri, Carlo; Luigiano, Carmelo; Maimone, Antonella; Polifemo, Anna Maria; Tarantino, Ilaria; Cennamo, Vincenzo

    2012-01-01

    Pancreatic fluid collections (PFCs) develop secondary to either fluid leakage or liquefaction of pancreatic necrosis following acute pancreatitis, chronic pancreatitis, surgery or abdominal trauma. Pancreatic fluid collections include acute fluid collections, acute and chronic pancreatic pseudocysts, pancreatic abscesses and pancreatic necrosis. Before the introduction of linear endoscopic ultrasound (EUS) in the 1990s and the subsequent development of endoscopic ultrasound-guided drainage (EUS-GD) procedures, the available options for drainage in symptomatic PFCs included surgical drainage, percutaneous drainage using radiological guidance and conventional endoscopic transmural drainage. In recent years, it has gradually been recognized that, due to its lower morbidity rate compared to the surgical and percutaneous approaches, endoscopic treatment may be the preferred first-line approach for managing symptomatic PFCs. Endoscopic ultrasound-guided drainage has the following advantages, when compared to other alternatives such as surgical, percutaneous and non-EUS-guided endoscopic drainage. EUS-GD is less invasive than surgery and therefore does not require general anesthesia. The morbidity rate is lower, recovery is faster and the costs are lower. EUS-GD can avoid local complications related to percutaneous drainage. Because the endoscope is placed adjacent to the fluid collection, it can have direct access to the fluid cavity, unlike percutaneous drainage which traverses the abdominal wall. Complications such as bleeding, inadvertent puncture of adjacent viscera, secondary infection and prolonged periods of drainage with resultant pancreatico-cutaneous fistulae may be avoided. The only difference between EUS and non-EUS drainage is the initial step, namely, gaining access to the pancreatic fluid collection. All the subsequent steps are similar, i.e., insertion of guide-wires with fluoroscopic guidance, balloon dilatation of the cystogastrostomy and insertion of

  6. Peroral endoscopic myotomy.

    PubMed

    Kumbhari, Vivek; Khashab, Mouen A

    2015-05-16

    Peroral endoscopic myotomy (POEM) incorporates concepts of natural orifice translumenal endoscopic surgery and achieves endoscopic myotomy by utilizing a submucosal tunnel as an operating space. Although intended for the palliation of symptoms of achalasia, there is mounting data to suggest it is also efficacious in the management of spastic esophageal disorders. The technique requires an understanding of the pathophysiology of esophageal motility disorders as well as knowledge of surgical anatomy of the foregut. POEM achieves short term response in 82% to 100% of patients with minimal risk of adverse events. In addition, it appears to be effective and safe even at the extremes of age and regardless of prior therapy undertaken. Although infrequent, the ability of the endoscopist to manage an intraprocedural adverse event is critical as failure to do so could result in significant morbidity. The major late adverse event is gastroesophageal reflux which appears to occur in 20% to 46% of patients. Research is being conducted to clarify the optimal technique for POEM and a personalized approach by measuring intraprocedural esophagogastric junction distensibility appears promising. In addition to esophageal disorders, POEM is being studied in the management of gastroparesis (gastric pyloromyotomy) with initial reports demonstrating technical feasibility. Although POEM represents a paradigm shift the management of esophageal motility disorders, the results of prospective randomized controlled trials with long-term follow up are eagerly awaited. PMID:25992188

  7. Peroral endoscopic myotomy

    PubMed Central

    Kumbhari, Vivek; Khashab, Mouen A

    2015-01-01

    Peroral endoscopic myotomy (POEM) incorporates concepts of natural orifice translumenal endoscopic surgery and achieves endoscopic myotomy by utilizing a submucosal tunnel as an operating space. Although intended for the palliation of symptoms of achalasia, there is mounting data to suggest it is also efficacious in the management of spastic esophageal disorders. The technique requires an understanding of the pathophysiology of esophageal motility disorders as well as knowledge of surgical anatomy of the foregut. POEM achieves short term response in 82% to 100% of patients with minimal risk of adverse events. In addition, it appears to be effective and safe even at the extremes of age and regardless of prior therapy undertaken. Although infrequent, the ability of the endoscopist to manage an intraprocedural adverse event is critical as failure to do so could result in significant morbidity. The major late adverse event is gastroesophageal reflux which appears to occur in 20% to 46% of patients. Research is being conducted to clarify the optimal technique for POEM and a personalized approach by measuring intraprocedural esophagogastric junction distensibility appears promising. In addition to esophageal disorders, POEM is being studied in the management of gastroparesis (gastric pyloromyotomy) with initial reports demonstrating technical feasibility. Although POEM represents a paradigm shift the management of esophageal motility disorders, the results of prospective randomized controlled trials with long-term follow up are eagerly awaited. PMID:25992188

  8. New Endoscopic Hemostasis Methods

    PubMed Central

    Leung Ki, En-Ling

    2012-01-01

    Endoscopic treatment for non-variceal upper gastrointestinal bleeding has evolved over decades. Injection with diluted epinephrine is considered as a less than adequate treatment, and the current standard therapy should include second modality if epinephrine injection is used initially. Definitive hemostasis rate following mono-therapy with either thermo-coagulation or hemo-clipping compares favorably with dual therapies. The use of adsorptive powder (Hemo-spray) is a promising treatment although it needs comparative studies between hemospray and other modalities. Stronger hemo-clips with better torque control and wider span are now available. Over-the-scope clips capture a large amount of tissue and may prove useful in refractory bleeding. Experimental treatments include an endoscopic stitch device to over-sew the bleeding lesion and targeted therapy to the sub-serosal bleeding artery as guided by echo-endoscopy. Angiographic embolization of bleeding artery should be considered in chronic ulcers that fail endoscopic treatment especially in elderly patients with a major bleed manifested in hypotension. PMID:22977807

  9. New endoscopic hemostasis methods.

    PubMed

    Leung Ki, En-Ling; Lau, James Y W

    2012-09-01

    Endoscopic treatment for non-variceal upper gastrointestinal bleeding has evolved over decades. Injection with diluted epinephrine is considered as a less than adequate treatment, and the current standard therapy should include second modality if epinephrine injection is used initially. Definitive hemostasis rate following mono-therapy with either thermo-coagulation or hemo-clipping compares favorably with dual therapies. The use of adsorptive powder (Hemo-spray) is a promising treatment although it needs comparative studies between hemospray and other modalities. Stronger hemo-clips with better torque control and wider span are now available. Over-the-scope clips capture a large amount of tissue and may prove useful in refractory bleeding. Experimental treatments include an endoscopic stitch device to over-sew the bleeding lesion and targeted therapy to the sub-serosal bleeding artery as guided by echo-endoscopy. Angiographic embolization of bleeding artery should be considered in chronic ulcers that fail endoscopic treatment especially in elderly patients with a major bleed manifested in hypotension. PMID:22977807

  10. Successful Removal of a Screw Nail in the Jejunum Using Double-Balloon Enteroscopy

    PubMed Central

    Kim, Dong Ju; Sim, Myoung Ki; Lee, Sang Wook

    2015-01-01

    The vast majority of foreign bodies (FBs) that enter the stomach pass through the gastrointestinal tract spontaneously. When the FB enters the small bowel-beyond the reach of conventional endoscopy-daily radiographs are needed to ensure its safe passage. However, endoscopic intervention is an appropriate management strategy for a sharp-pointed FB, because sharp FBs have a higher risk of intestinal perforation. We describe here a case in which a 1.5-cm, sharp-pointed screw nail in the proximal jejunum was removed successfully by double-balloon enteroscopy from a 19-year-old-male with autism. This case adds to the growing body of evidence demonstrating the value of therapeutic double-balloon enteroscopy in the field of FB ingestion PMID:26473131