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Sample records for lumboperitoneal lp shunt

  1. Intra-bronchial migration of peritoneal catheter of lumboperitoneal shunt

    PubMed Central

    Kawahara, Takashi; Yanagi, Masakazu; Hirano, Hirofumi; Arita, Kazunori

    2015-01-01

    Background: A rare case of intra-bronchial migration of peritoneal catheter of lumboperitoneal (LP) shunt was treated under the bronchoscopic and fluoroscopic observation. Case Description: A 71-year-old man, who underwent LP shunt installation due to idiopathic normal pressure hydrocephalus a year before, presented with history of high fever and sputum production. Roentgenography and computed tomography of the chest revealed migration of distal end of the peritoneal catheter into the left main bronchus. Migrated catheter was gently extracted through the abdominal wound incision under the bronchoscopic and fluoroscopic observation. Contrast material infused into the catheter did not spread into the pleural cavity. The patient was free of the symptoms within 2 postoperative weeks. Moreover, he underwent the ventriculo-peritoneal shunt surgery 1-month later. Conclusion: This is the first case of the migration of peritoneal catheter of LP shunt into the main bronchus.

  2. Acquired Chiari I malformation and syringomyelia after valveless lumboperitoneal shunt in infancy.

    PubMed

    Riffaud, Laurent; Moughty, Carolina; Henaux, Pierre-Louis; Haegelen, Claire; Morandi, Xavier

    2008-01-01

    The authors present the case of a 13-year-old boy who experienced frequent disabling episodes of typical postural induced headaches, which revealed a Chiari I malformation, syringomyelia and cervical spinal cord edema. This boy had received a valveless lumboperitoneal (LP) shunt at the age of 18 months for macrocephaly. At this time, cranial CT scan showed moderate enlargement of the subarachnoid spaces without hydrocephalus or tonsillar herniation. The LP shunt was clamped but the patient experienced signs of brain stem dysfunction and increased intracranial pressure. Finally, an adjustable valve (110 mm Hg) was inserted and all the symptoms resolved. Although some authors consider LP shunt as a safe and effective procedure even in the pediatric population, our case reminds us that these shunts, especially when valveless, may expose the patient to the risk of symptomatic acquired Chiari I malformation and syringomyelia consecutive to a chronic spinal CSF leakage. PMID:18354264

  3. Report of Dramatic Improvement after a Lumboperitoneal Shunt Procedure in a Case of Anticoagulation Therapy-Resistant Cerebral Venous Thrombosis.

    PubMed

    Torikoshi, Sadaharu; Akiyama, Yoshinori

    2016-02-01

    Cerebral venous thrombosis (CVT), which typically progresses from either acute or subacute onset, presents with symptoms related to intracranial hypertension (e.g., headache and papilledema) and brain parenchymal lesions (e.g., aphasia and hemiplegia). Anticoagulation therapy is generally accepted as a treatment for CVT and often leads to good clinical outcomes. However, we experienced a case of CVT with an uncommon clinical course. The patient was a 63-year-old man who presented with headache, papilledema, visual loss, and diplopia; his condition gradually deteriorated, and he was diagnosed with CVT via cerebral angiography. The sinus thrombus was extensive and resistant to anticoagulation therapy, and lumbar puncture revealed a progressive increase in cerebrospinal fluid (CSF) pressure. We performed a lumboperitoneal (LP) shunt procedure, which yielded marked improvement in the symptoms. The main mechanism of neurological dysfunction in CVT is venous outflow obstruction caused by venous thrombus, which results in brain edema, and/or venous infarction, which induces focal neurological signs. Another mechanism is impaired CSF absorption in the thrombosed sinuses, resulting in intracranial hypertension. We speculated that the latter mechanism strongly influenced our case, thus explaining the uncommon clinical course and effectiveness of the LP shunt procedure. Although LP shunting is not a common treatment for CVT, this case report could indicate the usefulness of this procedure for CVT with chronic progression and resistance to anticoagulation therapy. PMID:26654661

  4. Meningitis and shunt infection caused by anaerobic bacteria in children.

    PubMed

    Brook, Itzhak

    2002-02-01

    This review describes the microbiology and management of meningitis and shunt infections caused by anaerobic bacteria in children. The predominant anaerobes recovered in meningitis are Bacteriodes spp., Bacteriodes fragilis, Fusobacterium spp., and Clostridium spp. Peptostreptococcus, Veillonella, Actinomyces, Propionibacterium acnes, and Eubacterium are less commonly isolated. The predisposing conditions for meningitis are acute or chronic middle-ear infection, sinusitis, pharyngitis, and pulmonary infections. In newborn and preterm infants the predisposing conditions are rupture of membranes, amnionitis, fetal distress, necrotizing enterocolitis, gastric perforation and subsequent ileus followed by bacteremia, aspiration pneumonitis and septicemia, infected ventriculoperitoneal or ventriculoatrial shunt, and complicating dermal sinus tract infections. Shunt infection with Propionibacterium spp. has been reported in children, especially in association with ventriculoauricular and ventriculoperitoneal shunts. Clostridium perfringens has been recovered from infants with a ventriculoperitoneal shunt. Multiple-organism meningitis was reported as a complication of ventriculoperitoneal and lumboperitoneal shunts that perforated the gastrointestinal tract. Early recognition and effective therapy are essential to recovery. Management of meningitis includes the use of antimicrobials effective against anaerobes that penetrate the blood-brain barrier. These include metronidazole, chloramphenicol, the combination of a penicillin and a beta-lactamase inhibitor, and carbapenems. The treatment of shunt infection includes antimicrobial therapy and removal of the shunt. PMID:11897473

  5. Controversies: Optic nerve sheath fenestration versus shunt placement for the treatment of idiopathic intracranial hypertension

    PubMed Central

    Spitze, Arielle; Lam, Peter; Al-Zubidi, Nagham; Yalamanchili, Sushma; Lee, Andrew G

    2014-01-01

    Background: Idiopathic intracranial hypertension (IIH) has been increasing in prevalence in the past decade, following the obesity epidemic. When medical treatment fails, surgical treatment options must be considered. However, controversy remains as to which surgical procedure is the preferred surgical option – optic nerve sheath fenestration (ONSF) or cerebrospinal fluid (CSF) shunting – for the long-term treatment of this syndrome. Purpose: To provide a clinical update of the pros and cons of ONSF versus shunt placement for the treatment of IIH. Design: This was a retrospective review of the current literature in the English language indexed in PubMed. Methods: The authors conducted a PubMed search using the following terms: Idiopathic IIH, pseudotumor cerebri, ONSF, CSF shunts, vetriculo-peritoneal shunting, and lumbo-peritoneal shunting. The authors included pertinent and significant original articles, review articles, and case reports, which revealed the new aspects and updates in these topics. Results: The treatment of IIH remains controversial and lacks randomized controlled clinical trial data. Treatment of IIH rests with the determination of the severity of IIH-related visual loss and headache. Conclusion: The decision for ONSF versus shunting is somewhat institution and surgeon dependent. ONSF is preferred for patients with visual symptoms whereas shunting is reserved for patients with headache. There are positive and negative aspects of both procedures, and a prospective, randomized, controlled trial is needed (currently underway). This article will hopefully be helpful in allowing the reader to make a more informed decision until that time. PMID:25449938

  6. Ventriculoperitoneal shunting

    MedlinePLUS

    Risks of anesthesia are: Reactions to medications Problems breathing Changes in blood pressure or breathing rate Risks of ventriculoperitoneal shunt placement are: Blood clot or bleeding in the brain Brain swelling Hole in the intestines (bowel ...

  7. Management for traumatic chronic subdural hematoma patients with well-controlled shunt system for hydrocephalus

    PubMed Central

    Yamada, Shoko Mitrrt; Tomia, Yusuke; Murakami, Hideki; Nakane, Makoto

    2015-01-01

    Key Clinical Message Traumatic CSDH enlarged in two cases with VP or LP shunt system although the shunt valve pressure was increased to 200 mmH2O. In surgery, the hematoma cavity pressure was found to be 130 and 140 mmH2O, suggesting that to raise the shunt valve pressure is not effective for decreasing CSDH volume. PMID:26273439

  8. Distal splenorenal shunt

    MedlinePLUS

    ... splenic venous shunt; Warren shunt; Cirrhosis - distal splenorenal; Liver failure - distal splenorenal ... the intestine, spleen, pancreas, and gallbladder to the liver. When blood flow is blocked, the pressure in ...

  9. Cerebrospinal Fluid Shunts

    PubMed Central

    Sells, Clifford J.; Shurtleff, David B.

    1977-01-01

    Cerebrospinal fluid (CSF) shunt technology has undergone rapid advances in the past two decades. As a result, pediatricians and other primary care physicians are being asked with increasing frequency to provide care for persons with CSF shunts. Familiarity with the more common shunts is a prerequisite to intelligent management of shunt related problems. Physicians providing daily care must have carefully documented hospital records and operative notes available to them as well as information detailing the safe evaluation of shunt patency and function if they are to manage patients with CSF shunts properly. In addition, parents and guardians must be alerted to signs and symptoms related to shunt malfunction. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 7.Figure 8. PMID:898953

  10. Ventriculoperitoneal Shunting for Hydrocephalus

    PubMed Central

    Robertson, J. Sloan; Maraqa, M. I.; Jennett, Bryan

    1973-01-01

    Revision rate and complications were reviewed in 297 patients of all ages subjected to ventriculoperitoneal shunting and adequately followed. Both operative mortality and deaths due to complications of this type of shunt were much lower than after ventriculocaval shunts. Although 44% required revision a third of the cases had a period of three years without revision; two-thirds of these went for three years after the initial operation without need for operation. This shunt should be considered both in children and in adults because it is no more likely to block than ventriculoatrial, is easier to revise, and the other complications are fewer and much less serious. PMID:4574347

  11. Lymphovenous shunts in man

    PubMed Central

    Edwards, J. M.; Kinmonth, J. B.

    1969-01-01

    Lymphovenous shunts have been detected in patients by lymphography with Ultrafluid Lipiodol. No shunts were found in patients with normal lymphatic systems. They were found in patients with lymphoedema, with lymph nodes involved by malignant disease, and in patients who had had surgical interruption of lymphatic pathways, either vessels or nodes. The total incidence of lymphovenous shunts in 700 lymphographic studies was 2·3%. The incidence in the various pathological groups was highest in those with obvious lymph node involvement. In certain situations, particularly primary lymphoedema, the role of a lymphovenous shunt appears favourable to prognosis. In other situations a deleterious effect may be produced. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5 PMID:5356544

  12. Shunt tube calcification as a late complication of ventriculoperitoneal shunting.

    PubMed

    Salim, Abubakr Darrag; Elzain, Mohammed Awad; Mohamed, Haddab Ahmed; Ibrahim Zayan, Baha Eldin Mohamed

    2015-01-01

    Shunt calcification is a rare complication of ventriculoperitoneal shunting that occurs years later after the initial operation this condition is rarely reported in literature. Two patients with shunt calcifications were described. The first patient was 17-year-old lady who had congenital hydrocephalus and shunted in the early infancy, she was presented recently complaining of itching of the skin along the shunt track and limitation of neck movement. The patient was then operated with removal of the old peritoneal catheter and replacing it with a new one. The second patient was 17-year-old boy originally was a case of posterior fossa pilocytic astrocytoma associated with obstructive hydrocephalus, he was operated with both shunting for the hydrocephalus and tumor removal, 6 years later he presented with shunt exposure. Calcification of the shunt tube was discovered intraoperatively upon shunt removal. Shunt calcification has been observed mainly in barium-impregnated catheters. Introducing plain silicone-coated shunt tubing may reduce the rate of this condition. The usual complaints of the patients suffering from this condition are pain in the neck and chest wall along the shunt pathway and limitation of the neck movement due to shunt tube tethering, but features of shunt dysfunction and skin irritation above the shunt may be present. In this review, plain X-ray and operative findings showed that the most extensive calcification is present in the neck, where the catheters were subject to heavy mechanical stress. Disturbed calcium and phosphate metabolisms may be involved in this condition. Shunt calcification is a rare condition that occurs due to material aging presenting with features of shunt tethering, dysfunction or overlying skin irritation. Plain X-ray is needed to detect calcification while shunt removal, replacement or endoscopic third ventriculostomy may carry solution for this condition. PMID:26396620

  13. Aqueous shunts for glaucoma

    PubMed Central

    Minckler, Don; Vedula, Satyanarayana S; Li, Tianjing; Mathew, Milan; Ayyala, Ramesh; Francis, Brian

    2014-01-01

    Background Aqueous shunts are employed for intraocular pressure (IOP) control in primary and secondary glaucomas that fail medical, laser, and other surgical therapies. Objectives This review compares aqueous shunts for IOP control and safety. Search strategy We searched CENTRAL, MEDLINE, PubMed, EMBASE, NRR in January 2006, LILACS to February 2004 and reference lists of included trials. Selection criteria We included all randomized and quasi-randomized trials in which one arm of the study involved shunts. Data collection and analysis Two authors independently extracted data for included studies and a third adjudicated discrepancies. We contacted investigators for missing information. We used fixed-effect models and summarized continuous outcomes using mean differences. Main results We included fifteen trials with a total of 1153 participants with mixed diagnoses. Five studies reported details sufficient to verify the method of randomization but only two had adequate allocation concealment. Data collection and follow-up times were variable. Meta-analysis of two trials comparing Ahmed implant with trabeculectomy found trabeculectomy resulted in lower mean IOPs 11 to 13 months later (mean difference 3.81 mm Hg, 95% CI 1.94 to 5.69 mm Hg). Meta-analysis of two trials comparing double-plate Molteno implant with the Schocket shunt was not done due to substantial heterogeneity. One study comparing ridged with standard double-plate Molteno implants found no clinically significant differences in outcome. Two trials investigating the effectiveness of adjunctive mitomycin (MMC) with the Molteno and Ahmed implants found no evidence of benefit with MMC. Two trials that investigated surgical technique variations with the Ahmed found no benefit with partial tube ligation or excision of Tenon's capsule. One study concluded there were outcome advantages with a double versus a single-plate Molteno implant and one trial comparing the 350 mm2 and 500 mm2 Baerveldt shunts found no clinically significant advantage of the larger device but neither of these trials included all patients randomized. One study suggested improved clinical outcome when MMC was employed with a newly described shunt including ultrasound supporting the conclusion. One small study did not demonstrate an outcome advantage to systemic steroid use postoperatively with single-plate Molteno shunts. One study comparing endocyclophotocoagulation (ECP) with Ahmed implant in complicated glaucomas found no evidence of better IOP control with Ahmed implant over ECP. Authors' conclusions Relatively few randomized trials have been published on aqueous shunts and methodology and data quality among them is poor. To date there is no evidence of superiority of one shunt over another. PMID:16625616

  14. TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT

    PubMed Central

    Patidar, Kavish R.; Sydnor, Malcolm; Sanyal, Arun J.

    2014-01-01

    Transjugular intrahepatic portosystemic shunt (TIPS) is an established procedure for the complications of portal hypertension. The largest body of evidence for its use has been supported for recurrent or refractory variceal bleeding and refractory ascites. Its use has also been advocated for acute variceal bleed, hepatic hydrothorax, and hepatorenal syndrome. With the replacement of bare metal stents with polytetrafluoroethylen (PTFE) covered stents, shunt patency has improved dramatically thus improving outcomes. Therefore, reassessment of its utility, management of its complications, and understanding of various TIPS techniques is important. PMID:25438287

  15. LP Field, 2010

    USGS Multimedia Gallery

    Rivers in middle Tennessee crested May 2-3,2010, breaking records at many USGS-operated streamgages. The flood peak on the Cumberland River in downtown Nashville ranks as the highest observed during the past 73 years. Flooding on the Cumberland River damaged the Grand Ole Opry House, LP Field (shown...

  16. Subacute bacterial endocarditis and subsequent shunt nephritis from ventriculoatrial shunting 14?years after shunt implantation.

    PubMed

    Burström, Gustav; Andresen, Morten; Bartek, Jiri; Fytagoridis, Anders

    2014-01-01

    Fourteen years after shunt implantation, a 26-year-old patient with myelomeningocele, concomitant hydrocephalus and a ventriculoatrial cerebrospinal fluid (CSF) shunt presented with brief but recurrent episodes of fever predominantly when taking showers or during physical exertion. After 4?years of inconclusive multidisciplinary investigations, the patient progressed into end-stage renal disease before an echocardiogram revealed a vegetative plaque on the tendinous chords of the tricuspid valve. CSF cultures were grown from the shunt valve, confirming bacterial growth of Propionibacterium acnes suspected of causing subacute bacterial endocarditis and subsequent shunt nephritis. The patient was successfully treated with antibiotics combined with ventriculoatrial shunt removal and endoscopic third ventriculocisternostomy (VCS). This case illustrates the nowadays rare, but potentially severe complication of subacute bacterial endocarditis and shunt nephritis. It also exemplifies the VCS as an alternative to implanting foreign shunt systems for CSF diversion. PMID:24962489

  17. Coagulopathy post peritoneovenous shunt.

    PubMed Central

    LeVeen, H H; Ip, M; Ahmed, N; Hutto, R B; LeVeen, E G

    1987-01-01

    In 1942, 53% of medically treated patients with cirrhosis were dead 6 months after the onset of ascites. Only 30% survived 1 year. This dismal outlook has improved only slightly with advances in medicine. Yet, some internists reject the peritoneovenous shunt (PVS) for this fatal condition even if they are aware that a diminished blood volume causes the abnormal sodium retention responsible for ascites. Their objections are based on life-threatening complications of PVS, especially post shunt coagulopathy (PSC). Blood shed into the peritoneal cavity becomes incoagulable. Such blood is immediately coagulated by a protocoagulant (soluble collagen) and concurrently lysed by tissue plasminogen activator (TPA) secreted by the peritoneal serosa. Wide zones of lysis surround peritoneal tissue placed on fibrin plates. Large volumes of ascitic fluid infused into circulating blood simulates the fate of blood shed into the peritoneal cavity with lysis playing the major role. Addition of ascitic fluid to normal platelet-rich plasma in vitro initiates clot lysis on thromboelastogram (TEG). Epsilon-aminocaproic acid (EACA) counteracts this lysis. EACA and clotting factors normalize the TEG and arrest PSC. Disposal of ascitic fluid at surgery prevents or ameliorates PSC. Mild PSC was encountered only twice in 150+ consecutive patients (1.3%) with only one case being clinically significant (0.6%). Severe PSC occurred seven times in 98 early shunt patients whose ascitic fluid was not discarded. Severe PSC requires shunt interruption and control of bleeding with clotting factors and EACA. Peritoneal lavage with saline prevents the recurrence of PSC on reopening the shunt. In four patients, EACA and clotting factors were adequate to arrest coagulopathy. Three earlier patients died of PSC before its cause and treatment were understood. Proper management eliminates this life-threatening complication, and PSC cannot be considered a deterrent to PVS. Disseminated intravascular coagulopathy (DIC) is produced in experimental animals only by the injection of thrombin or thromboplastin. PSC is a distinct entity differing from DIC; EACA and not heparin is the antidote for PSC. Images Fig. 1. Fig. 2. Fig. 4. Fig. 5. Fig. 6. PMID:3103556

  18. [The transjugular intrahepatic portosystemic shunt].

    PubMed

    Pisco, J M; Martins, J M; Garcia, V; Correia, M G; Figueiredo, M L; Jalles, N; Freitas, J M; Leal, F C

    1994-03-01

    The case of a 66-year-old woman with several episodes of hemorrhage by esophageal varices and ascites due to portal hypertension is presented. Despite 4 sessions of endoscopic sclerotherapy bleeding recurred. A transjugular intrahepatic portosystemic shunt was performed. In the 10 months following the intervention, there was no further hemorrhage, the ascites disappeared and the shunt is open. PMID:8209705

  19. Hydrodynamic properties of hydrocephalus shunts: United Kingdom Shunt Evaluation Laboratory.

    PubMed Central

    Czosnyka, M; Czosnyka, Z; Whitehouse, H; Pickard, J D

    1997-01-01

    BACKGROUND: Although about 80% of properly diagnosed patients with hydrocephalus improve after implantation of any model of shunt, the remaining 20% may develop further complications because of inadequate shunt performance. Therefore, hydrocephalus shunts require careful independent laboratory evaluation. METHOD: Computer supported shunt testing, based on the new International Standard Organisation directives, characterises various aspects of pressure-flow performance of shunts such as variability with time, susceptibility to reflux, siphoning, temperature related behaviour, external pressure, the influence of a strong magnetic field (for example, MRI), presence of pulsation in differential pressure, particles in drained fluid, etc. RESULTS: Seven different models of valves, representing most common constructions, have been tested so far. Most contemporary valves have a hydrodynamic resistance which is too low. This may result in overdrainage both related to posture and during nocturnal cerebral vasogenic waves. A long distal catheter increases the resistance of these valves by 100%-200%. Most shunts are very sensitive to the presence of air bubbles and small particles in drained fluid. Few shunt models offer reasonable resistance to negative outlet pressure, preventing complications related to overdrainage. Valves with an antisiphon device may be blocked by raised subcutaneous pressure. All programmable valves are susceptible to overdrainage in an upright position. CONCLUSION: The behaviour of a valve during such testing is of immediate relevance to the surgeon and may not be adequately described in the manufacturer's product information. Images PMID:9010399

  20. LP-80 IMU program status

    NASA Astrophysics Data System (ADS)

    Jackson, Edward N.

    Development history, system design features, performance, and hardware status are reviewed for the fourth-generation LP-80 strapdown inertial measurement unit (IMU) which is currently in full-scale development to meet the design objectives required for missiles, torpedoes, drones, and range instrumentation system applications. The LP-80 is fully self-contained and operates at all attitudes, providing digital processed outputs of angular rate and linear acceleration measured in the body axis frame. For range applications, the LP-80 is designed to provide linear velocities with respect to a space stabilized coordinate frame.

  1. Mesoatrial shunt: a prosthesis modification.

    PubMed

    Cameron, J L; Kadir, S; Pierce, W S

    1984-07-01

    The mesoatrial shunt is the indicated treatment in the Budd-Chiari syndrome when the inferior vena cava is occluded and not usable for the standard portasystemic shunts. As the mesoatrial shunt courses from the abdomen into the right side of the chest, it passes posterior to the xiphoid and sternum and frequently is compressed at this point. A prosthesis modification is reported whereby an exterior silicone rubber cuff is bonded to the Dacron or Gortex graft at the point at which it passes posterior to the sternum. This obviates the possibility of graft compression and should increase long-term patency. PMID:6234672

  2. Registration of LP1-2581, LP1-2163H, LP3-1159, and LP640-1304 low phytate spring barley germplasm lines

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Agricultural Research Service, U.S. Dept. of Agriculture (USDA-ARS) has developed and released four low-phytate spring barley (Hordeum vulgare L.) germplasm lines: LP1-2581 (Reg. No._____, PI 658245), LP1-2163H (Reg. No._____, PI 658248 ), LP3-1159 (Reg. No._____, PI 658247), and LP640-1304 (...

  3. 76 FR 9771 - SFPP, L.P.; SFPP, L.P.; SFPP, L.P.; SFPP, L.P.; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ...; OR94-4-021; Docket No. IS06-215-003; Docket No. IS06-220-002] SFPP, L.P.; SFPP, L.P.; SFPP, L.P.; SFPP, L.P.; Notice of Filing Take notice that on February 10, 2011, the SFPP, L.P. filed with the... shippers may be entitled to refunds pursuant to the Commission's orders dated December 8, 2006 (SFPP,...

  4. [Nephritis following shunt operation for hydrocephalus].

    PubMed

    Bódi, I; István, B

    1998-07-12

    The ventriculo-atrial (VA) and ventriculo-peritoneal (VP) shunts implanted due to hypertensive hydrocephalus might get infected and be complicated by shunt nephritis. We reviewed the morphological changes in kidney retrospectively in the autopsy materials of our institute for the last 15 years after shunt implantation. Histological examination of the kidney was performed in 26 of these cases having 7 cases with glomerular morphological changes. Thus, the shunt nephritis is a relatively frequent complication of VA or VP shunts implanted due to hydrocephalus. Monitorization and follow-up of kidney function in case of any dysfunction of the shunt may suggest the possibility of shunt infection, and the removal of the infected shunt may protect the development of more severe, septic complications. PMID:9702081

  5. An unusual cause of ventriculoperitoneal shunt infection.

    PubMed

    Esmaeilzadeh, Majid; Islamian, Ariyan Pirayesh; Lang, Josef M; Hornef, Mathias; Suerbaum, Sebastian; Krauss, Joachim K

    2015-08-01

    Infection associated with ventriculoperitoneal (VP) shunt implantation can be a significant problem. VP shunt infection with Serratia marcescens, a gram-negative anaerobic rod, usually is related to underlying abdominal disease. This article describes treatment of two patients suffering from a VP shunt infection with S. marcescens without underlying abdominal disease. PMID:26208014

  6. Students with Shunts: Program Considerations.

    ERIC Educational Resources Information Center

    French, Ron; And Others

    1997-01-01

    Examines how the medical condition of hydrocephalus can affect physical education students and physical education programs, and stresses the need to provide physical educators with information on students' medical conditions. Describes hydrocephalus and its treatment with ventricular peritoneal shunts, and offers suggestions on modifying…

  7. Peritoneovenous shunts--devices of last resort.

    PubMed

    Shepherd, K E; Miller, B J

    1988-11-01

    This study examines the usefulness of peritoneovenous shunts through a retrospective review of the charts of 16 patients who received this shunt at the University Hospital in Saskatoon up to May 1987. Fourteen shunts were placed for malignant ascites, 1 for alcoholic cirrhosis and 1 for nephrogenic ascites. All patients had symptoms related to abdominal pressure or dyspnea. Diuretics were most frequently used as initial management, and paracentesis was performed to relieve symptoms in all but one patient. However, a trial of sodium restriction was used in only eight patients, and only five of these trials lasted longer than 1 week. Thus, the adequacy of medical management was questionable. The death of one patient was directly attributable to the shunt, and the deaths of four others were suspected to be sequelae of surgery or shunting. Only five shunts were functioning at the time the patient died. In this study, the majority of the patients received little benefit from the peritoneovenous shunt. PMID:3179855

  8. Shunt regulation electric power system

    NASA Technical Reports Server (NTRS)

    Wright, W. H.; Bless, J. J. (inventors)

    1971-01-01

    A regulated electric power system having load and return bus lines is described. A plurality of solar cells interconnected in a power supplying relationship and having a power shunt tap point electrically spaced from the bus lines is provided. A power dissipator is connected to the shunt tap point and provides for a controllable dissipation of excess energy supplied by the solar cells. A dissipation driver is coupled to the power dissipator and controls its conductance and dissipation and is also connected to the solar cells in a power taping relationship to derive operating power therefrom. An error signal generator is coupled to the load bus and to a reference signal generator to provide an error output signal which is representative of the difference between the electric parameters existing at the load bus and the reference signal generator. An error amplifier is coupled to the error signal generator and the dissipation driver to provide the driver with controlling signals.

  9. Ventriculoperitoneal shunt perforations of the gastrointestinal tract.

    PubMed

    Thiong'o, Grace Muthoni; Luzzio, Christopher; Albright, A Leland

    2015-07-01

    OBJECT The purposes of this study were to evaluate the frequency with which children presented with ventriculoperitoneal (VP) shunt perforations of the gastrointestinal (GI) tract, to determine the type of shunts that caused the perforations, and to compare the stiffness of perforating catheters with the stiffness of catheters from other manufacturers. METHODS Medical records were reviewed of 197 children who were admitted with VP shunt malfunction. Catheter stiffness was evaluated by measuring relative resistance to cross-sectional compression, resistance to column buckling, and elasticity in longitudinal bending. Catheter frictional force was measured per unit length. RESULTS Six children were identified whose VP shunts had perforated the GI tract; 2 shunts subsequently protruded through the anal orifice, 1 protruded through the oral cavity, and 3 presented with subcutaneous abscesses that tracked upward from the intestine to the chest. All perforating shunts were Chhabra shunts. Catheter stiffness and resistance to bending were greatest with a Medtronic shunt catheter, intermediate with a Codman catheter, and least with a Chhabra catheter. Frictional force was greatest with a Chhabra catheter and least with a Medtronic catheter. CONCLUSIONS The frequency of perforations by Chhabra shunts appears to be higher than the frequency associated with other shunts. The increased frequency does not correlate with their stiffness but may reflect their greater frictional forces. PMID:25837887

  10. Arterioportal shunts on dynamic computed tomography

    SciTech Connect

    Nakayama, T.; Hiyama, Y.; Ohnishi, K.; Tsuchiya, S.; Kohno, K.; Nakajima, Y.; Okuda, K.

    1983-05-01

    Thirty-two patients, 20 with hepatocelluar carcinoma and 12 with liver cirrhosis, were examined by dynamic computed tomography (CT) using intravenous bolus injection of contrast medium and by celiac angiography. Dynamic CT disclosed arterioportal shunting in four cases of hepatocellular carcinoma and in one of cirrhosis. In three of the former, the arterioportal shunt was adjacent to a mass lesion on CT, suggesting tumor invasion into the portal branch. In one with hepatocellular carcinoma, the shunt was remote from the mass. In the case with cirrhosis, there was no mass. In these last two cases, the shunt might have been caused by prior percutaneous needle puncture. In another case of hepatocellular carcinoma, celiac angiography but not CT demonstrated an arterioportal shunt. Thus, dynamic CT was diagnostic in five of six cases of arteriographically demonstrated arterioportal shunts.

  11. Radiological Insertion and Management of Peritoneovenous Shunt

    SciTech Connect

    Bratby, M. J.; Hussain, F. F. Lopez, A. J.

    2007-06-15

    The purpose of the study was to report our experience of the management of complications following the insertion of a peritoneovenous shunt for intractable malignant ascites. From June 1999 to January 2006, 26 patients underwent insertion of a peritoneovenous shunt for ascites by interventional radiologists. We have used ultrasound and shuntography to assist in the diagnosis of the cause of shunt blockage. Successful techniques for the restoration of the shunt function include port- pumping, stripping of any fibrin sheath, and revision of either the venous or peritoneal catheter. The procedure was initially successful in all patients with continued patency until death in 17. A further four patients are still alive with a functioning shunt. There was one rapid postprocedure death resulting from pulmonary edema. Two patients developed pneumothorax, managed successfully with either a chest drain or aspiration. Shunt dysfunction occurred eight times in seven patients. There were five successful revisions in four patients. Overall, shunt patency has been maintained in 80.1% of patients. Shunt dysfunction is seen in a significant number of patients, but successful revision of the shunt can be achieved in the majority.

  12. Spectropolarimetry of ASASSN-14lp

    NASA Astrophysics Data System (ADS)

    Porter, Amber L.; Leising, Mark D.; Milne, Peter; Williams, Grant; Smith, Paul S.

    2016-01-01

    Spectropolarimetric observations which capture the degree of polarization as a function of wavelength help us to explore the aspherical nature of supernova explosions. Using the CCD Imaging/Spectropolarimeter (SPOL) at the 6.5-m MMT and 90" Bok telescopes, we obtained multi-epoch observations of the Type Ia supernova ASASSN-14lp from pre-maximum through late times. We confirm a low continuum polarization indicating a nearly spherical explosion and investigate how the evolution of the Si II 6355Å feature compares to other Type Ia supernovae.

  13. Liver transplantation in patients with splenorenal shunts: intraoperative flow measurements to indicate shunt occlusion.

    PubMed

    Margarit, C; Lázaro, J L; Charco, R; Hidalgo, E; Revhaug, A; Murio, E

    1999-01-01

    Two patients with previous distal splenorenal shunts (DSRSs) performed 6 years earlier underwent liver transplantation (LT). A preoperative selective mesenteric artery angiogram showed collateral veins draining mesenteric venous flow into the shunt. Intraoperative flow measurements were performed to assess the steal of portal venous flow by the shunt and determine the need for shunt occlusion. Portal vein, hepatic artery, and shunt flows were measured by ultrasound transit-time flow probes in the native liver and after graft implantation with and without temporary shunt occlusion. Hemodynamic studies showed that long-standing DSRSs are high-flow shunts that steal portal flow. After graft implantation, DSRS flows remained high. Occlusion of the shunts produced an increase in portal vein flow at an amount similar to those of splenorenal shunt. Thus, the flow measurements showed persistent steal by the shunts after graft implantation and, therefore, the DSRSs were occluded but splenectomy was not performed. We conclude that the decision to occlude a DSRS should be based on the demonstration of steal of portal flow by the shunt and reversibility once the shunt is occluded. Splenectomy is not required when the DSRS is occluded. PMID:9873090

  14. Predicting shunt failure in children: should the global shunt revision rate be a quality measure?

    PubMed

    Rossi, Nicholas B; Khan, Nickalus R; Jones, Tamekia L; Lepard, Jacob; McAbee, Joseph H; Klimo, Paul

    2016-03-01

    OBJECT Ventricular shunts for pediatric hydrocephalus continue to be plagued with high failure rates. Reported risk factors for shunt failure are inconsistent and controversial. The raw or global shunt revision rate has been the foundation of several proposed quality metrics. The authors undertook this study to determine risk factors for shunt revision within their own patient population. METHODS In this single-center retrospective cohort study, a database was created of all ventricular shunt operations performed at the authors' institution from January 1, 2010, through December 2013. For each index shunt surgery, demographic, clinical, and procedural variables were assembled. An "index surgery" was defined as implantation of a new shunt or the revision or augmentation of an existing shunt system. Bivariate analyses were first performed to evaluate individual effects of each independent variable on shunt failure at 90 days and at 180 days. A final multivariate model was chosen for each outcome by using a backward model selection approach. RESULTS There were 466 patients in the study accounting for 739 unique ("index") operations, for an average of 1.59 procedures per patient. The median age for the cohort at the time of the first shunt surgery was 5 years (range 0-35.7 years), with 53.9% males. The 90- and 180-day shunt failure rates were 24.1% and 29.9%, respectively. The authors found no variable-demographic, clinical, or procedural-that predicted shunt failure within 90 or 180 days. CONCLUSIONS In this study, none of the risk factors that were examined were statistically significant in determining shunt failure within 90 or 180 days. Given the negative findings and the fact that all other risk factors for shunt failure that have been proposed in the literature thus far are beyond the control of the surgeon (i.e., nonmodifiable), the use of an institution's or individual's global shunt revision rate remains questionable and needs further evaluation before being accepted as a quality metric. PMID:26544083

  15. 49 CFR 236.56 - Shunting sensitivity.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Shunting sensitivity. 236.56 Section 236.56 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...: All Systems Track Circuits § 236.56 Shunting sensitivity. Each track circuit controlling home...

  16. 49 CFR 234.229 - Shunting sensitivity.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Shunting sensitivity. 234.229 Section 234.229 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION..., Inspection, and Testing Maintenance Standards § 234.229 Shunting sensitivity. Each highway-rail...

  17. 49 CFR 236.56 - Shunting sensitivity.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Shunting sensitivity. 236.56 Section 236.56 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...: All Systems Track Circuits § 236.56 Shunting sensitivity. Each track circuit controlling home...

  18. 49 CFR 236.56 - Shunting sensitivity.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Shunting sensitivity. 236.56 Section 236.56 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...: All Systems Track Circuits § 236.56 Shunting sensitivity. Each track circuit controlling home...

  19. 49 CFR 236.56 - Shunting sensitivity.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Shunting sensitivity. 236.56 Section 236.56 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...: All Systems Track Circuits § 236.56 Shunting sensitivity. Each track circuit controlling home...

  20. 49 CFR 234.229 - Shunting sensitivity.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Shunting sensitivity. 234.229 Section 234.229 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION..., Inspection, and Testing Maintenance Standards § 234.229 Shunting sensitivity. Each highway-rail...

  1. 49 CFR 236.56 - Shunting sensitivity.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Shunting sensitivity. 236.56 Section 236.56 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...: All Systems Track Circuits § 236.56 Shunting sensitivity. Each track circuit controlling home...

  2. 21 CFR 874.3820 - Endolymphatic shunt.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Endolymphatic shunt. 874.3820 Section 874.3820 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3820 Endolymphatic shunt....

  3. 21 CFR 874.3820 - Endolymphatic shunt.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endolymphatic shunt. 874.3820 Section 874.3820 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3820 Endolymphatic shunt....

  4. 21 CFR 874.3820 - Endolymphatic shunt.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Endolymphatic shunt. 874.3820 Section 874.3820 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3820 Endolymphatic shunt....

  5. 21 CFR 874.3820 - Endolymphatic shunt.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endolymphatic shunt. 874.3820 Section 874.3820 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3820 Endolymphatic shunt....

  6. 21 CFR 874.3820 - Endolymphatic shunt.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Endolymphatic shunt. 874.3820 Section 874.3820 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3820 Endolymphatic shunt....

  7. Congenital Portosystemic Shunt: Our Experience

    PubMed Central

    Timpanaro, Tiziana; Passanisi, Stefano; Sauna, Alessandra; Trombatore, Claudia; Pennisi, Monica; Petrillo, Giuseppe; Smilari, Pierluigi; Greco, Filippo

    2015-01-01

    Introduction. Congenital portosystemic venous malformations are rare abnormalities in which the portal blood drains into a systemic vein and which are characterized by extreme clinical variability. Case Presentations. The authors present two case reports of a congenital extrahepatic portosystemic shunt (Type II). In the first patient, apparently nonspecific symptoms, such as headache and fatigue, proved to be secondary to hypoglycemic episodes related to the presence of a portosystemic shunt, later confirmed on imaging. During portal vein angiography, endovascular embolization of the portocaval fistula achieved occlusion of the anomalous venous tract. In the second patient, affected by Down's syndrome, the diagnosis of a portosystemic malformation was made by routine ultrasonography, performed to rule out concurrent congenital anomalies. Because of the absence of symptoms, we chose to observe this patient. Conclusions. These two case reports demonstrate the clinical heterogeneity of this malformation and the need for a multidisciplinary approach. As part of a proper workup, clinical evaluation must always be followed by radiographic diagnosis. PMID:25709849

  8. LP01 to LP0m mode converters using all-fiber two-stage tapers

    NASA Astrophysics Data System (ADS)

    Mellah, Hakim; Zhang, Xiupu; Shen, Dongya

    2015-11-01

    A mode converter between LP01 and LP0m modes is proposed using two stages of tapers. The first stage is formed by an adiabatically tapering a circular fiber to excite the desirable LP0m mode. The second stage is formed by inserting an inner core (tapered from both sides) with a refractive index smaller than the original core. This second stage is used to obtain low insertion loss and high extinction ratio of the desired LP0m mode. Three converters between LP01 and LP0m, m=2, 3, and 4, are designed for C-band, and simulation results show that less than 0.24, 0.54 and 0.7 dB insertion loss and higher than 15, 16, and 17.5 dB extinction ratio over the entire band were obtained for the three converters, respectively.

  9. Scintisplenoportography in assessing patency of distal splenorenal shunts

    SciTech Connect

    Teres, J.; Herranz, R.; Visa, J.; Lomena, F.; Pera, C.; Rodes, J.

    1983-06-01

    Scintisplenoportography was performed on 33 occasions in 28 cirrhotic patients who had bled from esophagogastric varices. In 17 cases scintisplenoportography was carried out after a retroperitoneal distal splenorenal shunt procedure and in the remaining 16 instances in patients without any surgical shunt. In four patients scintisplenoportography was performed before and after a surgical shunt procedure, and in one case, before and after the shunt thrombosed. Gammagraphic patterns and spleen-heart times helped determine which patients did not have a surgical shunt, which had a patent shunt, and which patients had a thrombosed shunt. A patent shunt pattern and a thrombosed shunt pattern have been defined. It is concluded that scintisplenoportography is a useful, reproducible, and safe method to assess the patency of distal splenorenal shunts.

  10. Ventricle to sagittal sinus shunt for hydrocephalus.

    PubMed

    Hash, C J; Shenkin, H A; Crowder, L E

    1979-05-01

    A technique of shunting the lateral ventricle to the superior sagittal sinus is described. It has been used in 36 adult patients; infection occured in 2 patients (5.6%), and 2 patients required shunt revision (5.6%). The outcome of 18 patients with high pressure hydrocephalus could be validly evaluated, and successful control was achieved in 15 (83%). One of the 3 failures could have been avoided because shunting was undertaken before the ventricular fluid had cleared of blood. Four patients with normal or low pressure hydrocephalus were treated; only 1 had a successful result. This technique is suitable for patients with high pressure hydrocephalus and is of particular value in very ill or debilitated patients because of the rapidity with which it can be performed under local analgesia. Its use in normal or low pressure hydrocephalus must still be evaluated. In any event, the sagittal sinus is certainly a feasible alternate receptor site for ventricular shunting. PMID:460566

  11. Severe respiratory failure following ventriculopleural shunt

    PubMed Central

    Alam, Shahzad; Manjunath, Nagaraju M.

    2015-01-01

    Cerebrospinal fluid (CSF) diversion procedure has been used for long to treat hydrocephalus in children. The principle of shunting is to establish a communication between the CSF and a drainage cavity (peritoneum, right atrium, and pleura). Ventriculoperitoneal shunt is used most commonly, followed secondly by ventriculopleural shunt (VPLS). Hydrothorax due to excessive CSF accumulation is a rare complication following both the type of shunts and is more frequently seen with VPLS. We report a case of a 6-year-old female child presenting with massive CSF hydrothorax with respiratory failure following VPLS. The aim of the article is to highlight early recognition of this rare and life-threatening condition, which could easily be missed if proper history is not available. PMID:26730125

  12. Syringosubarachnoid shunting using a myringotomy tube

    PubMed Central

    Leschke, Jack M.; Mumert, Michael L.; Kurpad, Shekar N.

    2016-01-01

    Background: Syringomyelia results from obstruction of cerebrospinal fluid (CSF) flow due to a multitude of causes. Often symptoms of pain, weakness, and sensory disturbance are progressive and require surgical treatment. We present here a rare technique for syringosubarachnoid shunting. Case Description: We present the case of a 38-year-old male who suffered a traumatic cervical spinal cord injury due to a motor vehicle accident. With progressive pain and motor decline, a magnetic resonance imaging was obtained and showed a new syrinx extending cervical multiple segments. A unique surgical procedure using a myringotomy tube to shunt CSF into the subarachnoid space was employed in this case. The patient's examination stabilized postoperatively, and at 2 months and 6 months follow-up visits, his strength and sensation continued to improve. Conclusion: We used a myringotomy tube for syringosubarachnoid shunting for the surgical management of a posttraumatic syrinx with good results. This technique minimizes suturing and may minimize shunt-related complications. PMID:26862456

  13. Tunable electrically shunted piezoceramic vibration absorber

    NASA Astrophysics Data System (ADS)

    Davis, Christopher L.; Lesieutre, George A.; Dosch, Jeffrey J.

    1997-05-01

    A shunting method has been developed and experimentally verified for tuning the natural frequency and damping of a piezoceramic inertial actuator (PIA). Without power, a PIA behaves much like a passive vibration absorber (PVA). PVAs typically minimize vibration at a specific frequency often associated with a lightly damped structural mode. Large response reductions, however, may only be achieved if the PVA is accurately tuned to the frequency of concern. Thus, an important feature of a PVA is the ability to be accurately tuned to the possibly varying frequency of a target vibration mode. Tuning an absorber requires a change in either the mass or stiffness of the device. The electromechanical properties of the piezoceramic forcing element within a PIA in conjunction with an external passive electrical shunt circuit can be used to alter the natural frequency and damping of the device. An analytical model of a PIA was created to predict changes in natural frequency and damping due to passive electrical shunting. Capacitive shunting alters the natural frequency of the actuator only, while resistive shunting alters both the natural frequency and damping of the actuator. Experiments using both passive capacitive and passive resistive shunt circuits verified the ability to predictably shift the natural frequencies of the piezoceramic inertial actuator by more than 5%.

  14. 78 FR 25262 - TexStar Transmission, LP; TEAK Texana Transmission Company, LP; Notice of Filings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission TexStar Transmission, LP; TEAK Texana Transmission Company, LP; Notice of Filings Take notice that on April 23, 2013, the applicants listed above submitted an amendment to...

  15. 78 FR 22872 - TexStar Transmission, LP; TEAK Texana Transmission Company, LP; Notice of Filings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission TexStar Transmission, LP; TEAK Texana Transmission Company, LP; Notice of Filings Take notice that on April 5, 2013, the applicants listed above submitted an amendment to...

  16. Pleuroperitoneal shunt for recurrent malignant pleural effusions.

    PubMed Central

    Tsang, V; Fernando, H C; Goldstraw, P

    1990-01-01

    The therapeutic options available for the management of malignant pleural effusions associated with a restricting malignant cortex remain unsatisfactory. The efficacy of pleuroperitoneal shunts was evaluated in 16 patients with recurrent malignant effusions. There were no operative deaths; one patient died on the third postoperative day as a result of lymphangitis carcinomatosa. The median hospital stay was five (range 3-21) days. Palliation was obtained in all but one of the other 15 patients. There was no appreciable reaccumulation of pleural fluid as judged by radiography. Two patients developed occlusion of the shunt. In one case this was due to blood clots in the pleural catheter and necessitated insertion of a new shunt. The other shunt was removed because of obstructing infected fibrin debris, and a rib resection was performed. There were eight deaths related to the underlying malignancy after a mean interval of 7.3 (range 1.5-23) months. The other six patients are still alive, with a mean survival of 11.0 (range 5-20) months, and have achieved good symptomatic relief. The insertion of a pleuroperitoneal shunt can offer effective palliation for patients with recurrent malignant pleural effusions. Images PMID:1696401

  17. Radionuclide demonstration of intrapulmonary shunting in cirrhosis

    SciTech Connect

    Bank, E.R.; Thrall, J.H.; Dantzker, D.R.

    1983-05-01

    The association of hepatic cirrhosis and severe arterial hypoxemia has been well described. Although alterations in ventilatory function may partially account for the hypoxemia, the principal mechanism is thought to be a microangiopathic change in the pulmonary vasculature resulting in intrapulmonary arteriovenous shunting with resultant systemic desaturation. Whole-body radionuclide scans with technetium-99m macroaggregated albumin labeling have been diagnostic of right-to-left shunting by their demonstration of tracer accumulation within the extrapulmonary circulation. A case of severe pulmonary arteriovenous shunting in an alcoholic patient in whom hepatic disease had not been of apparent clinical significance before radionuclide scanning is reported. He did not have cuntaeous angiomata as have all other patients with alcoholic cirrhosis and hypoxemia.

  18. Radionuclide demonstration of intrapulmonary shunting in cirrhosis

    SciTech Connect

    Bank, E.R.; Thrall, J.H.; Dantzker, D.R.

    1983-05-01

    The association of hepatic cirrhosis and severe arterial hypoxemia has been well described. Although alterations in ventilatory function may partially account for the hypoxemia, the principal mechanism is thought to be a microangiopathic change in the pulmonary arteriovenous shunting with resultant systemic desaturation. Whole-body radionuclide scans with technetium-99m macroaggrregated albumin (/sup 99m/Tc MAA) labeling have been diagnostic of right-to-left shunting by their demonstration of tracer accumulation within the extrapulmonary circulation. A case of severe pulmonary arteriovenous shunting in an alcoholic patient in whom hepatic disease had not been of apparent clinical significance before radionuclide scanning is reported. He did not have cutaneous angiomata as have all other patients with alcoholic cirrhosis and hypoxemia.

  19. Surgical shunting versus transjugular intrahepatic portasystemic shunting for bleeding varices resulting from portal hypertension and cirrhosis: a meta-analysis.

    PubMed

    Clark, Whalen; Hernandez, Jonathan; McKeon, Brianne; Villadolid, Desiree; Al-Saadi, Sam; Mullinax, John; Ross, Sharona B; Rosemurgy, Alexander S

    2010-08-01

    Surgical shunting was the mainstay in treating portal hypertension for years. Recently, transjugular intrahepatic portasystemic shunting (TIPS) has replaced surgical shunting, first as a "bridge" to transplantation and ultimately as first-line therapy for bleeding varices. This study was undertaken to examine evidence from trials comparing TIPS with surgical shunting to reassess the role of surgery in treating portal hypertension. The National Library of Medicine and the National Institutes of Health were searched for clinical trials comparing surgical shunting with TIPS. Meta-analysis using the fixed effects model was undertaken with end points of 30-day and 1- and 2-year survival and shunt failure (inability to complete shunt, irreversible shunt occlusion, major rehemorrhage, unanticipated liver transplantation, death). Three prospective randomized trials and one retrospective case-controlled study were identified. Analysis was limited to patients of Child Classes A or B. Significantly better 2-year survival (OR 2.5 [1.2-5.2]) and significantly less frequent shunt failure (OR 0.3 [0.1-0.9]) were seen in patients undergoing surgical shunting compared with TIPS. Meta-analysis promotes surgical shunting relative to TIPS because of improved survival and less frequent shunt failure. Surgical shunting should be accepted as first-line therapy for bleeding varices resulting from portal hypertension. PMID:20726417

  20. Recovery from confabulation after normotensive hydrocephalus shunting.

    PubMed

    Dalla Barba, Gianfranco; Barbera, Claudia; Brazzarola, Marta; Marangoni, Sara

    2016-02-01

    Confabulation, the production of statements and actions that are unintentionally incongruous to the subject's history, background, present and future situation, is observed in several conditions affecting the nervous system, but it has never been described in normotensive hydrocephalus. In this article we report on a patient with normotensive hydrocephalus who suffered from an amnesic-confabulatory syndrome. After hydrocephalus shunting, both amnesia and confabulation cleared up abruptly. We discuss this finding in terms of a possible disconnection of the hippocampus, due to transitory white matter damage, which may have recovered after hydrocephalus shunting. PMID:26724492

  1. 49 CFR 236.104 - Shunt fouling circuit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Shunt fouling circuit. 236.104 Section 236.104 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION...: All Systems Inspections and Tests; All Systems § 236.104 Shunt fouling circuit. Shunt fouling...

  2. 49 CFR 236.60 - Switch shunting circuit; use restricted.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Switch shunting circuit; use restricted. 236.60... Instructions: All Systems Track Circuits § 236.60 Switch shunting circuit; use restricted. Switch shunting circuit shall not be hereafter installed, except where tract or control circuit is opened by the...

  3. 49 CFR 236.725 - Circuit, switch shunting.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Circuit, switch shunting. 236.725 Section 236.725 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Circuit, switch shunting. A shunting circuit which is closed through contacts of a switch...

  4. LP Daac Product Lifecyle Plan in Action

    NASA Astrophysics Data System (ADS)

    Bennett, S. D.

    2014-12-01

    The Land Processes Distributed Active Archive Center (LP DAAC) is a NASA Earth Observing System (EOS) Data and Information System (EOSDIS) DAAC that supports selected EOS Community non-standard data products such as the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) Global Emissivity Database (GED), and also supports NASA Earth Science programs such as Making Earth System Data Records for Use in Research Environments (MEaSUREs) to contribute in providing long-term, consistent, and mature data products. To support and deliver excellence for NASA data stewardship, and to accommodate long-tail data preservation with Community and MEaSUREs products, the LP DAAC introduces a Product Lifecycle Plan that features a phased project framework to facilitate long-term product preservation. The first phase, Inception, captures all artifacts applied by the Product Developer(s) and develops Earth Science Data Records based on product artifacts. The second phase, Active Archive, distributes, promotes and provides services for the matured products to the science community. The third and final phase, Long-term Archive, establishes a permanent preservation location for all project artifacts. This poster depicts the LP DAAC Product Lifecycle Plan in action using the LP DAAC recently released NASA WELD Version 1.5 artifacts and phased objectives.

  5. Fabrication of capacitively-shunted superconducting qubits

    NASA Astrophysics Data System (ADS)

    Yoder, Jonilyn L.; Gudmundsen, Theodore J.; Bolkhovsky, Vladimir; Welander, Paul B.; Gustavsson, Simon; Hover, David; Kerman, Andrew J.; Sears, Adam P.; Oliver, William D.

    2014-03-01

    Improvements in superconducting qubit coherence times and reproducibility have been demonstrated using capacitive shunting. In this study, we present methods for the preparation of both capacitively-shunted charge qubits (transmons) and capacitively-shunted flux qubits. Hybrid fabrication techniques were employed to combine high-quality-factor aluminum capacitive shunts with shadow-evaporated Josephson junctions, and the Josephson junctions were prepared using suspended-bridge germanium masks. We also will describe process testing results that were acquired to assess wafer-to-wafer reproducibility of our fabrication protocols. This research was funded in part by the Office of the Director of National Intelligence (ODNI), Intelligence Advanced Research Projects Activity (IARPA); and by the Assistant Secretary of Defense for Research and Engineering under Air Force Contract number FA8721-05-C-0002. All statements of fact, opinion or conclusions contained herein are those of the authors and should not be construed as representing the official views or policies of IARPA, the ODNI, or the U.S. Government.

  6. 49 CFR 234.229 - Shunting sensitivity.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Shunting sensitivity. 234.229 Section 234.229 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... sensitivity. Each highway-rail grade crossing train detection circuit shall detect the application of a...

  7. 49 CFR 234.229 - Shunting sensitivity.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Shunting sensitivity. 234.229 Section 234.229 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... sensitivity. Each highway-rail grade crossing train detection circuit shall detect the application of a...

  8. 49 CFR 234.229 - Shunting sensitivity.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Shunting sensitivity. 234.229 Section 234.229 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... sensitivity. Each highway-rail grade crossing train detection circuit shall detect the application of a...

  9. A New Look at Shunt Compensation.

    SciTech Connect

    Kimbark, Edward Wilson

    1983-01-01

    This paper introduces the concept that the surge impedance of a transmission line can be rapidly controlled by shunt compensation to make the corresponding surge impedance loading always equal to the actual loading. So doing prevents normal-frequency overvoltages and limits undervoltages. On a doublecircuit line it permits the compensation to be employed on either circuit when the other circuit is disabled.

  10. Muzzle shunt augmentation of conventional railguns

    SciTech Connect

    Parker, J.V.

    1990-01-01

    Augmentation is a well-known technique for reducing the armature current and hence the armature power dissipation in a plasma armature railgun. In spite of the advantages, no large augmented railguns have been built, primarily due to the mechanical and electrical complexity introduce by the extra conductors required. It is possible to achieve some of the benefits of augmentation in conventional railgun by diverting a fraction {phi} of the input current through a shunt path at the muzzle of the railgun. In particular, the relation between force and armature current is the same as that obtained in an n-turn, series connected augmented railgun with n = 1/(1-{phi}). The price of this simplification is a reduction in electrical efficiency and some additional complexity in the external electrical system. Additions to the electrical system are required to establish the shunt current and to control its magnitude during projectile acceleration. The relationship between muzzle shunt augmentation and conventional series augmentation is developed and various techniques is developed and various techniques for establishing and controlling the shunt current are illustrated with a practical example. 5 refs., 8 figs., 2 tabs.

  11. 21 CFR 886.3920 - Aqueous shunt.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Aqueous shunt. 886.3920 Section 886.3920 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... implantable device intended to reduce intraocular pressure in the anterior chamber of the eye in patients...

  12. Charging effects in the inductively shunted Josephson junction.

    PubMed

    Koch, Jens; Manucharyan, V; Devoret, M H; Glazman, L I

    2009-11-20

    The choice of impedance used to shunt a Josephson junction determines if the charge transferred through the circuit is quantized: a capacitive shunt renders the charge discrete, whereas an inductive shunt gives continuous charge. This discrepancy leads to a paradox in the limit of large inductances L. We show that while the energy spectra of the capacitively and inductively shunted junction are vastly different, their high-frequency responses become identical for large L. Inductive shunting thus opens the possibility to observe charging effects unimpeded by charge noise. PMID:20366063

  13. 77 FR 53885 - Jordan Cove Energy Project LP, Pacific Connector Gas Pipeline LP; Notice of Extension of Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-04

    ... Energy Regulatory Commission Jordan Cove Energy Project LP, Pacific Connector Gas Pipeline LP; Notice of Extension of Comment Period and Additional Public Scoping Meetings for the Jordan Cove Liquefaction and... comment period for Jordan Cove Energy Project LP's (Jordan Cove) proposed liquefaction project in...

  14. A large spontaneous intrahepatic portosystemic shunt in a cirrhotic patient

    PubMed Central

    Qi, Xingshun; Ye, Chun; Hou, Yue; Guo, Xiaozhong

    2016-01-01

    Summary A spontaneous portosystemic shunt is a rare malformation of the vessels supplying the liver. This condition often leads to the development of hepatic encephalopathy due to excessive shunting of blood from the portal vein to the inferior vena cava. Some studies have suggested that the presence of spontaneous portosystemic shunts is inversely associated with the appearance of large esophageal varices. Spontaneous intrahepatic portosystemic shunts (SIPSS) are far less frequently observed than extrahepatic portosystemic shunts, which include spleno-gastric-renal shunts, mesenteric-caval shunts, and a large patent umbilical vein. Reported here is a case of decompensated liver cirrhosis with a large SIPSS without any incidence of overt hepatic encephalopathy. PMID:26989653

  15. Late calcification and rupture: a rare complication of ventriculoperitoneal shunting.

    PubMed

    Kural, Cahit; Kirik, Alparslan; Pusat, Serhat; Senturk, Tolga; Izci, Yusuf

    2012-01-01

    A 10-year old boy who had undergone a ventriculoperitoneal (V/P) shunt because of hydrocephalus at 10 days of age was doing well until 20 days ago, when he began to experience headache and seizures. CT scan revealed dilated lateral ventricles and calcification at the shunt site. X-rays showed an unusual calcification pattern around the shunt tube and rupture of the tube between the mastoid bone and clavicle. The patient underwent surgery and the shunt was changed completely. The ventricles became small in the follow-up. Even though V/P shunts may induce fibrous tissue formation and calcification around the tube, there are a few cases of shunt rupture and calcification of shunts in the literature. Possible mechanisms of the rupture and calcification are discussed in this paper. PMID:23208915

  16. Passively Shunted Piezoelectric Damping of Centrifugally-Loaded Plates

    NASA Technical Reports Server (NTRS)

    Duffy, Kirsten P.; Provenza, Andrew J.; Trudell, Jeffrey J.; Min, James B.

    2009-01-01

    Researchers at NASA Glenn Research Center have been investigating shunted piezoelectric circuits as potential damping treatments for turbomachinery rotor blades. This effort seeks to determine the effects of centrifugal loading on passively-shunted piezoelectric - damped plates. Passive shunt circuit parameters are optimized for the plate's third bending mode. Tests are performed both non-spinning and in the Dynamic Spin Facility to verify the analysis, and to determine the effectiveness of the damping under centrifugal loading. Results show that a resistive shunt circuit will reduce resonant vibration for this configuration. However, a tuned shunt circuit will be required to achieve the desired damping level. The analysis and testing address several issues with passive shunt circuit implementation in a rotating system, including piezoelectric material integrity under centrifugal loading, shunt circuit implementation, and tip mode damping.

  17. 75 FR 39680 - Houston Pipe Line Company LP, Worsham-Steed Gas Storage, L.P., Energy Transfer Fuel, LP, Mid...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-12

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. PR10-44-000; Docket No. PR10-46-000; Docket No. PR10-48- 000; Docket No. PR10-49-000; Docket No. PR10-50-000] Houston Pipe Line Company LP, Worsham-Steed Gas Storage, L.P., Energy Transfer Fuel, LP,...

  18. Trigonometric approximation in Lp-norm

    NASA Astrophysics Data System (ADS)

    Leindler, László

    2005-02-01

    We shall weaken the conditions of monotonicity given by Chandra [J. MathE Anal. Appl. 275 (2002) 13-26], where he investigated trigonometrical polynomials associated with f[set membership, variant]Lip([alpha],p) (0<[alpha][less-than-or-equals, slant]1, p[greater-or-equal, slanted]1) to approximate f in Lp-norm to the degree of O(n-[alpha]) (0<[alpha][less-than-or-equals, slant]1).

  19. Nitrogen heat pipe for cryocooler thermal shunt

    NASA Astrophysics Data System (ADS)

    Prenger, F. C.; Hill, D. D.; Daney, D. E.; Daugherty, M. A.; Green, G. F.; Roth, E. W.

    A nitrogen heat pipe was designed, built and tested for the purpose of providing a thermal shunt between the two stages of a Gifford-McMahan (GM) cryocooler during cooldown. The nitrogen heat pipe has an operating temperature range between 63 and 123 K. While the heat pipe is in the temperature range during the system cooldown, it acts as a thermal shunt between the first and second stage of the cryocooler. The heat pipe increases the heat transfer to the first stage of the cryocooler, thereby reducing the cooldown time of the system. When the heat pipe temperature drops below the triple point, the nitrogen working fluid freezes, effectively stopping the heat pipe operation. A small heat leak between cryocooler stages remains because of axial conduction along the heat pipe wall. As long as the heat pipe remains below 63 K, the heat pipe remains inactive. Heat pipe performance limits were measured and the optimum fluid charge was determined.

  20. Thecoperitoneal shunt for post-traumatic syringomyelia.

    PubMed Central

    Vassilouthis, J; Papandreou, A; Anagnostaras, S

    1994-01-01

    A case of post-traumatic syringomyelia developing two years after spinal cord injury is presented. The patient was treated with the placement of a thecoperitoneal shunt incorporating a low pressure valve. Response was excellent with restoration of neurological function and almost complete collapse of the cavity at one year follow up. The rationale of this form of treatment is discussed in the light of recent evidence concerning the pathogenesis of the condition. Images PMID:8006663

  1. Quantitative evaluation fo cerebrospinal fluid shunt flow

    SciTech Connect

    Chervu, S.; Chervu, L.R.; Vallabhajosyula, B.; Milstein, D.M.; Shapiro, K.M.; Shulman, K.; Blaufox, M.D.

    1984-01-01

    The authors describe a rigorous method for measuring the flow of cerebrospinal fluid (CSF) in shunt circuits implanted for the relief of obstructive hydrocephalus. Clearance of radioactivity for several calibrated flow rates was determined with a Harvard infusion pump by injecting the Rickham reservoir of a Rickham-Holter valve system with 100 ..mu..Ci of Tc-99m as pertechnetate. The elliptical and the cylindrical Holter valves used as adjunct valves with the Rickham reservoir yielded two different regression lines when the clearances were plotted against flow rats. The experimental regression lines were used to determine the in vivo flow rates from clearances calculated after injecting the Rickham reservoirs of the patients. The unique clearance characteristics of the individual shunt systems available requires that calibration curves be derived for an entire system identical to one implanted in the patient being evaluated, rather than just the injected chamber. Excellent correlation between flow rates and the clinical findings supports the reliability of this method of quantification of CSF shunt flow, and the results are fully accepted by neurosurgeons.

  2. Active shunt capacitance cancelling oscillator circuit

    DOEpatents

    Wessendorf, Kurt O.

    2003-09-23

    An oscillator circuit is disclosed which can be used to produce oscillation using a piezoelectric crystal, with a frequency of oscillation being largely independent of any shunt capacitance associated with the crystal (i.e. due to electrodes on the surfaces of the crystal and due to packaging and wiring for the crystal). The oscillator circuit is based on a tuned gain stage which operates the crystal at a frequency, f, near a series resonance frequency, f.sub.S. The oscillator circuit further includes a compensation circuit that supplies all the ac current flow through the shunt resistance associated with the crystal so that this ac current need not be supplied by the tuned gain stage. The compensation circuit uses a current mirror to provide the ac current flow based on the current flow through a reference capacitor that is equivalent to the shunt capacitance associated with the crystal. The oscillator circuit has applications for driving piezoelectric crystals for sensing of viscous, fluid or solid media by detecting a change in the frequency of oscillation of the crystal and a resonator loss which occur from contact of an exposed surface of the crystal by the viscous, fluid or solid media.

  3. Incidence and Risk Factors of Ventriculoperitoneal Shunt Infections in Children: A Study of 333 Consecutive Shunts in 6 Years

    PubMed Central

    Lee, Joon Kee; Seok, Joon Young; Lee, Joon Ho; Phi, Ji Hoon; Kim, Seung-Ki; Wang, Kyu-Chang; Lee, Hoan Jong

    2012-01-01

    The major aims of this study were to estimate the infection rate and recognize the risk factor for ventriculoperitoneal (VP) shunt infections in children. To analyze shunt infection rate and identify risk factors, a retrospective cohort analysis of 333 consecutive VP shunt series was performed at Seoul National University Children's Hospital in Korea between January 2005 and February 2011. Overall, 35 shunts (10.5%) were infected, which represented an infection rate of 0.075 infection cases per shunt per year. VP shunt infection occurred at a median of 1 month (range, 6 days to 8 months) after insertion. An independent risk factor for shunt infection was undergoing an operation before the first year of life (relative risk 2.31; 95% confidence interval, 1.19-4.48). The most common causative microorganism was coagulase-negative staphylococci in 16 (45.7%) followed by Staphylococcus aureus in 8 (22.9%). Methicillin resistance rate was 83.3% among coagulase-negative staphylococci and S. aureus. In this study, cerebrospinal fluid shunt infection rate was 10.5%. Infection was frequently caused by methicillin-resistant coagulase-negative staphylococci and S. aureus within two months after shunt surgery. Vancomycin may be considered as the preoperative prophylaxis for shunt surgery in a situation where methicillin resistance rate is very high. PMID:23255859

  4. Peritoneovenous shunt occlusion. Etiology, diagnosis, therapy.

    PubMed Central

    LeVeen, H H; Vujic, I; d'Ovidio, N G; Hutto, R B

    1984-01-01

    Electronic pressure testing of every LeVeen valve has practically eliminated mechanical malfunction as a cause of shunt failure. Nonetheless, failures do occur and in a series of 240 cases, early or late shunt failure occurred in 29 patients. Thirty-five additional cases of failures were either referred by other physicians over a period of 6 years or information and x-rays were accumulated by direct contact. Shunt failure becomes manifest by a sudden reaccumulation of ascites in patients with a previously functioning shunt. In immediate failure, the ascites may fail to disappear after surgery or reaccumulate if removed. Ideally, caval clotting should be first excluded by x-ray visualization of the superior vena prior to injection of the shunt with contrast agent. Shuntograms are done with fine-bore needles. The venous pressure is also measured. The entry of contrast into the vena cava without pooling indicates a patent venous limb. The contrast will empty from the venous tubing with forceful inspiration if the entire system is patent. The venous tube will not clear if the valve or peritoneal collecting tubes are blocked. Only the valve and collecting tube need then be replaced if contrast enters the cava but does not leave the venous tubing. Occluded valves must not be flushed to restore patency since inflammatory exudate and cellular debris are erroneously identified as "fibrin flecks." Histology and culture are mandatory. Immediate and early failure are often caused by malposition of the venous tubing. Malplacements can often be diagnosed simply by chest x-rays. Intraoperative injection of methylene blue into the venous tubing establishes a satisfactory washout prior to wound closure. Fresh clots in the vena cava can be dissolved by the slow injection of streptokinase into the venous tubing. Other patent veins are chosen for access. Patients having repeat surgery after clotting must be heparinized to prevent a similar recurrence. Flushing blood clots from the cava can be fatal. Images FIG. 1. FIG. 2. FIGS. 3A and B. FIG. 4. FIG. 5. FIG. 6. FIG. 7. FIG. 8. FIG. 10. FIG. 11. FIG. 12. FIG. 13. FIGS. 14A and B. FIG. 15. FIG. 16. FIG. 17. FIG. 18. FIGS. 19A and B. FIGS. 20A and B. PMID:6465977

  5. Factors affecting ventriculoperitoneal shunt survival in adult patients

    PubMed Central

    Khan, Farid; Rehman, Abdul; Shamim, Muhammad S.; Bari, Muhammad E.

    2015-01-01

    Background: Ventriculoperitoneal (VP) shunt insertion remains the mainstay of treatment for hydrocephalus despite a high rate of complications. The predictors of shunt malfunction have been studied mostly in pediatric patients. In this study, we report our 11-year experience with VP shunts in adult patients with hydrocephalus. We also assess the various factors affecting shunt survival in a developing country setting. Methods: A retrospective chart analysis was conducted for all adult patients who had undergone shunt placement between the years 2001 and 2011. Kaplan–Meier curves were used to determine the duration from shunt placement to first malfunction and log-rank (Cox–Mantel) tests were used to determine the factors affecting shunt survival. Results: A total of 227 patients aged 18–85 years (mean: 45.8 years) were included in the study. The top four etiologies of hydrocephalus included post-cranial surgery (23.3%), brain tumor or cyst (22.9%), normal pressure hydrocephalus (15%), and intracranial hemorrhage (13.7%). The overall incidence of shunt malfunction was 15.4% with the median time to first shunt failure being 120 days. Etiology of hydrocephalus (P = 0.030) had a significant association with the development of shunt malfunction. Early shunt failure was associated with age (P < 0.001), duration of hospital stay (P < 0.001), Glasgow Coma Scale (GCS) score less than 13 (P = 0.010), excision of brain tumors (P = 0.008), and placement of extra-ventricular drains (P = 0.033). Conclusions: Patients with increased age, prolonged hospital stay, GCS score of less than 13, extra-ventricular drains in situ, or excision of brain tumors were more likely to experience early shunt malfunction. PMID:25722930

  6. Percutaneous upsizing of a Blalock-Taussig shunt.

    PubMed

    Tzifa, Aphrodite; Rosenthal, Eric; Qureshi, Shakeel

    2012-04-01

    Percutaneous upsizing of surgically placed Blalock-Taussig shunts is an uncommon practice. We report the case of an 8-month-old infant with single-ventricle physiology, who - due to comorbidities - was deemed unsuitable to proceed with Glenn operation. The 3.5-millimetre Blalock-Taussig shunt was stented successfully with a 5-millimetre pre-mounted stent, resulting in an increase in shunt diameter and oxygen saturation by nearly 30% and 10%, respectively. PMID:21920058

  7. Adaptive resonant shunted piezoelectric devices for vibration suppression

    NASA Astrophysics Data System (ADS)

    Niederberger, Dominik; Morari, Manfred; Pietrzko, Stanislaw J.

    2003-08-01

    This paper presents a new adaptation technique for R-L shunted piezoelectric patches (PZT) bonded on mechanical structures for single mode vibration suppression. For the implementation of the adaptive R-L shunt circuit, a new variable inductor circuit controlled by transistors is developed. Additionally, a new modeling method for shunted PZTs based on equivalent transformer and gyrator circuits is presented. This leads to a comprehensive model that simplifies the search for optimal shunt circuits. Furthermore, it allows simulating the system consisting of the structure, the PZT patch and a complex transistor or other non-linear shunts on standard electronic simulators like PSpice or Saber. Damping performance of R-L shunted piezoelectric devices is very sensitive to environmental factors changing the circuit"s resonance frequency corresponding to the damped vibration mode. This requires fast adaptive tuning of the R-L shunted circuit, which is implemented using a new adaptation technique. The tuning direction of this adaptation law is obtained by detecting the phase shift between the velocity of the mechanical structure and the current in the shunt circuit. As the exact value of the phase for this technique is not required, one can reduce the adaptation problem to multiplication and integration of current and velocity. The performance of the presented new adaptive R-L shunt is compared with the common adaptation law based on minimizing the RMS value of the strain and then experimentally verified. The adaptive R-L shunt, which minimizes the phase-shift, can tune to the optimal parameters within seconds, but it needs an additional velocity sensor. In contrast, the R-L shunt minimizing the RMS value works without extra sensors, but needs some minutes to tune optimally. The new adaptive R-L shunt circuit can be implemented in small analog electronic chips that allows integrating it in smart materials.

  8. Superconducting fault current-limiter with variable shunt impedance

    DOEpatents

    Llambes, Juan Carlos H; Xiong, Xuming

    2013-11-19

    A superconducting fault current-limiter is provided, including a superconducting element configured to resistively or inductively limit a fault current, and one or more variable-impedance shunts electrically coupled in parallel with the superconducting element. The variable-impedance shunt(s) is configured to present a first impedance during a superconducting state of the superconducting element and a second impedance during a normal resistive state of the superconducting element. The superconducting element transitions from the superconducting state to the normal resistive state responsive to the fault current, and responsive thereto, the variable-impedance shunt(s) transitions from the first to the second impedance. The second impedance of the variable-impedance shunt(s) is a lower impedance than the first impedance, which facilitates current flow through the variable-impedance shunt(s) during a recovery transition of the superconducting element from the normal resistive state to the superconducting state, and thus, facilitates recovery of the superconducting element under load.

  9. Impedance Changes Indicate Proximal Ventriculoperitoneal Shunt Obstruction In Vitro.

    PubMed

    Basati, Sukhraaj; Tangen, Kevin; Hsu, Ying; Lin, Hanna; Frim, David; Linninger, Andreas

    2015-12-01

    Extracranial cerebrospinal fluid (CSF) shunt obstruction is one of the most important problems in hydrocephalus patient management. Despite ongoing research into better shunt design, robust and reliable detection of shunt malfunction remains elusive. The authors present a novel method of correlating degree of tissue ingrowth into ventricular CSF drainage catheters with internal electrical impedance. The impedance based sensor is able to continuously monitor shunt patency using intraluminal electrodes. Prototype obstruction sensors were fabricated for in-vitro analysis of cellular ingrowth into a shunt under static and dynamic flow conditions. Primary astrocyte cell lines and C6 glioma cells were allowed to proliferate up to 7 days within a shunt catheter and the impedance waveform was observed. During cell ingrowth a significant change in the peak-to-peak voltage signal as well as the root-mean-square voltage level was observed, allowing the impedance sensor to potentially anticipate shunt malfunction long before it affects fluid drainage. Finite element modeling was employed to demonstrate that the electrical signal used to monitor tissue ingrowth is contained inside the catheter lumen and does not endanger tissue surrounding the shunt. These results may herald the development of "next generation" shunt technology that allows prediction of malfunction before it affects patient outcome. PMID:25014951

  10. Portosystemic Shunt Syndrome and Endovascular Management of Hepatic Encephalopathy

    PubMed Central

    Saad, Wael E.

    2014-01-01

    The term “portosystemic shunt syndrome” was coined by Kumamoto et al referring to reduction of the hepatic reserve (reflected by progression of the Child–Pugh score) over 5 years compared with portal hypertensive cirrhotics without gastrorenal shunts or with prior history of obliterated gastrorenal shunts. Saad et al elaborated on this term further by describing a complete syndrome with clinical findings (including worsening liver failure and hepatic encephalopathy [HE]) and imaging findings (including hepatic atrophy, portal vein thrombosis, and paucity of intrahepatic portal vein radicles). This article discusses the syndrome in detail. In addition, the article describes the types of HE and the endovascular management of shunt-related HE. PMID:25177088

  11. A compact, coaxial shunt current diagnostic for X pinches.

    PubMed

    Wang, Liangping; Zhang, Jinhai; Li, Mo; Zhang, Xinjun; Zhao, Chen; Zhang, Shaoguo

    2015-08-01

    A compact coaxial shunt was applied in X-pinches experiments on Qiangguang pulsed power generator. The coaxial shunt was designed to have a compact construction for smaller inductance and more, for conveniently assembling upon the X pinch load structure. The coaxial shunt is also a cheap current probe and was easily built by research groups. The shunt can monitor a 100 kA high current with a 100 ns rise time. The calibration results showed that the probe used in the experiments has a resistance of 3.2 m? with an uncertainty of 3%, and its response time to the step signal is less than 7 ns. PMID:26329193

  12. Semi-shunt field emission in electronic devices

    SciTech Connect

    Karpov, V. G.; Shvydka, Diana

    2014-08-04

    We introduce a concept of semi-shunts representing needle shaped metallic protrusions shorter than the distance between a device electrodes. Due to the lightening rod type of field enhancement, they induce strong electron emission. We consider the corresponding signature effects in photovoltaic applications; they are: low open circuit voltages and exponentially strong random device leakiness. Comparing the proposed theory with our data for CdTe based solar cells, we conclude that stress can stimulate semi-shunts' growth making them shunting failure precursors. In the meantime, controllable semi-shunts can play a positive role mitigating the back field effects in photovoltaics.

  13. Compact vs. Exponential-Size LP Relaxations

    SciTech Connect

    Carr, R.D.; Lancia, G.

    2000-09-01

    In this paper we introduce by means of examples a new technique for formulating compact (i.e. polynomial-size) LP relaxations in place of exponential-size models requiring separation algorithms. In the same vein as a celebrated theorem by Groetschel, Lovasz and Schrijver, we state the equivalence of compact separation and compact optimization. Among the examples used to illustrate our technique, we introduce a new formulation for the Traveling Salesman Problem, whose relaxation we show equivalent to the subtour elimination relaxation.

  14. Over-drainage and persistent shunt-dependency in patients with idiopathic intracranial hypertension treated with shunts and bariatric surgery

    PubMed Central

    Roth, Jonathan; Constantini, Shlomi; Kesler, Anat

    2015-01-01

    Background: Idiopathic intracranial hypertension (IIH) may lead to visual impairment. Shunt surgery is indicated for refractory IIH-related symptoms that persist despite medical treatment, or those presenting with significant visual decline. Obesity is a risk factor for IIH; a reduction in weight has been shown to improve papilledema. Bariatric surgery (BS) has been suggested for treating IIH associated with morbid obesity. In this study, we describe a high rate of over-drainage (OD) seen in patients following shunts and BS. Methods: The study cohort includes 13 patients with IIH that underwent shunt surgery for treatment of the IIH-related symptoms. Six patients underwent BS in addition to the shunt surgery (but not concomitantly). Seven patients had only shunt surgeries with no BS. Data were collected retrospectively. Results: BS effectively led to weight reduction (body mass index decreasing from 43 ± 4 to 28 ± 5). Patients undergoing BS had 1–6 (2.5 ± 1.9) shunt revisions for OD following BS, as opposed to 0–3 (1.4 ± 1.1) revisions prior to BS over similar time spans (statistically insignificant difference), and 0–6 (1.6 ± 2.5) revisions among the non-BS patients over a longer time span (statistically insignificant difference). Two patients in the BS group underwent shunt externalization and closure; however, they proved to be shunt-dependent. Conclusions: Patients with IIH that undergo shunt surgery and BS (not concomitantly) may suffer from OD symptoms, necessitating multiple shunt revisions, and valve upgrades. Despite BS being a valid primary treatment for some patients with IIH, among shunted patients, BS may not lead to resolution of IIH-related symptoms and patients may remain shunt-dependent. PMID:26713173

  15. 507 Warren-Zeppa Distal Splenorenal Shunts

    PubMed Central

    Livingstone, Alan S.; Koniaris, Leonidas G.; Perez, Eduardo A.; Alvarez, Nicholas; Levi, Joe U.; Hutson, Duane G.

    2006-01-01

    Objective: To define the long-term characteristics, prognostic factors, and outcomes of patients undergoing selective splenorenal shunting procedures for portal hypertension-induced recurrent upper gastrointestinal bleeding. Materials and Methods: A retrospective evaluation of a prospectively collected data set. Results: From June 1971 through May 2005, 507 Warren-Zeppa shunts were performed at a single institution. Indications included: alcoholic cirrhosis, 52.6%; viral cirrhosis, 21.8%; cryptogenic cirrhosis, 8.4%; autoimmune cirrhosis, 5.8%; and other causes, 6.3%. Median survival was 81 months (5-year survival, 58.9%; 10-year survival, 34.4%; 20-year survival, 12.5%). patients with portal vein thrombosis and biliary cirrhosis demonstrated better survival than others (P = 0.03), while patients with alcoholic cirrhosis trended toward worse survival than those with nonalcoholic causes (P = 0.11). Multivariate analysis of preoperative risk factors found body hair loss (hazard ratio, 17.3; P > 0.005), preoperative encephalopathy (hazard ratio, 1.93; P > 0.003), diuretic use (hazard ratio, 1.43; P > 0.003), and age (hazard ratio, 1.02 per year of age; P > 0.051) were independent predictors of poor long-term survival. Multivariate analysis of operative factors demonstrated blood loss <500 mL was predictive of up to a 4-fold improved long-term survival (hazard ratio, 3.95; P < 0.013). Postoperative complications included: recurrent bleeding, 12%; ascites, 17.5%; and encephalopathy, 13.9%. Multivariate analysis of postoperative factors prospectively collected in 130 patients found that alcoholic recidivism (hazard ratio, 2.66; P > 0.001) was the only independent predictor of poor prognosis. Conclusions: The Warren-Zeppa shunt provides long-term survival and control of bleeding in most patients with portal hypertension. Excellent long-term survival can be obtained in properly selected patients with portal hypertension and relatively spared hepatic function. PMID:16772792

  16. Cryptococcal Infection of the Ventriculoperitoneal Shunt in an Immunocompetent Patient

    PubMed Central

    Foong, Kap Sum; Lee, Ashley; Vasquez, Gustavo

    2016-01-01

    Patient: Male, 52 Final Diagnosis: Cryptococcal ventriculoperitoneal shunt infection Symptoms: Confusion • fever • Lethargy Medication: Amphotericin B • Flucytosine Clinical Procedure: Ventriculoperitoneal shunt removal Specialty: Infectious disease Objective: Rare disease Background: Ventriculoperitoneal shunting is an effective treatment for hydrocephalus. Ventriculoperitoneal shunt (VPS) infection is a common complication. Cryptococcus neoformans as an implicated organism is rare. In this report, we describe a patient with cryptococcal VPS infection. Case Report: A 52-year-old male with normal pressure hydrocephalus, status post implantation of VPS one year prior to the presentation; who was admitted with a fever, lethargy and confusion for three days. He was treated empirically with intravenous cefepime and vancomycin for VPS infection. The CSF analysis from both the lumbar puncture and the VPS was significant for a low white blood count, low glucose and high protein. Other work-up including India ink and cryptococcal antigen was unrevealing. He remained febrile despite antibiotic treatment for 5 days. The CSF from the shunt was sent for analysis again and it demonstrated similar results from the prior study, but the culture was now positive for Cryptococcus neoformans. The patient was started on oral flucytosine and intravenous liposomal amphotericin B. The VPS was removed and an externalized ventricular catheter was placed. The patient showed rapid resolution of the symptoms. Conclusions: To date, there was a total of nine reported cases of cryptococcal VPS infection upon review of the literature. Our presenting case and the literature review highlight the difficulties in making an accurate diagnosis of cryptococcal shunt infection. There were case reports of false negative cryptococcal antigen tests with culture proven cryptococcal meningitis. The CSF culture from the shunt remains a mainstay for identifying cryptococcal shunt infection. Cryptococcal shunt infections are rare and early diagnosis and treatment is essential for patient management which involves shunt replacement with concomitant administration of intravenous antifungal medication. High clinical suspicion is crucial and shunt culture preferably from the valve is recommended. PMID:26778598

  17. Shunting branch of portal vein and stent position predict survival after transjugular intrahepatic portosystemic shunt

    PubMed Central

    Bai, Ming; He, Chuang-Ye; Qi, Xing-Shun; Yin, Zhan-Xin; Wang, Jian-Hong; Guo, Wen-Gang; Niu, Jing; Xia, Jie-Lai; Zhang, Zhuo-Li; Larson, Andrew C; Wu, Kai-Chun; Fan, Dai-Ming; Han, Guo-Hong

    2014-01-01

    AIM: To evaluate the effect of the shunting branch of the portal vein (PV) (left or right) and the initial stent position (optimal or suboptimal) of a transjugular intrahepatic portosystemic shunt (TIPS). METHODS: We retrospectively reviewed 307 consecutive cirrhotic patients who underwent TIPS placement for variceal bleeding from March 2001 to July 2010 at our center. The left PV was used in 221 patients and the right PV in the remaining 86 patients. And, 224 and 83 patients have optimal stent position and sub-optimal stent positions, respectively. The patients were followed until October 2011 or their death. Hepatic encephalopathy, shunt dysfunction, and survival were evaluated as outcomes. The difference between the groups was compared by Kaplan-Meier analysis. A Cox regression model was employed to evaluate the predictors. RESULTS: Among the patients who underwent TIPS to the left PV, the risk of hepatic encephalopathy (P = 0.002) and mortality were lower (P < 0.001) compared to those to the right PV. Patients who underwent TIPS with optimal initial stent position had a higher primary patency (P < 0.001) and better survival (P = 0.006) than those with suboptimal initial stent position. The shunting branch of the portal vein and the initial stent position were independent predictors of hepatic encephalopathy and shunt dysfunction after TIPS, respectively. And, both were independent predictors of survival. CONCLUSION: TIPS placed to the left portal vein with optimal stent position may reduce the risk of hepatic encephalopathy and improve the primary patency rates, thereby prolonging survival. PMID:24574750

  18. 78 FR 21491 - DeltaPoint Capital IV, L.P., DeltaPoint Capital IV (New York), L.P.; Notice Seeking Exemption...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... ADMINISTRATION DeltaPoint Capital IV, L.P., DeltaPoint Capital IV (New York), L.P.; Notice Seeking Exemption... that DeltaPoint Capital IV, L.P. and DeltaPoint Capital IV (New York), L.P., 45 East Avenue, 6th Floor... Business Administration (``SBA'') Rules and Regulations (13 CFR 107.730). DeltaPoint Capital IV,...

  19. 78 FR 21491 - DeltaPoint Capital IV, L.P., DeltaPoint Capital IV (New York), L.P.; Notice Seeking Exemption...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... DeltaPoint Capital IV, L.P., DeltaPoint Capital IV (New York), L.P.; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of Interest Notice is hereby given that DeltaPoint Capital IV, L.P. and DeltaPoint Capital IV (New York), L.P., 45 East Avenue, 6th Floor,...

  20. Hydrocephalus: the zero ICP ventricle shunt (ZIPS) to control gravity shunt flow. A clinical study in 56 patients.

    PubMed

    Foltz, E L; Blanks, J; Meyer, R

    1994-01-01

    Significant morbidity from ventricle shunt overdrainage at 6-7 years after initial shunt placement for hydrocephalus is increasingly recognized as due to excessive gravity-flow of shunted CSF when upright. Shunts are designed primarily to control high ICP. Shunts should also mimic normal upright ICP. Normal upright ICP is -65 mm of water (vertex reference), indicating that a level of zero ICP exists at 65 mm below the brain vertex, with negative ICP above and positive ICP below that level. This normal zero ICP level must be maintained by CSF shunts to mimic normal upright ICP. This will prevent and correct CSF shunt overdrainage. The zero ICP shunt (ZIPS) by design controls this zero level with a zero pressure device (ZPD; siphon control device) installed at the normal vertical level of zero ICP (cm/mm) below the vertex (65 mm). The shunt thus prevents excessive gravity-induced CSF shunt flow. Successful use of ZIPS in 56 patients is reported (low ICP group: n = 42; high ICP group: n = 14). Follow-up is up to 4.5 years. Results show that: (1) adjustability of ZPD level can achieve the desired clinical results; (2) the level of ZPD installed correlates within 4 mm of upright ICP attained; (3) the optimal level of ZPD installation to produce normal upright ICP is 65 mm below the vertex; (4) CT ventricle size, both slit ventricles and large ventricles, may or may not normalize when normal upright ICP is attained in this group of complex, previously shunted patients. PMID:8194062

  1. Effect of portasystemic venous shunt surgery on hyperglucagonaemia in cirrhosis: paired studies of pre- and post-shunted subjects

    PubMed Central

    Dudley, F. J.; Alford, F. P.; Chisholm, D. J.; Findlay, D. M.

    1979-01-01

    The effect of liver disease on glucagon metabolism was examined in nine patients with chronic liver disease who were studied both before and after the creation of a surgical portasystemic shunt. Hepatocellular function did not deteriorate after shunt surgery. However, hepatic perfusion with splanchnic venous blood, as determined by scintisplenoportography, decreased after shunt surgery in six subjects but appeared unaltered in three. Basal plasma immunoreactive glucagon (IRG) levels in the pre-shunt cirrhotic group were significantly greater (p <0·005) than in control subjects and further increased (p <0·05) after shunt surgery. Moreover, the increase in basal IRG after shunt was evident only in patients in whom portasystemic shunting was demonstrably increased by surgery. Despite the higher basal IRG levels postoperatively, shunt surgery in the cirrhotics did not alter basal glucose and insulin levels or the glucose and insulin response to a glucose or protein load. Circulating IRG was heterogeneous in the pre-shunt cirrhotic patients: the 9000 molecular weight fraction comprised 27±4%, the 3500 mol. wt. fraction 71±4%, and the > 40 000 mol. wt. fraction was minimal. After shunt surgery, the relative proportion of the 9000 mol. wt. fraction of IRG (13±3%) decreased significantly (p <0·05) and this fall was associated with a corresponding increase in the 3,500 mol. wt. fraction (84±4%). It is concluded that, in cirrhosis, hyperglucagonaemia is: (1) dependent on the degree of portasystemic shunting rather than impaired hepatocellular function; (2) predominantly due to increased circulating 3500 molecular weight glucagon; and (3) not a major factor in the pathogenesis of carbohydrate intolerance in liver disease. PMID:533693

  2. Portacaval shunt in a calf: Clinical, pathologic, and ultrasonographic findings

    PubMed Central

    Buczinski, Sébastien; Duval, Julie; d’Anjou, Marc-André; Francoz, David; Fecteau, Gilles

    2007-01-01

    A calf with a previous history of lameness was presented for weakness and anorexia. Increased liver enzymes and difficulty in assessing the portal system by ultrasonography were compatible with liver disease. Doppler ultrasonography revealed an extrahepatic portacaval shunt. This is the first ultrasonographic description of extra-hepatic portacaval shunt in a ruminant. PMID:17494368

  3. 49 CFR 236.724 - Circuit, shunt fouling.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Circuit, shunt fouling. 236.724 Section 236.724... Circuit, shunt fouling. The track circuit in the fouling section of a turnout, connected in multiple with the track circuit in the main track....

  4. Internal carotid artery rupture caused by carotid shunt insertion

    PubMed Central

    Illuminati, Giulio; Caliò, Francesco G.; Pizzardi, Giulia; Vietri, Francesco

    2015-01-01

    Introduction Shunting is a well-accepted method of maintaining cerebral perfusion during carotid endarterectomy (CEA). Nonetheless, shunt insertion may lead to complications including arterial dissection, embolization, and thrombosis. We present a complication of shunt insertion consisting of arterial wall rupture, not reported previously. Presentation of case A 78-year-old woman underwent CEA combined with coronary artery bypass grafting (CABG). At the time of shunt insertion an arterial rupture at the distal tip of the shunt was detected and was repaired via a small saphenous vein patch. Eversion CEA and subsequent CABG completed the procedure whose postoperative course was uneventful. Discussion Shunting during combined CEA-CABG may be advisable to assure cerebral protection from possible hypoperfusion due to potential hemodynamic instability of patients with severe coronary artery disease. Awareness and prompt management of possible shunt-related complications, including the newly reported one, may contribute to limiting their harmful effect. Conclusion Arterial wall rupture is a possible, previously not reported, shunt-related complication to be aware of when performing CEA. PMID:26255001

  5. 21 CFR 882.4545 - Shunt system implantation instrument.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Shunt system implantation instrument. 882.4545 Section 882.4545 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4545 Shunt...

  6. 21 CFR 882.4545 - Shunt system implantation instrument.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Shunt system implantation instrument. 882.4545 Section 882.4545 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4545 Shunt...

  7. Study of a shunt reactor with transformer function

    SciTech Connect

    Egawa, Takeshi; Kyono, Mikio; Misawa, Kazutaka

    1997-03-01

    In this paper, a method for supplying the service power of a UHV switching station from the shunt reactor installed in it is studied. Characteristics and one-turn fault condition of the shunt reactor is investigated using equivalent circuits deduced from the magnetic field analysis by the finite element method.

  8. Biosynthetic route towards saxitoxin and shunt pathway.

    PubMed

    Tsuchiya, Shigeki; Cho, Yuko; Konoki, Keiichi; Nagasawa, Kazuo; Oshima, Yasukatsu; Yotsu-Yamashita, Mari

    2016-01-01

    Saxitoxin, the most potent voltage-gated sodium channel blocker, is one of the paralytic shellfish toxins (PSTs) produced by cyanobacteria and dinoflagellates. Recently, putative biosynthetic genes of PSTs were reported in these microorganisms. We previously synthesized genetically predicted biosynthetic intermediates, Int-A' and Int-C'2, and also Cyclic-C' which was not predicted based on gene, and identified them all in the toxin-producing cyanobacterium Anabaena circinalis (TA04) and the dinoflagellate Alexandrium tamarense (Axat-2). This study examined the incorporation of (15)N-labeled intermediates into PSTs (C1 and C2) in A. circinalis (TA04). Conversions from Int-A' to Int-C'2, from Int-C'2 to Cyclic-C', and from Int-A' and Int-C'2 to C1 and C2 were indicated using high resolution-LC/MS. However, Cyclic-C' was not converted to C1 and C2 and was detected primarily in the extracellular medium. These results suggest that Int-A' and Int-C'2 are genuine precursors of PSTs, but Int-C'2 converts partially to Cyclic-C' which is a shunt product excreted to outside the cells. This paper provides the first direct demonstration of the biosynthetic route towards saxitoxin and a shunt pathway. PMID:26842222

  9. Ventriculoperitoneal shunt infection with Listeria innocua.

    PubMed

    Karli, Arzu; Sensoy, Gulnar; Unal, Nevzat; Yanik, Keramettin; Cigdem, Halit; Belet, Nursen; Sofuoglu, Ayse

    2014-08-01

    Listeria species may cause life-threatening events including meningitis and invasive infection in newborns, pregnant women, older and immunodeficient people. The most common Listeria species that causes infection is L. monocytogenes. It is known that Listeria innocua has no pathogenicity. A 9-month-old baby had ventriculoperitoneal shunt and was treated with adrenocorticotropic hormone because of infantile spasms. He was brought to hospital with fever and vomiting. Upon physical examination, the patient seemed uncomfortable and had a temperature of 38.6°C. Laboratory results were as follows: hemoglobin, 6.7 g/dL; leukocyte count, 5420/mm(3) ; platelet count, 169,000/mm(3) ; and C-reactive protein, 100 mg/L (normal <5 mg/L). On analysis of cerebrospinal fluid (CSF), leukocyte count was 480/mm(3) , protein was 46 mg/dL and CSF glucose was 35 mg/dL. L. innocua was isolated in CSF culture. We describe this unusual case of ventriculoperitoneal shunt infection with L. innocua. PMID:25252053

  10. Biosynthetic route towards saxitoxin and shunt pathway

    PubMed Central

    Tsuchiya, Shigeki; Cho, Yuko; Konoki, Keiichi; Nagasawa, Kazuo; Oshima, Yasukatsu; Yotsu-Yamashita, Mari

    2016-01-01

    Saxitoxin, the most potent voltage-gated sodium channel blocker, is one of the paralytic shellfish toxins (PSTs) produced by cyanobacteria and dinoflagellates. Recently, putative biosynthetic genes of PSTs were reported in these microorganisms. We previously synthesized genetically predicted biosynthetic intermediates, Int-A’ and Int-C’2, and also Cyclic-C’ which was not predicted based on gene, and identified them all in the toxin-producing cyanobacterium Anabaena circinalis (TA04) and the dinoflagellate Alexandrium tamarense (Axat-2). This study examined the incorporation of 15N-labeled intermediates into PSTs (C1 and C2) in A. circinalis (TA04). Conversions from Int-A’ to Int-C’2, from Int-C’2 to Cyclic-C’, and from Int-A’ and Int-C’2 to C1 and C2 were indicated using high resolution-LC/MS. However, Cyclic-C’ was not converted to C1 and C2 and was detected primarily in the extracellular medium. These results suggest that Int-A’ and Int-C’2 are genuine precursors of PSTs, but Int-C’2 converts partially to Cyclic-C’ which is a shunt product excreted to outside the cells. This paper provides the first direct demonstration of the biosynthetic route towards saxitoxin and a shunt pathway. PMID:26842222

  11. 78 FR 79687 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-31

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Texas Eastern Transmission, LP; Notice of Application Take notice that on December 10, 2013 Texas Eastern Transmission, LP (Texas Eastern), at 5400 Westheimer Court, Houston, Texas 77056, filed an application in...

  12. 78 FR 45592 - DeltaPoint Capital IV, LP;

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-29

    ... ADMINISTRATION DeltaPoint Capital IV, LP; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of Interest Notice is hereby given that DeltaPoint Capital IV, L.P., 45 East Avenue... Business Administration (``SBA'') Rules and Regulations (13 CFR 107.730). DeltaPoint Capital IV,...

  13. 78 FR 16846 - Notice of Application; Equitrans, L.P.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-19

    ... Energy Regulatory Commission Notice of Application; Equitrans, L.P. Take notice that on March 1, 2013, Equitrans, L.P. (Equitrans), 625 Liberty Avenue, Suite 1700, Pittsburgh, Pennsylvania 15222, filed in Docket...: 5:00 p.m. Eastern Time on April 2, 2013. Dated: March 12, 2013. Kimberly D. Bose, Secretary....

  14. 78 FR 43190 - DCP Midstream, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-19

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission DCP Midstream, LP; Notice of Application Take notice that on July 1, 2013, DCP Midstream, LP (DCP), filed an application pursuant to Section 7(c) of the Natural Gas Act and Part 157 of the Commission's Regulations, for...

  15. 76 FR 9341 - Equitrans, L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Equitrans, L.P.; Notice of Application Take notice that on January 27, 2011, Equitrans, L.P. (``Equitrans''), having its principal place of business at 625 Liberty Avenue, Suite...

  16. 76 FR 41238 - Regency Intrastate Gas LP; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Regency Intrastate Gas LP; Notice of Filing Take notice that on July 7, 2011, Regency Intrastate Gas LP, (Regency) filed to revise its Operating Statement. Regency states this...

  17. 76 FR 34974 - Regency Intrastate Gas LP; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-15

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Regency Intrastate Gas LP; Notice of Filing Take notice that on June 7, 2011, Regency Intrastate Gas LP, (Regency) filed to revise its Operating Statement. Regency states...

  18. 75 FR 27551 - Keystone Energy Partners, LP; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Keystone Energy Partners, LP; Notice of Filing May 10, 2010. Take notice that on December 16, 2009, Keystone Energy Partners, LP submit for filing an Updated Market...

  19. 78 FR 66352 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Texas Eastern Transmission, LP; Notice of Application Take notice that on October 17, 2013, Texas Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056, filed an application in Docket...

  20. Shunt attachment and method for interfacing current collection systems

    DOEpatents

    Denney, P.E.; Iyer, N.C.; Hannan, W.F. III.

    1992-12-08

    A composite brush to shunt attachment wherein a volatile component of a composite but mostly metallic brush, used for current collection purposes, does not upon welding or brazing, adversely affect the formation of the interfacial bond with a conductive shunt which carries the current from the zone of the brush. The brush to shunt attachment for a brush material of copper-graphite composite and a shunt of copper, or substituting silver for copper as an alternative, is made through a hot isostatic pressing (HIP). The HIP process includes applying high pressure and temperature simultaneously at the brush to shunt interface, after it has been isolated or canned in a metal casing in which the air adjacent to the interface has been evacuated and the interfacial area has been sealed before the application of pressure and temperature. 6 figs.

  1. Syringomyelia Regression after Shunting of a Trapped Fourth Ventricle

    PubMed Central

    Morina, Dukagjin; Petridis, Athanasios K.; Fritzsche, Friederike S.; Ntoulias, Georgios; Scholz, Martin

    2013-01-01

    We describe a case of progressive syringomyelia following post-infectious trapped fourth ventricle (TFV), which resolved after shunting of the fourth ventricle. A 28-year-old female who had previously undergone treatment of intracerebral hemorrhage and meningitis developed a hydrocephalus with TFV. After 3 years she developed disturbance of walking and coordination. Cranial-CT revealed an enlargement of the shunted fourth ventricle as a result of shunt dysfunction. Furthermore a cervical syringomyelia developed. The patient underwent a revision of a failed fourth ventriculo-peritoneal shunt. Postoperatively, syringomyelia resolved within 6 months and the associated neurological deficits improved significantly. An insufficiency of cerebrospinal fluid draining among patients with TFV can be associated with communicating syringomyelia. An early detection and treatment seems important on resolving syringomyelia and avoiding permanent neurological deficits. Ventriculo-peritoneal shunt in trapped fourth ventricles can resolve a secondary syringomyelia. PMID:24765489

  2. Vancomycin for treating cerebrospinal fluid shunt infections in pediatric patients.

    PubMed

    Thompson, Jill B; Einhaus, Stephanie; Buckingham, Steve; Phelps, Stephanie J

    2005-01-01

    Infection is a major cause of CSF shunt failure that places the patient at risk of intellectual impairment, development of loculated CSF compartments, and death. The purpose of this article is to review the published literature related to vancomycin for treatment of pediatric CSF shunt infections. Fifty percent of shunt infections appear within 2 months of shunt placement or revision; 90% occur within 6 months. Ninety percent of organisms infecting CSF shunting devices are Staphylococcus and Streptococcus species. The emergence of methicillin-resistant strains of staphylococci has made vancomycin the antibiotic of choice for these infections. The usual intravenous regimen is 60 mg/kg/day divided every 6 hours. Intraventricular vancomycin should be considered for most patients, starting with 10 mg daily. CSF vancomycin concentrations should be monitored and dosing adjustments made as needed to maintain CSF trough vancomycin concentrations between 5 and 20 mg/L. PMID:23118622

  3. The "H-graft" in portacaval shunt in dogs.

    PubMed

    Grga, A; Matici?, Z; Hlevnjak, D; Hofman, B

    1994-01-01

    When working experimentally on dogs we have investigated the possibility of using an autogenous vein graft and polytetrafluoroethylene (Gore-Tex) prosthesis in the construction of the portacaval shunt. The portacaval shunt flow has been examined under similar hemodynamic conditions by experimenting on surviving dogs with the internal jugular vein and the above prosthesis. This study presents methods of research, hemodynamic measurements and the technique of portacaval shunt construction. After performance of the arteriovenous mesenteric-renal fistula we have succeeded in raising partially the portal vein pressure with the increase in the venous blood flow markedly higher. The portacaval shunt flow and the mesenteric-renal fistula have been verified by aortography and on autopsy. The jugular vein employed in the construction of the portacaval shunt remained unobstructed in 6 dogs (75 per cent) and the Gore-Tex prosthesis in 4 (50 per cent). PMID:7603080

  4. Shunt attachment and method for interfacing current collection systems

    DOEpatents

    Denney, Paul E. (State College, PA); Iyer, Natraj C. (Columbia, SC); Hannan, III, William F. (Monroeville Boro, PA)

    1992-01-01

    A composite brush to shunt attachment wherein a volatile component of a composite but mostly metallic brush, used for current collection purposes, does not upon welding or brazing, adversely affect the formation of the interfacial bond with a conductive shunt which carries the current from the zone of the brush. The brush to shunt attachment for a brush material of copper-graphite composite and a shunt of copper, or substituting silver for copper as an alternative, is made through a hot isostatic pressing (HIP). The HIP process includes applying high pressure and temperature simultaneously at the brush to shunt interface, after it has been isolated or canned in a metal casing in which the air adjacent to the interface has been evacuated and the interfacial area has been sealed before the application of pressure and temperature.

  5. [Purification and characterization of antifungal peptide LP-1].

    PubMed

    Liu, Y; Xu, Q; Chen, Z

    1999-10-01

    An antifungal peptide LP-1 from Bacillus subtilis TG26 strain was purified by acid precipitation, acetone precipitation and Hi-pore reversed phase column chromatography. The molecular weight of LP-1 is 1057.3 D as determined by MALDI-TOF mass spectrometry, and its pI is 4.75 by PAG-IEF. It was also found to be thermostable. Its antifungal spectrum showed that LP-1 has strong inhibitory activity against many plant pathogenic fungi, such as Pythium aphanidermatum, Gibberella zeae, Alternaria longipe, Fusarium oxysporum f. lycopersici, etc.. The abnormal hyphal growth of Trichoderma viride caused by LP-1 such as swollen tips, twisted, short growth and cytoplasm condensation was also observed. Both ninhydrin reaction and peptide sequencing suggested that LP-1 is a cyclic peptide. PMID:12555526

  6. LP based approach to optimal stable matchings

    SciTech Connect

    Teo, Chung-Piaw; Sethuraman, J.

    1997-06-01

    We study the classical stable marriage and stable roommates problems using a polyhedral approach. We propose a new LP formulation for the stable roommates problem. This formulation is non-empty if and only if the underlying roommates problem has a stable matching. Furthermore, for certain special weight functions on the edges, we construct a 2-approximation algorithm for the optimal stable roommates problem. Our technique uses a crucial geometry of the fractional solutions in this formulation. For the stable marriage problem, we show that a related geometry allows us to express any fractional solution in the stable marriage polytope as convex combination of stable marriage solutions. This leads to a genuinely simple proof of the integrality of the stable marriage polytope. Based on these ideas, we devise a heuristic to solve the optimal stable roommates problem. The heuristic combines the power of rounding and cutting-plane methods. We present some computational results based on preliminary implementations of this heuristic.

  7. 77 FR 74179 - TexStar Transmission, LP; TEAK Texana Transmission Company, LP; Notice of Baseline Filings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission TexStar Transmission, LP; TEAK Texana Transmission Company, LP; Notice of Baseline Filings Take notice that on December 6, 2012, the applicants listed above submitted a...

  8. Lithium in LP944-20

    NASA Astrophysics Data System (ADS)

    Pavlenko, Ya. V.; Jones, H. R. A.; Martín, E. L.; Guenther, E.; Kenworthy, M. A.; Zapatero Osorio, M. R.

    2007-09-01

    We present a new estimate of the lithium abundance in the atmosphere of the brown dwarf LP944-20. Our analysis is based on a self-consistent analysis of low-, intermediate- and high-resolution optical and near-infrared spectra. We obtain logN(Li) = 3.25 +/- 0.25 using fits of our synthetic spectra to the LiI resonance line doublet profiles observed with Very Large Telescope/Ultraviolet-Visual Echelle Spectrograph (VLT/UVES) and Anglo-Australian Telescope/Segmented Pupil/Image Reformatting Array of Lenslets (AAT/SPIRAL). This lithium abundance is over two orders of magnitude larger than previous estimates in the literature. In order to obtain good fits of the resonance lines of KI and RbI and better fits to the TiO molecular absorption around the LiI resonance line, we invoke a semi-empirical model atmosphere with the dusty clouds located above the photosphere. The lithium abundance, however, is not changed by the effects of the dusty clouds. We discuss the implications of our estimate of the lithium abundance in LP944-20 for the understanding of the properties of this benchmark brown dwarf. Based on observations obtained on the European Southern Observatory at Cerro Paranal, Chile, in programs 68.C-0063(A) and 072.C-0110(B), the Anglo-Australian Telescope at Siding Springs Observatory during commissioning observations for SPIRAL (Segmented Pupil/Image Reformatting Array of Lenslets) instrument and the Keck Observatory in Mauna Kea, Hawaii. E-mail: yp@mao.kiev.ua

  9. Muzzle shunt augmentation of conventional railguns

    SciTech Connect

    Parker, J.V. . Physics Div.)

    1991-01-01

    This paper reports on augmentation which is a technique for reducing the armature current and hence the armature power dissipation in a plasma armature railgun. In spite of the advantages, no large augmented railguns have been built, primarily due to the mechanical and electrical complexity introduced by the extra conductors required. it is possible to achieve some of the benefits of augmentation in a conventional railgun by diverting a fraction {phi} of the input current through a shunt path at the muzzle of the railgun. In particular, the relation between force and armature current is the same as that obtained in an n-turn, series-connected augmented railgun with n = 1/(1 {minus} {phi}). The price of this simplification is a reduction in electrical efficiency and some additional complexity in the external electrical system.

  10. Research on spark discharge of floating roof tank shunt

    NASA Astrophysics Data System (ADS)

    Bi, Xiaolei; Liu, Quanzhen; Liu, Baoquan; Gao, Xin; Hu, Haiyan; Liu, Juan

    2013-03-01

    In order to quantitatively analyze the spark discharge risk of floating roof tank shunts, the breakdown voltage of shunt has been calculated by Townsend theory, the shunt spark discharge experiment is carried out by using 1.2/50 ?s impulse voltage wave, and the relationship between breakdown voltage of shunt spark discharge and air gap is analyzed. It has been indicated by theoretical analysis and experimental study that the small gap is more easily cause spark discharge than the big gap when the contact between shunt and tank shell is poor. When air gap distance is equal to 0.1 cm, average breakdown voltage is 5280 V. When the air gap distance is less than 0.3 cm, experiment data agree well with Townsend theory. Therefore, in the condition of small gap, Townsend theory can be used to calculated breakdown voltage of shunt. Finally, based on the above conclusions, improvements for avoiding the spark discharge risk of shunt of floating roof tanks have been proposed.

  11. Cryptococcal Infection of the Ventriculoperitoneal Shunt in an Immunocompetent Patient.

    PubMed

    Foong, Kap Sum; Lee, Ashley; Vasquez, Gustavo

    2016-01-01

    BACKGROUND Ventriculoperitoneal shunting is an effective treatment for hydrocephalus. Ventriculoperitoneal shunt (VPS) infection is a common complication. Cryptococcus neoformans as an implicated organism is rare. In this report, we describe a patient with cryptococcal VPS infection. CASE REPORT A 52-year-old male with normal pressure hydrocephalus, status post implantation of VPS one year prior to the presentation; who was admitted with a fever, lethargy and confusion for three days. He was treated empirically with intravenous cefepime and vancomycin for VPS infection. The CSF analysis from both the lumbar puncture and the VPS was significant for a low white blood count, low glucose and high protein. Other work-up including India ink and cryptococcal antigen was unrevealing. He remained febrile despite antibiotic treatment for 5 days. The CSF from the shunt was sent for analysis again and it demonstrated similar results from the prior study, but the culture was now positive for Cryptococcus neoformans. The patient was started on oral flucytosine and intravenous liposomal amphotericin B. The VPS was removed and an externalized ventricular catheter was placed. The patient showed rapid resolution of the symptoms. CONCLUSIONS To date, there was a total of nine reported cases of cryptococcal VPS infection upon review of the literature. Our presenting case and the literature review highlight the difficulties in making an accurate diagnosis of cryptococcal shunt infection. There were case reports of false negative cryptococcal antigen tests with culture proven cryptococcal meningitis. The CSF culture from the shunt remains a mainstay for identifying cryptococcal shunt infection. Cryptococcal shunt infections are rare and early diagnosis and treatment is essential for patient management which involves shunt replacement with concomitant administration of intravenous antifungal medication. High clinical suspicion is crucial and shunt culture preferably from the valve is recommended. PMID:26778598

  12. Ultrasound-Guided Retrieval and Position Replacement of a Dislodged Fetal Pleuro-Amniotic Shunt: A Novel Approach for a Known Complication of Feto-Amniotic Shunting.

    PubMed

    Adams, Tracy M; Kunzier, Nadia B; Chavez, Martin R; Vintzileos, Anthony M

    2016-01-01

    Untreated fetal pleural effusion can cause significant perinatal morbidity and mortality. Treatment of pleural effusions with pleuro-amniotic shunting has been shown to improve outcomes. Pleuro-amniotic shunting is associated with complications including ruptured membranes, preterm labor and shunt dislodgement into either the amniotic cavity or the fetal thorax. Shunt dislodgement into the thoracic cavity can cause prenatal complications from the shunt itself or may necessitate neonatal surgery for removal. We present a case where a novel ultrasound-guided technique was used to replace the dislodged pleural shunt in utero, thereby effectively draining the effusion while simultaneously obviating the need for neonatal surgery and decreasing possible perinatal complications. PMID:25660293

  13. Rapid evaluation of ventriculoperitoneal shunt function in a pediatric patient using emergency ultrasound.

    PubMed

    Hamburg, Leah Marion; Kessler, David O

    2012-07-01

    A 9-year-old girl with a ventriculoperitoneal shunt presents to the emergency department with progressive positional headaches, vomiting, fatigue, and pain over her shunt tract. Emergency ultrasound was used to diagnose discontinuity in the cervical portion of the shunt allowing for expedited care while waiting for confirmatory testing. She underwent urgent shunt replacement with good outcome. PMID:22766597

  14. Ion beam sputter-etched ventricular catheter for hydrocephalus shunt

    NASA Technical Reports Server (NTRS)

    Banks, B. A. (Inventor)

    1983-01-01

    A cerebrospinal fluid shunt in the form of a ventricular catheter for controlling the condition of hydrocephalus by relieving the excessive cerebrospinal fluid pressure is described. A method for fabrication of the catheter and shunting the cerebral fluid from the cerebral ventricles to other areas of the body is also considered. Shunt flow failure occurs if the ventricle collapse due to improper valve function causing overdrainage. The ventricular catheter comprises a multiplicity of inlet microtubules. Each microtubule has both a large openings at its inlet end and a multiplicity of microscopic openings along its lateral surfaces.

  15. Postpriapism erectile dysfunction and shunt-related urethral stricture: long-term morbidity after proximal shunt for ischaemic priapism

    PubMed Central

    Bello, Jibril Oyekunle

    2014-01-01

    Recent guidelines have advocated for step-wise treatment of increasing invasiveness in the management of ischaemic priapism though with low-level evidences. In the past, proximal shunts were favoured as first-line treatment. We present an African man who had proximal shunt (cavernoso-spongiosal) three decades ago for ischaemic priapism and subsequently had long-term morbidity over the three decades with adverse effect on his quality of life. Recent guidelines appear to be sound despite their limitations and more invasive cavernoso-spongiosal shunts may be associated with significant long-term morbidities and poor quality of life. PMID:25709730

  16. 7. VIEW OF SHUNT LOCOMOTIVE NO. 9072 POSITIONING ELECTRIC DIESEL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. VIEW OF SHUNT LOCOMOTIVE NO. 9072 POSITIONING ELECTRIC DIESEL LOCOMOTIVE NO. 6734 ON TURNTABLE, adjacent to Erecting Shop and Machine Shop - Juniata Shops, Turntable, South of Sixth Street at Third Avemue, Altoona, Blair County, PA

  17. 5. VIEW OF SHUNT LOCOMOTIVE NO. 9072 POSITIONING ELECTRIC DIESEL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. VIEW OF SHUNT LOCOMOTIVE NO. 9072 POSITIONING ELECTRIC DIESEL LOCOMOTIVE NO. 6734 ON TURNTABLE, adjacent to Erecting Shop and Machine Shop - Juniata Shops, Turntable, South of Sixth Street at Third Avemue, Altoona, Blair County, PA

  18. 8. VIEW OF SHUNT LOCOMOTIVE NO. 9072 POSITIONING ELECTRIC DIESEL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. VIEW OF SHUNT LOCOMOTIVE NO. 9072 POSITIONING ELECTRIC DIESEL LOCOMOTIVE NO. 6734 ON TURNTABLE, adjacent to Erecting Shop and Machine Shop - Juniata Shops, Turntable, South of Sixth Street at Third Avemue, Altoona, Blair County, PA

  19. 4. VIEW OF SHUNT LOCOMOTIVE NO. 9072 POSITIONING ELECTRIC DIESEL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. VIEW OF SHUNT LOCOMOTIVE NO. 9072 POSITIONING ELECTRIC DIESEL LOCOMOTIVE NO. 6734 ON TURNTABLE, adjacent to Erecting Shop and Machine Shop - Juniata Shops, Turntable, South of Sixth Street at Third Avemue, Altoona, Blair County, PA

  20. 9. VIEW OF SHUNT LOCOMOTIVE NO. 9072 POSITIONING ELECTRIC DIESEL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. VIEW OF SHUNT LOCOMOTIVE NO. 9072 POSITIONING ELECTRIC DIESEL LOCOMOTIVE NO. 6734 ON TURNTABLE, adjacent to Erecting Shop and Machine Shop - Juniata Shops, Turntable, South of Sixth Street at Third Avemue, Altoona, Blair County, PA

  1. 6. VIEW OF SHUNT LOCOMOTIVE NO. 9072 POSITIONING ELECTRIC DIESEL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. VIEW OF SHUNT LOCOMOTIVE NO. 9072 POSITIONING ELECTRIC DIESEL LOCOMOTIVE NO. 6734 ON TURNTABLE, adjacent to Erecting Shop and Machine Shop - Juniata Shops, Turntable, South of Sixth Street at Third Avemue, Altoona, Blair County, PA

  2. Shunt capacitor effect on electrical distribution system reliability

    NASA Astrophysics Data System (ADS)

    Sallam, Abdelhay A.; Desouky, Mohamed; Desouky, Hussien

    1994-03-01

    To improve the security & reliability of a distribution system, as much power as feasible must go through a given transmission line. This can be achieved by using shunt capacitors as compensators. These shunt capacitive compensators improve the load carrying capability of the line by controlling the reactive power flow. Consequently, the capacitor existence can not be ignored in evaluating system reliability. The paper applies the state-space method to calculate the reliability indices for compensated & uncompensated systems with different success criteria. The importance of using shunt capacitors to improve the level of distribution system reliability is illustrated in addition to their original function as reactive power controllers. Our procedure, based on a Markov process, is applied to a numerical example, and indicates that system reliability is improved when using shunt capacitors.

  3. 21 CFR 874.3850 - Endolymphatic shunt tube with valve.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3850 Endolymphatic shunt... of a pressure-limiting valve associated with a tube intended to be implanted in the inner ear...

  4. 21 CFR 874.3850 - Endolymphatic shunt tube with valve.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3850 Endolymphatic shunt... of a pressure-limiting valve associated with a tube intended to be implanted in the inner ear...

  5. 21 CFR 874.3850 - Endolymphatic shunt tube with valve.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3850 Endolymphatic shunt... of a pressure-limiting valve associated with a tube intended to be implanted in the inner ear...

  6. 21 CFR 874.3850 - Endolymphatic shunt tube with valve.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3850 Endolymphatic shunt... of a pressure-limiting valve associated with a tube intended to be implanted in the inner ear...

  7. 21 CFR 874.3850 - Endolymphatic shunt tube with valve.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3850 Endolymphatic shunt... of a pressure-limiting valve associated with a tube intended to be implanted in the inner ear...

  8. 21 CFR 876.5955 - Peritoneo-venous shunt.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Identification. A peritoneo-venous shunt is an implanted device that consists of a catheter and a pressure activated one-way valve. The catheter is implanted with one end in the peritoneal cavity and the other in...

  9. 21 CFR 876.5955 - Peritoneo-venous shunt.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) Identification. A peritoneo-venous shunt is an implanted device that consists of a catheter and a pressure activated one-way valve. The catheter is implanted with one end in the peritoneal cavity and the other in...

  10. 21 CFR 876.5955 - Peritoneo-venous shunt.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Identification. A peritoneo-venous shunt is an implanted device that consists of a catheter and a pressure activated one-way valve. The catheter is implanted with one end in the peritoneal cavity and the other in...

  11. 21 CFR 876.5955 - Peritoneo-venous shunt.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Identification. A peritoneo-venous shunt is an implanted device that consists of a catheter and a pressure activated one-way valve. The catheter is implanted with one end in the peritoneal cavity and the other in...

  12. A case of breast cancer involving a ventriculoperitoneal shunt.

    PubMed

    Kamei, Mirei; Kikuchi, Nobuyuki; Ichimura, Homare; Chujo, Masao; Takahashi, Yoshiaki; Sugio, Kenji

    2016-12-01

    An 84-year-old woman was examined for an enlargement of an induration in the left breast. A ventriculoperitoneal shunt had been placed for postoperative normal pressure hydrocephalus of a cerebral hemorrhage, and it had penetrated the mass according to the computed tomography findings. Breast cancer was diagnosed after a close examination; however, close observation was selected because her family rejected treatment. She developed somnolence 7 months after the initial examination, and ventricular dilatation and expansion of the low-density region around the ventricle were noted on computed tomography, suggesting that the enlarged tumor had excluded the shunt and caused obstruction. The growth of breast carcinoma involving a shunt tube can be the cause of obstruction of a ventriculoperitoneal shunt. Our findings suggest that a breast lesion should be evaluated at both pre- and postoperation. PMID:26943684

  13. Spontaneous spinal epidural haemorrhage complicating transjugular intrahepatic portosystemic stent shunting.

    PubMed Central

    McLellan, S.; de Silva, R.; Sandercock, P. A.; Hayes, P. C.; Dillon, J.; Redhead, D.

    1997-01-01

    A patient with chronic liver disease and portal hypertension who developed acute spinal cord compression following transjugular intrahepatic portosystemic stent shunting is described. Radiological and pathological examinations revealed an epidural haematoma. Images Figure PMID:9497978

  14. 21 CFR 876.5955 - Peritoneo-venous shunt.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) Identification. A peritoneo-venous shunt is an implanted device that consists of a catheter and a pressure activated one-way valve. The catheter is implanted with one end in the peritoneal cavity and the other in...

  15. 78 FR 48668 - Kalaeloa Partners, LP; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-09

    ..., Kalaeloa Partners, L.P. (Kalaeloa) filed a petition for recertification as a qualifying cogeneration... cogeneration facility operating and efficiency standard requirements for its facility for year 2013. Any...

  16. In vitro flow measurements in ion sputtered hydrocephalus shunts

    NASA Technical Reports Server (NTRS)

    Cho, Y. I.; Back, L. H.

    1989-01-01

    This paper describes an experimental procedure for accurate measurements of the pressure-drop/flow rate relationship in hydrocephalus shunts. Using a fish-hook arrangement, small flow rates in a perforated ion-sputtered Teflon microtubule were measured in vitro in a pressured system and were correlated with pressure in the system. Results indicate that appropriate drainage rates could be obtained in the physiological range for hydrocephalus shunts.

  17. Proximal ventricular shunt malfunctions in children: Factors associated with failure.

    PubMed

    Buster, Bryan E; Bonney, Phillip A; Cheema, Ahmed A; Glenn, Chad A; Conner, Andrew K; Safavi-Abbasi, Sam; Andrews, Mason B; Gross, Naina L; Mapstone, Timothy B

    2016-02-01

    Ventricular shunt failures and subsequent revisions are a significant source of patient morbidity. We conducted a review of pediatric patients undergoing placement or revision of ventricular shunts at our institution between January 2007 and December 2008. Patients were followed through to July 2014. Data collected included patient demographics, shunt history and indication for procedure, approach taken for shunt placement, and location of shunt tip in relation to the foramen of Monro. Univariate and multivariate analyses were conducted to identify factors associated with proximal failure. A total of 87 procedures were identified in 40 patients, consisting of 23 initial placements and 64 revisions. Thirty-nine proximal catheter malfunctions were identified. Indications for shunt placement included Chiari II malformation (33%) and intraventricular hemorrhage (33%). Mean follow-up period was 5.5years. Median time to shunt failure was 1.57years. In the multivariate model, younger age at placement was associated with decreased time to proximal failure (hazard ratio [HR]=0.80 per increasing year of age, 95% confidence interval [CI] 0.64-0.98). Both anterior approach (HR=0.39, 95% CI 0.23-0.67) and farther distance to foramen of Monro (HR=0.02 per increasing 10mm, 95% CI 0.00-0.22) were associated with increased time to proximal failure when the catheter tip was located within the contralateral lateral ventricle. Optimizing outcomes in patients with shunt-dependent hydrocephalus continues to be a challenge. Despite unsatisfactory outcomes, particularly in the pediatric population, few conclusions can be drawn from studies assessing operative variables. PMID:26601815

  18. Multiresolution analysis of Lp space on compact set

    NASA Astrophysics Data System (ADS)

    Li, Bingzheng; Wang, Hongyan

    2006-05-01

    In this paper we define multiresolution analysis (MRA) in function space Lp([Omega],[mu]) for p>1, where [Omega] is a compact subset in and [mu] is a probability measure defined on [Omega]. We establish a general framework for construction of MRA in Lp([Omega],[mu]) and its conjugate space Lq([Omega],[mu]) with p-1+q-1=1, p, q>1.

  19. First Report of Ventriculoperitoneal Shunt Infection due to Cyberlindnera fabianii

    PubMed Central

    Baghdadi, Jonathan; Hemarajata, Peera; Humphries, Romney; Kelesidis, Theodoros

    2015-01-01

    Fungal infections in the central nervous system (CNS) are associated with significant morbidity and death. Transient fungemia in immunocompetent patients without any other risk factors for fungemia has been suggested as a possible mechanism that may lead to serious fungal ventriculoperitoneal (VP) shunt infections, but evidence is lacking. The clinical spectrum, diagnosis, and optimal therapy of Cyberlindnera fabianii infections remain to be determined. We describe the first case of CNS infection due to C. fabianii that occurred in an immunocompetent adult with a VP shunt. Spontaneous translocation with yeast that is not part of the normal gastrointestinal flora in the setting of ingestion of multiple servings of a fermentation product was the likely source from which Cyberlindnera fabianii gained entrance into the VP shunt system, causing meningitis in this patient. The authors conclude that, in view of the high morbidity associated with yeast infection of the CNS, long-term antifungal therapy should be strongly considered in cases where the VP shunt cannot be completely removed. Transient fungemia may lead to invasive disease in an immunocompetent host with VP shunt, even in the absence of any other risk factors for fungemia and even after remote placement of the VP shunt. PMID:26618013

  20. Exercise reduces persistent ductus arteriosus shunting in piglets.

    PubMed

    Seaberg, D; Lorenz, E; Lund, G; Rysavy, J; Pierpont, M E; Zhang, S L; Einzig, S

    1987-11-01

    To determine the effects of dynamic exercise on ductal left to right shunting and skeletal and myocardial blood flow distribution, a persistent ductus arteriosus was created by balloon catheters in neonatal piglets. At 8-10 weeks of age, aortic, pulmonary artery, and left atrial catheters were placed and radiolabelled microspheres injected for measuring left ventricular output, organ blood flows, and ductus left to right shunting at rest and during treadmill exercise (1.6 mph). At rest, effective left ventricular output and myocardial and skeletal muscle blood flows were similar in the study group and controls. Exercise increased skeletal muscle and left ventricular blood flows similarly in the control and study group and did not accentuate the exercise induced small reduction in the left ventricular subendocardial to subepicardial blood flow ratio. This was due to a significant reduction in the ductus left to right shunt during exercise (mean(SD) 34(15) vs 18(7)%, p less than 0.02) and maintenance of effective left ventricular output in the study group (447(144) vs 446(98) ml.min-1.kg-1 in controls). The reduction in ductus shunting during exercise was due to a significant decrease in systemic vascular resistance and a small increase in pulmonary vascular and ductus resistance. Thus, reduced persistent ductus arteriosus shunting and maintenance of effective left ventricular output prevents myocardial perfusion abnormalities during dynamic exercise in swine with a persistent ductus and small to moderate left to right shunts. PMID:3370667

  1. Activity of an Antimicrobial Hydrocephalus Shunt Catheter against Propionibacterium acnes ? †

    PubMed Central

    Bayston, Roger; Vera, Litza; Ashraf, Waheed

    2010-01-01

    Shunt infection is a major complication affecting approximately 10% of procedures. Propionibacterium acnes, an anaerobic skin bacterium, is increasingly recognized as a shunt pathogen, causing up to 14% of infections. Though susceptible to penicillin and cephalosporins, P. acnes shunt infections are not preventable by means of perioperative prophylaxis, due to poor cerebrospinal fluid penetration. Antimicrobial shunts with activity against staphylococci are available, but their activity against P. acnes is unknown, and the study was designed to determine this. Three methods of evaluation were used in order to determine the emergence of resistance when exposure is to high inocula for long periods, the time taken to kill 100% of the bacteria attached to the shunt, and the duration of activity under constant flow conditions with repeated bacterial challenge. Despite repeated exposure to high bacterial inocula over 70 days, no resistance was seen. The time taken to kill all attached bacteria, 96 h, was twice that taken to kill attached staphylococci. Nevertheless, under constant flow conditions with repeated challenges, the antimicrobial catheters resisted colonization by P. acnes for 56 days. Using tests that were designed to be clinically predictive when done together, the results suggest that the antimicrobial catheters will be able to prevent colonization of hydrocephalus shunts by P. acnes. PMID:20837763

  2. Lp-PLA2: A new target for statin therapy.

    PubMed

    Braun, Lynne T; Davidson, Michael H

    2010-01-01

    Inflammation plays an important role in atherogenesis and plaque vulnerability. Inflammatory-type markers have been evaluated for their association with atherosclerotic vascular disease and their ability to improve cardiovascular disease (CVD) risk stratification. Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is a vascular-specific inflammatory enzyme that increases the risk of CVD events and stroke approximately twofold. A consensus panel recently recommended the measurement of Lp-PLA(2) in moderate-risk and high-risk patients for improved risk stratification and modification of low-density lipoprotein target levels. Lipid-lowering agents, particularly statins, lower Lp-PLA(2) mass and activity; therefore, Lp-PLA(2) may represent an important target of lipid-lowering therapy for reducing the inflammatory nature of atherosclerosis and plaque vulnerability. It is unknown whether lowering inflammatory markers such as Lp-PLA(2) will have a direct benefit on CVD events and mortality. A large morbidity and mortality trial was recently initiated to evaluate the long-term safety and efficacy of darapladib, an Lp-PLA(2) antagonist, in patients with high-risk coronary heart disease. PMID:20425268

  3. Bending characteristics of dual-hole PM-PCF based on LP01 and LP11 modal interference

    NASA Astrophysics Data System (ADS)

    Guo, Xuan; Liu, Feng; Gao, Meng-yuan; Tan, Ai-ling; Fu, Xing-hu; Bi, Wei-hong

    2016-03-01

    The bending characteristics of dual-hole polarization maintaining photonic crystal fiber (PM-PCF) are demonstrated in this paper. The modal interference is induced by the LP01 mode and LP11 mode propagating in a single PM-PCF with the same polarization direction. Simulation results demonstrate that the bending radius induces the phase difference between LP01 mode and LP11 mode, which leads to the change of light interference intensity on the fiber output facet. The relationship between bending radius and normalized interference intensity with three different bending angles is discussed, where the bending angle is defined as the angle between hole axis and the x axis. The bending sensitivity is obtained to be about -188.78/m around the bending radius of 1.5 cm with the bending angle of 90°. The bending characteristics can contribute for online bending detection in widespread areas.

  4. A Hybridized GA with LP-LP Model for the Management of Confined Groundwater.

    PubMed

    Khadem, M; Afshar, M H

    2015-01-01

    A novel hybrid methodology is introduced in this paper for the optimal solution of the groundwater management problem. The problem to be addressed is the optimal determination and operation of a predefined number of wells out of a priori known set of potential wells with fixed locations to minimize the pumping cost of utilizing a two-dimensional (2D) confined aquifer under steady-state flow condition. The solution to this problem should satisfy a downstream demand, a lower/upper bound on the pumping rates, and a lower/upper bound on the water level drawdown in the wells. The problem is solved by hybridizing a genetic algorithm (GA) which suggests the candidate configurations for the operational wells and a hybrid linear programming (LP-LP) approach with the duty of finding the optimal operation policy of the candidate wells defined by their pumping rates. Two different codings, namely binary and integer codings, are used for the GA and their performances are compared. The ability of the proposed hybrid method is tested against two benchmark problems: (1) finding the optimal configuration and pumping rates of a predefined number of wells out of potential wells and (2) finding the optimal number, configuration and pumping rates of the operating wells out of potential wells and the results are presented and compared with the available ones showing superior efficiency and effectiveness of the proposed method. PMID:25059262

  5. A shunt-excited inductive power link.

    PubMed

    Sylvan, K; Jordan, J R; Whittington, H W

    1989-01-01

    An alternative derivation of the separation-insensitive property of series-excited self-oscillating inductive power transfer circuits is presented. This analysis is based on network theory and does not include the explicit determination of frequency as a step in the derivation. The separation-insensitivity principle is extended to shunt-excited links which exhibit a theoretical voltage transfer function of unity while the coupling factor exceeds the reciprocal of the secondary quality factor. This requires the inclusion of a series resistor in the primary resonator's capacitive arm. Series RC elements are replaced by parallel forms in both the primary and secondary; this provides a more convenient output impedance level without the need for another transformer. A demonstration circuit is described and tested. It is found that separation-insensitivity occurs while the coupling factor exceeds the reciprocal of the loaded secondary quality factor. Somewhat inferior response is obtained from a simpler circuit having no added resistances in the primary. PMID:2769731

  6. Lp-PLA2 levels in HIV-infected patients

    PubMed Central

    Díaz-Pollán, Beatriz; Estrada, Vicente; Fuentes-Ferrer, Manuel; Gómez-Garré, Dulcenombre; San Román-Montero, Jesús

    2014-01-01

    Introduction HIV-infected patients show an increased risk of cardiovascular disease (CVD). In the general population, lipoprotein-associated phospholipase A2 (Lp-PLA2) appears to be an independent predictor of CVD. We aimed to study associations between Lp-PLA2 plasma levels and other risk factors for CVD in HIV patients. Materials and Methods A cross-sectional, comparative study of two series of cases (HIV patients, n=116 and age-matched non-HIV healthy controls, n=113) was conducted. Eighty-seven percent HIV patients on antiretroviral therapy (ART), 72.4% with HIV-1 viral load <50 cop/mL. Inflammatory biomarkers (CRP, Lp-PLA2) and internal carotid intima-media thickness (IMT) were measured and CVD risk (Framingham and SCORE algorithms) was calculated. Univariate and multivariable associations between these variables were performed. Results HIV patients presented higher Lp-PLA2 levels [276.81 ng/mL (209.71–356.58)] than uninfected healthy controls [220.80 ng/mL (172.70–256.90)], p?0.01. In univariate analysis of the global sample, only cigarette smoking was associated with higher Lp-PLA2 levels, p?0.001. In HIV group, female and smoker patients showed higher Lp-PLA2 levels, p?0.05. No significant association was found between Lp-PLA2 levels and another CVD risk factors, carotid IMT, Framingham and SCORE algorithms, ART, HIV-1 viral load neither and CD4+ T lymphocyte count. In multivariate analysis, cigarette smoking remained significantly associated with Lp-PLA2 levels [?=64.8 (95% CI 10.8–118.9) ng/mL, p=0.020]. Conclusions HIV-infected patients present higher Lp-PLA2 levels than healthy controls, and in this population, tobacco smoking is significantly associated with increased Lp-PLA2 levels. Smoking cessation should be a priority in CVD prevention in HIV-infected patients. PMID:25397467

  7. Laparoscopic treatment of abdominal complications following ventriculoperitoneal shunt

    PubMed Central

    Grigorean, VT; Onose, G; Popescu, M; Strambu, V; Sandu, AM

    2009-01-01

    The aim of this study is the evaluation of laparoscopic treatment in abdominal complications following ventriculoperitoneal (VP) shunt. Methods: We report a retrospective study including 17 patients with abdominal complications secondary to VP shunt for hydrocephalus, laparoscopically treated in our department, between 2000 and 2007. Results: Patients' age ranged from 1 to 72 years old (mean age 25.8 years old). Male: female ratio was 1.4. Abdominal complications encountered were: shunt disconnection with intraperitoneal distal catheter migration 47.05% (8/17), infections 23.52% (4/17) such as abscesses and peritonitis, pseudocysts 11.76% (2/17), CSF ascites 5.88% (1/17), inguinal hernia 5.88% (1/17), and shunt malfunction due to excessive length of intraperitoneal tube 5.88% (1/17). Free–disease interval varies from 1 day to 21 years, depending on the type of complication, short in peritoneal irritation syndrome and abscesses (days) and long in ascites, pseudocysts(months– years). Laparoscopic treatment was: extraction of the foreign body in shunt disconnection with intraperitoneal distal catheter migration, evacuation, debridement, lavage and drainage for pseudocysts, abscess and peritonitis, shortening of the tube in shunt malfunction due to excessive length of intraperitoneal tube a nd hernioraphy. One diagnostic laparoscopy was performed in a peritoneal irritation syndrome, which found only CSF ascites. There were no conversions to open surgery. The overall mortality was of 5.88% and postoperative morbidity was of 11.76%. In 7 patients operated for abscesses, peritonitis, pseudocysts, and CSF ascites the shunting system was converted in to a ventriculocardiac shunt. Conclusions: Abdominal complication following VP shunt can be successfully performed laparoscopically. Abdominal surgery required, in selected cases, the repositioning of the distal catheter, frequently as a ventriculocardiac shunt. There are abdominal complications with no indication of surgery, like peritoneal irritation syndrome and CSF ascites. Free– disease interval varies from days (peritoneal irritation syndrome, abscesses) to month–years (pseudocyst, ascites), according to type of complication. PMID:20108757

  8. Temporary arterial shunts to maintain limb perfusion after arterial injury: an animal study

    NASA Technical Reports Server (NTRS)

    Dawson, D. L.; Putnam, A. T.; Light, J. T.; Ihnat, D. M.; Kissinger, D. P.; Rasmussen, T. E.; Bradley, D. V. Jr

    1999-01-01

    BACKGROUND: Temporary shunt placement can quickly restore perfusion after extremity arterial injury. This study examined the adequacy of limb blood flow with shunt use, non-heparin-bonded shunt patency over prolonged periods, and the safety of this technique. METHODS: Common iliac arteries were divided and 4.0-mm Silastic Sundt shunts placed in 16 anesthetized pigs. Eight (group I) had shunts placed immediately; eight others (group II) were shunted after an hour of limb ischemia and hemorrhagic shock. Physiologic parameters and femoral artery blood flow in both hindlimbs were continuously monitored. Limb lactic acid generation, oxygen utilization, and hematologic and metabolic effects were serially evaluated for 24 hours. RESULTS: Shunts remained patent in 13 of 16 pigs. Shunts thrombosed in two group I animals because of technical errors, but functioned well after thrombectomy and repositioning. Patency could not be maintained in one animal that died from shock. Flow in group I shunted limbs was 57 (+/-11 SD) % of control. For group II animals in shock, shunted limb flow initially averaged 46 +/- 15% of control, but 4 hours after shunt placement, the mean limb blood flow was the same as in group I. Increased oxygen extraction compensated for the lower flow. Lactic acid production was not increased in comparison to control limbs. CONCLUSION: Shunts provided adequate flow in this model of extremity trauma. Correctly placed shunts stayed patent for 24 hours, without anticoagulation, if shunt placement followed resuscitation.

  9. 77 FR 58371 - Allegheny Hydro No. 8, L.P., Allegheny Hydro No. 9, L.P., and U.S. Bank National Association...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-20

    ... Energy Regulatory Commission Allegheny Hydro No. 8, L.P., Allegheny Hydro No. 9, L.P., and U.S. Bank National Association Allegheny Hydro, LLC; Notice of Application for Transfer of License, and Soliciting Comments and Motions To Intervene On August 31, 2012, Allegheny Hydro No. 8, L.P., Allegheny Hydro No. 9,...

  10. The right-to-left shunt of crocodilians serves digestion.

    PubMed

    Farmer, C G; Uriona, T J; Olsen, D B; Steenblik, M; Sanders, K

    2008-01-01

    Abstract All amniotes except birds and mammals have the ability to shunt blood past the lungs, but the physiological function of this ability is poorly understood. We studied the role of the shunt in digestion in juvenile American alligators in the following ways. First, we characterized the shunt in fasting and postprandial animals and found that blood was shunted past the lungs during digestion. Second, we disabled the shunt by surgically sealing the left aortic orifice in one group of animals, and we performed a sham surgery in another. We then compared postprandial rates of gastric acid secretion at body temperatures of 19 degrees and 27 degrees C and rates of digestion of bone at 27 degrees C. Twelve hours after eating, maximal rates of gastric acid secretion when measured at 19 degrees and 27 degrees C were significantly less in the disabled group than in sham-operated animals. Twenty-four hours postprandial, a significant decrease was found at 27 degrees C but not at 19 degrees C. For the first half of digestion, dissolution of cortical bone was significantly slower in the disabled animals. These data suggest the right-to-left shunt serves to retain carbon dioxide in the body so that it can be used by the gastrointestinal system. We hypothesize that the foramen of Panizza functions to enrich with oxygen blood that is destined for the gastrointestinal system to power proton pumps and other energy-demanding processes of digestion and that the right-to-left shunt serves to provide carbon dioxide to gastrointestinal organs besides the stomach, such as the pancreas, spleen, upper small intestine, and liver. PMID:18194087

  11. Attenuation of Congenital Portosystemic Shunt Reduces Inflammation in Dogs

    PubMed Central

    Tivers, Michael S.; Handel, Ian; Gow, Adam G.; Lipscomb, Victoria J.; Jalan, Rajiv; Mellanby, Richard J.

    2015-01-01

    Liver disease is a major cause of morbidity and mortality. One of the most significant complications in patients with liver disease is the development of neurological disturbances, termed hepatic encephalopathy. The pathogenesis of hepatic encephalopathy is incompletely understood, which has resulted in the development of a wide range of experimental models. Congenital portosystemic shunt is one of the most common congenital disorders diagnosed in client owned dogs. Our recent studies have demonstrated that the pathophysiology of canine hepatic encephalopathy is very similar to human hepatic encephalopathy, which provides strong support for the use of dogs with a congenital portosystemic shunt as a naturally occurring model of human hepatic encephalopathy. Specifically, we have demonstrated an important role for ammonia and inflammation in the development of hepatic encephalopathy in dogs with a congenital portosystemic shunt. Despite the apparent importance of inflammation in driving hepatic encephalopathy in dogs, it is unclear whether inflammation resolves following the successful treatment of liver disease. We hypothesized that haematological and biochemical evidence of inflammation, as gauged by neutrophil, lymphocyte and monocyte concentrations together with C-reactive protein concentrations, would decrease following successful treatment of congenital portosystemic shunts in dogs. One hundred and forty dogs with a congenital portosystemic shunt were enrolled into the study. We found that the proportion of dogs with a monocyte concentration above the reference range was significantly greater in dogs with hepatic encephalopathy at time of initial diagnosis. Importantly, neutrophil and monocyte concentrations significantly decreased following surgical congenital portosystemic shunt attenuation. We also found a significant decrease in C-reactive protein concentrations following surgical attenuation of congenital portosystemic shunts. Our study demonstrates that haematological and biochemical indices of inflammation reduce following successful treatment of the underlying liver disorder. PMID:25658922

  12. LP DAAC and MEaSUREs - Optimizing Collection Inception

    NASA Astrophysics Data System (ADS)

    Bennett, S.

    2013-12-01

    The Land Processes Distributed Active Archive Center (LP DAAC) is a selected NASA Earth Observing System (EOS) Data and Information System (EOSDIS) DAAC supporting the Making Earth System Data Records for Use in Research Environments (MEaSUREs) Program to contribute in providing long-term, consistent, and mature data products. The LP DAAC has identified three essential components for the MEaSUREs collection inception. The first component includes a framework of LP DAAC's data lifecycle including overall inception of products, curation of products, and long-term archiving of products. The second component fuses data producer and data provider operations, interleaving key personnel into key processes throughout the project. The third component integrates and evolves stakeholder elements into a standard methodology, alongside affording an overall homogeneous data delivery system for MEaSUREs collections. As an active participant on the Metadata Evolution for NASA Data Systems (MENDS) Tiger Team, the LP DAAC is working to categorize all data model elements into the ISO 19115 international metadata standard. This poster depicts how each of these three components optimizes the LP DAAC MEaSUREs collection inception process.

  13. Coherence properties of a capacitively-shunt flux qubit

    NASA Astrophysics Data System (ADS)

    Birenbaum, Jeffrey; Sears, Adam; Nugroho, Christopher; Gudmundsen, Ted; Welander, Paul; Yoder, Jonilyn; Kamal, Archana; Gustavsson, Simon; Kerman, Jamie; Oliver, William; Clarke, John

    2014-03-01

    Coherence times for typical flux qubits have plateaued at 5 - 10 ? s for T1 and 1 - 3 ? s for TRamsey. To achieve longer coherence times we study capacitively-shunted flux qubits using high-Q capacitors to individually shunt all four Josephson junctions (JJs). The additional shunt capacitance moves 90 + % of the qubit energy from the lossy capacitance of the JJs into the high-Q shunts while preserving an anharmonicity greater than 100 % and maintaining f01 shunted flux qubit inductively coupled to a lumped-element readout resonator. The qubit junctions are deposited via aluminum e-beam evaporation using a bridgeless mask. We characterize the influence of qubit design parameters such as capacitance and geometry on the coherence time of the device. This research was funded in part by the Office of the Director of National Intelligence (ODNI), Intelligence Advanced Research Projects Activity (IARPA), through the Army Research Office.

  14. A Subglandular Breast Cerebrospinal Fluid Pseudocyst Following Postsurgical Shunt Migration

    PubMed Central

    Mlynek, Karolina; Frautschi, Russell; Halasa, Brianna; Kwiecien, Grzegorz

    2015-01-01

    Summary: Cerebrospinal fluid (CSF) drainage catheters have been associated with numerous complications in various anatomic locations, because of migration, infection, and obstruction. However, breast-related CSF shunt complications tend to occur infrequently or have seldom been reported in the empirical literature. Therefore, a case is presented detailing a breast pseudocyst caused by migration and subsequent coiling of a ventriculoperitoneal shunt in the right breast pocket. To the best of the authors’ knowledge, this is the first case that has been reported in the peer-reviewed literature of a pseudocyst resulting from a CSF drainage catheter coiling around the breast implant post pancreaticoduodenectomy. Moreover, this case highlights the importance of cross-disciplinary procedural awareness, particularly in regards to breast, ventriculoperitoneal shunt, and pancreatic procedures. PMID:26894004

  15. Material-induced shunts in multicrystalline silicon solar cells

    SciTech Connect

    Breitenstein, O. Bauer, J.; Rakotoniaina, J. P.

    2007-04-15

    By applying lock-in thermography imaging, light-beam-induced current imaging, electron-beam-induced current imaging at different stages of sample preparation, and infrared light microscopy in transmission mode, the physical nature of the dominant material-induced shunts in multicrystalline solar cells made from p-type silicon material has been investigated. It turns out that these shunts are due to silicon carbide (SiC) filaments, which grow preferentially in grain boundaries and cross the whole cell. These filaments are highly n-type doped, like the emitter layer on the surface of the cells. They are electrically connected both with the emitter and with the back contact, thereby producing internal shunts in the solar cell.

  16. A Subglandular Breast Cerebrospinal Fluid Pseudocyst Following Postsurgical Shunt Migration.

    PubMed

    Mlynek, Karolina; Frautschi, Russell; Halasa, Brianna; Kwiecien, Grzegorz; Papay, Francis

    2015-12-01

    Cerebrospinal fluid (CSF) drainage catheters have been associated with numerous complications in various anatomic locations, because of migration, infection, and obstruction. However, breast-related CSF shunt complications tend to occur infrequently or have seldom been reported in the empirical literature. Therefore, a case is presented detailing a breast pseudocyst caused by migration and subsequent coiling of a ventriculoperitoneal shunt in the right breast pocket. To the best of the authors' knowledge, this is the first case that has been reported in the peer-reviewed literature of a pseudocyst resulting from a CSF drainage catheter coiling around the breast implant post pancreaticoduodenectomy. Moreover, this case highlights the importance of cross-disciplinary procedural awareness, particularly in regards to breast, ventriculoperitoneal shunt, and pancreatic procedures. PMID:26894004

  17. Shunted Piezoelectric Vibration Damping Analysis Including Centrifugal Loading Effects

    NASA Technical Reports Server (NTRS)

    Min, James B.; Duffy, Kirsten P.; Provenza, Andrew J.

    2011-01-01

    Excessive vibration of turbomachinery blades causes high cycle fatigue problems which require damping treatments to mitigate vibration levels. One method is the use of piezoelectric materials as passive or active dampers. Based on the technical challenges and requirements learned from previous turbomachinery rotor blades research, an effort has been made to investigate the effectiveness of a shunted piezoelectric for the turbomachinery rotor blades vibration control, specifically for a condition with centrifugal rotation. While ample research has been performed on the use of a piezoelectric material with electric circuits to attempt to control the structural vibration damping, very little study has been done regarding rotational effects. The present study attempts to fill this void. Specifically, the objectives of this study are: (a) to create and analyze finite element models for harmonic forced response vibration analysis coupled with shunted piezoelectric circuits for engine blade operational conditions, (b) to validate the experimental test approaches with numerical results and vice versa, and (c) to establish a numerical modeling capability for vibration control using shunted piezoelectric circuits under rotation. Study has focused on a resonant damping control using shunted piezoelectric patches on plate specimens. Tests and analyses were performed for both non-spinning and spinning conditions. The finite element (FE) shunted piezoelectric circuit damping simulations were performed using the ANSYS Multiphysics code for the resistive and inductive circuit piezoelectric simulations of both conditions. The FE results showed a good correlation with experimental test results. Tests and analyses of shunted piezoelectric damping control, demonstrating with plate specimens, show a great potential to reduce blade vibrations under centrifugal loading.

  18. In Vitro and In Vivo Comparison of Two Suprachoroidal Shunts

    PubMed Central

    Oatts, Julius T.; Zhang, Ze; Tseng, Harry; Shields, M. Bruce; Sinard, John H.; Loewen, Nils A.

    2013-01-01

    Purpose. To compare fibrosis, aqueous humor dynamics, and intraocular pressure (IOP) of two suprachoroidal shunts as part of a new class of glaucoma drainage devices. Methods. Following proliferation analysis in vitro, 20 rabbits were implanted with either a gold shunt (GS, GMSplus+, SOLX) or a polypropylene shunt (PS, Aquashunt, OPKO). Ten eyes received mitomycin C (MMC) and triamcinolone. Peak and trough IOP were monitored with a pneumatonometer and tono-pen for 15 weeks. Aqueous humor dynamics were evaluated fluorophotometrically and tonographically. Fibrosis was quantified. Results. In vitro proliferation was similar. In vivo, both shunts were devoid of foreign body reaction but exhibited fibrosis, and GS showed vascularization. There was no significant difference in aqueous or uveoscleral flow. Preoperative morning IOP was 23.7 ± 2 mm Hg, and evening IOP was 26.5 ± 2 mm Hg (P = 0.000). Morning IOP was decreased through 15 weeks and evening IOP through 8 weeks in all groups. The morning IOP decrease was most profound at 15 weeks in PS (41%) compared to GS (18%). Antifibrotics initially enhanced but eventually diminished shunt performance. At 15 weeks, thickness of scleral fibrosis was greater in GS (246 ± 47 ?m) and PS (188 ± 47 ?m, P = 0.285) compared with GS+MMC (109 ± 26 ?m, P = 0.023 to GS) and PS+MMC (48 ± 30 ?m, P = 0.028 to PS). Conclusions. In a rabbit model, suprachoroidal polypropylene and gold shunts allow access to a new drainage pathway with different IOP profiles that can be modified with antifibrotics. PMID:23847318

  19. [Intracardiac migration of a ventriculoatrial shunt catheter treated by endovascular transvenous retrieval].

    PubMed

    Matsubara, Noriaki; Miyachi, Shigeru; Tsukamoto, Nobuhiro

    2012-06-01

    The authors report a case of intracardiac migration of a ventriculoatrial (VA) shunt catheter and transvenous retrieval of the migrated shunt catheter. A 67-year-old male, who had previously undergone a VA shunt for hydrocephalus after subarachnoid hemorrhage, presented disorientation, memory disturbance and gait disturbance without any cardiopulmonary symptom. Head CT scan revealed ventriculomegaly that indicated hydrocephalus due to shunt malfunction. Radiogram revealed that the caudal segment of the broken atrial catheter had migrated into the heart (right ventricle). The migrated shunt catheter was retrieved by a transfemoral approach with a pigtail catheter and a snare retriever catheter, although the rostral catheter segment partially remained because of tight adhesion. The VA shunt was then reconstructed. Postoperatively, symptoms due to recurrent hydrocephalus were markedly improved and the VA shunt functioned well. Transvenous catheter retrieval was a less invasive and effective method for VA shunt catheter migration. PMID:22647514

  20. Fractured inlet connecting tube of the flat bottom flushing device of a posterior fossa cystoperitoneal shunt

    PubMed Central

    Amirjamshidi, Abbas; Abbasioun, Kazem; Ghassemi, Babak

    2015-01-01

    Background: There are well-known complications for shunt procedures. Shunt fracture or disconnection is the second most frequent cause of shunt malfunction in children. Shunt disconnection is not a common cause of shunt malfunction in the early period after installation, especially in the adulthood. Case Description: Fracture of the proximal (inlet) connector of a flat-based shunt installed for decompression of a large posterior fossa arachnoid cyst in a 31-year-old female with signs of increased intracranial pressure led to recurrence of her symptoms 6 months after surgery. Conclusion: Awareness of the possibility of fracture site in the junction of the inlet connector of flat bottom shunt systems is warranted and can be diagnosed by three-dimensional computed tomography (3D CT) imaging without performing shunt series study. PMID:25789198

  1. [Simultaneous reconstruction of pharyngoesophagus and phonetic shunt following laryngopharyngoesophagectomy].

    PubMed

    Matsuura, K; Yamada, A; Hashimoto, S; Tateda, M; Miyakura, H; Hozawa, K; Takasaka, T

    1999-02-01

    Because of its many advantages, free jejunal transfer has gained wide acceptance for pharyngoesophageal reconstruction after ablative surgery. Because the jejunum is well vascularized, it facilitates good wound healing, and has a low incidence of anastomotic insufficiency, fistula formation and stricture. However, voice rehabilitation in this group of patients can be difficult. Therefore, we performed primary tracheojejunal shunt operations for voice restoration with jejunum siphons using Nozaki's method (type 3). In this procedure, after dividing a section of the jejunum into two segments, the reconstructed neopharyngoesophagus is anastomosed in a side-to-end fashion to the fabricated shunt using the other segment of the jejunum, as an "elephant nose shunt" so called because of its appearance. Voice restoration can be achieved in patients who undergo laryngopharyngoesophagectomy through these reconstructive procedures. We performed this surgery for nine hypopharyngeal cancer patients after total pharyngo-laryngo-esophagectomy. Following placement of the shunt, no special care was required. Only one patient developed a severe aspiration. No leakage was seen and the swallowing function was preserved in all patients. Four of nine patients could speak well following these procedures. A vibratory source is created in the neoesophagus, above the elephant shunt. During speech production, narrowing of the inside and vibration of the jejunal mucosa can be observed using a laryngeal fiber scope. In order to study the acoustical characteristics of shunt speech, voice analysis was performed in patients with restored phonatory function using Computerized Speech Lab Model 4300 (KAY). Irregularities of pitch periods in the voice sample were measured using Jita (the pitch period) and Jitt (relative evaluation of the pitch) for the very short term (cycle-to-cycle), and PPQ (pitch period pertubation quotient) for the short term (cycle-to-cycle with a smoothing factor of 5 periods). Irregularities of the peak-to-peak amplitude were measured using ShdB (evaluation in dB of the peak-to-peak amplitude) and Shim (relative evaluation of the peak-to-peak amplitude) for the very short term (cycle-to-cycle), and APQ (amplitude perturbation quotient) for the short term (cycle-to-cycle with a smoothing factor of 11 periods). The pertubation parameters of shunt speech are larger than normal ones not only in terms of the period but also in terms of the amplitude. These results are similar to those of laryngeal polyps, recurrent nerve palsy and esophageal speech. Recovery of phonation using Nozaki's type 3 method with the elephant nose shunt appears promising for pharyngo-laryngo-esophagectomized patients. PMID:10191622

  2. Modeling, analysis and verification of a partial shunt system

    SciTech Connect

    Lee, J.R.

    1996-12-31

    Spacecraft power system modeling, analysis and verification techniques using the electronic circuit simulation programs such as SPICE and SABER are presented. Partial shunt control system dynamics including the loop gain and bus impedance are derived. A typical partial shunt system is modeled and the loop gain of the system is simulated using an electronic circuit simulator. To confirm the circuit model simulation results prior to expensive hardware testing, they should be compared with the results simulated from a transfer function model derived from circuit equations. The spacecraft test results finally verify the modeling and analysis.

  3. Acquired lacunar skull deformity following ventriculoperitoneal shunt placement.

    PubMed

    Nakahara, Kuniaki; Shimizu, Satoru; Kan, Shinichi; Oka, Hidehiro; Fujii, Kiyotaka

    2008-01-01

    A female infant developed hydrocephalus as a result of intraventricular hemorrhage related to premature birth. Radiography showed no sign of lacunar skull deformity (LSD). Lateral and fourth ventricle ventriculoperitoneal shunts were placed. The fourth ventricle shunt required replacement at age 3 years. Radiography and computed tomography showed LSD. Follow-up radiography at age 8 years showed the LSD was becoming unclear. LSD generally appears before birth, and disappears shortly after birth. LSD is most commonly associated with spina bifida cystica or encephalocele. This case of acquired LSD indicates that abnormal disorganized collection of collagen fibers of the skull plates may be triggered by iatrogenic intracranial hypotension even after infancy. PMID:18219193

  4. Potts Shunt in Patients with Primary Pulmonary Hypertension

    PubMed Central

    Kim, Sue Hyun; Jang, Woo-Sung; Lim, Hong-Gook; Kim, Yong-Jin

    2015-01-01

    Idiopathic pulmonary arterial hypertension eventually leads to right-sided heart failure and sudden death. Its mortality rate in children is still high, despite improvements in pharmacological therapy, and therefore novel treatments are necessary. The Potts shunt, which creates an anastomosis between the left pulmonary artery and the descending aorta, has been proposed as a theoretically promising palliative surgical technique to decompress the right ventricle. We report the case of a 12-year-old girl with suprasystemic idiopathic pulmonary hypertension and right ventricular failure who underwent a Potts shunt for palliation with good short-term results. PMID:25705598

  5. Potts shunt in patients with primary pulmonary hypertension.

    PubMed

    Kim, Sue Hyun; Jang, Woo-Sung; Lim, Hong-Gook; Kim, Yong-Jin

    2015-02-01

    Idiopathic pulmonary arterial hypertension eventually leads to right-sided heart failure and sudden death. Its mortality rate in children is still high, despite improvements in pharmacological therapy, and therefore novel treatments are necessary. The Potts shunt, which creates an anastomosis between the left pulmonary artery and the descending aorta, has been proposed as a theoretically promising palliative surgical technique to decompress the right ventricle. We report the case of a 12-year-old girl with suprasystemic idiopathic pulmonary hypertension and right ventricular failure who underwent a Potts shunt for palliation with good short-term results. PMID:25705598

  6. [Spontaneous splenorenal and splenocaval shunts studied by echotomography].

    PubMed

    Pietri, H; Clément, J P; Corbeau, A; Boscaini, M; De Iorio, M; Cicero, F; Sarles, H

    1982-11-01

    Spontaneous spleno-renal and spleno-caval shunts may be anatomically and functionally important in portal hypertension syndromes, as demonstrated by the distinct opacification of the inferior vena cava observed after portal venography with iodine contrast media. Part of the course of these porto-caval anastomotic vessels can be visualized by ultrasonography opposite the left adrenal gland and in the space between the spleen and the left kidney. The images obtained are characteristic enough for the diagnosis of spleno-renal shunt to be suspected before it is confirmed by portal venography, as was the case in the four patients with hepatic cirrhosis reported by the authors. PMID:7155827

  7. Treatment of Portosystemic Shunt Myelopathy with a Stent Graft Deployed through a Transjugular Intrahepatic Route

    SciTech Connect

    Jain, Deepak Arora, Ankur; Deka, Pranjal; Mukund, Amar Bhatnagar, Shorav; Jindal, Deepti Kumar, Niteen Pamecha, Viniyendra

    2013-08-01

    A case of surgically created splenorenal shunt complicated with shunt myelopathy was successfully managed by placement of a stent graft within the splenic vein to close the portosystemic shunt and alleviate myelopathy. To our knowledge, this is the first report of a case of shunt myelopathy in a patient with noncirrhotic portal fibrosis without cirrhosis treated by a novel technique wherein a transjugular intrahepatic route was adopted to deploy the stent graft.

  8. Percutaneous rheolytic mechanical thrombectomy in thrombosed direct intrahepatic portosystemic shunt: Report of two cases

    PubMed Central

    Tsetis, Dimitrios; Kehagias, Elias; Samonakis, Dimitrios; Kouroumalis, Elias; Hatzidakis, Adam

    2015-01-01

    We report two patients with Budd–Chiari syndrome, who underwent direct intrahepatic portosystemic shunt complicated by shunt thrombosis. Percutaneous AngioJet mechanical thrombectomy in combination with manual catheter aspiration and balloon disruption of the residual clot was successful, restoring patency of the thrombosed shunt. PMID:26767124

  9. Successful Embolization of a Spontaneous Mesocaval Shunt Using the Amplatzer Vascular Plug II

    SciTech Connect

    Boixadera, Helena; Tomasello, Alejandro; Quiroga, Sergi; Cordoba, Joan; Perez, Mercedes; Segarra, Antoni

    2010-10-15

    A 48-year-old man with alcoholic liver cirrhosis and hepatic encephalopathy was found to have a large, spontaneous mesocaval shunt. The shunt was successfully occluded with the use of an Amplatzer Vascular Plug. To our knowledge, this is the first report of the use of this device to embolize a mesocaval shunt involving the superior mesenteric vein.

  10. High-Flow Arterio-Hepatic Venous Shunt in Hepatocellular Carcinoma: Use of Multi-Electrode Radiofrequency for Shunt Obliteration.

    PubMed

    Pua, Uei

    2015-10-01

    Intra-tumoral arterio-hepatic venous shunting (AHVS) poses an impediment to transarterial chemoembolization of liver tumors. Not only does it present a potential hazard for systemic shunting and embolization, but also the altered flow dynamics may also result in poor delivery of drug/embolics to the target tumor bed. Current available techniques to overcome AVHS include arterial embolization (particles, coils, glue, etc.) or temporary venous occlusion using balloons. We hereby illustrate the use of radiofrequency ablation to obliterate a complex AHVS consisting of a varix-like venous aneurysm. PMID:25189667

  11. 76 FR 41041 - Special Conditions: Gulfstream Aerospace LP (GALP) Model G250 Airplane, Interaction of Systems...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... Administration 14 CFR Part 25 Special Conditions: Gulfstream Aerospace LP (GALP) Model G250 Airplane, Interaction... special conditions are issued for the Gulfstream Aerospace LP (GALP) Model G250 airplane. This...

  12. 75 FR 38514 - Application to Export Electric Energy; Brookfield Energy Marketing LP

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ... Application to Export Electric Energy; Brookfield Energy Marketing LP AGENCY: Office of Electricity Delivery and Energy Reliability, DOE. ACTION: Notice of application. SUMMARY: Brookfield Energy Marketing LP... power marketing agencies and other entities within the United States. The existing...

  13. 77 FR 38128 - Withdrawal of TORP Terminal LP, Bienville Offshore Energy Terminal Liquefied Natural Gas (LNG...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-26

    ... Maritime Administration Withdrawal of TORP Terminal LP, Bienville Offshore Energy Terminal Liquefied... Terminal LP's (TORP) withdrawal of the deepwater port license application for the proposed Bienville Offshore Energy Terminal (BOET). All actions related to the processing and agency coordination...

  14. 77 FR 65680 - Gulf South Pipeline Company, L.P.; Notice of Request Under Blanket Authorization

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-30

    ... Authorization Take notice that on October 11, 2012, Gulf South Pipeline Company, L.P. (Gulf South), 9 Greenway... South Pipeline Company, L.P., 9 Greenway Plaza, Suite 2800, Houston, Texas 77046, (713) 479-8033,...

  15. 77 FR 69449 - Gulf South Pipeline Company, LP; Notice of Request Under Blanket Authorization

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-19

    ... Authorization Take notice that on November 1, 2012, Gulf South Pipeline Company, LP (Gulf South), 9 Greenway..., Regulatory Affairs, Boardwalk Pipeline Partners, LP, 9 Greenway Plaza, Suite 2800, Houston, TX 77046...

  16. 78 FR 17193 - Gulf South Pipeline Company, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-20

    ... March 1, 2013, Gulf South Pipeline Company, LP (Gulf South), 9 Greenway Plaza, Suite 2800, Houston.... Kyle Stephens, Vice President, Regulatory Affairs, Gulf South Pipeline Company, LP, 9 Greenway...

  17. Fire Service Training. LP and Compressed Gas Emergencies.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Community Colleges, Raleigh.

    Part of a series of instructional outlines intended for use in a training program for firemen with no previous formal training, this curriculum guide discusses safety precautions for liquefied petroleum (LP) and compressed gas emergencies. During its twelve hours of instruction it covers (1) terminology; (2) the chemical composition of the gases;…

  18. Fire Service Training. LP and Compressed Gas Emergencies.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Community Colleges, Raleigh.

    Part of a series of instructional outlines intended for use in a training program for firemen with no previous formal training, this curriculum guide discusses safety precautions for liquefied petroleum (LP) and compressed gas emergencies. During its twelve hours of instruction it covers (1) terminology; (2) the chemical composition of the gases;…

  19. 76 FR 68745 - Seneca Power Partners, L.P.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-07

    ... complaint were served on the Respondent and the New York Public Service Commission. Any person desiring to... Energy Regulatory Commission Seneca Power Partners, L.P. v. New York Independent System Operator, Inc... a complaint against the New York Independent System Operator, Inc. (Respondent), alleging that...

  20. 78 FR 64933 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... Emerald Coal Resources, LP (Emerald) in Greene County, Pennsylvania in Panel D1 of Emerald's mine, ground subsidence may occur. In order to maintain the operation of their existing pipeline facilities throughout the..., for a certificate of public convenience and necessity to construct its Emerald Longwall Mine Panel...

  1. US EPA Testing of LP & MP UV Disinfection Technologies

    EPA Science Inventory

    Presentation will discuss the ongoing USEPA research on UV disinfection addressing the following objectives: Conservatively predict log inactivation and RED of adenovirus with surrogates; Conduct many (LP=61) UV reactor conditions challenged with Ad2, B. pumilus, and MS2 & conduc...

  2. Lp-PLA2 Inhibition—The Atherosclerosis Panacea?

    PubMed Central

    Karakas, Mahir; Koenig, Wolfgang

    2010-01-01

    Based on the complex pathophysiology of atherosclerosis, a large number of biomarkers that relate to lipids, inflammation, immunity, thrombosis and hemostasis, have been investigated experimentally, in epidemiologic studies and in clinical trials. Interest focuses on their potential role to aid in risk stratification, as possible surrogate markers of atherosclerosis, and potential targets for therapy. More recently, one lipid associated biomarker, lipoprotein-associated phospholipase A2 (Lp-PLA2), has gained considerable interest. In addition to a plausible pathophysiological role by generating pro-inflammatory and pro-atherogenic compounds from oxidized LDL in the vessel wall, there is a large, fairly consistent epidemiological database indicating that increased levels of Lp-PLA2 mass or activity are associated with increased risk for cardiovascular outcomes; such data further suggest that it might improve risk stratification. In addition, clinical studies indicate that increased Lp-PLA2 levels are associated with endothelial dysfunction. Moreover, it may also serve as an interesting therapeutic target, since a specific inhibitor of the enzyme is available with promising animal data and initial positive data in humans. Recent experimental data from a hyperlipidemic diabetic pig model strongly suggest that increased Lp-PLA2 in the vessel wall is associated with a more vulnerable plaque phenotype which can be modulated by inhibiting Lp-PLA2 activity. A biomarker study in more than 1,000 patients with CHD over three months has demonstrated a positive effect on various inflammatory molecules. In addition, an imaging study using IVUS based modalities (greyscale, virtual histology, and palpography) together with a panel of biomarkers (IBIS-2) has been done in more than 300 patients with CHD treated over 12 months and results indicate that the progression of the necrotic core of the plaque can be retarded. Inhibition of the pro-atherogenic and pro-inflammatory effects of Lp-PLA2 may therefore contribute to decrease the residual risk in high risk patients already on polypharmacotherapy. This hypothesis is now being tested in two large phase 3 clinical trials. Thus, Lp-PLA2 indeed may represent a biomarker and a promising target for intervention.

  3. Hypertensive slit ventricle syndrome: pseudotumor cerebri with a malfunctioning shunt?

    PubMed

    Bateman, Grant A

    2013-12-01

    Symptomatic shunt malfunction without ventricular enlargement is known as slit ventricle syndrome (SVS). Patients presenting with this syndrome are not a homogeneous group. Of the 5 different types classified by Rekate, Type 1 is caused by CSF overdrainage and is associated with low pressures; Types 2 and 3 are associated with shunt blockage and elevated CSF pressures; Type 4 is cephalocranial disproportion that increases brain parenchymal pressure but not CSF pressure; and Type 5 is headache unrelated to shunt function. The low and normal CSF pressure types are relatively well understood, but the high-pressure forms are more problematic. In the high-pressure forms of SVS it is said that the lack of ventricular dilation is related to a reduction in brain compliance analogous to idiopathic intracranial hypertension or pseudotumor cerebri. Despite this, there is little evidence in the literature to support this conjecture. With this in mind, 3 cases of SVS associated with elevated CSF pressure are presented. The MR venogram findings and hemodynamics of these 3 cases are shown to be identical to those of pseudotumor cerebri. A literature review indicates that an underlying venous impairment may be functioning in the patients who re-present with small ventricles following shunt malfunction. PMID:23991845

  4. Surgical treatment of idiopathic syringomyelia: Silastic wedge syringosubarachnoid shunting technique

    PubMed Central

    Soo, Teck M.; Sandquist, Lee; Tong, Doris; Barrett, Ryan

    2014-01-01

    Background: The underlying pathophysiology leading to syringomyelia is elusive with multiple flow-related theories constituting our current limited understanding of the disease process. Syringomyelia is associated with pathologies related to the disturbance of cerebral spinal fluid flow found in conditions such as Chiari I malformations, spinal malignancy, spinal cord tethering, trauma, or arachnoid adhesions. Our aim is to describe a unique surgical shunting technique used to treat refractory cases of idiopathic syringomyelia. Methods: Five patients, aged 22-50, presented with progressive neurologic symptoms associated with an idiopathic syrinx. All underwent decompressive laminectomy surgery with syringosubarachnoid shunting using the silastic wedge technique. Results: In five cases of idiopathic syringomyelia, clinical and radiographic follow up ranges from 3 to 36 months. Three patients have radiographic and clinical follow up greater than 24 months. All patients improved clinically and their symptoms have been stable. Conclusions: Shunting procedures for the syringomyelia disease spectrum have been criticized due to the inconsistent long-term outcomes. This surgical technique used to treat symptomatic idiopathic syringomyelia has been devised based on our intraoperative experience, surgical outcomes, and evaluation of the literature. The purpose of the wedges is to preserve patency of the communication between the syrinx cavity and the expanded subarachnoid space by preventing healing of the myelotomy edges and by maintaining an artificial conduit between the syrinx cavity and the subarachnoid space. Although short-term results are promising, continued long-term follow up is needed to determine the ultimate success of the silastic wedge shunting procedure. PMID:25101209

  5. CONTEXT VIEW ALONG EXISTING PERIMETER TRACKS LOOKING TOWARDS SHUNTS IN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    CONTEXT VIEW ALONG EXISTING PERIMETER TRACKS LOOKING TOWARDS SHUNTS IN THEIR PRESENT-DAY POSITIONS, STORAGE SHED, AND MACHINE SHOP. LOOKING NORTHEAST. - Pennsylvania Railway Ore Dock, Lake Erie at Whiskey Island, approximately 1.5 miles west of Public Square, Cleveland, Cuyahoga County, OH

  6. Bilhemia: A Rare Complication of Transjugular Intraheptic Portosytemic Shunt

    PubMed Central

    Zhang, Michael

    2015-01-01

    A 56-year-old woman with cirrhosis due to chronic hepatitis C underwent emergent transjugular intrahepatic portosystemic shunt (TIPS) due to a ruptured esophageal varix during esophagogastroduodenoscopy. Following TIPS, the patient experienced a rapid rise in serum bilirubin with no evidence of biliary obstruction or hepatic injury. She was determined to have bilhemia, a rare but serious complication of TIPS. PMID:26504882

  7. 21 CFR 882.4545 - Shunt system implantation instrument.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Shunt system implantation instrument. 882.4545 Section 882.4545 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... components under the skin. (b) Classification. Class I (general controls). When made only of surgical...

  8. 49 CFR 236.57 - Shunt and fouling wires.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Shunt and fouling wires. 236.57 Section 236.57 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RULES, STANDARDS, AND INSTRUCTIONS GOVERNING THE INSTALLATION, INSPECTION, MAINTENANCE, AND REPAIR OF SIGNAL AND...

  9. Focally spared area of fatty liver caused by arterioportal shunt

    SciTech Connect

    Arita, Takeshi; Matsunaga, Naofumi; Honma, Yutaka

    1996-05-01

    We describe a case with a focally spared area in fatty liver caused by arterioportal shunt. Furthermore, we discuss the cause of the focally spared area related to a localized dilution or reduction in portal blood flow. 13 refs., 1 fig.

  10. Factorial analysis in diagnosis of left-to-right shunts

    SciTech Connect

    Villanueva-Meyer, J.; Philippe, L.; Mena, I.

    1985-05-01

    Factor analysis (FA) extracts curves and images from a dynamic study with minimal operator intervention. This study applies FA to the left-to-right (L-R) shunt diagnosis, using it with deconvolution and gamma fitting techniques and comparing it to current procedures. 14 patients with a L-R shunt confirmed by catheterization and 10 normal subjects were studied. A first-pass ventriculogram was gathered in list mode for 25 sec after bolus injection of 15-20 mCi Tc99m. .5 sec frames were created. For FA 3 factors were requested, the dixel size was 4 by 4 pixels and 30 dixels were analyzed. The heart was masked out for the analysis. Three images and curves were obtained: venous input, lungs and background. The lung curve was deconvolved by the venous input curve using the lagged normal algorithm. The unit impulse response was used to obtain a calculated output lung curve. Gamma functions were fitted on this curve and area ratios yielded the Qp/Qs. Only FA with deconvolution separates the shunt patients from the control group with a p <0.001. Qp/Qs for the shunt group was 2.30, SD .54 and the control group was 1.12, SD .07. The best correlation with oximetry was obtained with this technique, r=.87 and SEE .28. The FA lung curve has excellent counting statistics derived from 48% of the total counts, thus the improvement of results.

  11. TIPS Versus Peritoneovenous Shunt in the Treatment of Medically Intractable Ascites

    PubMed Central

    Rosemurgy, Alexander S.; Zervos, Emmanuel E.; Clark, Whalen C.; Thometz, Donald P.; Black, Thomas J.; Zwiebel, Bruce R.; Kudryk, Bruce T.; Grundy, L Shane; Carey, Larry C.

    2004-01-01

    Objective: We undertook a prospective randomized clinical trial comparing TIPS to peritoneovenous (PV) shunts in the treatment of medically intractable ascites to establish relative efficacy and morbidity, and thereby superiority, between these shunts. Methods: Thirty-two patients were prospectively randomized to undergo TIPS or peritoneovenous (Denver) shunts. All patients had failed medical therapy. Results: After TIPS versus peritoneovenous shunts, median (mean ± SD) duration of shunt patency was similar: 4.4 months (6 ± 6.6 months) versus 4.0 months (5 ± 4.6 months). Assisted shunt patency was longer after TIPS: 31.1 months (41 ± 25.9 months) versus 13.1 months (19 ± 17.3 months) (P < 0.01, Wilcoxon test). Ultimately, after TIPS 19% of patients had irreversible shunt occlusion versus 38% of patients after peritoneovenous shunts. Survival after TIPS was 28.7 months (41 ± 28.7 months) versus 16.1 months (28 ± 29.7 months) after peritoneovenous shunts. Control of ascites was achieved sooner after peritoneovenous shunts than after TIPS (73% vs. 46% after 1 month), but longer-term efficacy favored TIPS (eg, 85% vs. 40% at 3 years). Conclusion: TIPS and peritoneovenous shunts treat medically intractable ascites. Absence of ascites after either is uncommon. PV shunts control ascites sooner, although TIPS provides better long-term efficacy. After either shunt, numerous interventions are required to assist patency. Assisted shunt patency is better after TIPS. Treating medically refractory ascites with TIPS risks early shunt-related mortality for prospects of longer survival with ascites control. This study promotes the application of TIPS for medically intractable ascites if patients undergoing TIPS have prospects beyond short-term survival. PMID:15166968

  12. Embolization of splenorenal shunt associated to portal vein thrombosis and hepatic encephalopathy

    PubMed Central

    Franzoni, Letícia de Campos; de Carvalho, Fábio Cardoso; Garzon, Rafael Gomes de Almeida; Yamashiro, Fábio da Silva; Augusti, Laís; Santos, Lívia Alves Amaral; Dorna, Mariana de Souza; Baima, Júlio Pinheiro; Lima, Talles Bazeia; Caramori, Carlos Antonio; Silva, Giovanni Faria; Romeiro, Fernando Gomes

    2014-01-01

    Hepatic encephalopathy (HE) is a cognitive disturbance characterized by neuropsychiatric alterations. It occurs in acute and chronic hepatic disease and also in patients with portosystemic shunts. The presence of these portosystemic shunts allows the passage of nitrogenous substances from the intestines through systemic veins without liver depuration. Therefore, the embolization of these shunts has been performed to control HE manifestations, but the presence of portal vein thrombosis is considered a contraindication. In this presentation we show a cirrhotic patient with severe HE and portal vein thrombosis who was submitted to embolization of a large portosystemic shunt. Case report: a 57 years-old cirrhotic patient who had been hospitalized many times for persistent HE and hepatic coma, even without precipitant factors. She had a wide portosystemic shunt and also portal vein thrombosis. The abdominal angiography confirmed the splenorenal shunt and showed other shunts. The larger shunt was embolized through placement of microcoils, and the patient had no recurrence of overt HE. There was a little increase of esophageal and gastric varices, but no endoscopic treatment was needed. Since portosystemic shunts are frequent causes of recurrent HE in cirrhotic patients, portal vein thrombosis should be considered a relative contraindication to perform a shunt embolization. However, in particular cases with many shunts and severe HE, we found that one of these shunts can be safely embolized and this procedure can be sufficient to obtain a good HE recovery. In conclusion, we reported a case of persistent HE due to a wide portosystemic shunt associated with portal vein thrombosis. As the patient had other shunts, she was successfully treated by embolization of the larger shunt. PMID:25400477

  13. A new method for the measurement of intrahepatic shunts

    SciTech Connect

    Hoefs, J.C.; Reynolds, T.B.; Pare, P.; Sakimura, I.

    1984-03-01

    After transhepatic portal pressure determination, 96 patients were assessed for the presence of intrahepatic shunts by injection of microspheres (25 +/- 5 micron diameter) into the portal vein using RISA-131I as an indicator of dilution. Multiple portal vein injections in each patient allowed blood sampling from the hepatic vein (site 1) and from two inferior vena cava sampling sites (site 2, at the junction of the hepatic vein orifice with the inferior vena cava, and site 3, 2 to 3 cm closer to or within the right atrium). Intrahepatic shunting was calculated from each site: hepatic vein in 57 patients and inferior vena cava, site 2 in 43 patients and site 3 in 77 patients. At least one valid IHS calculation was available in 92 of the patients. Intrahepatic shunting calculated from sequential portal vein injections with sampling from the hepatic vein was highly correlated (r . 0.98, p less than 0.0001, slope . 1.0), with a mean difference of 1.9% +/- 1.9%. There was no significant difference by t test comparison of the mean IHS calculated from sites 1, 2, and 3. Occasional marked discrepancies were noted between IHS calculated from site 1 or site 2 compared with site 3, and the site 3 calculation was always greater. A shunt index in all patients included shunts calculated from the hepatic vein in 57 patients plus shunt calculation from the inferior vena cava in the remaining patients (site 2 in 26 patients and site 3 in nine). The 82 patients with portal hypertension or chronic liver disease had a higher portal pressure, 13.8 +/- 4.6 mm Hg, and a significantly greater shunt index, 13.7% +/- 24.5% compared with controls. The frequency distribution of IHS in patients with chronic liver disease demonstrated less than 2% IHS in 49% of patients and less than 5% IHS in 63%. The validity of our methods and the implications of the infrequent demonstration of a large IHS are discussed.

  14. 75 FR 74029 - Sabine Pass LNG, L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-30

    ... Energy Regulatory Commission Sabine Pass LNG, L.P.; Notice of Application November 22, 2010. Take notice that on November 12, 2010, Sabine Pass LNG, L.P. (Sabine Pass), 700 Milam Street, Suite 800, Houston... directed to Patricia Outtrim, Sabine Pass LNG, L.P., 700 Milam Street, Suite 800, Houston, Texas 77002,...

  15. 76 FR 58850 - Highland Capital Management, L.P., et al.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-22

    ... COMMISSION Highland Capital Management, L.P., et al.; Notice of Application September 15, 2011. AGENCY... Capital Management, L.P. (``HCM''), Highland Funds Asset Management, L.P. (``HFAM''), Highland Funds I..., and should be accompanied by proof of service on applicants, in the form of an affidavit or,...

  16. 78 FR 69078 - Houston Pipe Line Company LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-18

    ... Energy Regulatory Commission Houston Pipe Line Company LP; Notice of Application Take notice that on October 28, 2013, Houston Pipe Line Company LP (HPL), 1300 Main Street, Houston, Texas 77002, filed an... directed to Mr. Jim Wright, Deputy General Counsel, Houston Pipe Line Company LP, 1300 Main Street,...

  17. Seismo-Acoustic LP Swarms at Tungurahua Volcano, Ecuador

    NASA Astrophysics Data System (ADS)

    Kim, K.; Lees, J. M.; Ruiz, M. C.

    2012-12-01

    A massive swarm of seismo-acoustic events interrupted a long period of quiescence at Tungurahua Volcano, Ecuador, in May 2010. We present here details of moment tensor solutions to 84 of the event that occurred over the five day crises that include vulcanian explosions, sustained ash emissions, and pyroclastic flows. Long-peroid seismicity at volcanoes have long been considered related to activity of magmatic and hydrothermal fluids. The LP events of Tungurahua were characterized by: 1) an initial vent explosion, 2) an emergent, dilatational first motion seismic arrival, 3) followed by quasi-harmonic coda and volcanic tremor. During the May swarm period, both infrasound and seismic waves exhibited significant, non-isotropic radiation patterns. Wave analysis of the infrasound band acoustic waves showed considerable asymmetry, most likely associated with the truncated bowl shape of the 300 m vent. Acoustic wave propagation was explained using combinations of acoustic monopole and dipole sources to illuminate the explosion dynamics. Seismic moment tensors of LP first motions were estimated by waveform inversion, accounting for the considerable topographic relief of Tungurahua. Particle motion analysis indicates that the LP waves, in the 2-5 s band, are body waves. Although the LP sources cluster at 2 km depth below the vent, the station array does not allow for tight bounds on the depth, and vertical uncertainty is large. The strong association of acoustic blasts and LP waves suggests a shallow source for these events. We present the relation between the acoustic and seismic source mechanisms with time over the period.

  18. Control of an electromechanical hydrocephalus shunt--a new approach.

    PubMed

    Elixmann, Inga M; Kwiecien, Monika; Goffin, Christine; Walter, Marian; Misgeld, Berno; Kiefer, Michael; Steudel, Wolf-Ingo; Radermacher, Klaus; Leonhardt, Steffen

    2014-09-01

    Hydrocephalus is characterized by an excessive accumulation of cerebrospinal fluid (CSF). Therapeutically, an artificial pressure relief valve (so-called shunt) is implanted which opens in case of increased intracranial pressure (ICP) and drains CSF into another body compartment. Today, available shunts are of a mechanical nature and drainage depends on the pressure drop across the shunt. According to the latest data, craniospinal compliance is considered to be even more important than mean ICP alone. In addition, ICP is not constant but varies due to several influences. In fact, heartbeat-related ICP waveform patterns depend on volume changes in the cranial vessels during a heartbeat and changes its shape as a function of craniospinal compliance. In this paper, we present an electromechanical shunt approach, which changes the CSF drainage as a function of the current ICP waveform. A series of 12 infusion tests in patients were analyzed and revealed a trend between the compliance and specific features of the ICP waveform. For waveform analysis of patient data, an existing signal processing algorithm was improved (using a Moore machine) and was implemented on a low-power microcontroller within the electromechanical shunt. In a test rig, the ICP waveforms were replicated and the decisions of the ICP analysis algorithm were verified. The proposed control algorithm consists of a cascaded integral controller which determines the target ICP from the measured waveform, and a faster inner-loop integral controller that keeps ICP close to the target pressure. Feedforward control using measurement data of the patient's position was implemented to compensate for changes in hydrostatic pressure during change in position. A model-based design procedure was used to lay out controller parameters in a simple model of the cerebrospinal system. Successful simulation results have been obtained with this new approach by keeping ICP within the target range for a healthy waveform. PMID:25148657

  19. Association of freezing tolerance to LpCBFIIIb and LpCBFIIIc gene polymorphism in perennial ryegrass accessions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    CBF/DREB related genes are considered important genes for regulation of abiotic stress in plants. In this study, CBF/DREB genes in perennial ryegrass (Lolium perenne L.), also known as LpCBF genes, were resequenced from several cultivated and landrace plants from a worldwide collection. The same pla...

  20. 78 FR 36182 - APL SouthTex Transmission Company LP, Formerly TEAK Texana Transmission Company, LP; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission APL SouthTex Transmission Company LP, Formerly TEAK Texana Transmission... SouthTex) filed to notify the Commission of its name change from TEAK Texana Transmission Company,...

  1. 78 FR 53745 - Gulf South Pipeline Company, LP; Petal Gas Storage, L.L.C.; Gulf South Pipeline Company, LP...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... requires the unique operational capabilities of Petal's salt-dome storage facilities. In Docket No. RP13... Partners, LP, 9 Greenway Plaza, Houston, Texas, 77046; by fax 713-479- 1846 or email to kyle.stephens@bwpmlp.com . There are two ways to become involved in the Commission's review of this project. First,...

  2. Fuzzy Inference System Approach for Locating Series, Shunt, and Simultaneous Series-Shunt Faults in Double Circuit Transmission Lines.

    PubMed

    Swetapadma, Aleena; Yadav, Anamika

    2015-01-01

    Many schemes are reported for shunt fault location estimation, but fault location estimation of series or open conductor faults has not been dealt with so far. The existing numerical relays only detect the open conductor (series) fault and give the indication of the faulty phase(s), but they are unable to locate the series fault. The repair crew needs to patrol the complete line to find the location of series fault. In this paper fuzzy based fault detection/classification and location schemes in time domain are proposed for both series faults, shunt faults, and simultaneous series and shunt faults. The fault simulation studies and fault location algorithm have been developed using Matlab/Simulink. Synchronized phasors of voltage and current signals of both the ends of the line have been used as input to the proposed fuzzy based fault location scheme. Percentage of error in location of series fault is within 1% and shunt fault is 5% for all the tested fault cases. Validation of percentage of error in location estimation is done using Chi square test with both 1% and 5% level of significance. PMID:26413088

  3. Fuzzy Inference System Approach for Locating Series, Shunt, and Simultaneous Series-Shunt Faults in Double Circuit Transmission Lines

    PubMed Central

    Swetapadma, Aleena; Yadav, Anamika

    2015-01-01

    Many schemes are reported for shunt fault location estimation, but fault location estimation of series or open conductor faults has not been dealt with so far. The existing numerical relays only detect the open conductor (series) fault and give the indication of the faulty phase(s), but they are unable to locate the series fault. The repair crew needs to patrol the complete line to find the location of series fault. In this paper fuzzy based fault detection/classification and location schemes in time domain are proposed for both series faults, shunt faults, and simultaneous series and shunt faults. The fault simulation studies and fault location algorithm have been developed using Matlab/Simulink. Synchronized phasors of voltage and current signals of both the ends of the line have been used as input to the proposed fuzzy based fault location scheme. Percentage of error in location of series fault is within 1% and shunt fault is 5% for all the tested fault cases. Validation of percentage of error in location estimation is done using Chi square test with both 1% and 5% level of significance. PMID:26413088

  4. Systemic-pulmonary artery shunts in infants: modified Blalock-Taussig and central shunt procedures.

    PubMed

    Brooks, Andre

    2014-01-01

    Access is gained through a midline sternotomy, the thymus partially excised and the superior part of the pericardium is opened. The innominate vein is retracted and the innominate artery is mobilized up to the bifurcation. The aorta is retracted to the left, the superior vena cavae to the right and the right atrial appendage inferiorly. The adventitia around the right pulmonary artery (PA) is dissected, taking care to incise the bulky pericardial reflection between the superior vena cavae and the trachea. Heparin is administrated. An occlusive clamp is applied to the right PA to test for haemodynamic tolerance prior to proceeding with the interposition of a suitable size artificial vascular prosthesis, based on the weight of the patient, between the innominate artery, or proximal subclavian artery and the right PA. Alternatively, if a sufficient main PA is present and adequate flow from a patent ductus arteriosus an end-to-side interposition shunt may be constructed between the ascending aorta and the main PA, provided the patient is stable with the test occlusion of the main PA. The management of the patent arterial ductus depends on whether or not there is forward flow through the PA. PMID:24941030

  5. ASSOCIATION OF LP-PLA2 ACTIVITY WITH ALLELE-SPECIFIC LP(a) LEVELS IN A BI-ETHNIC POPULATION

    PubMed Central

    Enkhmaa, Byambaa; Anuurad, Erdembileg; Zhang, Wei; Pearson, Thomas A.; Berglund, Lars

    2010-01-01

    Objectives Lipoprotein-associated phospholipase A2 (Lp-PLA2) and lipoprotein(a) [Lp(a)] have been implicated as cardiovascular disease risk factors, and are differentially regulated across ethnicity. We investigated the association between Lp-PLA2 activity and allele-specific apolipoprotein(a) [apo(a)] levels in a bi-ethnic population. Methods Lp-PLA2 activity, Lp(a) and allele-specific apo(a) levels were determined in 224 African Americans and 336 Caucasians. Results Lp-PLA2 activity level was higher among Caucasians compared to African Americans (173 ± 41 vs. 141 ± 39 nmol/min/ml, P<0.001), and positively associated with Lp(a), total and LDL cholesterol, triglyceride, apolipoprotein B-100, and negatively with HDL cholesterol levels in both ethnic groups. The association between Lp-PLA2 activity and Lp(a) was stronger among African Americans compared to Caucasians (R=0.238, ?1=3.48, vs. R=0.111, ?1=1.93, respectively). The Lp-PLA2 activity level was significantly associated with allele-specific apo(a) levels for smaller (<26 K4 repeats) apo(a) sizes in both ethnic groups (P=0.015 for African Americans, P=0.038 for Caucasians). In contrast, for larger (>26 K4 repeats) apo(a) sizes, high Lp-PLA2 activity levels were associated with higher allele-specific apo(a) levels in African Americans (P=0.009), but not in Caucasians. Conclusion The association between Lp-PLA2 activity and allele-specific apo(a) levels differs across African American-Caucasian ethnicity. PMID:20444451

  6. Risk factors associated with distal catheter migration following ventriculoperitoneal shunt placement.

    PubMed

    Abode-Iyamah, Kingsley O; Khanna, Ryan; Rasmussen, Zachary D; Flouty, Oliver; Dahdaleh, Nader S; Greenlee, Jeremy; Howard, Matthew A

    2016-03-01

    Ventriculoperitoneal (VP) shunt placement is used to treat hydrocephalus. Shunt migration following VP shunt placement has been reported. The risk factors related to this complication have not been previously evaluated to our knowledge. In this retrospective cohort study, we aimed to determine risk factors leading to distal catheter migration and review the literature on the current methods of management and prevention. Adult patients undergoing VP shunt placement from June 2011 to December 2013 at a single institution were identified using electronic health records. The records were reviewed for demographic and procedural information, and subsequent treatment characteristics. The parameters of patients with distal shunt migration were compared to those undergoing new VP shunt placement for the same time period. We identified 137 patients undergoing 157 new VP shunt procedures with an average age of 57.7±standard deviation of 18.4years old. There were 16 distal shunt migrations. Body mass index >30kg/m(2) and number of previous shunt procedures were found to be independent risk factors for distal catheter migration. Obesity and number of previous shunt procedures were factors for distal catheter migration. Providers and patients should be aware of these possible risk factors prior to VP shunt placement. PMID:26549674

  7. Measurement of flow of cerebrospinal fluid in shunts by transcutaneous thermal convection. Technical note.

    PubMed

    Neff, Samuel

    2005-10-01

    With the goal of developing a practical method of performing noninvasive measurements of flow in cerebrospinal fluid (CSF) shunts, transcutaneous thermal convection CSF shunt flow measurement was investigated using dimensional analysis, numerical modeling, and bench testing. Using appropriate manufacturing practices and controls, a microcontroller-based device was designed, constructed, and clinically tested. Flow was detected in functioning shunts nine times in 10 attempts. One test failed due to postoperative edema, and subsequent testing was limited to patients who had not undergone shunt surgery within the previous 2 weeks. On the basis of these data and previous reports, 510(k) clearance was granted by the Food and Drug Administration for detection of flow in CSF shunts. Flow in CSF shunts can be detected noninvasively and cost effectively by using a simple thermal convection system. The positive and negative predictive values of the test are equal to or greater than those of brain imaging and radionuclide shunt studies. PMID:16270690

  8. Management of surgical splenorenal shunt-related hepatic myelopathy with endovascular interventional techniques.

    PubMed

    Wang, Mao-Qiang; Liu, Feng-Yong; Duan, Feng

    2012-12-21

    We present a case with hepatic myelopathy (HM) due to a surgical splenorenal shunt that was successfully treated by endovascular interventional techniques. A 39-year-old man presented with progressive spastic paraparesis of his lower limbs 14 mo after a splenorenal shunt. A portal venogram identified a widened patent splenorenal shunt. We used an occlusion balloon catheter initially to occlude the shunt. Further monitoring of the patient revealed a decrease in his serum ammonia level and an improvement in leg strength. We then used an Amplatzer vascular plug (AVP) to enable closure of the shunt. During the follow up period of 7 mo, the patient experienced significant clinical improvement and normalization of blood ammonia, without any complications. Occlusion of a surgically created splenorenal shunt with AVP represents an alternative therapy to surgery or coil embolization that can help to relieve shunt-induced HM symptoms. PMID:23323015

  9. Comparison of Distal and Proximal Splenorenal Shunts: A Randomized Prospective Trial

    PubMed Central

    Fischer, Josef E.; Bower, Robert H.; Atamian, Susan; Welling, Richard

    1981-01-01

    Controversy still surrounds the place of portalsystemic shunting in the therapy of bleeding esophageal varices. Recently, a selective shunt, the distal splenorenal shunt, has achieved some degree of popularity and, apparently, is associated with less chronic encephalopathy. Because of this, a trial was initiated at the Massachusetts General Hospital and continued at the University of Cincinnati Medical Center, prospectively randomizing central and distal splenorenal shunts in consecutive elective cases of patients with established variceal bleeding. Preoperative evaluation included endoscopic examination at the time of hemorrhage, angiography and upper gastrointestinal series, emphasis on mental function including EEG, amino acids, neurologic examination, as well as standard liver chemistries. Nineteen patients underwent central splenorenal shunts and 23 distal splenorenal shunt. There was one operative death from hemorrhagic pancreatitis in a Child's Class A patient with distal splenorenal shunt. Four late deaths, from gunshot wound, auto accident, overwhelming pneumonitis similar to postsplenectomy syndrome, and metastatic carcinoma (2.5 years after operation), have been recorded in the distal splenorenal shunt group, and none in the central splenorenal shunt group. On follow-up angiographic examination, six shunts have clotted, with three patients requiring reoperation, generally mesocaval shunt. There has been no chronic encephalopathy, three individual episodes of encephalopathy, two in the central splenorenal shunt group and one in the distal splenorenal shunt group, two associated with gastrointestinal bleeding and one with intercurrent infection and overdiuresis. Follow-up liver chemistries and amino acids which may be useful as an indicator of hepatic function suggest that although the distal shunt group had a better amino acid pattern before operation, branched-chain amino acids tend to become lower in the distal group while remaining the same in the central group. Aromatic amino acids increase post shunt, equally in the two groups. The results do not support the contention that distal splenorenal shunt is associated either with greater survival or freedom from encephalopathy than central splenorenal shunt, a small side-to-side shunt. Ascites seems better controlled by the central splenorenal shunt. ImagesFig. 1.Fig. 2.Fig. 3.Fig. 4.Fig. 5.Fig. 6. PMID:6974543

  10. Switching a mainframe LP to a personal computer

    SciTech Connect

    Dixon, D.E.

    1986-01-01

    It is becoming apparent that future advances in hardware will make PC-based LP systems even more attractive and productive then they are now. The authors recently ran one of our typical models with recursion using the new 80386 chip on the Compaq Deskpro 386. The time required it took to generate and solve the problem was approximately 15 minutes compared to 33 minutes with the IBM 80286 chip, 43 minutes with our speed up board added PC and 105 minutes on an IBM PC. This illustrates the tremendous computing power now available on personal computers and convinces them that they made the right decision to switch to a PC-based LP system.

  11. 77 FR 30589 - SteelRiver Infrastructure Partners LP, SteelRiver Infrastructure Associates LLC, SteelRiver...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-23

    ... Surface Transportation Board SteelRiver Infrastructure Partners LP, SteelRiver Infrastructure Associates LLC, SteelRiver Infrastructure Fund North America LP, and Patriot Funding LLC--Control Exemption--Patriot Rail Corp., et al. SteelRiver Infrastructure Partners LP (SRIP LP), SteelRiver...

  12. Unilateral shunt formation with thoracic aortic dissection in a whippet.

    PubMed

    Cornelis, I; Bosmans, T; Doom, M; Binst, D; Van der Vekens, E; Kromhout, K; Cornillie, P; Van Ham, L

    2014-06-01

    A three-year-old neutered male whippet was presented with intermittent, exercise-induced paraparesis. Femoral pulses were bilaterally absent. Neurologic examination was suggestive of a thoracolumbar myelopathy. Blood pressure measurements revealed hypotension in both pelvic limbs, hypertension in the right thoracic limb and it was immeasurable in the left thoracic limb. Echocardiography was within reference limits. A clear vascular pulsation was palpable on the right ventral abdominal wall. Computed tomographic angiography revealed a dissection of the aortic wall between the left subclavian artery and the brachiocephalic trunk with subsequent thrombus formation. A shunt between the right internal thoracic, cranial and caudal epigastric arteries to preserve blood flow to the pelvic limbs was visualized. Necropsy was declined by the owner. This is the first case report describing the formation of a unilateral vascular shunt following a thoracic aortic occlusion, which presented as exercise-induced paraparesis. PMID:24602076

  13. Smell of danger: an analysis of LP-gas odorization

    SciTech Connect

    Cain, W.S.; Turk, A.

    1985-03-01

    LP-gas derives warning properties from the odorants ethyl mercaptan or thiophane. Laboratory tests have implied that the average person has the ability to smell the odors before leaking LP-gas reaches one-fifth its lower limit of flammability. Generally, however, laboratory tests ignore or discard persons with a poor sense of smell, especially the elderly and persons with certain types of hyposmia. Some persons who apparently can smell the warning agents when directed may otherwise fail to notice or identify them. Elderly men seem particularly vulnerable to instances of incidental anosmia and olfactory agnosia. Psychophysical testing of the warning agents has been rather unsophisticated. There exists neither a standard protocol for testing nor adequate specification of the perceptual properties that might make one warning agent better than another. Without such developments, improvement in warning agents will fail to occur. Possible improvements include increases in concentration, the use of blends to insure more uniform delivery of agent and, to decrease the perceptual vulnerability of relatively insensitive people, use of agents with favorable psychophysical (stimulus-response) functions and use of agents with favorable adaptation characteristics. Even without a change in existing products, it seems advisable to learn more about the vulnerability of LP-gas users and to employ educational means to reduce risks.

  14. Autoregressive model in the Lp norm space for EEG analysis.

    PubMed

    Li, Peiyang; Wang, Xurui; Li, Fali; Zhang, Rui; Ma, Teng; Peng, Yueheng; Lei, Xu; Tian, Yin; Guo, Daqing; Liu, Tiejun; Yao, Dezhong; Xu, Peng

    2015-01-30

    The autoregressive (AR) model is widely used in electroencephalogram (EEG) analyses such as waveform fitting, spectrum estimation, and system identification. In real applications, EEGs are inevitably contaminated with unexpected outlier artifacts, and this must be overcome. However, most of the current AR models are based on the L2 norm structure, which exaggerates the outlier effect due to the square property of the L2 norm. In this paper, a novel AR object function is constructed in the Lp (p?1) norm space with the aim to compress the outlier effects on EEG analysis, and a fast iteration procedure is developed to solve this new AR model. The quantitative evaluation using simulated EEGs with outliers proves that the proposed Lp (p?1) AR can estimate the AR parameters more robustly than the Yule-Walker, Burg and LS methods, under various simulated outlier conditions. The actual application to the resting EEG recording with ocular artifacts also demonstrates that Lp (p?1) AR can effectively address the outliers and recover a resting EEG power spectrum that is more consistent with its physiological basis. PMID:25448380

  15. Assessment of surgical portosystemic shunts and associated complications: The diagnostic and therapeutic role of radiologists.

    PubMed

    Taslakian, Bedros; Faraj, Walid; Khalife, Mohammad; Al-Kutoubi, Aghiad; El-Merhi, Fadi; Saade, Charbel; Hallal, Ali; Haydar, Ali

    2015-08-01

    Surgical portosystemic shunting, the formation of a vascular connection between the portal and systemic venous circulation, has been used as a treatment to reduce portal venous pressure. Although the use of portosystemic shunt surgery in the management of portal hypertension has declined during the past decade in favour of alternative therapies, and subsequently surgeons and radiologists became less familiar with the procedure, it remains a well-established treatment. Knowledge of different types of surgical portosystemic shunts, their pathophysiology and complications will help radiologists improve communication with surgeons and enhance their understanding of the diagnostic and therapeutic role of radiology in the assessment and management of these shunts. Optimal assessment of the shunt is essential to determine its patency and allow timely intervention. Both non-invasive and invasive imaging modalities complement each other in the evaluation of surgical portosystemic shunts. Interventional radiology plays an important role in the management of complications, such as shunt thrombosis and stenosis. This article describes the various types of surgical portosystemic shunts, explains the anatomy and pathophysiology of these shunts, illustrates the pearls and pitfalls of different imaging modalities in the assessment of these shunts and demonstrates the role of radiologists in the interventional management of complications. PMID:25963504

  16. Neurodevelopmental Outcome of Extremely Low Birth Weight Infants With Posthemorrhagic Hydrocephalus Requiring Shunt Insertion

    PubMed Central

    Adams-Chapman, Ira; Hansen, Nellie I.; Stoll, Barbara J.; Higgins, Rose

    2009-01-01

    OBJECTIVE We aimed to evaluate neurodevelopmental and growth outcomes among extremely low birth weight infants who had severe intraventricular hemorrhage that required shunt insertion compared with infants without shunt insertion. METHODS Infants who were born in 1993–2002 with birth weights of 401 to 1000 g were enrolled in a very low birth weight registry at medical centers that participate in the National Institute of Child Health and Human Development Neonatal Research Network, and returned for follow-up at 18 to 22 months’ corrected age were studied. Eighty-two percent of survivors completed follow-up, and 6161 children were classified into 5 groups: group 1, no intraventricular hemorrhage/no shunt (n = 5163); group 2, intraventricular hemorrhage grade 3/no shunt (n = 459); group 3, intraventricular hemorrhage grade 3/shunt (n = 103); group 4, intraventricular hemorrhage grade 4/no shunt (n = 311); and group 5, intraventricular hemorrhage grade 4/shunt (n = 125). Group comparisons were evaluated with ?2 and Wilcoxon tests, and regression models were used to compare outcomes after adjustment for covariates. RESULTS Children with severe intraventricular hemorrhage and shunts had significantly lower scores on the Bayley Scales of Infant Development IIR compared with children with no intraventricular hemorrhage and with children with intraventricular hemorrhage of the same grade and no shunt. Infants with shunts were at increased risk for cerebral palsy and head circumference at the <10th percentile at 18 months’ adjusted age. Greatest differences were observed between children with shunts and those with no intraventricular hemorrhage on these outcomes. CONCLUSIONS This large cohort study suggests that extremely low birth weight children with severe intraventricular hemorrhage that requires shunt insertion are at greatest risk for adverse neurodevelopmental and growth outcomes at 18 to 22 months compared with children with and without severe intraventricular hemorrhage and with no shunt. Long-term follow-up is needed to determine whether adverse outcomes persist or improve over time. PMID:18390958

  17. Transjugular Intrahepatic Portosystemic Shunt before and after Liver Transplantation

    PubMed Central

    Saad, Wael E.

    2014-01-01

    The transjugular intrahepatic portosystemic shunt (TIPS) has long been referred to as a procedure performed as “a bridge to transplantation” since, like many other portosystemic shunts, it decompresses the portal circulation and stabilizes patients but does not definitively treat portal hypertension. One of the major advantages of TIPS over surgically placed portosystemic shunts in the transplant era is that the TIPS is intrahepatic and is removed in situ with the native liver, and usually does not need additional surgery (unlike takedown/ligation of surgical shunts). There are several studies that evaluate TIPS before transplantation—not as a bridge/temporizing measure, but as a prelude to the transplant to decompress the portal circulation and reduce portosystemic engorgement and collaterals and thus, in theory, reduce intraoperative bleeding during liver transplantation. However, these studies, mostly in the transplant literature, have been equivocal from an intraoperative and posttransplant clinical outcome standpoint. TIPS creation in liver transplant recipients is another interesting aspect of TIPS. There has been a debate about whether or not liver transplantation adds additional technical difficulty to the TIPS procedure. Initially, many theories were proposed as to the technical difficulty of TIPS in a transplanted liver. However, recent opinions and published studies demonstrate that whole-graft liver transplantation does not pose a significant technical difficulty to TIPS. Moreover, there are several recent studies evaluating the outcomes of TIPS in liver transplant recipients, showing that outcomes are less favorable when compared with TIPS in nontransplanted patients. This article discusses the results of TIPS as a preoperative prelude to liver transplantation. In addition, it discusses the technical and clinical outcomes of TIPS in liver transplant recipients. PMID:25177084

  18. Cardiac Perforation and Tamponade During Transjugular Intrahepatic Portosystemic Shunt Placement

    SciTech Connect

    McCowan, Timothy C.; Hummel, Michael M.; Schmucker, Tracey; Goertzen, Timothy C.; Culp, William C.; Habbe, Thomas G.

    2000-07-15

    A patient developed acute severe hemodynamic compromise during a transjugular intrahepatic portosystemic shunt (TIPS) procedure for intractable ascites. Rapid clinical and radiographic evaluation of the patient disclosed pericardial blood and cardiac tamponade as the cause, probably due to right heart perforation from guidewire and catheter manipulation. The tamponade was successfully treated percutaneously, and the patient survived. Cardiac tamponade should be considered in the differential diagnosis of patients who develop hypotension during TIPS placement.

  19. Transjugular Intrahepatic Portosystemic Shunt before and after Liver Transplantation.

    PubMed

    Saad, Wael E

    2014-09-01

    The transjugular intrahepatic portosystemic shunt (TIPS) has long been referred to as a procedure performed as "a bridge to transplantation" since, like many other portosystemic shunts, it decompresses the portal circulation and stabilizes patients but does not definitively treat portal hypertension. One of the major advantages of TIPS over surgically placed portosystemic shunts in the transplant era is that the TIPS is intrahepatic and is removed in situ with the native liver, and usually does not need additional surgery (unlike takedown/ligation of surgical shunts). There are several studies that evaluate TIPS before transplantation-not as a bridge/temporizing measure, but as a prelude to the transplant to decompress the portal circulation and reduce portosystemic engorgement and collaterals and thus, in theory, reduce intraoperative bleeding during liver transplantation. However, these studies, mostly in the transplant literature, have been equivocal from an intraoperative and posttransplant clinical outcome standpoint. TIPS creation in liver transplant recipients is another interesting aspect of TIPS. There has been a debate about whether or not liver transplantation adds additional technical difficulty to the TIPS procedure. Initially, many theories were proposed as to the technical difficulty of TIPS in a transplanted liver. However, recent opinions and published studies demonstrate that whole-graft liver transplantation does not pose a significant technical difficulty to TIPS. Moreover, there are several recent studies evaluating the outcomes of TIPS in liver transplant recipients, showing that outcomes are less favorable when compared with TIPS in nontransplanted patients. This article discusses the results of TIPS as a preoperative prelude to liver transplantation. In addition, it discusses the technical and clinical outcomes of TIPS in liver transplant recipients. PMID:25177084

  20. Dynamic 320-section CT angiography in cranial arteriovenous shunting lesions.

    PubMed

    Brouwer, P A; Bosman, T; van Walderveen, M A A; Krings, T; Leroux, A A; Willems, P W A

    2010-04-01

    Novel 320-section CT scanning equipment enables dynamic noninvasive angiographic imaging of the entire cranial vasculature (4D-CTA). We describe this technique and demonstrate its potential in arteriovenous shunting lesions. 4D-CTA imaging resulted in a correct diagnosis, lesion classification, and treatment-strategy selection in 3 patients, compared with CA. We think that 4D-CTA can further reduce the need for CA, sparing the patient the discomfort and risk associated with an invasive procedure. PMID:19875470

  1. A unique multipurpose damping circuit for shunt capacitor bank switching

    SciTech Connect

    Sabot, A.; Morin, C.; Guillaume, C.; Pons, A. . Les Renardieres Lab.); Taisne, J.P. . Transmission Division); Pizzo, G.L.; Morf, H.U. )

    1993-07-01

    Considerations on disturbances related to Shunt Capacitor Bank (SCB) switching are summarized and a unique damping circuit able to cope with all of them is proposed. This damping circuit consists of a reactor in parallel with a resistor which is in series with a Metal Oxide Varistor (MOV), the latter being used to switch on the resistor only during transients. The design parameter of this damping circuit are described and the main tests performed are presented.

  2. Fetal pleuroamniotic shunting for bronchopulmonary sequestration with hydrops.

    PubMed

    Hayashi, S; Sago, H; Kitano, Y; Kuroda, T; Honna, T; Nakamura, T; Ito, Y; Kitagawa, M; Natori, M

    2006-12-01

    Bronchopulmonary sequestration (BPS), a non-functional pulmonary tissue mass, when complicated by fetal hydrops, carries a high risk of perinatal mortality. However, a limited number of cases of BPS complicated by fetal hydrops with an informative clinical course have been reported. We report here on three cases of BPS complicated by fetal hydrothorax and hydrops that were successfully treated by pleuroamniotic shunting, which should be considered as a treatment option for fetal hydrothorax and hydrops associated with BPS. PMID:17086582

  3. Results of Trabectome Surgery Following Failed Glaucoma Tube Shunt Implantation

    PubMed Central

    Mosaed, Sameh; Chak, Garrick; Haider, Asghar; Lin, Ken Y.; Minckler, Don S.

    2015-01-01

    Abstract To evaluate the safety and efficacy of Trabectome after failed tube shunt surgery. Twenty patients with prior failed tube shunt surgery who underwent Trabectome alone were included. All patients had at least 3 months of follow-up. Outcomes measured included intraocular pressure (IOP), glaucoma medications, and secondary glaucoma surgeries. The success for Kaplan–Meier survival analysis is defined as IOP ?21?mm Hg, IOP reduced by at least 20% from preoperative IOP, and no secondary glaucoma surgery. Mean preoperative IOP was 23.7?±?6.4?mm Hg and mean number of glaucoma medications was 3.2?±?1.5. At 12 months, IOP was reduced to 15.5?±?3.2?mm Hg (P?=?0.05) and number of medications was reduced to 2.4?±?1.5 (P?=?0.44). Survival rate at 12 months was 84% and 3 patients required additional glaucoma surgery with 15 patients reaching 12 months follow-up. Other than failure of IOP control and transient hypotony (IOP?shunt surgery, may benefit from procedures that avoid conjunctival incision such as Trabectome. This study indicates potential benefits in this patient population. Trabectome was safe and effective in reducing IOP at 1-year follow-up in patients with prior failed tube shunt surgery, but not effective in reducing medication reliance in these patients. PMID:26222842

  4. 78 FR 32294 - DeltaPoint Capital IV, L.P., DeltaPoint Capital IV (New York), L.P., License No. 02/02-0662,02/02...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-29

    ... ADMINISTRATION DeltaPoint Capital IV, L.P., DeltaPoint Capital IV (New York), L.P., License No. 02/02-0662,02/02... Interest Notice is hereby given that DeltaPoint Capital IV, L.P. and DeltaPoint Capital IV (New York), L.P...). DeltaPoint Capital IV, L.P. provided financing to Switchgear Acquisition, Inc., 1211Stewart...

  5. Hysteresis Control for Current Harmonics Suppression Using Shunt Active Filter

    NASA Astrophysics Data System (ADS)

    Ahuja, Rajesh Kr; Chauhan, Aasha; Sharma, Sachin

    2012-11-01

    Recently wide spread of power electronic equipment has caused an increase of the harmonic disturbances in the power systems. The nonlinear loads draw harmonic and reactive power components of current from ac mains. Current harmonics generated by nonlinear loads such as adjustable speed drives,static powersupplies and UPS. Thus a perfect compensator is required to avoid the consequences due to harmonics. To overcome problems due to harmonics, Shunt Active Power Filter (SAPF) has been considered extensively. SAPF has better harmonic compensation than the other approaches used for solving the harmonic related problems. The performance of the SAPF depends upon different control strategies. This paper presents the performance analysis of SAPF under most important control strategy namely instantaneous real active and reactive power method (p-q) for extracting reference currents of shunt active filters under unbalanced load condition. Detailed simulations have been carried out considering this control strategy and adequate results were presented. In this paper, harmonic control strategy is applied to compensate the current harmonics in the system. A detailed study about the harmonic control method has been used using shunt active filter technique.

  6. Net cardiac shunts in anuran amphibians: physiology or physics?

    PubMed

    Hillman, Stanley S; Hedrick, Michael S; Kohl, Zachary F

    2014-08-15

    Amphibians have a single ventricle and common conus arteriosus that produces an equal pressure to the parallel pulmocutaneous and systemic vascular circuits. The distribution of blood flows between the pulmocutaneous (Qpul) and systemic (Qsys) circuits (net cardiac shunt) varies with a number of environmental conditions and behaviours; although autonomic regulation of pulmonary vascular resistance conductance has been emphasized, little attention has been paid to the possible contribution of the passive physical characteristics of the two circuits to pressure changes associated with variation in cardiac output. In this study, we re-analysed three recent studies that recorded net cardiac shunts in the cane toad (Rhinella marina) under a variety of conditions and treatments. In all three studies, Qpul and Qsys were linearly related to cardiac output (Qtot), but the slope was threefold higher for Qpul compared with Qsys as predicted by relative conductance increases associated with increases in pressure from perfused preparations where autonomic regulation and humoral control were eliminated. Our analysis indicates that the net cardiac shunt in the cane toad is predicted primarily by the physical, rather than physiological, characteristics of the parallel pulmonary and systemic vascular circuits. PMID:24902743

  7. [Syndromes of overdrainage of ventricular shunting in childhood hydrocephalus].

    PubMed

    Martínez-Lage, J F; Pérez-Espejo, M A; Almagro, M J; Ros de San Pedro, J; López, F; Piqueras, C; Tortosa, J

    2005-04-01

    Overdrainage in ventricular shunting constitutes a difficult to prevent and to treat complication. The authors reviewed a retrospective series of 512 children submitted to a ventricular shunting procedure aimed at analysing factors influencing this type of complication. The causes for the hydrocephalus were congenital (n=172), post-myelomeningocele (n=123), posthemorrhagic (n=103), tumoral (n=64), postmeningitis (n=40) and posttraumatic (n=10). Eighty-eight children (17.8%) evolved with a complication related to the excessive function of the valve. The authors investigated the relationship between hydrocephalus' etiology and type of overdrainage syndromes. The most frequent complication was ventricular catheter block (n=50), followed by symptomatic slit ventricle syndrome (SVS) (n=19), subdural hematoma (n=10) and trapped fourth ventricle (n=9). There were no statistical differences regarding complications for each etiologic subset of hydrocephalus. SVS occurred in 19 children (3.71%), a low rate according to the current literature. Posthemorrhagic and postinfectious hydrocephalus grouped together showed a higher rate of SVS (p=0.005), a feature that we attributed to the cerebral destruction caused by these two conditions. Treatment of SVS was complex and required diverse procedures, applied in an escalated way, which included five decompressive craniectomies. The authors suggest avoiding, as much as possible, the use of ventricular shunts, and recommend the alternative use of new technology valves and neuroendoscopic procedures. PMID:15915302

  8. Utility of Lp-PLA2 in lipid-lowering therapy.

    PubMed

    Racherla, Sreekanth; Arora, Rohit

    2012-03-01

    Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a vascular-specific inflammatory marker. It is so named because of its association with low-density lipoprotein in plasma. Atherosclerosis is an inflammatory disease. Lp-PLA2 is recognized as a risk marker in primary or secondary prevention of atherosclerosis. Elevated Lp-PLA2 levels are associated with the increased risk for cardiovascular events, even after multivariable adjustment for traditional risk factors. Patients with dyslipidemia are shown to benefit largely from the modification of Lp-PLA2. The degree of coronary artery disease (0-, 1-, 2-, or 3-vessel disease) and plasma low-density lipoprotein cholesterol significantly correlated to Lp-PLA2 levels. The low biologic fluctuation and high vascular specificity of Lp-PLA2 make it possible to use a single measurement in clinical decision making, and it also permits clinicians to follow the Lp-PLA2 marker serially. Simvastatin significantly reduces macrophage content, lipid retention, and the intima to media ratio but increased the content of smooth muscle cells in atherosclerotic lesions. Statin treatment markedly reduced Lp-PLA2 in both plasma and atherosclerotic plaques with attenuation of the local inflammatory response and improved plaque stability due to reduced inflammation and decreased apoptosis of macrophages. Darapladib, an inhibitor of Lp-PLA2 when added to lipid-lowering therapy such as statins, offers great benefit in the reduction of plaque formation. This article explores the atherosclerotic process at molecular level, role of Lp-PLA2 in atherosclerosis, the effect of lipid-lowering drugs on Lp-PLA2, effect of direct Lp-PLA2 inhibitor darapladib in the atherosclerosis process, the therapeutic implications of Lp-PLA2 as risk marker, and finally the net effect on plaque stabilization. PMID:20634673

  9. Post Blalock–Taussig shunt mediastinal mass – a single shadow with two different destinies

    PubMed Central

    Rohit, Manoj Kumar; Vadivelu, Ramalingam; Khandelwal, Niranjan; Krishna, Satheesh

    2014-01-01

    The modified Blalock–Taussig shunt is a synthetic shunt between the subclavian and pulmonary artery, used in the treatment of congenital cyanotic heart diseases with pulmonary hypoperfusion. Delayed complications include progressive failure of the shunt, serous fluid leak, and pseudoaneurysm formation. We report two different and rare mediastinal vascular complications following modified BT shunt surgery in this case report. The first one is a seroma, due to serous fluid leakage through the shunt graft, which is a relatively benign complication. The second one is a pseudoaneurysm, arising from the shunt, a frequently fatal complication. Generally, X-ray chest is used for screening in these patients. CT angiography plays a vital role in the diagnosis of both these conditions. Management in pseudoaneurysm should be aggressive, as timely intervention may be life saving, while in seroma the management is most often conservative occasionally requiring surgical intervention. PMID:24814123

  10. Chemoembolic Hepatopulmonary Shunt Reduction to Allow Safe Yttrium-90 Radioembolization Lobectomy of Hepatocellular Carcinoma

    SciTech Connect

    Gaba, Ron C.; VanMiddlesworth, Kyle A.

    2012-12-15

    Yttrium-90 ({sup 90}Y) radioembolization represents an emerging transcatheter treatment option for the management of hepatocellular carcinoma (HCC). Elevation of the hepatopulmonary shunt fraction risks nontarget radiation to the lungs and may limit the use of {sup 90}Y therapy in patients with locally advanced disease with vascular invasion, who often demonstrate increased shunting. We present two cases in which patients with HCC and portal vein invasion resulting in elevated hepatopulmonary shunt fractions underwent chemoembolic shunt closure to allow safe {sup 90}Y radioembolization. Both patients demonstrated excellent tumor response and patient survival. On this basis, we propose a role for chemoembolic reduction of the lung shunt fraction before {sup 90}Y radioembolization in patients with extensive tumor-related hepatopulmonary shunting.

  11. Reversibility of intrapulmonary arteriovenous shunts in liver cirrhosis documented by serial radionuclide perfusion lung scans

    SciTech Connect

    Chen, N.S.; Barnett, C.A.; Farrer, P.A.

    1984-05-01

    Using serial perfusion lung scans, the opening up and closure of right-to-left intrapulmonary arteriovenous shunts has been documented over a period of several weeks in a patient with chronic alcoholic liver disease. The presence of the shunts correlates well with the severity of hypoxemia and the presence of nodular mottling on chest radiographs. The time course of these changes with clinical status suggests lability and the functional nature of these shunts.

  12. CSF hydrothorax without intrathoracic catheter migration in children with ventriculoperitoneal shunt

    PubMed Central

    Kim, Joon-Hyung; Roberts, David W.; Bauer, David F.

    2015-01-01

    Background: Thoracic complications of ventriculoperitoneal (VP) shunts have been extensively reported in the literature. Cerebrospinal fluid (CSF) hydrothorax without catheter migration, however, has been rarely described and poorly understood. Case Description: We describe development of pleural effusion and respiratory distress in a 3-year-old boy with no evidence of VP shunt catheter displacement on plain radiograph and stable ventricle size on rapid sequence magnetic resonance imaging (MRI) brain. Chest X-ray revealed complete opacity of right hemithorax. Pleural effusion was consistent with transudate. Beta-2 transferrin returned positive. The patient underwent externalization of VP shunt, and upon resolution of effusion, re-internalization with new distal shunt catheter. A literature review of CSF hydrothorax in children without intrathoracic shunt migration was performed. Eleven cases were identified in the English literature. Age at VP shunt placement ranged from birth to 8 years of age. Interval from VP shunt placement to CSF hydrothorax ranged from 1.5 months to 5 years. History of shunt revision was reported in two cases. Presenting symptoms also included ascites and inguinal hernia or hydrocele. Reported diagnostic studies consist of CSF culture, radionuclide shuntogram, beta-2 transferrin, and beta-trace protein. Laterality of the VP shunt and development of pleural effusion were predominantly right sided. Definitive surgical treatment included VA shunt, repositioning of the peritoneal catheter, and endoscopic choroid plexus coagulation. Conclusion: CSF hydrothorax is a rare thoracic complication of VP shunt placement with no radiographic evidence of shunt migration or malfunction. Postulated mechanisms include limited peritoneal capacity to resorb CSF in children and microscopic communications present in congenital diaphragmatic hiatuses. PMID:26236552

  13. Stacked inspiratory spirometry reduces pulmonary shunt in patients after coronary artery bypass.

    PubMed

    Strider, D; Turner, D; Egloff, M B; Burns, S M; Truwit, J D

    1994-08-01

    Atelectasis is a major factor in postoperative morbidity for patients undergoing cardiopulmonary surgery. We evaluated the effectiveness of stacked inspiratory spirometry (STIS) in 17 patients status postcoronary artery bypass graft in a nonrandomized fashion. We measured pulmonary shunt as an endpoint, and compared the magnitudes before and after the STIS maneuver. Our results showed an 8.66 percent reduction in pulmonary shunt (p < 0.05). The reduction in shunt was modest; however, repetitive maneuvers might result in greater improvement. PMID:7774308

  14. Using Controlled Shunt Reactors for Voltage Stabilization on the Example of Real Electric Power System

    NASA Astrophysics Data System (ADS)

    Gusev, A. S.; Suvorov, A. A.; Sulaymanov, A. O.

    2015-10-01

    The article is devoted to actual task of real-time simulation controlled shunt reactors to use in the appropriate electric power system. Such development allows fully and reliably reproducing the processes running in controlled shunt reactors and electric power systems as whole. As an example of such task solution the working results of controlled shunt reactors simulation and its application for voltage stabilization are presented.

  15. 2-LP mode few-mode fiber amplifier employing ring-core erbium-doped fiber.

    PubMed

    Ono, Hirotaka; Hosokawa, Tsukasa; Ichii, Kentaro; Matsuo, Shoichiro; Nasu, Hitoshi; Yamada, Makoto

    2015-10-19

    A fiber amplifier supporting 2 LP modes that employs a ring-core erbium-doped fiber (RC-EDF) is investigated to reduce differential modal gain (DMG). The inner and outer radii of the ring-core of the RC-EDF are clarified for 2-LP mode operation of the amplifier, and are optimized to reduce the DMG. It is shown that using the overlap integral between the erbium-doped core area and the signal power mode distribution is a good way to optimize the inner and outer radii of the ring-core of the RC-EDF and thus minimize the DMG. A fabricated RC-EDF and a constructed 2-LP mode EDFA are described and a small DMG of around 1 dB is realized for LP01, LP11 and LP21 pumping. PMID:26480402

  16. Robert H. Pudenz (1911-1998) and Ventriculoatrial Shunt: Historical Perspective.

    PubMed

    Konar, Subhas K; Maiti, Tanmoy K; Bir, Shyamal C; Kalakoti, Piyush; Nanda, Anil

    2015-11-01

    Robert H. Pudenz was a renowned neurosurgeon in North America in the 20th century, famous for his contributions in the evolution of the shunt valve and ventriculoatrial shunt surgery. With his innovative idea and help from Heyer, in 1955, he demonstrated that a venous catheter worked best when in the right atrium and that the slit valve should be located at the most distal portion of the shunt system to prevent retrograde filling and thrombosis. He also contributed to various experimental studies on the brain, especially the electrical response of different neural structures. This historical vignette focuses on the work of Robert Pudenz and the evolution of the ventriculoatrial shunt. PMID:26074435

  17. Thrombosed Mesocaval Shunt: Salvage by Mechanical Thrombolysis. Case Report and Review of the Literature

    SciTech Connect

    Baijal, Sanjay Saran Mohan, Suyash; Singh, Jagadeesh R.; Verma, Ashish

    2008-07-15

    We report the case of a 27-year-old male who presented with acute mesocaval shunt thrombosis, which was successfully managed by mechanical thrombolysis. Shunt thrombosis was suspected when the patient showed clinical signs and symptoms of obstructive jaundice in the immediate postoperative period. Doppler sonography showed absence of flow across the shunt, suggestive of thrombosis, which was mechanically thrombolyzed by a percutaneous approach. The portocaval pressure gradient noted at the end of procedure was <5 mm Hg. The shunt remained patent at the end of 3 months' follow-up.

  18. Distal Dunk for Right Ventricle to Pulmonary Artery Shunt in Stage 1 Palliation.

    PubMed

    Mascio, Christopher E; Spray, Thomas L

    2015-12-01

    The use of a right ventricle-to-pulmonary artery (RV-PA) conduit for stage 1 palliation of hypoplastic left heart syndrome is common. A prospective randomized multiinstitutional study revealed that approximately 40% of those receiving this shunt required intervention on the shunt or pulmonary arteries, or both. A technique has been developed to help ameliorate proximal conduit stenosis. We present a new technique to improve distal conduit stenosis and decrease anastomotic bleeding from this site. The technique involves dunking a segment of the shunt into the pulmonary arteries and suture placement in the shunt rings and not in the polytetrafluoroethylene (PTFE). PMID:26652546

  19. Simultaneous urethrocutaneous and urethrocavernous fistula after proximal corporospongiosal shunt for priapism.

    PubMed

    Manjunath, Adarsh S; Mazur, Daniel J; Han, Justin S; Gonzalez, Christopher M

    2015-03-01

    Proximal corporospongiosal shunts are used for the most refractory cases of priapism. Here, we present the case of a 58-year-old man whose priapism was only partially responsive to phenylephrine injections and distal shunting. Proximal shunting was required, and he subsequently developed fistulization of the proximal penile urethra into the skin and the corpora cavernosa. The formation of simultaneous urethrocutaneous and urethrocavernous fistulae is a rare complication of proximal corporospongiosal shunts that can be initially managed with urinary diversion with a suprapubic tube. PMID:25733307

  20. Embolization of portal-systemic shunts in cirrhotic patients with chronic recurrent hepatic encephalopathy

    SciTech Connect

    Sakurabayashi, Shin; Sezai, Shuichi; Yamamoto, Yoshihiro; Hirano, Masanori; Oka, Hiroshi

    1997-03-15

    Purpose. To evaluate the efficacy of embolization of portal-systemic shunts in cirrhotic patients with chronic recurrent hepatic encephalopathy (CRHE). Methods. Seven cirrhotic patients with CRHE refractory to medical treatment (3 men and 4 women, mean age 66 years) were studied. Five patients had splenorenal shunts, 1 had a gastrorenal shunt, and 1 had an intrahepatic portal vein-hepatic vein shunt. Shunt embolization was performed using stainless steel coils, with a percutaneous transhepatic portal vein approach in 4 patients and a transrenal vein approach in 3 patients. Results. After embolization, the shunt disappeared in 4 patients on either ultrasound pulsed Doppler monitoring or portography. Complications observed in the 7 patients were fever, transient pleural effusion, ascites, and mild esophageal varices. For 3-6 months after embolization, the 4 patients whose shunts disappeared showed minimal or no reappearance of a shunt, and had no recurrence of encephalopathy. The serum ammonia levels decreased and electroencephalograms also improved. One of the 4 patients, who developed mild esophageal varices, required no treatment. Treatment was effective in 3 of the 4 patients (75%) who underwent embolization via a transhepatic portal vein. Conclusion. Transvascular embolization of shunts improved the outcome in 4 of 7 patients. The most effective embolization was achieved via the percutaneous transhepatic portal vein approach.

  1. 78 FR 44943 - EcoEléctrica, L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-25

    ... Energy Regulatory Commission EcoEl ctrica, L.P.; Notice of Application Take notice that on July 3, 2013, EcoEl ctrica, L.P. (EcoEl ctrica), Road 337, Km. 3.7, Bo. Tallaboa Poniente, Pe uelas, PR 00624, filed... directed to Jaime L. Sanabria, EcoEl ctrica, L.P., Road 337, Km. 3.7, Bo. Tallaboa Poniente, Pe uelas,...

  2. Aerosol Correction for Improving OMPS/LP Ozone Retrieval

    NASA Technical Reports Server (NTRS)

    Chen, Zhong; Bhartia, Pawan K.; Loughman, Robert

    2015-01-01

    The Ozone Mapping and Profiler Suite Limb Profiler (OMPS-LP) on board the Suomi National Polar-orbiting Partnership (SNPP) satellite was launched on Oct. 28, 2011. Limb profilers measures the radiance scattered from the Earth's atmospheric in limb viewing mode from 290 to 1000 nm and infer ozone profiles from tropopause to 60 km. The recently released OMPS-LP Version 2 data product contains the first publicly released ozone profiles retrievals, and these are now available for the entire OMPS mission, which extends from April, 2012. The Version 2 data product retrievals incorporate several important improvements to the algorithm. One of the primary changes is to turn off the aerosol retrieval module. The aerosol profiles retrieved inside the ozone code was not helping the ozone retrieval and was adding noise and other artifacts. Aerosols including polar stratospheric cloud (PSC) and polar mesospheric clouds (PMC) have a detectable effect on OMPS-LP data. Our results show that ignoring the aerosol contribution would produce an ozone density bias of up to 10 percent in the region of maximum aerosol extinction. Therefore, aerosol correction is needed to improve the quality of the retrieved ozone concentration profile. We provide Aerosol Scattering Index (ASI) for detecting aerosols-PMC-PSC, defined as ln(Im-Ic) normalized at 45km, where Im is the measured radiance and Ic is the calculated radiance assuming no aerosols. Since ASI varies with wavelengths, latitude and altitude, we can start by assuming no aerosol profiles in calculating the ASIs and then use the aerosol profile to see if it significantly reduces the residuals. We also discuss the effect of aerosol size distribution on the ozone profile retrieval process. Finally, we present an aerosol-PMC-PSC correction scheme.

  3. Chaos detection tools: The LP-VIcode and its applications

    NASA Astrophysics Data System (ADS)

    Darriba, L. A.; Maffione, N. P.; Cincotta, P. M.; Giordano, C. M.

    A very important topic in galactic dynamics is the detection of instabilities of a given system and the possible appearance of chaos. Such a chaotic bahaviour can be detected and studied by means of variational chaos in- dicators (CIs). The CIs are based on the study of the evolution of initial deviation vectors, which makes these techniques specially sensitive to in- dicate the presence of chaos. Notwithstanding their special sensitiveness to identify chaos, the CIs are still good alternatives to determine also the resonance web. On the other hand, the so-called spectral analysis methods are based on the study of some quantity (e.g. the frequency) on a single orbit, which turns these techniques very efficient for the determination of the resonant struc- ture of the system. The analysis of the interaction among chaotic and regular components as well as the determination of the resonant structure of the Hamiltonian leads to a deeper understanding of the system's dynamics. Despite the advan- tages of the simultaneous application of both types of techniques, many researchers keep applying only one of them. Herein, we present an alpha version of a program coded in Fortran, the LP-VIcode. Although the code is in a developing stage, it can compute several CIs, and here we apply it together with the Frequency Modified Fourier Transform (FMFT) (Sidlichovský & Nesvorný 1996) to study the stationary space (Schwarzchild 1993) of an average realistic Hamiltonian model (Muzzio et al. 2005). Using the LP-VIcode, in Maffione et al. (2011b) and Darriba et al. (sub- mitted) the authors suggest an efficient package of CIs to study a general Hamiltonian. Here the research is extended to show that the complemen- tary use of the LP-VIcode and the spectral analysis methods is highly rec- ommended to study a realistic Hamiltonian model.

  4. Lp-PLA2 inhibitors (GlaxoSmithKline).

    PubMed

    Booker, M L

    2001-10-01

    GlaxoSmithKline is investigating a series of substituted pyrimidin-4-ones, including SB-435495, as reversible inhibitors of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) for the potential treatment of atherosclerosis [339220], [422380]. This series is being developed alongside a series of irreversible inhibitors such as SB-222657 and derivatives of SB-253514 [339220], [401355]. SB-435495 was discovered through the use of gene technology provided by Human Genome Sciences (HGS) [400047]. By October 2001, phase II trials of SB-435495 had been initiated [424613]. PMID:15957087

  5. RNA elements directing translation of the duck hepatitis B Virus polymerase via ribosomal shunting.

    PubMed

    Cao, Feng; Tavis, John E

    2011-07-01

    The duck hepatitis B virus (DHBV) reverse transcriptase (P) is translated from the downstream position on a bicistronic mRNA, called the pregenomic RNA, through a poorly characterized ribosomal shunt. Here, the positions of the discontinuous ribosomal transfer during shunting were mapped, and RNA elements important for shunting were identified as a prelude to dissecting the shunting mechanism. Mutations were introduced into the DHBV genome, genomic expression vectors were transfected into cells which support reverse transcription, and P translation efficiency was defined as the ratio of P/mRNA. Five observations were made. First, ribosomes departed from sequences that comprise the RNA stem-loop called ε that is key to viral replication, but the known elements of ε were not needed for shunting. Second, at least two landing sites for ribosomes were found on the mRNA. Third, all sequences upstream of ε, most sequences between the cap and the P AUG, and sequences within the P-coding region were dispensable for shunting. Fourth, elements on the mRNA involved in reverse transcription or predicted to be involved in shunting on the basis of mechanisms documented in other viruses, including short open reading frames near the departure site, were not essential for shunting. Finally, two RNA elements in the 5' portion of the mRNA were found to assist shunting. These observations are most consistent with shunting being directed by signals that act through an uncharacterized RNA secondary structure. Together, these data indicate that DHBV employs either a novel shunting mechanism or a major variation on one of the characterized mechanisms. PMID:21507974

  6. Shunting arc plasma source for pure carbon ion beam

    SciTech Connect

    Koguchi, H.; Sakakita, H.; Kiyama, S.; Shimada, T.; Sato, Y.; Hirano, Y.

    2012-02-15

    A plasma source is developed using a coaxial shunting arc plasma gun to extract a pure carbon ion beam. The pure carbon ion beam is a new type of deposition system for diamond and other carbon materials. Our plasma device generates pure carbon plasma from solid-state carbon material without using a hydrocarbon gas such as methane gas, and the plasma does not contain any hydrogen. The ion saturation current of the discharge measured by a double probe is about 0.2 mA/mm{sup 2} at the peak of the pulse.

  7. Shunting arc plasma source for pure carbon ion beam.

    PubMed

    Koguchi, H; Sakakita, H; Kiyama, S; Shimada, T; Sato, Y; Hirano, Y

    2012-02-01

    A plasma source is developed using a coaxial shunting arc plasma gun to extract a pure carbon ion beam. The pure carbon ion beam is a new type of deposition system for diamond and other carbon materials. Our plasma device generates pure carbon plasma from solid-state carbon material without using a hydrocarbon gas such as methane gas, and the plasma does not contain any hydrogen. The ion saturation current of the discharge measured by a double probe is about 0.2 mA∕mm(2) at the peak of the pulse. PMID:22380206

  8. [PERITONEAL VENOUS SHUNT IN THE TREATMENT OF MALIGNANTASCITIS: PRELIMINARY REPORT

    PubMed

    Brazzini, Augusto; Cantella, Raúl

    1998-01-01

    The present study, mentions the use of a valve for the drainage os ascitic fluid, better known as the peritoneo venous shunt, as a paliation treatment in terminal oncologic patients. It was performed in four patients with diseminated carcinomas, of diferent primary ethiology. These patients had a bad life quality, because when admitted in our Radiology suite, the clinical examination showed shortness of breathearly saciety, lethargy, and were found handiccapped to perform their habitual skills. This is a short and preliminar series, but it is an encouraging report, because, the quality of life, our goal, is improved. PMID:12209221

  9. Shunting arc plasma source for pure carbon ion beama)

    NASA Astrophysics Data System (ADS)

    Koguchi, H.; Sakakita, H.; Kiyama, S.; Shimada, T.; Sato, Y.; Hirano, Y.

    2012-02-01

    A plasma source is developed using a coaxial shunting arc plasma gun to extract a pure carbon ion beam. The pure carbon ion beam is a new type of deposition system for diamond and other carbon materials. Our plasma device generates pure carbon plasma from solid-state carbon material without using a hydrocarbon gas such as methane gas, and the plasma does not contain any hydrogen. The ion saturation current of the discharge measured by a double probe is about 0.2 mA/mm2 at the peak of the pulse.

  10. [Vesico-amniotic shunt-therapy in fetal obstructive uropathy].

    PubMed

    Nguyen, T H; Thorup, J M; Larsen, T

    1996-09-23

    Due to the widespread use of obstetric ultrasound an increasing number of congenital malformations are diagnosed prenatally. Some of these can be treated in utero. A 17 week-old fetus with a posterior urethral valve was diagnosed due to a dilated bladder, bilateral hydronephrosis and oligohydramnios. An ultrasonically guided vesicoamniotic shunt was successfully placed in utero at 24 weeks of gestation in order to prevent development of dysplastic kidneys and hypoplastic lungs. Transurethral valve resection was performed five months postnatally. The one year-old infant is now well and has one normally functioning kidney. PMID:8928259

  11. Cholesterol esters selectively delivered in vivo by high-density-lipoprotein subclass LpA-I to rat liver are processed faster into bile acids than are LpA-I/A-II-derived cholesterol esters.

    PubMed Central

    Pieters, M N; Castro, G R; Schouten, D; Duchateau, P; Fruchart, J C; Van Berkel, T J

    1993-01-01

    High-density lipoprotein (HDL) subclass LpA-I has been reported to promote cholesterol efflux from mouse adipose cells in vitro, whereas subclass LpA-I/A-II has no effect. To investigate whether the apolipoprotein composition of HDL plays a role in the selective delivery of cholesterol esters to the liver in vivo, we labelled HDL in its cholesterol ester moiety and separated [3H]cholesterol oleate-labelled HDL into subclasses LpA-I and LpA-I/A-II by immuno-affinity chromatography. Serum decay and liver association of LpA-I and LpA-I/A-II were compared for the apoprotein and cholesterol ester moieties. Both LpA-I and LpA-I/A-II selectively delivered cholesterol esters to the liver with similar kinetics. The kinetics of biliary secretion of processed cholesterol esters, initially associated with LpA-I or LpA-I/A-II, were studied in rats equipped with permanent catheters in bile, duodenum and heart. For both LpA-I and LpA-I/A-II, liver association was coupled to bile acid synthesis, with an increase in secretion rate during the night. During the first night period, the biliary secretion of LpA-I-derived radio-activity was significantly greater than for LpA-I/A-II. The data indicate that with both LpA-I and LpA-I/A-II selective delivery of cholesterol esters from HDL to the liver occurs, but that cholesterol esters delivered by LpA-I are more efficiently coupled to bile acid synthesis. PMID:8318010

  12. Detection of CSF flow in the ventriculo-peritoneal shunt using MRI

    SciTech Connect

    Chang, Han Soo

    1996-05-01

    A noninvasive test for shunt function would be beneficial in the management of patients with CSF shunting. We present our method to diagnose shunt function using MRI. We performed two experiments. In the first we simultaneously performed MRI of two tubes, one with water flowing inside at various flow speeds and the other with static water inside, and compared the signal intensity inside each lumen. In the second we took four MR images of the actual shunt tubes in three patients at different states of shunt function, each having a tube containing static water pasted side by side with the actual subcutaneous shunt tube. In the first experiment we could detect the enhancement effect of slow flow. The minimal detectable flow speed using this method was {approx}1.7 ml/h. The results obtained in actual patients matched the clinical status of the shunt function. This method would be useful as a qualitative test for shunt function. 19 refs., 4 figs., 1 tab.

  13. Reasons, procedures, and outcomes in ventriculoatrial shunts: A single-center experience

    PubMed Central

    Yavuz, Celal; Demırtas, Sinan; Calıskan, Ahmet; Kamasak, Kaan; Karahan, Oguz; Guclu, Orkut; Yazıcı, Suleyman; Mavıtas, Binali

    2013-01-01

    Background: Ventricular shunts are used to drain cerebrospinal fluid into extra-cranial spaces. Ventriculoatrial (VA) shunts are provided to transfer cerebrospinal fluid from the cerebral ventricle into the right atrium of the heart. A single center experience of indications, procedure, and clinical outcomes in VA shunt was presented in current study. Methods: VA shunts were applied in 10 patients who had repeated previous shunt dysfunction or infection. The reasons, clinical findings, replacement methods, and postoperative clinical follow-ups and outcomes were recorded retrospectively. Results: There were seven female (70%) and three (30%) male patients; their ages ranged from 5 to 13 years (mean ± SD; 8.5 ± 2.6 years). Shunt re-placement reasons were as follows: Shunt occlusion in five patients, intraperitoneal infection in four patients and a distal catheter was kinked and knotted in one patient. Postoperative early complications were seen in one patient as early catheter thrombosis and catheter revision were applied. Late complications were seen in two patients as follows: Catheter infection and infective endocarditis occurred in one patient and pulmonary thrombus occurred in one other patient. There was not any catheter-related mortality observed at the one year follow-up period. Conclusion: VA shunts may be an option for cerebrospinal fluid drainage at necessary conditions. However, sterilization and general training on asepsy and antisepsy are the most important determinants affecting the clinical outcome due to the cardio systemic relationship. PMID:23493480

  14. Transhepatic Embolization of Congenital Intrahepatic Portosystemic Venous Shunts with Associated Aneurysms

    PubMed Central

    Paudel, Kalyan; Hoffer, Eric K.

    2015-01-01

    Intrahepatic shunts between the portal and systemic venous systems with associated aneurysms are extremely rare. A middle aged woman presented with hepatic encephalopathy and was found to have two intrahepatic portosystemic venous shunts with associated aneurysms. Diagnosis was made by duplex ultrasound and was confirmed with contrast enhanced MRI. Treatment was performed percutaneously with an Amplatzer vascular plug. PMID:26257785

  15. Anoxic ventilation improves systemic perfusion during extracorporeal circulation with uncontrolled systemic-to-pulmonary shunt.

    PubMed

    Hammel, James M; Deptula, Joseph; Hunt, Peter W; Lang, Haili; Duncan, Kim F

    2007-01-01

    Uncontrolled systemic-to-pulmonary shunt results in decreased systemic flow during extracorporeal life support (ECLS). Ligation of systemic-to-pulmonary shunts during ECLS is associated with poor outcome and is not always readily achieved. In ex vivo preparations, alveolar hypoxia results in pulmonary vasoconstriction despite normoxic pulmonary perfusate. We hypothesized that anoxic ventilation would result in reduced pulmonary shunting and increased systemic flow during ECLS in piglets with systemic-to-pulmonary shunt. Four piglets were placed on ECLS with right and left atrial drainage. A shunt was created between the bicarotid trunk and pulmonary artery, using 5-mm ePTFE tubing. Inspired oxygen was reduced to <1% for 10 minutes, then returned to room air; pH, hematocrit, temperature, ventilatory pressures, and total pump flow were maintained constant. Systemic arterial pressure and right atrial return volume and hemoglobin saturation were measured: All decreased significantly upon shunt unclamping. Anoxic ventilation caused increased systemic pressure (34 vs. 28 mm Hg, p < 0.05), flow (335 vs. 278 mL/min, p < 0.05), and systemic venous saturation (53% vs. 48%, p = 0.13) compared with room air ventilation. In conclusion, anoxic ventilation during normoxic ECLS in subjects with systemic-to-pulmonary shunts results in a significant and potentially clinically useful reduction in pulmonary shunting. PMID:17413566

  16. Normal-pressure hydrocephalus: current understanding of diagnostic tests and shunting

    SciTech Connect

    Black, P.M.

    1982-02-01

    Normal-pressure hydrocephalus is no longer difficult to diagnose or treat-cranial computed tomographic scanning has made the diagnosis of ventricular enlargement straightforward, and shunt placement often helps the patient whose condition can be traced to a specific cause. Predicting accurately whether a patient will benefit from a shunt, however, is still problematic.

  17. 21 CFR 882.5550 - Central nervous system fluid shunt and components.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Central nervous system fluid shunt and components. 882.5550 Section 882.5550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... shunt is a device or combination of devices used to divert fluid from the brain or other part of...

  18. 21 CFR 882.5550 - Central nervous system fluid shunt and components.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Central nervous system fluid shunt and components. 882.5550 Section 882.5550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... shunt is a device or combination of devices used to divert fluid from the brain or other part of...

  19. 21 CFR 882.5550 - Central nervous system fluid shunt and components.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Central nervous system fluid shunt and components. 882.5550 Section 882.5550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... shunt is a device or combination of devices used to divert fluid from the brain or other part of...

  20. 21 CFR 882.5550 - Central nervous system fluid shunt and components.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Central nervous system fluid shunt and components. 882.5550 Section 882.5550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... shunt is a device or combination of devices used to divert fluid from the brain or other part of...

  1. Superior vena cava syndrome with retropharyngeal edema as a complication of ventriculoatrial shunt

    PubMed Central

    Al-Natour, Mohammed S; Entezami, Pouya; Nazzal, Munier M S; Casabianca, Andrew B; Assaly, Ragheb; Riley, Kalen; Gaudin, Daniel

    2015-01-01

    Key Clinical Message Thirty-seven-year old female with hydrocephalus managed by a ventriculoatrial (VA) shunt presented with upper body edema, dysphagia, and headache. Imaging demonstrated thrombosis of the superior vena cava (SVC). Direct catheter thrombolysis led to resolution of thrombus burden. Superior vena cava thrombosis is a rare consequence of VA shunting and must be managed emergently. PMID:26509004

  2. Shunt currents in vanadium flow batteries: Measurement, modelling and implications for efficiency

    NASA Astrophysics Data System (ADS)

    Fink, H.; Remy, M.

    2015-06-01

    Shunt currents are an important factor which must be considered when designing a stack for flow batteries. They lead to a reduction of the coulombic efficiency and can cause furthermore a critical warming of the electrolyte. Shunt currents inevitably appear at bypass connections of the hydraulic system between the single cells of a stack. In this work the shunt currents of a five-celled mini stack of a vanadium flow battery with external hydraulic system and their effects are investigated directly. The external hydraulic system allows the implementation of current sensors for direct measurement of the shunt currents; moreover, the single bypass channels can be interrupted by clamping the tube couplings and with it the shunt currents between the cells when the pumps are off. Thus the shares of losses by cross contamination and by shunt currents are quantified separately by charge conservation measurements. The experimentally gained data are compared to a shunt current model based on a equivalent circuit diagram and the linear equation system derived from it. Experiments and model data are in good agreement. The effects of shunt currents for different flow frame geometries and number of cells in a stack are simulated and presented in this work.

  3. Ventriculoperitoneal shunt for treatment of hydrocephalus in a French bulldog puppy.

    PubMed

    Giacinti, Jolene A

    2016-03-01

    A 6.5-week-old bulldog was presented with lethargy, anorexia, and stunted growth. A domed skull, ventrolateral strabismus, hypermetria, and delayed hopping were observed. Congenital hydrocephalus was diagnosed and a ventriculoperitoneal shunt was placed. After surgery, a shunt obstruction occurred but resolved with treatment. The puppy responded well and neurological deficits continued to improve after surgery. PMID:26933271

  4. Transient right-to-left shunting through a patent foramen ovale secondary to unilateral diaphragmatic paralysis.

    PubMed Central

    Cordero, P. J.; Morales, P.; Mora, V.; Cebrian, J.; Vallterra, J.; Gudin, J.; Benlloch, E.; Marco, V.

    1994-01-01

    A 57 year old patient presented with unilateral diaphragmatic paralysis and severe hypoxaemia secondary to transient right-to-left interatrial shunting through a patent foramen ovale. The final diagnosis was made because of the initial detection of a shunt while the patient was breathing 100% oxygen. Images PMID:7940438

  5. Creation of transcatheter aortopulmonary and cavopulmonary shunts using magnetic catheters: feasibility study in swine.

    PubMed

    Levi, Daniel S; Danon, Saar; Gordon, Brent; Virdone, Nicky; Vinuela, Fernando; Shah, Sanjay; Carman, Greg; Moore, John W

    2009-05-01

    Surgical shunts are the basic form of palliation for many types of congenital heart disease. The Glenn shunt (superior cavopulmonary connection) and central shunt (aortopulmonary connection) represent surgical interventions that could potentially be accomplished by transcatheter techniques. We sought to investigate the efficacy of using neodymium iron boron (NdFeB) magnetic catheters to create transcatheter cavopulmonary and aortopulmonary shunts. NdFeB magnets were machined and integrated into catheters. "Target" catheters were placed in the pulmonary arteries (PAs), and radiofrequency "perforation" catheters were placed in either the descending aorta (DAo) for central shunts or the superior vena cava (SVC) for Glenn shunts. The magnet technique or "balloon target" method was used to pass wires from the DAo or the SVC into the PA. Aortopulmonary and cavopulmonary connections were then created using Atrium iCAST covered stents. Magnet catheters were used to perforate the left pulmonary artery from the DAo, thereby establishing a transcatheter central shunt. Given the orientation of the vasculature, magnetic catheters could not be used for SVC-to-PA connections; however, perforation from the SVC to the right pulmonary artery was accomplished with a trans-septal needle and balloon target. Transcatheter Glenn or central shunts were successfully created in four swine. PMID:19365662

  6. Fabrication and characterization of shunted μ-SQUID

    SciTech Connect

    Kumar, Nikhil; Fournier, T.; Courtois, H.; Gupta, Anjan K.

    2014-04-24

    In order to eliminate hysteresis, we have fabricated and characterized niobium based shunted micron size superconducting quantum interference devices (μ-SQUIDs). We find a wide temperature range where these μ-SQUIDs are non-hysteretic in nature and show a very good I{sub c} vs. B oscillations in hysteretic regime and V vs. B oscillations in non-hysteretic regime. Here we report the characteristics of a shunted- μ-SQUID (Wf38LS72D5). In this device we have achieved a large voltage modulation, in non-hysteretic regime, at various temperatures including such as 1.1 mV at 6.62 K with a transfer function V{sub Φ} = 7.2mV/Φ{sub 0}. The figures within the original article PDF file, as supplied to AIP Publishing, were affected by a PDF-processing error. Consequently, the article re-flowed and pagination increased from 3 to 4 pages. This article was updated on 14 May 2014 to correct the PDF-processing error, with the scientific content remaining unchanged. Readers are advised that the replacement article PDF file contains an additional blank page to preserve the original pagination.

  7. Transjugular Intrahepatic Portosystemic Shunts in Children with Biliary Atresia

    SciTech Connect

    Huppert, Peter E.; Goffette, Pierre; Sokal, Emil M.; Schweizer, Paul; Claussen, Claus D.

    2002-12-15

    Purpose: We retrospectively evaluated the technical and long-term clinical results of transjugularintrahepatic portosystemic shunts (TIPS) in children with portal hypertension and biliary atresia (BA). Methods: Nine children with BA and recurrent bleeding from esophagogastric and/or intestinal varices were treated by TIPS at the age of 34-156 months and followed-up in two centers. Different types of stents were used. Results: Shunt insertion succeeded in all patients, but in two a second procedure was necessary. Seven procedures lasted more than 3 hr, mainly due to difficult portal vein puncture.Variceal bleeding ceased in all patients; however, 16 reinterventions were performed in eight patients for clinical reasons (n =11) and sonographically suspected restenosis (n =5). Four patients underwent successful liver transplantation 4-51 months after TIPS and five are in good clinical conditions 64-75 months after TIPS. Conclusions: TIPS in children with BA is technically difficult, mainly due to periportal fibrosis and small portal veins. Frequency of reinterventions seems to be higher compared with adults.

  8. Design and measurement of improved capacitively-shunted flux qubits

    NASA Astrophysics Data System (ADS)

    Sears, Adam; Birenbaum, Jeffrey; Hover, David; Gudmundsen, Theodore; Kerman, Andrew; Welander, Paul; Yoder, Jonilyn L.; Gustavsson, Simon; Jin, Xiaoyue; Kamal, Archana; Clarke, John; Oliver, William

    2014-03-01

    The addition of a capacitive or inductive shunt across one of the junctions can alter the coherence properties of a classic flux or RF-SQUID qubit. We have studied the performance of capacitively shunted flux qubits fabricated with MBE aluminum, starting from a 2D coplanar waveguide geometry used in similar high-performance transmon qubits, and measured dispersively. We will detail the importance of design parameters that preserve the flux qubit's anharmonicity and discuss conclusions about materials quality based on calculations of the participation of junction, dielectric, and superconductor components. This research was funded in part by the Office of the Director of National Intelligence (ODNI), Intelligence Advanced Research Projects Activity (IARPA); and by the Assistant Secretary of Defense for Research & Engineering under Air Force Contract number FA8721-05-C-0002. All statements of fact, opinion or conclusions contained herein are those of the authors and should not be construed as representing the official views or policies of IARPA, the ODNI, or the U.S. Government Present address: SLAC National Accelerator Laboratory, Menlo Park, CA.

  9. Transjugular Intrahepatic Portosystemic Shunt (TIPS): Current Status and Future Possibilities

    SciTech Connect

    Bilbao, Jose Ignacio; Quiroga, Jorge; Herrero, Jose Ignacio; Benito, Alberto

    2002-08-15

    Since the insertion of the first TIPS in 1989 much has been learned about this therapeutic procedure. It has an established role for the treatment of some complications of portal hypertension: prevention of recurrent variceal bleeding and rescue of patients with acute uncontrollable variceal bleeding. In addition TIPS is useful for Budd-Chiari syndrome, refractory ascites and hepatorenal syndrome, although its specific role in these indications remains to be definitively established. However, the decrease in sinusoidal blood flow induced by TIPS can lead to the patient developing hepatic encephalopathy and liver failure in some cases. Therefore, TIPS should be used with caution in patients with very poor liver function. From a technical point of view, successful placement of TIPS is achieved in more than 98% of cases by experienced groups. At present, evaluation of TIPS dysfunction based on morphology probably leads to an overdiagnosis of this complication since most of these cases are not associated with clinical manifestations (recurrent bleeding or refractory ascites). The major disadvantage of TIPS remains its poor long-term patency requiring a mandatory surveillance program. The indicator for shunt function/malfunction should be the portosystemic pressure gradient, which is best assessed by intravascular measurements. Shunt obstructions may be prevented or reduced by the use of stent-grafts in the future.

  10. An Unusual Complication of Ventriculoperitoneal Shunt: Urinary Bladder Stone Case Report and Literature Review

    PubMed Central

    Xu, Songtao; Sheng, Weixin; Qiu, Yufa; Wang, Jianguo

    2016-01-01

    Introduction: Ventriculoperitoneal (V-P) shunt surgery is the most common technique used for the treatment of hydrocephalus. The migration of ventriculoperitoneal shunt to the bladder is rare. Only two cases have been previously reported in the literature. Case Presentation: We report on a 38-year-old male who had hydrocephalus and V-P shunt for 12 years. Two years ago, he found himself with recurrent urinary tract infections, haematuria and urges incontinence, and then he was diagnosed with bladder perforation and merge stones. The patient had an abdominal operation to cut off and take out the shunt catheter, as well as a transurethral holmium laser lithotripsy. Conclusions: Bladder perforation and stones are rare examples of complications in V-P surgical procedures. Controlling the effective length of the terminal V-P shunt and modifying it appropriately can effectively reduce these complications. PMID:26889393

  11. Multiple Liver Abscesses Associated with Ventriculoperitoneal Shunt Infection: Case Report and Review of the Literature

    PubMed Central

    Yang, Tae Ki

    2013-01-01

    Liver abscess following ventriculoperitoneal (VP) shunting occurs very rarely. We report an unusual case of multiple liver abscesses caused by Staphylococcus capitis in a 50-year-old compromised woman due to a complicating VP shunt infection. We reviewed the nine cases of VP shunt complications reported in the English literature, and speculated that the most likely pathogenetic mechanism in our case is an infected peritoneal tip that migrated to and penetrated the liver, which subsequently caused the formation of multiple liver abscesses. The patient was successfully treated with percutaneous aspiration, drainage of the abscesses, intravenous antibiotics, and shunt revision. Awareness and vigilance of the possibility of liver abscess formation caused by VP shunt infection will help establish an early accurate diagnosis and therapeutic strategy. PMID:24379956

  12. Sound absorption of a finite micro-perforated panel backed by a shunted loudspeaker.

    PubMed

    Tao, Jiancheng; Jing, Ruixiang; Qiu, Xiaojun

    2014-01-01

    Deep back cavities are usually required for micro-perforated panel (MPP) constructions to achieve good low frequency absorption. To overcome the problem, a close-box loudspeaker with a shunted circuit is proposed to substitute the back wall of the cavity of the MPP constructions to constitute a composite absorber. Based on the equivalent circuit model, the acoustic impedance of the shunted loudspeaker is formulated first, then a prediction model of the sound absorption of the MPP backed by shunted loudspeaker is developed by employing the mode solution of a finite size MPP coupled by an air cavity with an impendence back wall. The MPP absorbs mid to high frequency sound, and with properly adjusted electrical parameters of its shunted circuit, the shunted loudspeaker absorbs low frequency sound, so the composite absorber provides a compact solution to broadband sound control. Numerical simulations and experiments are carried out to validate the model. PMID:24437763

  13. Sound transmission loss of metamaterial thin plates with periodic subwavelength arrays of shunted piezoelectric patches

    NASA Astrophysics Data System (ADS)

    Zhang, Hao; Wen, Jihong; Xiao, Yong; Wang, Gang; Wen, Xisen

    2015-05-01

    This paper studies sound transmission loss (STL) of a metamaterial thin plate consisting of periodic subwavelength arrays of shunted piezoelectric patches bonded to the two surfaces of an unbounded homogeneous thin plate. An effective medium method is developed to calculate STL of such metamaterial thin plates. The effective medium method is validated by comparing with the results calculated from the finite element method. Numerical results show that the metamaterial plate with shunted piezoelectric patches (all of the shunting circuits are closed) can achieve much higher STL than the unshunted case (all of the shunting circuits are opened) within the mass-law region and coincidence region of sound transmission. The unique STL of the metamaterial plate can be well understood by explicit formulations derived based on the effective medium method. It is also shown that the bandwidth of increased STL of the metamaterial plate can be significantly broadened by utilizing negative capacitance shunting circuits.

  14. Clinical and ultrasonographic criteria for using ventriculoperitoneal shunts in newborns with myelomeningocele.

    PubMed

    Melo, Jose Roberto Tude; Pacheco, Pollyana; Melo, Emília Nunes de; Vasconcellos, Ângela; Passos, Rosane Klein

    2015-09-01

    Objective Hydrocephalus is one of the main complications associated with myelomeningocele (MM). This study aimed to identify clinical and ultrasonographic criteria for using ventriculoperitoneal (VP) shunts in this group of patients.Method A retrospective cohort study, based on established protocol for VP shunt implant in hydrocephalic children with MM. Parameters used to guide the indication of VP shunts included measurement of head circumference (HC), evaluation of fontanels, and measurement of lateral ventricular atrium (LVA) width by transcranial ultrasonography.Results 43 children were included in the analysis, of which 74% had hydrocephalus and required a VP shunt. These children had LVA width ≥ 15 mm, showed increased HC, or had bulging fontanels.Conclusion VP shunt is required in children with increased HC (≥ 2 standard deviation regarding age group), bulging fontanels, or LVA width of ≥ 15 mm after the closure of MM. PMID:26352494

  15. Elective minimally invasive coronary artery bypass: Shunt or tournique occlusion? Assessment of a protective role of perioperative left anterior descending shunting on myocardial damage. A prospective randomized study

    PubMed Central

    2012-01-01

    Background To determine impact of intraluminal-left anterior descending shunt to prevent myocardial damage in minimally invasive coronary artery bypass. Methods 38 patients were randomly assigned to external tournique occlusion (n?=?19) or intraluminal-left anterior descending shunt group (n?=?19). Blood samples for cardiac troponin T were collected at 30 minutes prior to, 6 and 24 hours after surgery. Results One patient in external tournique occlusion and two patients in intraluminal-left anterior descending shunt group were excluded from futher analysis due to preoperative cardiac troponin T level above the 99th-percentile. Postoperatively, each six patients in external tournique occlusion (33.3%) and intraluminal-left anterior descending shunt (35.3%) group were above the 99th-percentile. Two patients from each group (external tournique occlusion group 11.1% vs. intraluminal-left anterior descending shunt group 11.8%) had peak values above 10-% coeficient of variation cutoff (p?=?1). There were no significant differences in between both groups at all studied timepoints. Conclusion There was no protective effect of intraluminal shunting on myocardial damage compared to short-term tournique occlusion. It is upon the surgeon's discretion which method may preferrably be used to achieve a bloodless field in grafting of the non-occluded left anterior descending in minimally invasive coronary artery bypass. PMID:22809563

  16. 77 FR 58323 - Airworthiness Directives; Gulfstream Aerospace LP (Type Certificate Previously Held by Israel...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-20

    ... Policies and Procedures (44 FR 11034, February 26, 1979); 3. Will not affect intrastate aviation in Alaska... Aerospace LP (Type Certificate Previously Held by Israel Aircraft Industries, Ltd.) Airplanes AGENCY... propose to adopt a new airworthiness directive (AD) for all Gulfstream Aerospace LP (Type...

  17. 77 FR 44113 - Airworthiness Directives; Gulfstream Aerospace LP (Type Certificate Previously Held by Israel...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-27

    ... Policies and Procedures (44 FR 11034, February 26, 1979), (3) Will not affect intrastate aviation in Alaska... Aerospace LP (Type Certificate Previously Held by Israel Aircraft Industries, Ltd.) Airplanes AGENCY... adopting a new airworthiness directive (AD) for certain Gulfstream Aerospace LP (Type...

  18. 77 FR 32069 - Airworthiness Directives; Gulfstream Aerospace LP (Type Certificate Previously Held by Israel...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-31

    ... Procedures (44 FR 11034, February 26, 1979); 3. Will not affect intrastate aviation in Alaska; and 4. Will... Aerospace LP (Type Certificate Previously Held by Israel Aircraft Industries, Ltd.) Airplanes AGENCY... propose to adopt a new airworthiness directive (AD) for certain Gulfstream Aerospace LP (Type...

  19. 76 FR 25229 - Special Conditions: Gulfstream Aerospace LP (GALP) Model G250 Airplane, Dynamic Test Requirements...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Federal Aviation Administration 14 CFR Part 25 Special Conditions: Gulfstream Aerospace LP (GALP) Model... special conditions are issued for the Gulfstream Aerospace LP (GALP) model G250 airplane. This...

  20. 76 FR 35070 - Canexus Chemicals Canada L.P. v. BNSF Railway Company

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-15

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Surface Transportation Board Canexus Chemicals Canada L.P. v. BNSF Railway Company AGENCY: Surface... (FIRS) at: (800) 877-8339. SUPPLEMENTARY INFORMATION: Canexus Chemicals Canada L.P. (Canexus) has...

  1. 78 FR 26358 - TransCanada Keystone Pipeline, LP; Notice of Petition for Declaratory Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-06

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission TransCanada Keystone Pipeline, LP; Notice of Petition for Declaratory Order... and Procedure, 18 CFR 385.207(a)(2)(2012), TransCanada Keystone Pipeline, LP filed a petition...

  2. 76 FR 28026 - TransCanada Keystone Pipeline, LP; Notice of Request for Waiver

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-13

    ... Energy Regulatory Commission TransCanada Keystone Pipeline, LP; Notice of Request for Waiver Take notice that on May 2, 2011, TransCanada Keystone Pipeline, LP (TransCanada Keystone) filed a request for... changes to its committed rates. TransCanada Keystone states that good cause exists to grant such a...

  3. 76 FR 12103 - Erie Boulevard Hydropower, L.P; Notice of Settlement Agreement and Soliciting Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-04

    ... Energy Regulatory Commission Erie Boulevard Hydropower, L.P; Notice of Settlement Agreement and.... Date Filed: February 18, 2011. d. Applicant: Erie Boulevard Hydropower, L.P. e. Location: The existing... Daoust, Erie Boulevard Hydropower, 33 West 1st Street, South, Fulton, NY, 13069; (315) 598-6131. i....

  4. 77 FR 68116 - TEAK Texana Transmission Company, LP; Notice of Petition for Rate Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-15

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission TEAK Texana Transmission Company, LP; Notice of Petition for Rate Approval Take notice that on November 2, 2012, TEAK Texana Transmission Company, LP (TEAK) filed a Petition...

  5. 77 FR 68118 - TexStar Transmission, LP; Notice of Petition for Rate Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-15

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF ENERGY Federal Energy Regulatory Commission TexStar Transmission, LP; Notice of Petition for Rate Approval Take notice that on November 2, 2012, TexStar Transmission, LP (TexStar) filed a Petition for Rate...

  6. 78 FR 21929 - TexStar Crude Oil Pipeline, LP; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-12

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission TexStar Crude Oil Pipeline, LP; Notice of Filing Take notice that on March 26, 2013, TexStar Crude Oil Pipeline, LP (TexStar) submitted to the Federal Energy...

  7. 75 FR 29333 - Iroquois Gas Transmission System, L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-25

    ... Energy Regulatory Commission Iroquois Gas Transmission System, L.P.; Notice of Application May 18, 2010. Take notice that on May 17, 2010, Iroquois Gas Transmission System, L.P. (Iroquois), One Corporate..., 2010. Kimberly D. Bose, Secretary. BILLING CODE 6717-01-P...

  8. 78 FR 13663 - Equitrans, L.P. Notice of Request Under Blanket Authorization

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Equitrans, L.P. Notice of Request Under Blanket Authorization Take notice that on February 12, 2013, Equitrans, L.P. (Equitrans), pursuant to the blanket certificate authorization granted in Docket No....

  9. 77 FR 7572 - Alliance Pipeline L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-13

    ... Energy Regulatory Commission Alliance Pipeline L.P.; Notice of Application Take notice that on January 25, 2012, Alliance Pipeline L.P. filed with the Federal Energy Regulatory Commission an application under... Dakota to the Alliance mainline near Sherwood, North Dakota. Additional facilities to be constructed...

  10. 29 CFR 1926.153 - Liquefied petroleum gas (LP-Gas).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... published in 49 CFR part 178, Shipping Container Specifications. (3) Definition. As used in this section... 29 Labor 8 2011-07-01 2011-07-01 false Liquefied petroleum gas (LP-Gas). 1926.153 Section 1926.153... § 1926.153 Liquefied petroleum gas (LP-Gas). (a) Approval of equipment and systems. (1) Each system...

  11. 29 CFR 1926.153 - Liquefied petroleum gas (LP-Gas).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... published in 49 CFR part 178, Shipping Container Specifications. (3) Definition. As used in this section... 29 Labor 8 2014-07-01 2014-07-01 false Liquefied petroleum gas (LP-Gas). 1926.153 Section 1926.153... § 1926.153 Liquefied petroleum gas (LP-Gas). (a) Approval of equipment and systems. (1) Each system...

  12. 29 CFR 1926.153 - Liquefied petroleum gas (LP-Gas).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... published in 49 CFR part 178, Shipping Container Specifications. (3) Definition. As used in this section... 29 Labor 8 2012-07-01 2012-07-01 false Liquefied petroleum gas (LP-Gas). 1926.153 Section 1926.153... § 1926.153 Liquefied petroleum gas (LP-Gas). (a) Approval of equipment and systems. (1) Each system...

  13. 29 CFR 1926.153 - Liquefied petroleum gas (LP-Gas).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... published in 49 CFR part 178, Shipping Container Specifications. (3) Definition. As used in this section... 29 Labor 8 2013-07-01 2013-07-01 false Liquefied petroleum gas (LP-Gas). 1926.153 Section 1926.153... § 1926.153 Liquefied petroleum gas (LP-Gas). (a) Approval of equipment and systems. (1) Each system...

  14. 29 CFR 1926.153 - Liquefied petroleum gas (LP-Gas).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... published in 49 CFR Part 178, Shipping Container Specifications. (3) Definition. As used in this section... 29 Labor 8 2010-07-01 2010-07-01 false Liquefied petroleum gas (LP-Gas). 1926.153 Section 1926.153... § 1926.153 Liquefied petroleum gas (LP-Gas). (a) Approval of equipment and systems. (1) Each system...

  15. 78 FR 13661 - Energy Transfer Fuel, LP; Notice of Petition for Rate Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... From the Federal Register Online via the Government Printing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Energy Transfer Fuel, LP; Notice of Petition for Rate Approval Take notice that on February 15, 2013, Energy Transfer Fuel, LP filed for approval of rates for...

  16. 78 FR 18973 - Bridgeline Holdings, L.P.; Notice of Petition for Rate Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... Energy Regulatory Commission Bridgeline Holdings, L.P.; Notice of Petition for Rate Approval Take notice that on February 28, 2013, as supplemented on March 12, 2013, Bridgeline Holdings, L.P. filed for... free). For TTY, call (202) 502-8659. Comment Date: 5:00 p.m. Eastern Time on Monday, April 1,...

  17. 75 FR 63452 - Lobo Pipeline Company L.P.; Notice of Baseline Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-15

    ... Energy Regulatory Commission Lobo Pipeline Company L.P.; Notice of Baseline Filing October 7, 2010. Take notice that on October 1, 2010, Lobo Pipeline Company L.P. submitted a revised baseline filing of its...Support@ferc.gov , or call (866) 208-3676 (toll free). For TTY, call (202) 502-8659. Comment Date: 5...

  18. 78 FR 62349 - Sunoco Pipeline L.P.; Notice of Petition for Declaratory Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-18

    ... Energy Regulatory Commission Sunoco Pipeline L.P.; Notice of Petition for Declaratory Order Take notice... Procedure, 18 CFR 385.207(a)(2)(2013), Sunoco Pipeline L.P. (SPLP) filed a petition requesting a declaratory... and Procedure (18 CFR 385.211 and 385.214) on or before 5:00 p.m. Eastern Time on the...

  19. 78 FR 66354 - Sunoco Pipeline L.P.; Notice of Petition for Declaratory Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ... Energy Regulatory Commission Sunoco Pipeline L.P.; Notice of Petition for Declaratory Order Take notice... Procedure, 18 CFR 385.207(a)(2)(2013), Sunoco Pipeline L.P. (SPLP) filed a petition requesting a declaratory... (18 CFR 385.211 and 385.214) on or before 5:00 p.m. Eastern time on the specified comment...

  20. 76 FR 28221 - Trans-Union Interstate Pipeline, L.P.; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-16

    ... Energy Regulatory Commission Trans-Union Interstate Pipeline, L.P.; Notice of Filing Take notice that on April 7, 2011 Trans-Union Interstate Pipeline, L.P. submitted a request for a waiver of the reporting...-8659. Comment Date: June 9, 2011. Dated: May 10, 2011. Kimberly Bose, Secretary. BILLING CODE 6717-01-P...

  1. 77 FR 44610 - Enbridge Pipelines (North Texas) L.P.; Notice of Compliance Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-30

    ... Federal Energy Regulatory Commission Enbridge Pipelines (North Texas) L.P.; Notice of Compliance Filing Take notice that on July 13, 2012, Enbridge Pipelines (North Texas) L.P. filed a revised Statement of... TTY, call (202) 502-8659. Comment Date: 5:00 p.m. Eastern Time on Monday, July 30, 2012. Dated:...

  2. 77 FR 70432 - Magic Valley Pipeline, L.P.; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... Energy Regulatory Commission Magic Valley Pipeline, L.P.; Notice of Filing Take notice that on November 15, 2012, Magic Valley Pipeline, L.P. (Magic Valley) filed to revise its Statement of Operating... free). For TTY, call (202) 502-8659. Comment Date: 5:00 p.m. Eastern Time on Tuesday, November 27,...

  3. 78 FR 16845 - Equitrans, L.P.; Equitable Gas Company, LLC; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-19

    ... Energy Regulatory Commission Equitrans, L.P.; Equitable Gas Company, LLC; Notice of Application Take notice that on March 1, 2013, Equitrans, L.P. (Equitrans), 625 Liberty Avenue, Suite 1700, Pittsburgh...: 5:00 p.m. Eastern Time on April 2, 2013. Dated: March 12, 2013. Kimberly D. Bose, Secretary....

  4. 77 FR 71585 - Brookfield Energy Marketing LP v. ISO New England Inc.; Notice of Complaint

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-03

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Brookfield Energy Marketing LP v. ISO New England Inc.; Notice of... of the Federal Power Act, 16 U.S.C. 824(e) and 825(e), Brookfield Energy Marketing LP...

  5. 77 FR 73637 - Alliance Pipeline L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-11

    ... 26, 2012, Alliance Pipeline L.P. (Alliance), 800, 605-5 Ave. SW., Calgary, Alberta, Canada T2P 3H5... Pipeline L.P., 800, 605-5 Ave. SW., Calgary, Alberta, Canada T2P 3H5, by telephone at (403) 517-6354 or...

  6. 75 FR 60840 - Highland Capital Management, L.P. and Highland Funds I; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-01

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION Highland Capital Management, L.P. and Highland Funds I; Notice of Application September 27, 2010.... Applicants: Highland Capital Management, L.P. (the ``Adviser'') and Highland Funds I (the ``Trust''...

  7. 76 FR 4648 - PowerSmith Cogeneration Project, LP; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-26

    ... Energy Regulatory Commission PowerSmith Cogeneration Project, LP; Notice of Filing January 19, 2011. Take notice that on January 13, 2011, PowerSmith Cogeneration Project, LP (PowerSmith), pursuant to section... Regulations for the topping-cycle cogeneration facility owned and operated by PowerSmith located in...

  8. 77 FR 13593 - PowerSmith Cogeneration Project, LP; Notice of Request for Waiver

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ... Energy Regulatory Commission PowerSmith Cogeneration Project, LP; Notice of Request for Waiver Take... Act of 1978 (PURPA), as amended, 18 CFR 292.205(c), PowerSmith Cogeneration Project, LP (PowerSmith... operated by PowerSmith located in Oklahoma. PowerSmith makes such a request because of a delay in...

  9. Automated Test Assembly Using lp_Solve Version 5.5 in R

    ERIC Educational Resources Information Center

    Diao, Qi; van der Linden, Wim J.

    2011-01-01

    This article reviews the use of the software program lp_solve version 5.5 for solving mixed-integer automated test assembly (ATA) problems. The program is freely available under Lesser General Public License 2 (LGPL2). It can be called from the statistical language R using the lpSolveAPI interface. Three empirical problems are presented to…

  10. 78 FR 61947 - Equitrans, L.P.; Notice of Request Under Blanket Authorization

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-07

    ... instructions on the Commission's Web site under the ``e-Filing'' link. Dated: September 26, 2013. Nathaniel J... Energy Regulatory Commission Equitrans, L.P.; Notice of Request Under Blanket Authorization Take notice that on September 16, 2013, Equitrans, L.P. (Equitrans), 625 Liberty Avenue, Suite 1700,...

  11. 75 FR 49917 - Enbridge Pipelines (North Texas) L.P.; Notice of Baseline Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-16

    ...-8659. Comment Date: 5 p.m. Eastern Time on Monday, August 16, 2010. Nathaniel J. Davis, Sr., Deputy... Energy Regulatory Commission Enbridge Pipelines (North Texas) L.P.; Notice of Baseline Filing August 6, 2010. Take notice that on July 29, 2010, Enbridge Pipelines (North Texas) L.P. submitted a...

  12. 78 FR 66758 - Accreditation and Approval of Saybolt, LP, as a Commercial Gauger

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-06

    ... SECURITY U.S. Customs and Border Protection Bureau Accreditation and Approval of Saybolt, LP, as a... of accreditation and approval of Saybolt, LP, as a commercial gauger. SUMMARY: Notice is hereby given... for customs purposes for the next three years as of July 11, 2013. DATES: Effective: The...

  13. 77 FR 74280 - Proposed Information Collection (Learner's Perception (LP) Survey); Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... AFFAIRS Proposed Information Collection (Learner's Perception (LP) Survey); Comment Request AGENCY.... Title: Learner's Perception (LP) Survey, VA Form 10-0439. OMB Control Number: 2900-0691. Type of Review... trainees perception of their clinical experience with VA versus non-VA facilities. VA will use the data...

  14. 78 FR 11965 - Agency Information Collection (Learner's Perception (LP) Survey) Activities Under OMB Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-20

    ... AFFAIRS Agency Information Collection (Learner's Perception (LP) Survey) Activities Under OMB Review...'s Perception (LP) Survey, VA Form 10-0439. OMB Control Number: 2900-0691. Type of Review: Extension... trainees perception of their clinical experience with VA versus non-VA facilities. VA will use the data...

  15. 76 FR 81925 - Freeport LNG Development, L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-29

    ... Energy Regulatory Commission Freeport LNG Development, L.P.; Notice of Application Take notice that on December 9, 2011, Freeport LNG Development, L.P. (Freeport LNG), filed an application pursuant to Section 3..., Fulbright & Jaworski L.L.P., 666 Fifth Avenue, New York, New York 10103. Telephone (212) 318-3009, fax...

  16. 77 FR 28375 - Eagle Rock Desoto Pipeline, L.P.; Notice of Petition for Rate Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Eagle Rock Desoto Pipeline, L.P.; Notice of Petition for Rate Approval Take notice that on May 1, 2012, Eagle Rock Desoto Pipeline, L.P. (Desoto) filed a Rate Election pursuant...

  17. 76 FR 20971 - Eagle Rock Desoto Pipeline, L.P.; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Eagle Rock Desoto Pipeline, L.P.; Notice of Filing Take notice that on April 7, 2011, Eagle Rock Desoto Pipeline, L.P. filed a revised Statement of Operating Conditions...

  18. 75 FR 27774 - Eagle Rock Desoto Pipeline, L.P.; Notice of Rate Election

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-18

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Eagle Rock Desoto Pipeline, L.P.; Notice of Rate Election May 11, 2010. Take notice that on May 3, 2010, Eagle Rock Desoto Pipeline, L.P., (Desoto) filed a Notice of Rate...

  19. 76 FR 61682 - Panhandle Eastern Pipe Line Company, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ... Energy Regulatory Commission Panhandle Eastern Pipe Line Company, LP; Notice of Application On September 16, 2011, Panhandle Eastern Pipe Line Company, LP (Panhandle) filed with the Federal Energy... filing is accessible on-line at http://www.ferc.gov .using the ``eLibrary'' link and is available...

  20. 78 FR 11639 - Houston Pipe Line Company LP; Notice of Petition for Rate Approval

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-19

    ... Federal Energy Regulatory Commission Houston Pipe Line Company LP; Notice of Petition for Rate Approval Take notice that on February 1, 2013, Houston Pipe Line Company LP (HPL) filed for approval of rates... Commission, 888 First Street NE., Washington, DC 20426. This filing is accessible on-line at...

  1. 76 FR 40723 - Dominion Cove Point LNG, LP; Notice of Technical Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-11

    ... From the Federal Register Online via the Government Printing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Dominion Cove Point LNG, LP; Notice of Technical Conference On May 27, 2011, pursuant to section 4 of the Natural Gas Act (NGA), Dominion Cove Point LNG, LP (Cove Point) filed...

  2. 77 FR 26585 - Steel Partners Holdings L.P.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-04

    ... COMMISSION Steel Partners Holdings L.P.; Notice of Application April 27, 2012. AGENCY: Securities and... Investment Company Act of 1940 (``Act''). Summary of Application: Steel Partners Holdings L.P. (``SPH... its acquisition of WebBank in 1998 until July 14, 2009. 2. Prior to December 2008, Steel Partners...

  3. AB06. Shunting for prolonged ischemic priapism: a 50-year mistake?

    PubMed Central

    Lue, Tom F.

    2014-01-01

    Ischemic priapism Low flow (ischemic) priapism is a penile erection persisting beyond four hours unrelated to sexual interest or stimulation. This type of priapism causes a compartment syndrome of the corporal bodies with progressive hypoxia, hypercarbia and acidosis. Clinically, it is typified by progressive penile pain with rigid, tender corporal bodies and soft glans penis and corpus spongiosum. Treatment of ishemic priapism is an emergency and should begin in a stepwise fashion. The duration of priapism is the most significant predictor of future erectile function. Ischemic priapism longer than 4 hours in duration should begin immediately with aspiration and intracavernosal injection of sympathomimetic medication. If fails, one should proceed with a shunt procedure. The objective of shunt surgery is to re-establish outflow from the cavernosal bodies to the glans, corpus spongiosum or vein. Typically distal shunt procedures should be attempted before proximal shunt procedures. The first shunting procedure, the cavernosum-saphenous vein shunt, was published by Grayhack in 1964. About the same time, Al Ghorab devised an open cavernosum-glans shunt. In the next 50 years, many methods of creating shunt between the corpus cavernosum and the glans, the corpus spongiosum or the dorsal vein have been reported. However, the early recurrence rate remains high and a significant percentage of men developed severe penile fibrosis and erectile dysfunction. Recent model of coagulation cascade identifies exposed collagen as the most important initiating factor of blood clotting. About two years ago, we recognized that clotting of the newly created shunt was the main reason of early priapism recurrence. We have since institute peri-operative anticoagulation as a part of the shunting procedure. We have successfully reversed ischemic priapism in ALL cases in the past two years.

  4. Laparoscopic Cholecystectomy for Acute Calcular Cholecystitis in a Patient with Ventriculoperitoneal Shunt: A Case Report and Literature Review

    PubMed Central

    Albarrak, Abdullah A.; Khairy, Sami; Ahmed, Alzahrani Mohammed

    2015-01-01

    Management of patients who have ventriculoperitoneal shunt presenting with acute calcular cholecystitis has remained a clinical challenge. In this paper, the hospital course and the follow-up of a patient presenting with acute calcular cholecystitis and ventriculoperitoneal shunt managed with laparoscopic cholecystectomy are presented followed by literature review on the management of acute calcular cholecystitis in patients who have ventriculoperitoneal shunts. PMID:26798543

  5. Improvement of image quality of time-domain diffuse optical tomography with lp sparsity regularization

    PubMed Central

    Okawa, Shinpei; Hoshi, Yoko; Yamada, Yukio

    2011-01-01

    An lp (0 < p ≤ 1) sparsity regularization is applied to time-domain diffuse optical tomography with a gradient-based nonlinear optimization scheme to improve the spatial resolution and the robustness to noise. The expression of the lp sparsity regularization is reformulated as a differentiable function of a parameter to avoid the difficulty in calculating its gradient in the optimization process. The regularization parameter is selected by the L-curve method. Numerical experiments show that the lp sparsity regularization improves the spatial resolution and recovers the difference in the absorption coefficients between two targets, although a target with a small absorption coefficient may disappear due to the strong effect of the lp sparsity regularization when the value of p is too small. The lp sparsity regularization with small p values strongly localizes the target, and the reconstructed region of the target becomes smaller as the value of p decreases. A phantom experiment validates the numerical simulations. PMID:22162823

  6. 78 FR 4842 - Linden VFT, LLC v. Brookfield Energy Marketing, LP, Cargill Power Markets, LLC; Notice of Complaint

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Linden VFT, LLC v. Brookfield Energy Marketing, LP, Cargill Power Markets... a formal complaint against Brookfield Energy Marketing, LP and Cargill Power Markets,...

  7. Life prediction for nuclear LP rotor SCC cracks

    SciTech Connect

    Liu, J.Y.; Lai, E.E.; Su, C.C.; Lai, H.C.; Lin, D.H.R.

    1992-12-31

    The stress corrosion cracking (SCC) of nuclear LP rotors is a worldwide problem since late 1960`s, that has been considered as the major factor for maintaining the reliability of turbines for nuclear power plants. Since the problem is not exceptional to the local nuclear power plants, some efforts have been undertaken in order to mitigate or resolve the SCC problem. The main activities in this study were focused on the survey and determination of SCC growth rates, critical crack length calculation by finite element methods (FEM), and comparison of life assessment models. Examples of deterministic and probabilistic life assessment for a local steam rotor disc with SCC cracks are presented.

  8. Splenopancreatic disconnection. Improved selectivity of distal splenorenal shunt.

    PubMed Central

    Warren, W D; Millikan, W J; Henderson, J M; Abu-Elmagd, K M; Galloway, J R; Shires, G T; Richards, W O; Salam, A A; Kutner, M H

    1986-01-01

    Distal splenorenal shunt (DSRS) improves survival from variceal bleeding in nonalcoholic cirrhotics but not in alcoholic subjects. The metabolic response after DSRS is also different in alcoholic and nonalcoholic cirrhotics. Portal perfusion, quality of blood perfusing the liver, cardiac output, and liver blood flow do not change in nonalcoholics. In alcoholics, portal perfusion is frequently lost (60%), quality of blood perfusing the liver decreases, and cardiac output and liver blood flow increase. It is proposed that portal flow is lost in alcoholics via pancreatic and colonic collaterals after surgery. Elimination of this sump by adding complete dissection of the splenic vein and division of the splenocolic ligament to DSRS (splenopancreatic disconnection, SPD) could preserve portal perfusion, decrease shunt loss of hepatotrophic factor, and improve survival in alcoholic cirrhotics. This report compares data 1 year after surgery in two groups of cirrhotics: group I (8 nonalcoholic; 16 alcoholic) had DSRS without SPD; group II (17 nonalcoholic; 11 alcoholic) received DSRS + SPD. Methods: Portal perfusion grade, cardiac output (CO), liver blood flow (f), hepatic function (GEC), and hepatic volume (vol) were measured before and 1 year after surgery. Shunt loss of hepatotrophic factor was estimated by insulin response (change in plasma concentration over 10 minutes: AUC) after arginine stimulation. Results: Groups I and II were similar before surgery. Metabolically, nonalcoholics remained stable after both DSRS and DSRS + SPD. After standard DSRS, alcoholics lost portal perfusion (75%, p less than 0.05), CO, and f increased (p less than 0.05), and quality of blood perfusing the liver was decreased (GEC/f: p less than 0.05). DSRS + SPD preserved portal perfusion better (p less than 0.05) in alcoholic cirrhotics than did DSRS alone. After DSRS + SPD, the metabolic response in alcoholics resembled that of nonalcoholics. CO, f, and GEC/f remained stable. These data show: DSRS + SPD preserves postoperative portal perfusion in alcoholic cirrhotics better than DSRS alone. Metabolic response to DSRS + SPD is similar in alcoholic and nonalcoholic cirrhotics. Because portal perfusion and metabolic integrity are preserved after DSRS + SPD, its use in alcoholic cirrhotics should improve survival. PMID:3532968

  9. Prediction of the becalmed region for LP turbine profile design

    SciTech Connect

    Schulte, V.; Hodson, H.P.

    1998-10-01

    Recent attention has focused on the so-called ``becalmed region`` that is observed inside the boundary layers of turbomachinery blading and is associated with the process of wake-induced transition. Significant reductions of profile loss have been shown for high lift LP turbine blades at low Reynolds numbers due to the effects of the becalmed region on the diffusing flow at the rear of the suction surface. In this paper the nature and the significance of the becalmed region are examined using experimental observations and computational studies. It is shown that the becalmed region may be modeled using the unsteady laminar boundary layer equations. Therefore, it is predictable independent of the transition or turbulence models employed. The effect of the becalmed region on the transition process is modeled using a spot-based intermittency transition model. An unsteady differential boundary layer code was used to simulate a deterministic experiment involving an isolated turbulent spot numerically. The predictability of the becalmed region means that the rate of entropy production can be calculated in that region. It is found to be of the order of that in a laminar boundary layer. It is for this reason and because the becalmed region may be encroached upon by pursuing turbulent flows that for attached boundary layers, wake-induced transition cannot significantly reduce the profile loss. However, the becalmed region is less prone to separation than a conventional laminar boundary layer. Therefore, the becalmed region may be exploited in order to prevent boundary layer separation and the increase in loss that this entails. It is shown that it should now be possible to design efficient high lift LP turbine blades.

  10. LP turbine retrofit of Encina 4 and 5

    SciTech Connect

    Trimble, L.; Smiarowski, M.

    1995-12-31

    Power producers are faced with the ever increasing challenge of providing cost effective and reliable power to their customers. Having reliable generating equipment is a prime concern. In 1992, San Diego Gas and Electric (SDG&E) contracted with Siemens Power Corporation (SPC) to provide a low pressure (LP) turbine rotor and inner casing replacement for its units 4 and 5 at the Encina Power Station in Carlsbad, California. These units were doubleflow single casing LP turbines originally manufactured by Westinghouse Electric and installed in 1972 (Unit 4) and 1978 (Unit 5). The original configuration was the building block (BB) 72 model, which included 6 rows of blades per flow path and a nominal 28.5 inch last stage blade length. This design had suffered from continued problems including loss of tenons, rotor steeple cracking, and blade cracking exacerbated by high back-end loading. Siemens designed a replacement steam path that would best meet the existing steam conditions and fit into the confines of the original exhaust casing, so modification work would be kept to a minimum. The replacement turbine utilized an additional stage, or 7 stages per flow path, with a 32 inch last stage blade. By using this longer last stage blade, the higher back-end loading was significantly reduced. The blading consisted of Siemens T-4 integrally shrouded drum blading on the first three stages, twisted integrally shrouded blades on stages 4 and 5, and free standing-blades for the last two rows. In addition, the last stage stationary blading utilizes a curved forward design, or {open_quotes}banana{close_quotes} blade, that distributes steam flow across the airfoil more evenly. The retrofit outages of the units had a duration of approximately 6 weeks each. Unit 4 and 5 returned to service in May and December 1994, respectively. The low pressure sections were retrofitted with the reliable Siemens design and achieved unit heat rate improvements of 2.3% and 2.7%, respectively.

  11. 75 FR 6414 - Cardinal Growth, L.P.; Notice Seeking Exemption Under Section 312 of the Small Business...

    Federal Register 2010, 2011, 2012, 2013, 2014

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    Federal Register 2010, 2011, 2012, 2013, 2014

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    Federal Register 2010, 2011, 2012, 2013, 2014

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    Federal Register 2010, 2011, 2012, 2013, 2014

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  17. 78 FR 62614 - Guttman Energy, Inc., PBF Holding Company LLC v. Buckeye Pipe Line Company, L.P., Laurel Pipe...

    Federal Register 2010, 2011, 2012, 2013, 2014

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    ... Energy Regulatory Commission Guttman Energy, Inc., PBF Holding Company LLC v. Buckeye Pipe Line Company, L.P., Laurel Pipe Line Company, L.P.; Notice of Complaint Take notice that on October 15, 2013... Energy Regulatory Commission (Commission) a complaint against Buckeye Pipe Line Company L.P. and...

  18. Compensation strategies for shunt active-filter control

    SciTech Connect

    Cavallini, A.; Montanari, G.C. . Istituto di Elettrotecnica Industriale)

    1994-11-01

    Compensation strategies for control of shunt active filters are compared in the paper. It is shown that the strategy based on unity-power factor control is appropriate when the supply voltage waveform of the plant where the active filter is connected shows significant distortion. As voltage distortion increases, this strategy provides compensated line current having lower harmonic distortion and RMS value with respect to the strategy generally used. This contributes to diminish the current and voltage distortion in networks. The unity-power factor compensation strategy conditions the current flowing in the plant where compensation is realized to fit the voltage waveform, thus reaching a unity power factor. Hence, the line current RMS value is minimum. The comparison of the strategies is performed by both Monte Carlo and ATP simulation.

  19. A SQUID gradiometer module with large junction shunt resistors

    NASA Astrophysics Data System (ADS)

    Qiu, Yang; Liu, Chao; Zhang, Shu-Lin; Zhang, Guo-Feng; Wang, Yong-Liang; Li, Hua; Zeng, Jia; Kong, Xiang-Yan; Xie, Xiao-Ming

    2014-08-01

    A dual-washer superconducting quantum interference device (SQUID) with a loop inductance of 350 pH and two on-washer integrated input coils is designed according to conventional niobium technology. In order to obtain a large SQUID flux-to-voltage transfer coefficient, the junction shunt resistance is selected to be 33 ?. A vertical SQUID gradiometer module with a baseline of 100 mm is constructed by utilizing such a SQUID and a first-order niobium wire-wound antenna. The sensitivity of this module reaches about 0.2 fT/(cm·Hz1/2) in the white noise range using a direct readout scheme, i.e., the SQUID is directly connected to an operational amplifier, in a magnetically shielded room. Some magnetocardiography (MCG) measurements with a sufficiently high signal-to-noise ratio (SNR) are demonstrated.

  20. Arterio-venous shunts or low oxygen utilization?

    PubMed

    Rozin, Alexander P

    2010-02-01

    An idea of arteriovenous shunts (AVS) was proposed for explanation of dynamic regulation of oxygenation and venous hyperoxia. A formula enabling calculation of AVS and real CO2 production has recently been derived by comparing data of arterial and venous blood gases. Regarding venous hyperoxia, there is a need to differentiate capillary to tissue transport defect (low oxygen utilisation-LOU) from AVS, which may exist simultaneously. The AVS may be associated with normal or relatively high oxygen utilization from the capillary vessels and increased CO2 production. AVS is proposed to carry protective and 'stealing' properties including renal, cardiac, and pulmonary hemodynamic. Calculations of the AVS may be important for dynamic assessment of vascular and metabolic status and in emergency medicine. PMID:20026514

  1. Haptic device for a ventricular shunt insertion simulator.

    PubMed

    Panchaphongsaphak, Bundit; Stutzer, Diego; Schwyter, Etienne; Bernays, René-Ludwig; Riener, Robert

    2006-01-01

    In this paper we propose a new one-degree-of-freedom haptic device that can be used to simulate ventricular shunt insertion procedures. The device is used together with the BRAINTRAIN training simulator developed for neuroscience education, neurological data visualization and surgical planning. The design of the haptic device is based on a push-pull cable concept. The rendered forces produced by a linear motor connected at one end of the cable are transferred to the user via a sliding mechanism at the end-effector located at the other end of the cable. The end-effector provides the range of movement up to 12 cm. The force is controlled by an open-loop impedance algorithm and can become up to 15 N. PMID:16404092

  2. Refractory hepatic hydrothorax treated with transjugular intrahepatic portosystemic shunt.

    PubMed

    Degawa, M; Hamasaki, K; Yano, K; Nakao, K; Kato, Y; Sakamoto, I; Nakata, K; Eguchi, K

    1999-02-01

    A 66-year-old cirrhotic woman was referred to our hospital for evaluation of refractory pleural effusion and dyspnea. Massive right sided-pleural effusion but no ascites was detected. She had been treated with diuretics and albumin, repeated thoracenteses, and pleural drainage with an intercostal catheter, all of which had failed to relieve her symptoms. The diagnosis of hepatic hydrothorax without ascites was made by injection of technetium-99m-sulfur colloid into the peritoneal cavity. A transjugular intrahepatic portosystemic shunt was placed and successfully reduced the pleural effusion, resulting in complete relief of her symptoms. The patient has been free of symptoms for 18 months after the procedure. PMID:10204623

  3. Microwave power heterojunction bipolar transistors fabricated with thermal shunt bathtub

    SciTech Connect

    Bozada, C.A.; Barlage, D.W.; Barrette, J.P.

    1995-12-31

    Heterojunction bipolar transistor devices and circuits were fabricated using thermal shunt and bathtub thermal management techniques. Broadband cascode MMICs exhibited 10 - 14 dB gain at an output power of 2.5 - 3.0 Watts across 7 - 11 GHz. A 200 {mu}m{sup 2} common-emitter unit cell achieved 7 - 8 dB linear power gain and 40% power-added efficiency at a noise power ratio (NPR) of 18 dBc at 12 GHz. Under single tone measurements at 12 GHz, the unit cell achieved 52% power-added efficiency, with 9.5 dB linear gain, 8 dB power gain and 240 mW output power at 5 V bias.

  4. Universality of non-Ohmic shunt leakage in thin-film solar cells

    NASA Astrophysics Data System (ADS)

    Dongaonkar, S.; Servaites, J. D.; Ford, G. M.; Loser, S.; Moore, J.; Gelfand, R. M.; Mohseni, H.; Hillhouse, H. W.; Agrawal, R.; Ratner, M. A.; Marks, T. J.; Lundstrom, M. S.; Alam, M. A.

    2010-12-01

    We compare the dark current-voltage (IV) characteristics of three different thin-film solar cell types: hydrogenated amorphous silicon (a-Si:H) p-i-n cells, organic bulk heterojunction (BHJ) cells, and Cu(In,Ga)Se2 (CIGS) cells. All three device types exhibit a significant shunt leakage current at low forward bias (V <˜0.4) and reverse bias, which cannot be explained by the classical solar cell diode model. This parasitic shunt current exhibits non-Ohmic behavior, as opposed to the traditional constant shunt resistance model for photovoltaics. We show here that this shunt leakage (Ish), across all three solar cell types considered, is characterized by the following common phenomenological features: (a) voltage symmetry about V =0, (b) nonlinear (power law) voltage dependence, and (c) extremely weak temperature dependence. Based on this analysis, we provide a simple method of subtracting this shunt current component from the measured data and discuss its implications on dark IV parameter extraction. We propose a space charge limited (SCL) current model for capturing all these features of the shunt leakage in a consistent framework and discuss possible physical origin of the parasitic paths responsible for this shunt current mechanism.

  5. Shunt diode analysis using light emission for gallium arsenide solar cell predictability

    NASA Astrophysics Data System (ADS)

    Kilmer, Louis C.; Honsberg, Christiana; Phillips, James E.; Barnett, Allen M.

    The use of light emission as a defect analysis technique has been expanded to better differentiate the types of shunt defects and analyze their effects on GaAs solar cells. Light emission from full-size 2-cm x 2-cm space solar cells was detected, recorded, digitized, and enhanced in order to analyze the low-level light emission and the shunt diode's effects. Shunt diodes are of particular importance because they have been found to be the type of defect which is most likely to degrade and cause failure in GaAs solar cells. To analyze how the shunt diodes affect the quality of the solar cell, the pattern of light emission must be studied. In studying the low-level light emission, it was found that the pattern of light emission is different than that of the high-level light emission. The different light patterns show the changing effects of the shunt diodes. It is concluded that the shunt diode dominates over the junction diode at low values of current and that the junction diode dominates over the shunt diode at high values of current.

  6. Evaluation of magnetostrictive shunt damper performance using Iron (Fe)-Gallium (Ga) alloy

    NASA Astrophysics Data System (ADS)

    Yoo, JinHyeong; Murray, Andrew; Flatau, Alison B.

    2014-04-01

    This study presents the possibility of dissipating mechanical energy with a proof-of-concept prototype magnetostrictive based shunt circuit using passive electrical components. The device consists of a polycrystalline galfenol (Fe-Ga alloy) strip bonded to a brass cantilever beam. Two brass pieces, each containing a permanent magnet, are used to mass load each end of the beam and to provide a magnetic bias field through the galfenol strip. The voltage induced in an induction coil closely wound around the cantilever beam captures the time rate of change of magnetic flux within the galfenol strip as the beam vibrates. The first bending-mode resonant frequency of the device was 69.42 Hz. To dissipate the electrical voltage from the device, a shunt circuit is attached. The effective mechanical impedance for the magnetostrictive shunt circuit is derived. The shunted model is specialized for two shunt circuits: the case of a resistor and that of a capacitance. The experimental results for both the resistive and capacitance shunt circuits validate the shunted magnetostrictive damping model for couple of cased of resistance and capacitance.

  7. [The efficacy of transcatheter embolization of severe arterioportal shunts in hepatocellular carcinoma].

    PubMed

    Hiyoshi, Yukiharu; Beppu, Toru; Okabe, Kazutoshi; Hayashi, Hiromitsu; Masuda, Toshiro; Okabe, Hirohisa; Mizumoto, Takao; Komori, Hiroyuki; Tanaka, Hiroshi; Horino, Kei; Ishiko, Takatoshi; Takamori, Hiroshi; Hirota, Masahiko; Baba, Hideo

    2007-11-01

    Transcatheter arterial embolizations of severe arterioportal shunt (A-P shunt) were performed with steel coils in 3 patients with hepatocellurlar carcinoma (HCC) as shown below. Case 1: A 56-year-old man with HCC associated with portal hypertension (esophageal varices and ascites abnominal pain), portal vein tumor thrombus and severe A-P shunt was performed in critical conditions. Case 2: A 51-year-old man with HCC, lung and adrenal gland metastases was accompanied with severe portal hypertention caused by A-P shunt and was in a harmful condition similar to case 1. Case 3: A 68-year-old woman with HCC associated with autoimmune hepatitis was performed a hepatic resection. Then multiple intrahepatic recurrences appeared 6 months later. A-P shunt made impossible to detect the feeding artery of tumor. After embolization of A-P shunt, esophageal varices and ascites resolved, and abdominal pain improved in cases 1 and 2. In addition, embolization enabled to perform transcatheter arterial chemoembolization in case 3. This procedure is a useful tool to improve various symptoms due to A-P shunt and to continue treatments for HCCs. PMID:18219909

  8. Staged Transcatheter Treatment of Portal Hypoplasia and Congenital Portosystemic Shunts in Children

    SciTech Connect

    Bruckheimer, Elchanan Dagan, Tamir; Atar, Eli; Schwartz, Michael; Kachko, Ludmila; Superina, Riccardo; Amir, Gabriel; Shapiro, Rivka; Birk, Einat

    2013-12-15

    Purpose: Congenital portosystemic shunts (CPSS) with portal venous hypoplasia cause hyperammonemia. Acute shunt closure results in portal hypertension. A transcatheter method of staged shunt reduction to afford growth of portal vessels followed by shunt closure is reported. Methods: Pressure measurements and angiography in the CPSS or superior mesenteric artery (SMA) during temporary occlusion of the shunt were performed. If vessels were diminutive and the pressure was above 18 mmHg, a staged approach was performed, which included implantation of a tailored reducing stent to reduce shunt diameter by {approx}50 %. Recatheterization was performed approximately 3 months later. If the portal pressure was below 18 mmHg and vessels had developed, the shunt was closed with a device. Results: Six patients (5 boys, 1 girl) with a median age of 3.3 (range 0.5-13) years had CPSS portal venous hypoplasia and hyperammonemia. Five patients underwent staged closure. One patient tolerated acute closure. One patient required surgical shunt banding because a reducing stent could not be positioned. At median follow-up of 3.8 (range 2.2-8.4) years, a total of 21 procedures (20 transcatheter, 1 surgical) were performed. In all patients, the shunt was closed with a significant reduction in portal pressure (27.7 {+-} 11.3 to 10.8 {+-} 1.8 mmHg; p = 0.016), significant growth of the portal vessels (0.8 {+-} 0.5 to 4.0 {+-} 2.4 mm; p = 0.037), and normalization of ammonia levels (202.1 {+-} 53.6 to 65.7 {+-} 9.6 {mu}mol/L; p = 0.002) with no complications. Conclusion: Staged CPSS closure is effective in causing portal vessel growth and treating hyperammonemia.

  9. Percutaneous Transjugular Direct Porto-caval Shunt in Patients with Budd-Chiari Syndrome

    SciTech Connect

    Quateen, A.; Pech, M.; Berg, T.; Bergk, A.; Podrabsky, P.; Felix, R.; Ricke, J.

    2006-08-15

    The purpose of the study was to evaluate the feasibility and effectiveness of direct porto-caval shunts in patients with Budd-Chiari syndrome (BCS) in whom there is no access to the hepatic veins during transjugular intrahepatic portosystemic shunt (TIPSS). We included six consecutive patients with fulminant/acute Budd-Chiari syndrome (mean age: 35 years) in whom a conventional TIPSS was not possible due to inaccessible hepatic veins. We performed a direct porto-caval shunt via a transhepatic approach. Patients were followed up by means of clinical examination, laboratory investigations, and Doppler ultrasound. TIPSS implantation from the inferior vena cava (IVC) was successful in all six patients (100%). The median transhepatic shunt length was 9 cm (8-10 cm). No procedure-related complications were observed in our patients. Early shunt occlusion occurred in three out of six patients (50%). In all three of these patients, the stent used to stabilize the shunt ended 1-2 cm before reaching the IVC. All occlusions were successfully recanalized. One of these patients developed recurrent early shunt as well as mesenteric and splenic vein occlusions. She died 7 days after TIPSS placement due to an unmanageable coagulation disorder. The remaining five patients were followed up by planned clinical examination and laboratory investigations (mean follow-up time was 15 months; patient 1 was followed up for 13 months, patient 2 for 14 months, patient 3 for 15 months, and patients 4 and 5 for 16 months) and all displayed a complete and durable resolution of liver failure and ascites without reintervention. In patients with acute liver failure originating from BCS and inaccessible hepatic veins, a direct transhepatic porto-caval shunt can be performed safely and effectively under ultrasound guidance. Future studies in larger patient groups should investigate if the patency of transcaval TIPSS with long transhepatic shunt segments is similar compared to conventional TIPSS via the hepatic vein.

  10. The effects of dobutamine and dopamine on intrapulmonary shunt and gas exchange in healthy humans.

    PubMed

    Bryan, Tracey L; van Diepen, Sean; Bhutani, Mohit; Shanks, Miriam; Welsh, Robert C; Stickland, Michael K

    2012-08-15

    The development of intrapulmonary shunts with increased cardiac output during exercise in healthy humans has been reported in several recent studies, but mechanisms governing their recruitment remain unclear. Dobutamine and dopamine are inotropes commonly used to augment cardiac output; however, both can increase venous admixture/shunt fraction (Qs/Qt). It is possible that, as with exercise, intrapulmonary shunts are recruited with increased cardiac output during dobutamine and/or dopamine infusion that may contribute to the observed increase in Qs/Qt. The purpose of this study was to examine how dobutamine and dopamine affect intrapulmonary shunt and gas exchange. Nine resting healthy subjects received serial infusions of dobutamine and dopamine at incremental doses under normoxic and hyperoxic (inspired O(2) fraction = 1.0) conditions. At each step, alveolar-to-arterial Po(2) difference (A-aDo(2)) and Qs/Qt were calculated from arterial blood gas samples, intrapulmonary shunt was evaluated using contrast echocardiography, and cardiac output was calculated by Doppler echocardiography. Both dobutamine and dopamine increased cardiac output and Qs/Qt. Intrapulmonary shunt developed in most subjects with both drugs and paralleled the increase in Qs/Qt. A-aDo(2) was unchanged due to a concurrent rise in mixed venous oxygen content. Hyperoxia consistently eliminated intrapulmonary shunt. These findings contribute to our present understanding of the mechanisms governing recruitment of these intrapulmonary shunts as well as their impact on gas exchange. In addition, given the deleterious effect on Qs/Qt and the risk of neurological complications with intrapulmonary shunts, these findings could have important implications for use of dobutamine and dopamine in the clinical setting. PMID:22700799

  11. Correlation of experimental rCBF determinations in goats with flow measurements from a Doppler-modified carotid artery shunt

    SciTech Connect

    Loftus, C.M.; Silvidi, J.A.; Becker, J.A.; Miller, B.V.; Bernstein, D.D.

    1989-01-01

    A carotid artery shunt system has been developed that continuously monitors blood flow rates by embedding a Doppler crystal in the shunt wall. The crystal ranges through a liquid lens that enables it to be placed without violation of the shunt lumen. Because the crystal is at a fixed angle (45 degrees) to the axis of blood flow and the diameter of the lumen remains constant, a linear relationship exists between flow rates and the Doppler velocity signal. This shunt system was previously tested in vitro using a pulsatile pump and was found to be accurate to within 4.7% of the actual flow rate. In the present study, animal (goat) experiments were performed consisting of simultaneous carotid shunt flow and bilateral rCBF measurements by the radiolabeled microsphere technique to determine in vivo the accuracy of this Doppler modified shunt and to ascertain the ability of shunt flow to increase in the face of acute contralateral carotid occlusion. Data from five animals show that in vivo shunt flow can be recorded to within 13% of control rCBF and that shunt flow increases nearly 50% under conditions of distal demand (contralateral carotid occlusion). This device may prove useful in laboratory studies of carotid shunt dynamics and in clinical practice to quickly detect correctable shunt flow abnormalities.

  12. Characterization of the apoLp-III/LPS complex: insight in the mode of binding interaction

    PubMed Central

    Oztug, Merve; Martinon, Daisy; Weers, Paul M.M.

    2012-01-01

    Apolipoproteins are able to associate with lipopolysaccharides (LPS), potentially providing protection against septic shock. To gain insight in the molecular details of this binding interaction, apolipophorin III (apoLp-III) from Galleria mellonella was used as a model. The binding of apoLp-III to LPS was optimal around 37–40 °C, close to the LPS phase transition temperature. ApoLp-III formed complexes with LPS from E. coli (serotype O55:B5) with a diameter of 24 nm, a molecular weight of ~390 kDa, containing four molecules of apoLp-III and 24 molecules of LPS. The LPS-bound form of the protein was substantially more resistant to guanidine-induced denaturation compared to unbound protein. The denaturation profile displayed a multiphase character with a steep drop in secondary structure between 0–1 M guanidine, and a slower decrease above 1 M guanidine HCl. In contrast, apoLp-III bound to detoxified LPS was only slightly more resistant to guanidine HCl induced denaturation compared to unbound protein. Analysis of size-exclusion FPLC elution profiles of mixtures of apoLp-III with LPS or detoxified LPS indicated a much weaker binding interaction with detoxified LPS compared to intact LPS. These results indicate that apoLp-III initially interacts with exposed carbohydrate regions, but that the lipid A region is required for a more stable LPS binding interaction. PMID:22779761

  13. Coiling and migration of peritoneal catheter into the breast: a very rare complication of ventriculoperitoneal shunt.

    PubMed

    Shafiee, Sajad; Nejat, Farideh; Raouf, Sherief M; Mehdizadeh, Mehrzad; El Khashab, Mostafa

    2011-09-01

    Upward migration of distal catheter of a ventriculoperitoneal shunt with coiling is very rare. Pseudocyst and galactorrhea are known breast-related complications. Here, we report a 13-year-old girl, known case of myelomeningocele and shunted hydrocephalus, who presented with right breast pseudocyst due to distal tube migration and coiling of the catheter. Plain radiography was not diagnostic because of severe levoscoliosis, but chest computed tomography scan was confirmatory of shunt coiling lateral to the breast. The possible mechanisms causing this uncommon complication are described. PMID:21710231

  14. Evaluation of CSF shunt patency by means of /sup 99m/Tc DTPA

    SciTech Connect

    Graham, P.; Howman-Giles, R.; Johnston, I.; Besser, M.

    1982-08-01

    Evaluation of 192 cerebrospinal fluid shunts was performed using 1 mCi of /sup 99m/Tc DTPA which was injected into the shunt tubing. This was found to be a safe, simple method of evaluating shunt patency. No complications were noted with this procedure, nor was there any documented case of infection related to the injection of the isotope. The sensitivity of the test for evaluation of patency was 97%, specificity 90%, and accuracy 93%. Various patterns of tracer clearance are noted and discussed. The role on this test as an aid in making management decisions is detailed.

  15. Treatment of Syringomyelia due to Chiari Type I Malformation with Syringo-Subarachnoid-Peritoneal Shunt

    PubMed Central

    Akak?n, Ak?n; Y?lmaz, Baran; K?l?ç, Türker

    2015-01-01

    Chiari type I malformation is a tonsillar herniation more than 3 mm from the level of foramen magnum, with or without concurrent syringomyelia. Different surgical treatments have been developed for syringomyelia secondary to Chiari's malformations: craniovertebral decompression with or without plugging of the obex, syringo-subarachnoid, syringo-peritoneal, and theco-peritoneal shunt placement. Shunt placement procedures are useful for neurologically symptomatic large-sized syrinx. In this paper, authors define the first successful treatment of a patient with syringomyelia due to Chiari type I malformation using a pre-defined new technique of syringo-subarachnoid-peritoneal shunt with T-tube system. PMID:25932303

  16. Microvascular right-to-left pulmonary shunt demonstrated by a radionuclide method

    SciTech Connect

    Kjoller, E.; Pedersen, F.; Svendsen, T.L.; Sorensen, S.S. )

    1991-01-01

    A 37-yr-old man with angiolymphoid hyperplasia (Kimura's syndrome), who had been treated unsuccessfully for suspected asthma, was investigated due to a decrease in arterial oxygen saturation (86%). Right heart catheterization and angiography of the pulmonary artery failed to demonstrate any right-to-left shunts. However, simultaneous scintigraphy over the lungs, kidneys, and head after injection of 150 MBq technetium-99m-labeled macroaggregated albumin i.v. and inhalation of 150 MBq krypton-81m demonstrated a right-to-left shunt in the lungs probably caused by precapillary pulmonary arteriovenous shunts.

  17. [Functional and morphological characteristics of the vascular bed of the limbs in arteriovenous shunts].

    PubMed

    Ugnenko, N M; Novikov, Iu G

    1975-02-01

    Based on phlebo- and lymphography findings patients with congenital arterio-venous fistulas of the lower extremities and in experimental construction of intervascular shunts on different levels of the caudal vena cava basin, it was found that changes in lymphatic collectors of the curs and femur depended directly on venous insufficiency and duration of the disease. In damaged micro- and macroscopic shunts changes in lymph vessels are characterised by a number of peculiarities. Functional and morphological changes in the vascular bed of limbs in patients with congenital and experimentally produced arteriovenous shunts are characterized by a stage development of progressive disturbances. PMID:1189222

  18. Intrahepatic portosystemic venous shunt: successful embolization using the Amplatzer Vascular Plug II.

    PubMed

    Lee, Young-ju; Shin, Byung Seok; Lee, In Ho; Ohm, Joon Young; Lee, Byung-seok; Ahn, Moonsang; Kim, Ho Jun

    2012-01-01

    A 67-year-old woman presented with memory impairment and behavioral changes. Brain MRI indicated hepatic encephalopathy. Abdominal CT scans revealed an intrahepatic portosystemic venous shunt that consisted of two shunt tracts to the aneurysmal sac that communicated directly with the right hepatic vein. The large tract was successfully occluded by embolization using the newly available AMPLATZERTM Vascular Plug II and the small tract was occluded by using coils. The patient's symptoms disappeared after shunt closure and she remained free of recurrence at the 3-month follow-up evaluation. PMID:23118586

  19. Tunable acoustic waveguide based on vibro-acoustic metamaterials with shunted piezoelectric unit cells

    NASA Astrophysics Data System (ADS)

    Kwon, Byung-Jin; Jung, Jin-Young; Lee, Dooho; Park, Kwang-Chun; Oh, Il-Kwon

    2015-10-01

    We propose a new class of acoustic waveguides with tunable bandgaps (TBs) by using vibro-acoustic metamaterials with shunted periodic piezoelectric unit cells. The unit metamaterial cells that consist of a single crystal piezoelectric transducer and an electrical shunt circuit are designed to induce a strong vibro-acousto-electrical coupling, resulting in a tunable acoustic bandgap as well as local structural resonance and Bragg scattering bandgaps. The present results show that the TB frequency can be actively controlled and the transmission loss of the acoustic wave can be greatly improved by simply changing the inductance values in the shunt circuit.

  20. Radionuclide quantitation of left-to right cardiac shunts using deconvolution analysis: concise communication

    SciTech Connect

    Ham, H.R.; Dobbeleir, A.; Virat, P.; Piepsz, A.; Lenaers, A.

    1981-08-01

    Quantitative radionuclide angiocardiography (QRAC) was performed with and without deconvolution analysis (DA) in 87 children with various heart disorders. QRAC shunt quantitation was possible without DA in 70% of the cases and with DA in 95%. Among 21 patients with prolonged bolus injections, quantitation of the shunt was possible in 52% of the cases without DA an in all cases with DA. Correlation between oximetry and QRAC with DA was better than between oximetry and QRAC without DA. It is concluded that QRAC with DA is a more reliable, noninvasive means for detection and quantitation of left-to-right cardiac shunts than QRAC without DA.

  1. Neural Network Based Modeling and Analysis of LP Control Surface Allocation

    NASA Technical Reports Server (NTRS)

    Langari, Reza; Krishnakumar, Kalmanje; Gundy-Burlet, Karen

    2003-01-01

    This paper presents an approach to interpretive modeling of LP based control allocation in intelligent flight control. The emphasis is placed on a nonlinear interpretation of the LP allocation process as a static map to support analytical study of the resulting closed loop system, albeit in approximate form. The approach makes use of a bi-layer neural network to capture the essential functioning of the LP allocation process. It is further shown via Lyapunov based analysis that under certain relatively mild conditions the resulting closed loop system is stable. Some preliminary conclusions from a study at Ames are stated and directions for further research are given at the conclusion of the paper.

  2. [Spontaneous umbilical fistula as a complication of ventriculo-peritoneal shunt: case report].

    PubMed

    Takase, Takashi; Tane, Kazuyuki; Suzuki, Toshihisa; Inoue, Tsuyoshi; Fumoto, Yoshinaga

    2005-07-01

    We report a rare case of a spontaneous umbilical fistula as a complication of ventriculo-peritoneal shunt. A 36 year-old male was admitted our hospital complaining serous discharge from the umbilicus. Two years before admission, he underwent ventriculo-peritoneal shunt for the hydrocephalus due to right hypertensive intracranial hematoma and intraventricular hemorrhage. A shuntgraphy was done and it revealed the cerebrospinal fluid leakage from the umbilicus through an urachal remnant. The abdominal shunt tube was removed at the surgery, and the patient was discharged uneventfully without shunt revision. The possible etiology of this rare complication in this case was supposed to be due to the persistence of the urachus. PMID:16001814

  3. Carotid endarterectomy in an awake patient with contralateral carotid occlusion: influence of selective shunting.

    PubMed

    Locati, P; Socrate, A M; Lanza, G; Tori, A; Costantini, S

    2000-09-01

    The objectives of this study were to determine whether the presence of a contralateral carotid occlusion increases risk and whether the perioperative results are influenced by a systematic or selective policy of shunting during carotid endarterectomy (CEA) in an awake patient. In a retrospective study we compared patients with and without contralateral carotid occlusion (group I, n = 198 - group II, n = 1068) who required CEA. In 77 patients of group I, a shunt was systematically adopted (subgroup A); in the other 121 patients (subgroup B) and in all patients of group II a selective shunting policy was adopted. The risk for the patients with contralateral carotid occlusion was not significantly higher than that for patients without occlusion. Results were not influenced by systematic/selective shunting policy, and the incidence of signs of cerebral ischemia was higher in patients with contralateral carotid occlusion. PMID:10990554

  4. [Extracorporeal ventriculoatrial shunt with the use of one-way ball valve].

    PubMed

    Kubo, Shigeki; Takimoto, Hiroshi; Hosoi, Kazuki; Toyota, Shingo; Takakura, Shuji; Hayashi, Yasuhiro; Ueno, Masato; Morisako, Toshitaka; Karasawa, Jun; Ninaga, Hideo; Yoshimine, Toshiki

    2002-04-01

    We developed a simple system of an "extracorporeal" ventriculoatrial (VA) shunt using a one-way ball valve (Acty valve II, Kaneka Medix) to release the patient from postoperative constraint during the ventricular drainage. The system is constructed in such a way that the ventricular drainage tube is connected to the central venous catheter via a one-way valve. The CSF is regulated by using the valve and is diverted into the systemic circulation as in the conventional ventriculoatrial shunt. After 2 or 3 weeks of CSF diversion through the extracorporeal VA shunt, a ventriculoperitoneal shunt is placed if hydrocephalus is apparent by temporary occlusion of the system. We applied this system to 4 patients with hydrocephalus, and we found it useful and free from adverse effects. The patient was freed from physical constraint involved in conventional ventricular drainage and an effective program of early rehabilitation was able to be started. PMID:11968827

  5. Transjugular intrahepatic portosystemic stent-shunt: technical factors and new developments.

    PubMed

    Tripathi, Dhiraj; Redhead, Doris

    2006-11-01

    The introduction of expandable metal stents in the mid 1980s led to the development of transjugular intrahepatic portosystemic stent-shunt (TIPSS) as we know it today. Short-lived detrimental effects on the hyperdynamic circulation in cirrhosis accompany the acute reduction in portal pressure following TIPSS creation. Caution is needed in patients with cardiac dysfunction or pulmonary hypertension. With increasing expertise and careful patient selection, fatal procedural complications are rare and TIPSS can even be safely used as a bridge to liver transplantation. Shunt insufficiency and hepatic encephalopathy are more common following TIPSS. Currently, however, novel approaches to tackling both these limitations exist. These include the combination of uncovered TIPSS with variceal band ligation, and the introduction of polytetrafluoroethylene covered stents. Despite the lack of controlled studies, covered stents are now widely used and have the potential to drastically reduce shunt insufficiency, the need for long-term shunt surveillance and even hepatic encephalopathy. PMID:17033430

  6. Noninvasive prediction of shunt operation outcome in idiopathic normal pressure hydrocephalus

    PubMed Central

    Aoki, Yasunori; Kazui, Hiroaki; Tanaka, Toshihisa; Ishii, Ryouhei; Wada, Tamiki; Ikeda, Shunichiro; Hata, Masahiro; Canuet, Leonides; Katsimichas, Themistoklis; Musha, Toshimitsu; Matsuzaki, Haruyasu; Imajo, Kaoru; Kanemoto, Hideki; Yoshida, Tetsuhiko; Nomura, Keiko; Yoshiyama, Kenji; Iwase, Masao; Takeda, Masatoshi

    2015-01-01

    Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome characterized by gait disturbance, cognitive deterioration and urinary incontinence in elderly individuals. These symptoms can be improved by shunt operation in some but not all patients. Therefore, discovering predictive factors for the surgical outcome is of great clinical importance. We used normalized power variance (NPV) of electroencephalography (EEG) waves, a sensitive measure of the instability of cortical electrical activity, and found significantly higher NPV in beta frequency band at the right fronto-temporo-occipital electrodes (Fp2, T4 and O2) in shunt responders compared to non-responders. By utilizing these differences, we were able to correctly identify responders and non-responders to shunt operation with a positive predictive value of 80% and a negative predictive value of 88%. Our findings indicate that NPV can be useful in noninvasively predicting the clinical outcome of shunt operation in patients with iNPH. PMID:25585705

  7. Assessment of the intracardiac left to right shunts with a single scintillation probe

    SciTech Connect

    Tendera, M.; Bartoszewski, A.; Foremny, J.; Salamon, A.; Wodniecki, J.; Malecka-Tendera, E. )

    1989-08-01

    In order to assess the accuracy of pulmonary time-activity curves obtained at bedside with a single scintillation probe and Technetium-99m-labelled erythrocytes, pulmonary to systemic flow ratio (Qp:Qs) was calculated for radionuclide and hemodynamic investigations in 104 patients with suspected intracardiac left to right shunts. Cardiac catheterization confirmed the presence of shunts in 76 patients. Pulmonary time-activity curve was 100% sensitive, 88% specific, and 96% accurate in detecting the shunt. Correlation between the radionuclide and hemodynamic Qp:Qs was excellent (r = 0.93). Results were classified in four quantitative categories according to the Qp:Qs values. In 76 patients (73%) radionuclide and hemodynamic data fell in the same category. We conclude that radionuclide pulmonary time-activity curves generated with a scintillation probe is a reliable method in quantitative assessment of intracardiac left to right shunts.

  8. Evaluation of Microbial Bacterial and Fungal Diversity in Cerebrospinal Fluid Shunt Infection

    PubMed Central

    Simon, Tamara D.; Pope, Christopher E.; Browd, Samuel R.; Ojemann, Jeffrey G.; Riva-Cambrin, Jay; Mayer-Hamblett, Nicole; Rosenfeld, Margaret; Zerr, Danielle M.; Hoffman, Lucas

    2014-01-01

    Background Cerebrospinal fluid shunt infection can be recalcitrant. Recurrence is common despite appropriate therapy for the pathogens identified by culture. Improved diagnostic and therapeutic approaches are required, and culture-independent molecular approaches to cerebrospinal fluid shunt infections have not been described. Objectives To identify the bacteria and fungi present in cerebrospinal fluid from children with cerebrospinal fluid shunt infection using a high-throughput sequencing approach, and to compare those results to those from negative controls and conventional culture. Methods This descriptive study included eight children ?18 years old undergoing treatment for culture-identified cerebrospinal fluid shunt infection. After routine aerobic culture of each cerebrospinal fluid sample, deoxyribonucleic acid (DNA) extraction was followed by amplification of the bacterial 16S rRNA gene and the fungal ITS DNA region tag-encoded FLX-Titanium amplicon pyrosequencing and microbial phylogenetic analysis. Results The microbiota analyses for the initial cerebrospinal fluid samples from all eight infections identified a variety of bacteria and fungi, many of which did not grow in conventional culture. Detection by conventional culture did not predict the relative abundance of an organism by pyrosequencing, but in all cases, at least one bacterial taxon was detected by both conventional culture and pyrosequencing. Individual bacterial species fluctuated in relative abundance but remained above the limits of detection during infection treatment. Conclusions Numerous bacterial and fungal organisms were detected in these cerebrospinal fluid shunt infections, even during and after treatment, indicating diverse and recalcitrant shunt microbiota. In evaluating cerebrospinal fluid shunt infection, fungal and anaerobic bacterial cultures should be considered in addition to aerobic bacterial cultures, and culture-independent approaches offer a promising alternative diagnostic approach. More effective treatment of cerebrospinal fluid shunt infections is needed to reduce unacceptably high rates of reinfection, and this work suggests that one effective strategy may be reduction of the diverse microbiota present in infection. PMID:24421877

  9. Intestinal Perforation in the Context of Thoracoamniotic Shunting and Congenital Diaphragmatic Hernia

    PubMed Central

    Dassios, Theodore; Hassan, Wassim A.; Kazmierski, Marcin; Carroll, Daniel; Ahluwalia, Jag

    2013-01-01

    A fetus was diagnosed by prenatal ultrasound with bilateral intrauterine pleural effusions that were subsequently drained in utero by insertion of bilateral thoracoamniotic shunts. Serial prenatal ultrasound scans were consistent with a left-sided diaphragmatic hernia. On the first day of life, the infant underwent an exploratory laparotomy for intestinal obstruction, with radiographic findings of pneumatosis intestinalis. Intraoperative findings were suggestive of prenatal bowel and diaphragm perforation, which might have occurred as a complication of thoracoamniotic shunting. PMID:25755939

  10. PI and fuzzy logic controllers for shunt Active Power Filter--a report.

    PubMed

    Karuppanan, P; Mahapatra, Kamala Kanta

    2012-09-01

    The authors acknowledge certain errors in their recently published paper titled "PI and fuzzy logic controllers for shunt active power filter--A report.The ambiguity in band width calculation of adaptive hysteresis controller and control aspects of dc-link voltage issues are addressed. The shunt APF system is validated through extensive simulation and the results are support features of the proposed technique. PMID:23012711

  11. Treatment of portal hypertension by subtotal splenectomy and central splenorenal shunt.

    PubMed Central

    Petroianu, A.

    1988-01-01

    A method is proposed to reduce portal hypertension utilizing subtotal splenectomy and a central splenorenal shunt. The advantages of this method are: diversion of the splenic component of the portal circulation, creation of a shunt for the portal blood into the systemic circulation, preservation of the splenic function and correction of the manifestations of the hypersplenism. Two cases are presented who remain well four years after surgery. Images Figure 1 Figure 3 PMID:3420056

  12. Superconducting FCL using a combined inducted magnetic field trigger and shunt coil

    DOEpatents

    Tekletsadik, Kasegn D. (Rexford, NY)

    2007-10-16

    A single trigger/shunt coil is utilized for combined induced magnetic field triggering and shunt impedance. The single coil connected in parallel with the high temperature superconducting element, is designed to generate a circulating current in the parallel circuit during normal operation to aid triggering the high temperature superconducting element to quench in the event of a fault. The circulating current is generated by an induced voltage in the coil, when the system current flows through the high temperature superconducting element.

  13. Spontaneous expectoration of a Blalock-Taussig shunt a decade after operation

    PubMed Central

    Kothari, Shyam S; Murugan, Madhan Kumar; Chowdhury, Ujjwal Kumar

    2015-01-01

    An eleven-year-old boy expectorated a foreign body in cough that was identified as the prosthetic graft used for a Blalock-Taussig shunt. The shunt procedure was done 10 years earlier, and a definitive repair for tetralogy of Fallot was done a year later. He had no other symptoms, and a computed tomography (CT) angiogram did not reveal any other significant anomaly. The reason for this extremely rare event is unclear. PMID:25684887

  14. Penile Gangrene with Abscess Formation after Modified Al-Ghorab Shunt for Idiopathic Ischemic Priapism

    PubMed Central

    Ford-Glanton, Beneranda S.; Siddiqui, Sameer

    2014-01-01

    Penile gangrene is a rare but unfortunate complication of surgical intervention and priapism shunts. The literature regarding penile gangrene following surgical correction of priapism is sparse, the majority of which dates back to thirty to forty years. Here, we present the case of a 60-year-old man who presented with priapism that required operative management with a modified Al-Ghorab shunt and eventually suffered from complete necrosis of the penis with abscess formation in both corpora cavernosa. PMID:25276468

  15. Experimental Percutaneous Extrahepatic Portacaval Shunt Creation by Transjugular Approach in Swine

    SciTech Connect

    Seong, Chang Kyu; Pavcnik, Dusan Uchida, Barry T.; Anai, Hiroshi; Timmermans, Hans; Niyyati, Mahtab; Corless, Christopher L.; Correa, Luiz O.; Keller, Frederick S.; Roesch, Josef

    2005-06-15

    The purpose of the study was to evaluate the feasibility of the creation of a percutaneous extrahepatic portacaval shunt (PEPS) in swine by a transjugular approach and to find a suitable stent-graft to use in PEPS. In 12 swine, the extrahepatic portal vein (PV) was entered from the inferior vena cava (IVC) by a needle system introduced from the transjugular approach. A catheter introduced through the transhepatic approach served as a target. Five types of stent-graft consisting of homemade Z stents and a polytetrafluoethylene cover were explored for PEPS creation. Eight animals had follow-up venograms up to 6 weeks or until the shunt became severely stenotic. Gross and histologic examinations were performed after the final follow-up venography. The PV punctures and stent-graft placement were difficult, but the PEPS was established in all animals. In four animals, the stent-graft failed to adequately cover the tract, causing severe hemorrhage. Only two shunts remained patent up to 6 weeks. The other shunts exhibited severe stenosis or occlusion. At gross examination, all shunts traversed the liver parenchyma of the caudate lobe surrounding the IVC. The extravascular PEPS portion was 4 mm to 2 cm long. All shunts entered the PV close to the splenomesenteric junction and exhibited neointimal formation. Shunt stenoses were caused by neointimal hyperplasia and occlusions by a superimposed thrombus. PEPS can be created by the transjugular approach in swine, but only the PV shunt entrance is extrahepatic. None of the tested rigid stent-grafts were suitable for PEPS creation. A short flexible stent-graft with flanged ends is suggested for further exploration.

  16. Rheolytic Thrombectomy of an Acutely Thrombosed Transjugular Intrahepatic Portosystemic Stent Shunt

    SciTech Connect

    Mueller-Huelsbeck, Stefan; Link, Johann; Hoepfner, Michael; Loeser, Christian; Heller, Martin

    1996-04-15

    As an alternative to chemical thrombolysis, an acutely occluded transjugular intrahepatic portosystemic stent shunt in a 72-year-old woman was successfully recanalized using a 5 Fr rheolytic catheter system. No adjunctive thrombectomy treatment was necessary. The underlying stenotic leason was treated with percutaneous transluminal angioplasty and a Palmaz stent. Immediately after the intervention optimal shunt flow was achieved. Ascites vanished within a few days and no further bleeding complications appeared.

  17. Lp-PLA2: an emerging biomarker of coronary heart disease.

    PubMed

    Dada, Nisha; Kim, Nam W; Wolfert, Robert L

    2002-01-01

    Cardiovascular disease is the leading cause of death in most industrialized countries. However, the diagnosis and management of coronary heart disease is far from optimal. Lipoprotein-associated phospholipase A2 (Lp-PLA2), also known as platelet-activating factor acetylhydrolase, is an enzyme that hydrolyses oxidized phospholipids and is primarily associated with low-density lipoprotein. Discussed in this review is the accumulating evidence supporting the view that Lp-PLA2 is a potential biomarker of coronary heart disease and plays and an important proinflammatory role in the progression of atherosclerosis. A new ELISA method for the quantitative measurement of Lp-PLA2 mass in human plasma developed by diaDexus, Inc. is presented. Furthermore, potential clinical applications of Lp-PLA2 mass measurements are proposed. PMID:11963798

  18. Characterization of LpGPAT Gene in Lilium pensylvanicum and Response to Cold Stress

    PubMed Central

    Sun, Shao-kun; Yang, Ni-na; Chen, Li-jing; Irfan, Muhammad; Zhao, Xing-hua; Li, Tian-lai

    2015-01-01

    LpGPAT was obtained from L. pensylvanicum using RT-PCR and rapid amplification of cDNA ends. The cloned full-length cDNA was 1544 bp; it encoded 410 amino acids and had a molecular size of 46 KDa. The nucleic acid sequence analysis showed that it shared high homology with other known GPATs. SMAT result suggests that there is a PlsC that exists in 176-322 amino acid sequence of LpGAPT; it means LpGPAT protein is a member of the family of acyltransferase and has acyltransferase enzymatic activity. Result of real-time quantitative PCR and semiquantitative PCR support LpGPAT gene is definitely induced by low temperature stress. PMID:25710023

  19. 6. ROOF OF TURBINE BUILDING AND OF L.P. BOILER ROOM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. ROOF OF TURBINE BUILDING AND OF L.P. BOILER ROOM FROM NORTH END OF TURBINE BUILDING ROOF - Portland General Electric Company, Turbine Building, 1841 Southeast Water Street, Portland, Multnomah County, OR

  20. 76 FR 22698 - Gulf South Pipeline Company, LP; Notice of Request Under Blanket Authorization

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-22

    ... J. Kyle Stephens, Vice President, Regulatory Affairs, Gulf South Pipeline Company, LP, 9 Greenway....Stephens@bwpmlp.com . This filing is available for review at the Commission or may be viewed on...

  1. 76 FR 44902 - Gulf South Pipeline Company, LP; Notice of Request Under Blanket Authorization

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-27

    ... Authorization Take notice that on July 1, 2011, Gulf South Pipeline Company, LP (Gulf South), 9 Greenway Plaza..., 9 Greenway Plaza, Suite 2800, Houston, TX 77046 at telephone (713) 479-8252 or e-mail:...

  2. 76 FR 30326 - Gulf South Pipeline Company, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-25

    ... May 10, 2011, Gulf South Pipeline Company, LP (Gulf South), 9 Greenway Plaza, Suite 2800, Houston... Greenway Plaza, Suite 2800, Houston, Texas 77046, or by calling (713) 479-8033 (telephone), or (713)...

  3. 75 FR 61480 - Gulf South Pipeline Company, LP; Notice of Request Under Blanket Authorization

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-05

    ... South), 9 Greenway Plaza, Suite 2800, Houston, Texas 77046, filed a prior notice request pursuant to..., Director, Regulatory Affairs, Gulf South Pipeline Company, LP, 9 Greenway Plaza, Suite 2800, Houston,...

  4. Vibration and wave propagation attenuation for metamaterials by periodic piezoelectric arrays with high-order resonant circuit shunts

    NASA Astrophysics Data System (ADS)

    Zhou, Wanlu; Wu, You; Zuo, Lei

    2015-06-01

    Beam or plate metamaterials with periodic piezoelectric arrays have attracted more and more attention in recent years for wave propagation attenuation and the corresponding vibration reduction. Conventional designs use resistive shunt (R-shunt) and resistor-inductor shunt (RL-shunt). An innovative metamaterial with a high-order resonant shunt circuit is proposed and investigated for vibration and wave propagation attenuation in this paper. The proposed high-order resonant shunt circuit can introduce two local resonances in series around the tuning frequency to broaden the attenuation bandwidth, or can create two separate resonances to achieve two separate bandgaps. Finite element modeling of the beam metamaterial with wave propagation and vibration in the transverse direction is established. Simulations have been conducted to compare the vibration attenuation performances among R-shunt, RL-shunt, and the proposed high-order shunt. An impedance-based method has been presented for the parameter design of electrical components in the proposed high-order shunt for bandgaps at two desired frequencies.

  5. The collateral caval shunt as an alternative to classical shunt procedures in patients with recurrent duodenal varices and extrahepatic portal vein thrombosis

    PubMed Central

    2014-01-01

    Upper gastrointestinal bleeding episodes from variceal structures are severe complications in patients with portal hypertension. Endoscopic sclerotherapy and variceal ligation are the treatment options preferred for upper variceal bleeding owing to extrahepatic portal hypertension due to portal vein thrombosis (PVT). Recurrent duodenal variceal bleeding in non-cirrhotic patients with diffuse porto-splenic vein thrombosis and subsequent portal cavernous transformation represent a clinical challenge if classic shunt surgery is not possible or suitable. In this study, we represent a case of recurrent bleeding of duodenal varices in a non-cirrhotic patient with cavernous transformation of the portal vein that was successfully treated with a collateral caval shunt operation. PMID:24965047

  6. Global Measurement of Junge Layer Stratospheric Aerosol with OMPS/LP. Scattering Properties and Particle Size

    NASA Astrophysics Data System (ADS)

    Rault, D. F.; Bhartia, P. K.

    2014-12-01

    The OMPS/LP was launched on board the NPP space platform in October 2011. Over the past two years, the OMPS/LP was used to retrieve the global distribution of ozone and aerosol. The paper will describe the aerosol product, which NASA is presently preparing for public release. The current OMPS/LP aerosol product consists of latitude-altitude curtains along the NPP Sun-synchronous orbit, from cloud top to about 40 km. These curtains extend from local sunrise in Southern polar region to local sunset in Northern polar region. Aerosol extinctions are produced at five distinct wavelengths, namely 513, 525, 670, 750 and 870 nm, with a sampling of 1 km in vertical direction and 1 degree latitude in the along-track direction. The OMPS/LP aerosol dataset is fairly large, with 7000 vertical profiles produced each day for each wavelength. The aerosol product will be presented in terms of extinction monthly median values and mean Angstrom coefficient (particle size). Over the past two years, the Junge layer was affected by several events such as volcanic eruptions (Nabro and Kelut) and a meteor (Chelyabinsk), the effects of which are clearly visible in the OMPS/LP dataset. The Asian Tropopause Aerosol Layer (ATAL) can also be observed in the OMPS/LP dataset. Moreover the effect of the Brewer Dobson Circulation (BDC) can be observed at high altitudes: the BDC velocity at 35 km can be estimated from the time variation of iso-density heights and was found to compare well with BDC velocities evaluated with the water vapor tape recorder technique as well as MERRA model values. Finally, aerosol filaments are clearly visible in OMPS/LP aerosol dataset as they appear as distinct "bubbles" on the OMPS/LP curtain files at periodic intervals in both the Southern and Northern hemispheres. These filaments are a main source of transport from tropical to polar region, and OMPS/LP data can therefore be instrumental in quantifying the rate of this transport. The quality of the OMPS/LP aerosol product is being assessed by comparison with correlative measurements made by CALIPSO, OSIRIS and GOMOS. Statistical comparisons between OMPS/LP and other sensors show mean bias of less than 7% with an ensemble variance of 20-30%.

  7. Prevention options for ventriculoperitoneal shunt infections: a retrospective analysis during a five-year period.

    PubMed

    Wu, Xing; Liu, Qin; Jiang, Xiaofei; Zhang, Tao

    2015-01-01

    Shunt infection is the most common and dreaded complication in patients with hydrocephalus. For the purpose of reducing the high morbidity and mortality, how to prevent is a vital step. A retrospective analysis of 384 CSF cerebrospinal fluid (CSF) shunt procedures was undertaken from 2006 to 2010 in our neurosurgery department. Infection diagnosis was established by subjecting the CSF to biochemical and microbiological parameters. The patients' demographic and clinical characteristics, various treatment procedures and outcome were evaluated. The infection rate of ventriculoperitoneal (VP) shunt was 12.5% in 2006, which dropped to 2% and stabilized at lower level from 2008. The most common causes of hydrocephalus were traumatic injury and brain tumor. Fever and consciousness disturbance were the major clinical symptoms. Gram-negative rods episodes was the most frequently isolated microorganisms accounting for 58%, followed by S. aureus , S. epidermidis and Staphylococcus haemolyticus. With the removal of shunt and intravenous antibiotics therapy, 82% of the patients survived. Majority of the isolates were sensitive to the carbopenem antibiotics and vancomycin. The mean length of hospital stay was 47 days. Prompt shunt removal and perioperative antibiotic prophylaxis seems to be essential for the survival of patients with VP shunt infection. PMID:26770643

  8. Novel therapy for non-cirrhotic hyperammonemia due to a spontaneous splenorenal shunt.

    PubMed

    Rogal, Shari S; Hu, Angela; Bandi, Rupal; Shaikh, Obaid

    2014-07-01

    Spontaneous splenorenal shunts in the absence of cirrhosis have rarely been reported as a cause hyperammonemia with encephalopathy. Several closure techniques of such lesions have been described. Here we report a case of a patient with no history of liver disease who developed significant confusion. After an extensive workup, he was found to have hyperammonemia and encephalopathy due to formation of a spontaneous splenorenal shunt. There was no evidence of cirrhosis on biopsy or imaging and no portal hypertension when directly measured. The shunt was 18 mm and too large for embolization so the segment of the splenic vein between the portal vein and the shunt was occluded using an Amplatzer plug. Thus, the superior mesenteric flow was directed entirely to the liver. After interventional radiology closure of the shunt using this technique there was complete resolution of symptoms. The case represents the first report of a successful closure of splenorenal shunt via percutaneous embolization of the splenic vein with an amplatzer plug using a common femoral vein approach. PMID:25009405

  9. Syringomyelia as a presenting feature of shunt dysfunction: Implications for the pathogenesis of syringomyelia

    PubMed Central

    Muthukumar, Natarajan

    2012-01-01

    The pathogenesis of syringomyelia continues to be an enigma. The patency of the central canal and its role in the pathogenesis of communicating syringomyelia continues to elicit controversy. The case reported here provides an opportunity to retest some of the hypotheses of syringomyelia. A 33 year old female presented with sensory disturbances over the left upper extremity and trunk and was diagnosed to have panventriculomegaly with communicating syringomyelia. She was initially treated with ventriculoperitoneal shunting. As there was no change in her neurological status following shunt, this was followed by foramen magnum decompression with excision of an arachnoid veil covering the fourth ventricular outlet. She had clinical and radiological improvement after foramen magnum decompression. Five months later she had reappearance of the symptoms of syringomyelia and was found to have shunt dysfunction and holocord syrinx. She improved following shunt revision. This case is being reported to highlight the following points: 1. In patients with communicating syringomyelia and hydrocephalus, shunt dysfunction can present with symptoms of syringomyelia without the classical clinical features of shunt dysfunction, 2. In patients with communicating syringomyelia, the central canal of the spinal cord acts as an “exhaust valve” for the ventricular system, and, 3. studies about the patency of the central canal are reviewed in the context of this case and the role of the central canal in the pathogenesis of communicating syringomyelia is reviewed. PMID:23741127

  10. Solid noninfectious growing masses over cerebrospinal fluid shunts: report of 3 cases.

    PubMed

    James, Hector E; Postlethwait, Richard A; Sandler, E Dayan

    2015-04-01

    The authors describe 3 children who presented with progressively enlarging skin-covered solid masses over the shunt catheter in the neck/clavicular region. The authors reviewed the clinical, laboratory, pathological, radiographic, and follow-up data for all 3 patients and reviewed the literature on the subject. The patients had no clinical evidence of an infectious process. Surgical exploration revealed that masses were surrounding and encasing the shunt tubing to which they were strongly attached. Pathological studies of the tissues demonstrated varying degrees of exuberant chronically inflamed granulation tissues, interstitial fibrosis, and dystrophic calcification. One patient had associated thinning of the skin overlying the mass and subsequently developed ulceration. No infectious organisms were observed. The cerebrospinal fluid aspirates from the shunts did not yield any organisms. There has been no recurrence of the masses. The presence of a growing mass over the shunt tube in the neck or the chest region without clinical evidence of infection does not indicate that the mass should be treated with antibiotics and complete shunt removal. Rather, the mass can be cured by extirpation and with "bypass" new shunt tubing locally. PMID:25634820

  11. Prevention options for ventriculoperitoneal shunt infections: a retrospective analysis during a five-year period

    PubMed Central

    Wu, Xing; Liu, Qin; Jiang, Xiaofei; Zhang, Tao

    2015-01-01

    Shunt infection is the most common and dreaded complication in patients with hydrocephalus. For the purpose of reducing the high morbidity and mortality, how to prevent is a vital step. A retrospective analysis of 384 CSF cerebrospinal fluid (CSF) shunt procedures was undertaken from 2006 to 2010 in our neurosurgery department. Infection diagnosis was established by subjecting the CSF to biochemical and microbiological parameters. The patients’ demographic and clinical characteristics, various treatment procedures and outcome were evaluated. The infection rate of ventriculoperitoneal (VP) shunt was 12.5% in 2006, which dropped to 2% and stabilized at lower level from 2008. The most common causes of hydrocephalus were traumatic injury and brain tumor. Fever and consciousness disturbance were the major clinical symptoms. Gram-negative rods episodes was the most frequently isolated microorganisms accounting for 58%, followed by S. aureus , S. epidermidis and Staphylococcus haemolyticus. With the removal of shunt and intravenous antibiotics therapy, 82% of the patients survived. Majority of the isolates were sensitive to the carbopenem antibiotics and vancomycin. The mean length of hospital stay was 47 days. Prompt shunt removal and perioperative antibiotic prophylaxis seems to be essential for the survival of patients with VP shunt infection. PMID:26770643

  12. Successful ventricle to direct heart shunt placement as a salvage cerebrospinal fluid diversion technique. Case report.

    PubMed

    Thompson, Eric M; Giles, Stephen G; Song, Howard K; Litvack, Zachary N; Golshani, Kiarash J; Nemecek, Andrew N

    2009-06-01

    The authors report a complex case in a 35-year-old woman who underwent shunt placement at birth for myelomeningocele. She had previously undergone more than 30 shunt revisions, with placement of the distal catheter in the peritoneum multiple times, and also in the pleura, the gall bladder, and the upper venous system. All shunts had failed and the possible placement sites were now anatomically hostile. A median sternotomy was performed as the next option. The catheter was placed directly into the appendage of the right atrium and secured with a pursestring suture. One month postoperatively, the patient presented with a large pericardial effusion after the distal catheter migrated out of the atrium and into the pericardial space. A repeat sternotomy was performed to drain the pericardial CSF collection. The catheter was reinserted into the atrial appendage, and a tunnel was created in the atrial wall to fix the device more securely. At 1 year postoperatively, the patient had no further symptoms of shunt obstruction or cardiac tamponade, and imaging studies suggested that the shunt system was functional. The authors report the first successful ventricle to direct heart shunt in an adult. PMID:19485739

  13. Current-to-voltage converter for linearity correction of low shunt resistance photovoltaic detectors

    SciTech Connect

    Makai, J.P.; Makai, J.J.

    1996-06-01

    The most accurate absolute calibration of radiometric transfer standard detectors is carried out by cryogenic radiometers at a usually high irradiance level. A radiometric scale can be maintained by these calibrated detectors in a given irradiance range if they are linear or their nonlinearity is predictable in this range. The linearity of photovoltaic quantum detectors can be affected among others by their shunt resistance and the applied circuitry. Many of the radiometric quality large-area photodiodes exhibit very low shunt resistance in comparison to Si detectors. When used with a traditional current-to-voltage converter the requirement of the ideal short-circuit operation is not always met. Consequently, part of the photoinduced current flows through the shunt resistance of the detector as a shunt current, and only the rest produces the output voltage. This shunt current is highly temperature dependent and is generally proportional to the output voltage causing a nonlinear deviation of the output signal if the feedback resistor of the current-to-voltage converter, i.e., the sensitivity is changed. To practically eliminate the shunt current the bootstrapping technique was applied to these detectors, it enhanced the linear range of sensitivity by more than two decades. The circuit theory and the noise sources are detailed. {copyright} {ital 1996 American Institute of Physics.}

  14. Mechanism for measurement of flow rate of cerebrospinal fluid in hydrocephalus shunts.

    PubMed

    Rajasekaran, Sathish; Kovar, Spencer; Qu, Peng; Inwald, David; Williams, Evan; Qu, Hongwei; Zakalik, Karol

    2014-01-01

    The measurement of the flow rate of cerebrospinal fluid (CSF) or existence of CSF flow inside the shunt tube after shunt implant have been reported as tedious process for both patients and doctors; this paper outlines a potential in vitro flow rate measurement method for CSF in the hydrocephalus shunt. The use of implantable titanium elements in the shunt has been proposed to allow for an accurate temperature measurement along the shunt for prediction of CSF flow rate. The CSF flow velocity can be deduced by decoupling the thermal transfer in the measured differential time at a pair of measurement spots of the titanium elements. Finite element analyses on the fluidic and thermal behaviors of the shunt system have been conducted. Preliminary bench-top measurements on a simulated system have been carried out. The measured flow rates, ranging from 0.5 mm/sec to 1.0 mm/sec, which is clinically practical, demonstrate good agreements with the simulation results. PMID:25570411

  15. Therapeutic modulation of lipoprotein-associated phospholipase A2 (Lp-PLA2).

    PubMed

    Tselepis, Alexandros F; Rizzo, Manfredi; Goudevenos, Ioannis A

    2011-11-01

    Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a calcium-independent phospholipase A2 that circulates in plasma in association with lipoprotein particles, whereas in atherosclerotic plaques it is co-localized with macrophages. Lp-PLA2 generates two proinflammatory mediators, lysophosphatidylcholine and oxidized nonesterified fatty acids, which play a role in the development of atherosclerotic lesions and formation of a necrotic core, leading to more vulnerable plaques. Epidemiologic studies demonstrate that increased circulating levels of Lp-PLA2 predict an increased risk of myocardial infarction, stroke and cardiovascular mortality. Furthermore, histologic examination of diseased human coronary arteries reveals intense presence of the enzyme in atherosclerotic plaques that are prone to rupture. These considerations suggest Lp-PLA2 as a promising therapeutic target in cardiovascular disease. Plasma levels of Lp-PLA2 are increased in various types of hyperlipidemias, while hypolipidemic drugs reduce plasma Lp-PLA2 activity and mass along with the improvement of plasma lipid profile. A selective inhibitor of Lp-PLA2 activity, darapladib, has been developed and studies in animal models and humans have shown that it effectively and safely reduces Lp-PLA2 activity in plasma and in atherosclerotic plaques. Furthermore, in animal models darapladib decreases plaque area and necrotic core area whereas in humans it prevents the expansion of necrotic core volume. Whether the results obtained from the use of darapladib in studies in vitro, as well as in preclinical and clinical studies would translate into benefits on cardiovascular event outcomes, awaits to be proved in 2 ongoing phase 3 trials. PMID:22074435

  16. Lp-PLA2 inhibitory activities of fatty acid glycerols isolated from Saururus chinensis roots.

    PubMed

    Lee, Woo Song; Kim, Mi Jeong; Beck, Young-Il; Park, Yong-Dae; Jeong, Tae-Sook

    2005-08-01

    (R)-Glycerol-monolinoleate 4 and (R)-glycerol-monostearate 5 were isolated from the ethyl acetate extracts of Saururus chinensis roots and (R)- or (S)-fatty acid glycerols 4 and 5 were synthesized for confirming their structures and evaluating their inhibitory activities against Lp-PLA(2). The (R)-4 and (S)-4 exhibited Lp-PLA(2) inhibitory activities with IC(50) values of 45.0 and 52.0 microM, respectively. PMID:15961310

  17. Analysis of the Suitability of OMPS LP Ozone Profile Dataset for Extending the Aura MLS Record

    NASA Astrophysics Data System (ADS)

    Kramarova, N. A.; Bhartia, P. K.; Stolarski, R. S.; DeLand, M. T.

    2014-12-01

    The new Ozone Mapping and Profiler Suite (OMPS), launched on 28 October 2011 on the Suomi National Polar-orbiting Partnership satellite, represents the next generation of the US ozone monitoring system. The OMPS Limb Profiler (LP) sensor measures solar radiances scattered from the atmospheric limb in the UV and visible spectral ranges and reconstruct the vertical ozone profiles from the cloud top up to 60 km. The regular LP observations started in early 2012, and now the LP data record exceeds 2.5 years. In this presentation we will demonstrate capability of the new LP sensor to characterize the vertical ozone distribution in different atmospheric regions that are most sensitive to the changes in the stratospheric composition and dynamics. We will consider: a) the seasonal ozone patterns in the lower stratosphere - upper troposphere; b) the vertical ozone distribution inside the Antarctic ozone hole; c) the ozone patterns forced by the Quasi-Biennial Oscillations in the lower tropical stratosphere. The main focus of this study is to perform a comprehensive analysis of ozone patterns obtained from OMPS LP with those observed by Aura MLS to isolate similarities and differences between two sensors in characterizing these processes. We will examine how well LP reproduces the named above natural signals in comparison with MLS in terms of amplitude, phase and vertical structure. One of the key issues is that two instruments measure ozone in different coordinate systems: the LP measures ozone profiles as number density on a regular altitude scale, while Aura MLS retrieves ozone profiles as mixing ratios on pressure vertical grids. The comparison of two measurements requires unit conversion that in turn involves temperature profiles. Thus, the uncertainties related to the unit conversion should be accounted during the analysis. This scientific validation is critical for the further LP algorithm improvement and continuation of the Aura MLS ozone record in the future.

  18. Lp-PLA2: inflammatory biomarker of vascular risk in multiple sclerosis.

    PubMed

    Sternberg, Zohara; Drake, Alison; Sternberg, Daniel S; Benedict, Ralph H B; Li, Fan; Hojnacki, David; Weinstock-Guttmann, Bianca; Munschauer, Frederick E

    2012-06-01

    A member of the A2 phospholipase superfamily, the enzyme lipoprotein-associated phospholipase A2 (Lp-PLA2), is involved in atherogenic processes. Lp-PLA2 mass and activity were measured by the enzyme-linked immunosorbent assay and by a colorimetric method, respectively, and compared among 63 multiple sclerosis (MS) patients and 47 age-matched healthy controls (HCs). Lp-PLA2 plasma levels were significantly higher in MS patients (236.7?±?10 ng/ml) compared to HCs (197.0?±?7 ng/ml) (p?=?0.003), but LP-PLA2 activity did not differ between the two groups. Both Lp-PLA2 plasma mass and activity were higher in secondary progressive (mass 247.0?±15.5 ng/ml, p?=?0.05; activity 156.1 ±6 nmol/min/ml, p?=?0.003) compared to relapsing-remitting MS patients (mass 227.0?±?16 ng/ml; activity 128.8?±?5 nmol/min/ml) and compared to HCs. Lp-PLA2 plasma activity was associated with measures of MS clinical disability. However, this association was attenuated after adjustment for the components of lipid profiles. PMID:22246459

  19. Amplitude and recurrence time analysis of LP activity at Mount Etna, Italy

    NASA Astrophysics Data System (ADS)

    Cauchie, Léna; Saccorotti, Gilberto; Bean, Christopher J.

    2015-09-01

    The aim of this work is to improve our understanding of the long-period (LP) source mechanism at Mount Etna (Italy) through a statistical analysis of detailed LP catalogues. The behavior of LP activity is compared with the empirical laws governing earthquake recurrence, in order to investigate whether any relationships exist between these two apparently different earthquake classes. We analyzed a family of 8894 events detected during a temporary experiment in August 2005. For that time interval, the LP activity is sustained in time and the volcano did not exhibit any evident sign of unrest. The completeness threshold of the catalogue is established through a detection test based on synthetic waveforms. The retrieved amplitude distribution differs significantly from the Gutenberg-Richter law, and the interevent times distribution does not follow the typical ? law, expected for tectonic activity. In order to compare these results with a catalogue for which the source mechanism is well established, we applied the same procedure to a data set from Stromboli Volcano, where recurrent LP activity is closely related to very-long-period pulses, in turn associated with the summit explosions. Our results indicate that the two catalogues exhibit similar behavior in terms of amplitude and interevent time distributions. This suggests that the Etna's LP signals are most likely driven by stress changes caused by an intermittent degassing process occurring at depth, similar to that which drives the summit explosions at Stromboli Volcano.

  20. Prenatal surgery for myelomeningocele and the need for cerebrospinal fluid shunt placement.

    PubMed

    Tulipan, Noel; Wellons, John C; Thom, Elizabeth A; Gupta, Nalin; Sutton, Leslie N; Burrows, Pamela K; Farmer, Diana; Walsh, William; Johnson, Mark P; Rand, Larry; Tolivaisa, Susan; D'alton, Mary E; Adzick, N Scott

    2015-12-01

    OBJECT The Management of Myelomeningocele Study (MOMS) was a multicenter randomized trial comparing the safety and efficacy of prenatal and postnatal closure of myelomeningocele. The trial was stopped early because of the demonstrated efficacy of prenatal surgery, and outcomes on 158 of 183 pregnancies were reported. Here, the authors update the 1-year outcomes for the complete trial, analyze the primary and related outcomes, and evaluate whether specific prerandomization risk factors are associated with prenatal surgery benefit. METHODS The primary outcome was a composite of fetal loss or any of the following: infant death, CSF shunt placement, or meeting the prespecified criteria for shunt placement. Primary outcome, actual shunt placement, and shunt revision rates for prenatal versus postnatal repair were compared. The shunt criteria were reassessed to determine which were most concordant with practice, and a new composite outcome was created from the primary outcome by replacing the original criteria for CSF shunt placement with the revised criteria. The authors used logistic regression to estimate whether there were interactions between the type of surgery and known prenatal risk factors (lesion level, gestational age, degree of hindbrain herniation, and ventricle size) for shunt placement, and to determine which factors were associated with shunting among those infants who underwent prenatal surgery. RESULTS Ninety-one women were randomized to prenatal surgery and 92 to postnatal repair. The primary outcome occurred in 73% of infants in the prenatal surgery group and in 98% in the postnatal group (p < 0.0001). Actual rates of shunt placement were only 44% and 84% in the 2 groups, respectively (p < 0.0001). The authors revised the most commonly met criterion to require overt clinical signs of increased intracranial pressure, defined as split sutures, bulging fontanelle, or sunsetting eyes, in addition to increasing head circumference or hydrocephalus. Using these modified criteria, only 3 patients in each group met criteria but did not receive a shunt. For the revised composite outcome, there was a difference between the prenatal and postnatal surgery groups: 49.5% versus 87.0% (p < 0.0001). There was also a significant reduction in the number of children who had a shunt placed and then required a revision by 1 year of age in the prenatal group (15.4% vs 40.2%, relative risk 0.38 [95% CI 0.22-0.66]). In the prenatal surgery group, 20% of those with ventricle size < 10 mm at initial screening, 45.2% with ventricle size of 10 up to 15 mm, and 79.0% with ventricle size ? 15 mm received a shunt, whereas in the postnatal group, 79.4%, 86.0%, and 87.5%, respectively, received a shunt (p = 0.02). Lesion level and degree of hindbrain herniation appeared to have no effect on the eventual need for shunting (p = 0.19 and p = 0.13, respectively). Similar results were obtained for the revised outcome. CONCLUSIONS Larger ventricles at initial screening are associated with an increased need for shunting among those undergoing fetal surgery for myelomeningocele. During prenatal counseling, care should be exercised in recommending prenatal surgery when the ventricles are 15 mm or larger because prenatal surgery does not appear to improve outcome in this group. The revised criteria may be useful as guidelines for treating hydrocephalus in this group. PMID:26369371

  1. Fabrication and characterization of a capacitive micromachined shunt switch

    NASA Astrophysics Data System (ADS)

    Firebaugh, Samara L.; Charles, Harry K.; Edwards, Richard L.; Keeney, Allen C.; Wilderson, Samuel F.

    2004-07-01

    The design and fabrication of a capacitive shunt switch are described. The switch is based on a bridge structure that can be modulated using electrostatic actuation. The switch has two states: when the bridge is up the signal passes through with less than 0.1 dB insertion loss. When the bridge is down the signal is attenuated by 15-20 dB at 20 GHz. The residual stress of the bridge material is critical to operation of these switches. This stress was tightly controlled by varying the temperature of the plating bath. Different bridge widths and shapes are compared. ``Bowtie'' shaped bridges are demonstrated to have increased insertion loss and similar isolation compared to straight bridges. These devices were observed to be sensitive to packaging stress, resulting in more than doubling the actuation voltage. This work also describes the development of a test fixture that facilitates standard microwave connections for testing the devices without a probe station. The test fixture was observed to have an insertion loss of less than 3 dB up to 20 GHz. .

  2. Single-vortex dynamics in resistively shunted Josephson junction arrays

    NASA Astrophysics Data System (ADS)

    Ciria, José C.; Giovannella, C.

    1997-03-01

    We have numerically solved the equation of motion for a single vortex in a resistively shunted Josephson junction array. The vortex velocity (v), the damping coefficient 0953-8984/9/12/006/img6 and the dynamical barrier for the cell-to-cell vortex motion 0953-8984/9/12/006/img7 are studied. In particular, we have focused our attention on their dependence on the bias current 0953-8984/9/12/006/img8, the penetration depth of the magnetic field 0953-8984/9/12/006/img9, the vortex position (x), and the extension. The results obtained can be described in terms of the motion of a particle subjected to a potential 0953-8984/9/12/006/img10, the analytical form of which is discussed as a function of the array parameters. Under certain circumstances, the injection of one vortex into the array may unleash a recursive process of vortex/antivortex creation that extends to the whole array. This gives rise to the formation of a stable dynamical state: the AVM (alternate-vortex motion), where vortices and antivortices move along alternate rows of plaquettes.

  3. Hyperglucagonemia and hyperkinetic circulation after portocaval shunt in the rat

    SciTech Connect

    Kravetz, D.; Arderiu, M.; Bosch, J.; Fuster, J.; Visa, J.; Casamitjana, R.; Rodes, J.

    1987-02-01

    The study was aimed at investigating whether increased portal venous inflow (PVI) after portocaval shunt (PCS) in the rat is the result of selective splanchnic vasodilatation or whether it is part of a generalized circulatory disturbance. Rats with PCS and sham-operated controls were studied 2 wk after surgery by measuring cardiac output (CO), PVI, and hepatic artery flow (HAF) with radioactive microspheres (V Cr and UC). Plasma glucagon (GL) was measured by radioimmunoassay. PCS rats had increased CO and reduced arterial pressure and total peripheral resistance. PVI was markedly increased, but this appeared to be part of a generalized circulatory disturbance, since when PVI is expressed as percent of CO no difference is observed between PCS and sham-operated rats, indicating the absence of a preferential splanchnic vasodilatation. GL increased after PCS, and significant correlations were observed between GL and CO and between GL and PVI. HAF increased after PCS but did not compensate the loss of portal flow, evidence by a lower total hepatic flow in PCS rats. These results suggest that PCS induces a hyperkinetic circulatory state in which increased PVI represents its splanchnic manifestation and that increased GL release may be in part responsible for these hemodynamic changes.

  4. Geometric Studies of Shunt and Lead Orientation in EEC Devices

    NASA Astrophysics Data System (ADS)

    Werner, F. M.; Solin, S. A.

    2014-03-01

    Electric field sensors are ubiquitous in modern technology, from field effect transistors (FETs) in circuit boards to point-of-care testing (POCT) devices used in detecting the presence of specific protein markers in blood. The transport properties of these devices are limited by two general categories: intrinsic material properties and extrinsic geometric effects. Devices with a maximum electric field resolution of 3.05V/cm were previously reported. The metal semiconductor hybrid (MSH) devices are constructed by forming a Schottky interface between a mesa of nGaAs and Ti, while four ohmic leads surround the perimeter of the mesa and are used for four point resistance measurements. These devices exhibit extraordinary electroconductance (EEC) and make it possible to correlate measured four point resistance to changes in the local electric field. While maximizing the EEC response by optimizing the intrinsic material properties has been theoretically investigated, we present a phenomenological study of the impact of lead orientation and shunt geometry in the sensing capabilities of these devices. S.A.S. is a co-founder of and has a financial interest in PixelEXX, a start-up company whose mission is to market imaging arrays.

  5. Transjugular intrahepatic portosystemic shunts in liver transplant recipients.

    PubMed

    Bonnel, Alexander R; Bunchorntavakul, Chalermrat; Rajender Reddy, K

    2014-02-01

    The insertion of a transjugular intrahepatic portosystemic shunt (TIPS) is a minimally invasive procedure used to relieve the signs and symptoms of portal hypertension in patients with liver disease. The most common indications for placement are refractory ascites and variceal hemorrhage. In properly selected candidates, TIPS placement can serve as a bridge to liver transplantation. Expertise in TIPS placement after transplantation has significantly increased, which has allowed the procedure to become a viable option for retransplant candidates suffering the consequences of recurrent portal hypertension due to portal vein thrombosis, recurrent liver disease, or hepatic venous outflow obstruction (HVOO). However, TIPSs in liver transplant recipients are associated with a lower clinical response rate and a higher rate of complications in comparison with patients with native liver disease, and they are, therefore, generally reserved for patients with a Model for End-Stage Liver Disease (MELD) score???15 and ? 12 in patients with HCV. The role of TIPS placement in nonliver transplant recipients has been well studied in large trials, and it translates well into clinical applicability to candidates for orthotopic liver transplantation (OLT). However, the experience with OLT recipients is heterogeneous and restricted to small series. Thus, we focus here on reviewing the current literature and discussing the proper use of TIPSs in liver transplant recipients. PMID:24142390

  6. Histopathological characteristics of hepatic lipogranulomas with portosystemic shunt in dogs.

    PubMed

    Isobe, Kaori; Matsunaga, Satoru; Nakayama, Hiroyuki; Uetsuka, Koji

    2008-02-01

    In the canine liver with portosystemic shunts (PSS), focal lesions consisting of cells with cytoplasmic brown pigments and lipid vacuoles are often observed in the hepatic parenchyma. Termed lipogranulomas, their histopathological characteristics have been little studied. In the present study, we examined liver biopsy samples from 144 dogs (age: 3 months-16 years; 65 PSS and 79 non-PSS cases), and investigated the histopathological characteristics, incidence, and density of lipogranulomas. Lipogranulomas were detected histopathologically in 55.4% of PSS dogs. The lesions were then grouped into 3 types according to the amount of cytoplasmic lipid vacuoles and brown pigments. The pigments were positive for Berlin blue, PAS, and Sudan black B, but negative with the Hall method. The majority of the cells were immunohistochemically positive for macrophage scavenger receptor, class A (MSR-A), while no cells were positive for hepatocyte-antigen and albumin. The cytoplasmic pigments were recognized as electron-dense microgranular materials by electron microscopy. The incidence of lipogranulomas was significantly higher in the PSS group than non-PSS group when dogs less than 1 year old were excluded. The lipogranuloma density in the liver was significantly higher in the PSS group. It is concluded that lipogranulomas are frequently observed in liver biopsies of canine PSS especially in dogs more than 1 year old. The lesions consisted of Kupffer cells and/or macrophages, and the cytoplasmic brown pigments are ceroid and hemosiderin. The pathogenesis of lipogranuloma in PSS needs to be clarified. PMID:18319572

  7. Integrated fuel cell stack shunt current prevention arrangement

    DOEpatents

    Roche, Robert P. (Cheshire, CT); Nowak, Michael P. (Bolton, CT)

    1992-01-01

    A fuel cell stack includes a plurality of fuel cells juxtaposed with one another in the stack and each including a pair of plate-shaped anode and cathode electrodes that face one another, and a quantity of liquid electrolyte present at least between the electrodes. A separator plate is interposed between each two successive electrodes of adjacent ones of the fuel cells and is unified therewith into an integral separator plate. Each integral separator plate is provided with a circumferentially complete barrier that prevents flow of shunt currents onto and on an outer peripheral surface of the separator plate. This barrier consists of electrolyte-nonwettable barrier members that are accommodated, prior to the formation of the integral separator plate, in corresponding edge recesses situated at the interfaces between the electrodes and the separator plate proper. Each barrier member extends over the entire length of the associated marginal portion and is flush with the outer periphery of the integral separator plate. This barrier also prevents cell-to-cell migration of any electrolyte that may be present at the outer periphery of the integral separator plate while the latter is incorporated in the fuel cell stack.

  8. Functional impairment of two novel mutations detected in lipoprotein-associated phospholipase A2 (Lp-PLA2) deficiency patients.

    PubMed

    Ishihara, Mitsuaki; Iwasaki, Tadao; Nagano, Makoto; Ishii, Jun; Takano, Mayumi; Kujiraoka, Takeshi; Tsuji, Masahiro; Hattori, Hiroaki; Emi, Mitsuru

    2004-01-01

    Plasma lipoprotein-associated phospholipase A2 (Lp-PLA2), also known as platelet-activating factor (PAF) acetylhydrolase (PAF-AH), is a member of the serine-dependent class of A2 phospholipases that hydrolyze sn2-ester bonds of fragmented or oxidized phospholipids at sites where atherosclerotic plaques are forming. Most circulating Lp-PLA2 is bound to low-density lipoprotein (LDL) particles in plasma and the rest to high-density lipoprotein (HDL). Deficiency of Lp-PLA2 is a predisposing factor for cardiovascular diseases in the Japanese population. We describe here two novel mutations of the gene encoding Lp-PLA2, InsA191 and I317N in Japanese subjects. The first patient, with partial Lp-PLA2 deficiency, was heterozygous for the InsA191 mutation; macrophages from this patient secreted only half the normal amount of Lp-PLA2 in vitro. The other patient, who showed complete Lp-PLA2 deficiency, was a compound heterozygote for the novel I317N mutation and a common V279F mutation; macrophages from that patient failed to secrete any Lp-PLA2. Measurement of Lp-PLA2 mass, activity and Western blotting verified impaired production and secretion of the enzyme after transfection of mutant construct into COS-7 cells. These results indicated that both novel mutants, InsA191 and I317N, impair function of the Lp-PLA2 gene. PMID:15148590

  9. Effects of isradipine and other calcium antagonists on arteriovenous-shunt flow in anesthetized rabbits and cats

    SciTech Connect

    Hof, R.P.

    1989-04-17

    The effects of vasodilators on arteriovenous (AV)-shunt flow was investigated in anesthetized cats and rabbits, using the tracer microsphere method. In cats, the calcium antagonist isradipine reduced AV-shunt flow; verapamil showed a similar tendency and nicardipine was without effect. Dihydralazine strongly increased, but nitroglycerin and dipyridamole decreased AV-shunt flow. In rabbits, the effects of isradipine and verapamil were similar to those seen in cats. Sodium nitroprusside had no effect, whereas prazosin, minoxidil, and the potassium-channel activator cromakalim increased AV-shunt flow. The contrasting effects of drugs sharing the same mechanism of action suggest that target-tissue selectivity is more important than the mechanism of action. An increase of AV-shunt flow is unlikely to be beneficial but could be associated with a number of undesirable side effects. It might negatively affect migraine sufferers and, if AV-shunt dilatation shows no tolerance development, it represents an unnecessary hemodynamic burden for the heart.

  10. Gene and pathway identification with Lp penalized Bayesian logistic regression

    PubMed Central

    Liu, Zhenqiu; Gartenhaus, Ronald B; Tan, Ming; Jiang, Feng; Jiao, Xiaoli

    2008-01-01

    Background Identifying genes and pathways associated with diseases such as cancer has been a subject of considerable research in recent years in the area of bioinformatics and computational biology. It has been demonstrated that the magnitude of differential expression does not necessarily indicate biological significance. Even a very small change in the expression of particular gene may have dramatic physiological consequences if the protein encoded by this gene plays a catalytic role in a specific cell function. Moreover, highly correlated genes may function together on the same pathway biologically. Finally, in sparse logistic regression with Lp (p < 1) penalty, the degree of the sparsity obtained is determined by the value of the regularization parameter. Usually this parameter must be carefully tuned through cross-validation, which is time consuming. Results In this paper, we proposed a simple Bayesian approach to integrate the regularization parameter out analytically using a new prior. Therefore, there is no longer a need for parameter selection, as it is eliminated entirely from the model. The proposed algorithm (BLpLog) is typically two or three orders of magnitude faster than the original algorithm and free from bias in performance estimation. We also define a novel similarity measure and develop an integrated algorithm to hunt the regulatory genes with low expression changes but having high correlation with the selected genes. Pathways of those correlated genes were identified with DAVID . Conclusion Experimental results with gene expression data demonstrate that the proposed methods can be utilized to identify important genes and pathways that are related to cancer and build a parsimonious model for future patient predictions. PMID:18834526

  11. Ventriculo-bipleural shunt as last resort in a 4-year-old child in whom a VP and VA shunt failed.

    PubMed

    Ratliff, Miriam; Unterberg, Andreas; Bächli, Heidi

    2016-03-01

    The authors present the unusual case of a 4-year-old boy who had a complex history of posthemorrhagic hydrocephalus and who underwent more than 40 surgeries related to this condition. In the course of trying to treat his condition, ventriculoperitoneal, ventriculoatrial, and ventriculopleural shunts were inserted and failed. The child presented with a dysfunction of his shunt system. A ventriculopleural shunt was inserted, but within days the patient developed dyspnea as a clinical symptom of pleural effusion that required repeated thoracentesis. A bipleural drainage system was inserted, and no relevant pleural effusions developed during the follow-up period. Although the authors' experience is based on a single case, they do suggest bipleural drainage in patients with clinically relevant pleural effusions when the more common alternatives are not a good choice. Bipleural drainage might particularly be an option in children, who are prone to pleural effusion because of the smaller absorbing pleural surface. The authors reviewed the English-language literature on PubMed dating back to 1952. To their knowledge, this is the only published case in which a patient was treated with a ventriculo-bipleural shunt. PMID:26613270

  12. Transcatheter Closure of Perimembranous Ventricular Septal Defects with Left Ventricular to Right Atrial Shunt.

    PubMed

    Kerst, Gunter; Moysich, Axel; Ho, Siew Yen; Apitz, Christian; Latus, Heiner; Schranz, Dietmar

    2015-10-01

    During the development of so-called aneurysmal transformation of perimembranous ventricular septal defects (pmVSD), tricuspid valve (TV) morphology and function may be altered resulting in left ventricular (LV) to right atrial (RA) shunting. The feasibility and outcome of interventional closure of these pmVSD has not been investigated so far. Interventional closure of pmVSD associated with mild to moderate LV-to-RA shunt was performed in four patients (aged 6.5-12.5 years). pmVSD were closed under fluoroscopic guidance by establishing an arteriovenous wire loop via a femoral artery and advancing the delivery sheath from a femoral vein. Before device release (or withdrawal if necessary), residual shunting across the device and TV valve function was investigated by transthoracic echocardiography and LV angiography. pmVSD sizes of 4, 5.5, 8 and 8.5 mm were closed with a 4/4 and 6/6 Amplatzer duct occluder II and an 8- and 10-mm Amplatzer muscular VSD occluder device, respectively. There were no or only minor residual postinterventional LV-to-RA shunts. No atrioventricular blocks were observed during a mean follow-up of 12.5 months (range 6.5-17 months). Transthoracic echocardiography indicated that the elimination of the VSD jet pushing the antero-superior TV leaflet open is the key mechanism for LV-to-RA shunt reduction after transcatheter pmVSD closure. Interventional closure in pmVSD associated with mild to moderate indirect LV-to-RA shunting is feasible and results in significant reduction in or elimination of LV-to-RA shunting. PMID:25894760

  13. T1-201 per rectum: A noninvasive method for evaluating portosystemic shunt

    SciTech Connect

    Verdickt, X.; Reding, P.; Tshiamala, P.; Ham, H.R.

    1984-01-01

    Portosystemic shunt is one of the most important complications of liver cirrhosis. Unfortunately, current methods for detecting and quantifying this shunt are either non-specific or associated with significant morbidity. The aim of this work was to evaluate the clinical value of a new non-traumatic method which consisted of administrating T1-201 per rectum and monitoring the absorbed activity using a camera and a computer system. The method assumes that in the absence of portosystemic shunt, most of the absorbed activity will be fixed in the liver while in the presence of this shunt, some of the activity will be fixed in the myocardium. The ratio of heart to liver activity can therefore be used to evaluate the importance of the portosystemic shunt. 34 subjects have been studied. The ratio of heart to liver activity at the 25th minute after the tracer administration is higher in patients with liver cirrhosis (n=22, m=.9, s.d.=.37) than in patients with steatosis (n=10, m=.28, s.d.=.03). In two healthy subjects investigated the H/L ratio was .27 and .30. The reproducibility of the test was evaluated in 8 subjects and showed a good reproducibility (mean of difference =.03, range=.01 to .07). Patients with esophageal varices had always a high H/L ratio while some patients with liver cirrhosis without esophageal varices had also high H/L ratio, probably due to the presence of intrahepatic shunt. The authors' results showed the value of this new non-traumatic test for detecting and quantifying extra- as well as intrahepatic portosystematic shunt.

  14. Post-TIPS Hepatic Encephalopathy Treated by Occlusion Balloon-Assisted Retrograde Embolization of a Coexisting Spontaneous Splenorenal Shunt

    SciTech Connect

    Shioyama, Yasukazu; Matsueda, Kiyoshi; Horihata, Koushi; Kimura, Masashi; Nishida, Norifumi; Kishi, Kazushi; Terada, Masaki; Sato, Morio; Yamada, Ryusaku

    1996-11-15

    A 51-year-old man with posthepatitis cirrhosis underwent a transjugular intrahepatic portosystemic shunt (TIPS) for bleeding of recurrent esophageal varices. The patient had a coexisting, spontaneous, splenorenal shunt. He subsequently developed hepatic encephalopathy, presumably due to excessive portosystemic shunting. Since medical management resulted in no significant improvement, the splenorenal shunt was embolized from the jugular vein approach via renal vein access during temporary balloon occlusion. Within a few days, the patient's hepatic encephalopathy resolved. Twelve months later the patient showed no recurrence of encephalopathy and had maintained a patent TIPS.

  15. Colour Doppler sonography of hepatic haemangiomas with arterioportal shunts

    PubMed Central

    Lim, K J; Kim, K W; Jeong, W K; Kim, S Y; Jang, Y J; Yang, S; Lee, J J

    2012-01-01

    Objectives To determine the frequency of intratumoural flow and peritumoural hepatofugal portal flow using colour Doppler sonography (CDS) on hepatic haemangiomas with arterioportal shunt (APS), and to investigate possible factors that may affect the capability of CDS to depict such findings. Methods The study included 45 patients (35 men, 10 women; mean age, 56 years) with hepatic haemangiomas with APS on CT or MRI. Locating the tumour on greyscale sonography, the depth, size and echogenicity of the tumour were evaluated. CT or MR images were evaluated for fatty liver. CDS was performed to determine the presence of intratumoural flow and peritumoural hepatofugal portal flow. Differences in frequency of intratumoural flow and peritumoural hepatofugal portal flow according to the depth, size, echogenicity and fatty liver were evaluated by Student’s t-test and Fisher’s exact test. Results On CDS, intratumoural flow and peritumoural hepatofugal portal flow were found in 66.7% and 60%, respectively. The tumour depth was the significant variable that affected the capability of CDS to depict such findings. The frequencies of intratumoural flow and peritumoural hepatofugal portal flow were as high as 88% and 80% for shallow (?30 mm) lesions, and they were 40% and 35% for deep (>30 mm) lesions (p=0.0012; p=0.0051). Conclusion CDS can commonly depict intratumoural flow and peritumoural hepatofugal portal flow in patients with hepatic haemangiomas with APS. Therefore, CDS should be routinely performed when an incidental mass is encountered during the screening sonography, especially when the lesion is shallow. PMID:21385916

  16. Sarcopenia associated with portosystemic shunting is reversed by follistatin

    PubMed Central

    Dasarathy, Srinivasan; McCullough, Arthur J.; Muc, Sean; Schneyer, Alan; Bennett, Carole D.; Dodig, Milan; Kalhan, Satish C.

    2011-01-01

    Background & Aims The distinct role of portosystemic shunting (PSS) in the pathogenesis of sarcopenia (skeletal muscle loss) that occurs commonly in cirrhosis is unclear. We have previously shown increased expression of myostatin (inhibitor of skeletal muscle mass) in the portacaval anastamosis (PCA) rat model of sarcopenia of PSS. The present study was performed to examine the mechanisms of sarcopenia following PCA. Methods In PCA and sham operated pair fed control rats, the phenylalanine flooding dose method was used to quantify the fractional and absolute protein synthesis rates in the skeletal muscle over time and in response to follistatin, a myostatin antagonist. The expression of myostatin and markers of satellite cell (myocyte precursors) proliferation and differentiation were quantified by real-time PCR and Western blot analyses. Results The absolute synthesis rate (ASR) was lower at 2, 4, and 6 weeks (p <0.05) and the fractional synthesis rate (FSR) of skeletal muscle protein was significantly lower (p <0.05) at week 2 in the PCA rats compared to control rats. Expression of myostatin was elevated while markers of satellite cell proliferation and differentiation were lower at 4 and 6 weeks after PCA. Follistatin increased skeletal muscle mass, muscle FSR and ASR, decreased expression of myostatin protein, and an increased expression of markers of satellite cell function. Conclusions Sarcopenia associated with PSS is caused by impaired protein synthesis and reduced satellite cell function due to increased myostatin expression. Confirming these alterations in human patients with cirrhosis will provide novel therapeutic targets for sarcopenia of liver disease. PMID:21145817

  17. Lp-PLA2 Antagonizes Left Ventricular Healing After Myocardial Infarction by Impairing the Appearance of Reparative Macrophages

    PubMed Central

    He, Shun; Chousterman, Benjamin G.; Fenn, Ashley; Anzai, Atsushi; Nairz, Manfred; Brandt, Martin; Hilgendorf, Ingo; Sun, Yuan; Ye, Yu-Xiang; Iwamoto, Yoshiko; Tricot, Benoit; Weissleder, Ralph; Macphee, Colin; Libby, Peter; Nahrendorf, Matthias

    2015-01-01

    Background— Healing after myocardial infarction (MI) involves the biphasic accumulation of inflammatory Ly-6Chigh and reparative Ly-6Clow monocytes/macrophages. Excessive inflammation disrupts the balance between the 2 phases, impairs infarct healing, and contributes to left ventricle remodeling and heart failure. Lipoprotein-associated phospholipase A2 (Lp-PLA2), a member of the phospholipase A2 family of enzymes, produced predominantly by leukocytes, participates in host defenses and disease. Elevated Lp-PLA2 levels associate with increased risk of cardiovascular events across diverse patient populations, but the mechanisms by which the enzyme elicits its effects remain unclear. This study tested the role of Lp-PLA2 in healing after MI. Methods and Results— In response to MI, Lp-PLA2 levels markedly increased in the circulation. To test the functional importance of Lp-PLA2, we generated chimeric mice whose bone marrow–derived leukocytes were Lp-PLA2–deficient (bmLp-PLA2?/?). Compared with wild-type controls, bmLp-PLA2?/? mice subjected to MI had lower serum levels of inflammatory cytokines tumor necrosis factor-?, interleukin (IL)-1?, and IL-6, and decreased number of circulating inflammatory myeloid cells. Accordingly, bmLp-PLA2?/? mice developed smaller and less inflamed infarcts with reduced numbers of infiltrating neutrophils and inflammatory Ly-6Chigh monocytes. During the later, reparative phase, infarcts of bmLp-PLA2?/? mice contained Ly-6Clow macrophages with a skewed M2-prone gene expression signature, increased collagen deposition, fewer inflammatory cells, and improved indices of angiogenesis. Consequently, the hearts of bmLp-PLA2?/? mice healed more efficiently, as determined by improved left ventricle remodeling and ejection fraction. Conclusions— Lp-PLA2 augments the inflammatory response after MI and antagonizes healing by disrupting the balance between inflammation and repair, providing a rationale for focused study of ventricular function and heart failure after targeting this enzyme acutely in MI. PMID:26232205

  18. Cerebral oxygenation and processed EEG response to clamping and shunting during carotid endarterectomy under general anesthesia.

    PubMed

    Perez, William; Dukatz, Christopher; El-Dalati, Sami; Duncan, James; Abdel-Rasoul, Mahmoud; Springer, Andrew; Go, Michael R; Dzwonczyk, Roger

    2015-12-01

    Clamping and shunting during carotid endarterectomy (CEA) surgery causes changes in cerebral blood flow. The purpose of this study was to assess and compare, side by side, the cerebral oxygenation (rSO2) and processed electroencephalogram (EEG) response bilaterally to carotid artery clamping and shunting in patients undergoing CEA under general anesthesia. With institutional approval and written informed consent, patients undergoing CEA under general anesthesia and routine carotid artery shunting were recorded bilaterally, simultaneously and continuously with an rSO2 and processed EEG monitor. The response of the monitors during carotid artery clamping and shunting were assessed and compared between monitors and bilaterally within each monitor. Sixty-nine patients were included in the study. At clamping the surgical-side and contralateral-side rSO2 dropped significantly below the baseline incision value (-17.6 and -9.4% respectively). After shunting, the contralateral-side rSO2 returned to baseline while the surgical-side rSO2 remained significantly below baseline (-9.0%) until the shunt was removed following surgery. At clamping the surgical-side and contralateral-side processed EEG also dropped below baseline (-19.9 and -20.6% respectively). However, following shunt activation, the processed EEG returned bilaterally to baseline. During the course of this research, we found the rSO2 monitor to be clinically more robust (4.4% failure rate) than the processed EEG monitor (20.0% failure rate). There was no correlation between the rSO2 or processed EEG changes that occurred immediately after clamping and the degree of surgical side stenosis measured pre-operatively. Both rSO2 and processed EEG respond to clamping and shunting during CEA. Cerebral oximetry discriminates between the surgical and contralateral side during surgery. The rSO2 monitor is more reliable in the real-world clinical setting. Future studies should focus on developing algorithms based on these monitors that can predict clamping-induced cerebral ischemia during CEA in order to decide whether carotid artery shunting is worth the associated risks. From the practical point of view, the rSO2 monitor may be the better monitor for this purpose. PMID:25572653

  19. Complete Intestinal Obstruction and Necrosis as a Complication of a Ventriculoperitoneal Shunt in Children

    PubMed Central

    Zhao, Rui; Shi, Wei; Yu, Jianzhong; Gao, Xiaofeng; Li, Hao

    2015-01-01

    Abstract Ventriculoperitoneal (VP) shunt complications are common, but abdominal complications are rare. The objective of this report is to present 2 cases of intestinal obstruction due to a VP shunt and review the literature for data on this rare occurrence. A 4-month-old boy received surgical resection of a medulloblastoma and a VP shunt was inserted to manage progressive hydrocephalus. Two months later, he was admitted with intermittent vomiting, and plain abdominal radiography showed complete intestinal obstruction. Emergency laparotomy revealed an adhesive intestinal obstruction around the catheter, and approximately 5?cm of necrotic ileum was resected. His recovery was uneventful. In the second case, a 6-year-old boy was diagnosed with a primary nongerminomatous malignant germ cell tumor and a VP shunt was place to treat hydrocephalus. Two weeks after the first course of chemotherapy, he went into a coma; computed tomography demonstrated enlargement of the tumor and gross total resection was performed. Two weeks later, he developed abdominal distention; plain radiography showed intestinal obstruction and laparotomy revealed adhesive intestinal obstruction around the catheter with 15?cm of necrotic ileum. The necrotic bowel was resected. Unfortunately, the patient developed sepsis and despite treatment remained in a vegetative state. Medline, Central, Embase, and Google Scholar databases were searched up to May 9, 2014, using the terms VP shunt, shunting, and/or intestinal obstruction. Only cases involving children or adolescents were included. Eleven reports involving patients with abdominal complications resulting from a VP shunt for hydrocephalus were identified. The dates of the reports spanned from 1971 to 2014. Volvulus was the most common cause of VP shunt-related obstruction, and mechanical obstruction due to twisting of the catheter the second most common. Only 1 case in the literature review was related to intestinal adhesions. Treatment in most cases was laparotomy. Although intestinal obstruction is a rare complication of a VP shunt, it should be considered in the presence of abdominal symptoms and prompt treatment provided to have a good outcome. PMID:26313776

  20. Portal Cavernoma in the Era of Mesoportal Shunt (Rex) and Liver Transplant in Children.

    PubMed

    Chocarro, Gloria; Junco, Paloma Triana; Dominguez, Eva; Amesty, María Virginia; Cerezo, Vanesa Nuñez; Hernandez, Francisco; Murcia, Javier; Tovar, Juan Antonio; Lopez Santamaria, Manuel

    2016-02-01

    Objective The mesoportal shunt (MPS) and liver transplantation (LT) have changed the scenario of extrahepatic portal vein obstruction (EHPVO) since the MPS, the only "curative" technique, can now be offered in asymptomatic patients and also thrombotic complications of LT have increased the incidence of EHPVO. Material and Methods A retrospective study of patients undergoing surgery for EHPVO was conducted between 1990 and 2015. An analysis was done for the shunt permeability and clinical evolution over time. Results Of the 73 children with EHPVO, 39 were operated (12 posttransplant and 27 idiopathic). The median age at surgery was 9.36 years (range, 1.60-17.42 years). The MPS was the technique of choice; it was offered in 21 patients but eventually could be performed in only 18 (9 posttransplant and 9 idiopathic). The results of MPS were better in idiopathic (just one thrombosis successfully converted into mesocaval bypass). In the MPS after LT (n = 9), six shunts are permeable, two became thrombotic (one patient requiring retransplantation), and one late thrombosis occurred and the patient died eventually because of gastrointestinal bleeding. In the remaining patients (21 out of the 39), MPS was not performed because of intrahepatic cavernoma, portal vein hypoplasia, or insufficient length of vascular graft (especially in left lateral segment graft LT, since the portal vein is usually located in the right upper quadrant). They underwent 10 distal splenorenal shunts (DSRS) (1 posttransplant and 9 idiopathic), 5 proximal splenorenal shunts (PSRS) (1/4), 6 mesocaval shunts (1/5), and 1 modified Sugiura procedure. The results with DSRS have been favorable (one thrombosis, converted into mesocaval bypass). In the PSRS no thrombosis was identified and in the mesocaval shunt one early thrombosis occurred. Posttransplantation group had higher risk of shunt thrombosis, regardless of the surgical technique (chi-square, 0.021). The total increase of platelets after 6 months was not different in MPS as compared with other surgical techniques (analysis of variance, 0.110). Conclusions The MPS is the technique of choice in EHPVO for idiopathic thrombosis as well as secondary to LT. Not all cases are favorable for MPS, so the surgeon must consider the possibility of alternative techniques for EHPVO. The results in terms of shunt patency are much better in idiopathic cavernoma that posttransplant patients. PMID:26378482

  1. Modification of the iso-shunt lines for low inspired oxygen concentrations.

    PubMed

    Petros, A J; Doré, C J; Nunn, J F

    1994-05-01

    Arterial PO2 (PaO2) has been related to inspired oxygen concentration (FIO2 range 0.21-0.60) in 20 patients, breathing spontaneously, while recovering from a range of conditions treated in an intensive therapy unit. There was a highly significant linear trend (P < 0.001) for the mean venous admixture ("virtual shunt"), calculated from the iso-shunt diagram (model A), to increase from 0.11 to 0.19 as FIO2 decreased from 0.60 to 0.21. As this appeared to be caused by relative ventilation/perfusion (V/Q) mismatch, we prepared a second model (model B) with a variable two-compartment relative V/Q mismatch in addition to a shunt. Regression of the degree of mismatch on the shunt gave good agreement between predicted and observed PaO2 values (mean bias -0.17 kPa, pooled within patient SD 1.22). Model B is now proposed to extend the applicability of the iso-shunt diagram for FIO2 values less than 0.35. Published postoperative PaO2 data from other workers showed good agreement with our final model (mean bias 0.10 kPa, pooled SD 0.41). The new diagram may therefore have wide applicability in the field of anaesthesia and intensive care. PMID:8198900

  2. Kidney plays a major role in ammonia homeostasis after portasystemic shunting in patients with cirrhosis.

    PubMed

    Olde Damink, Steven W M; Dejong, Cornelis H C; Deutz, Nicolaas E P; Redhead, Doris N; Hayes, Peter C; Soeters, Peter B; Jalan, Rajiv

    2006-08-01

    The kidney plays an important role in ammonia metabolism. In this study the hypothesis was tested that the kidney can acutely diminish ammonia release after portacaval shunting. Thirteen patients with cirrhosis (6 female/7 male, age 54.4 +/- 3.3 yr) were studied. Blood was sampled prior to and 1 h after transjugular intrahepatic stent-shunt (TIPSS) insertion from the portal vein, a hepatic vein, the right renal vein, and the femoral vein, and renal and liver plasma flow were measured. Prior to TIPSS, renal ammonia release was significantly higher than ammonia release from the splanchnic region, which was not significantly different from zero. TIPSS insertion did not change arterial ammonia concentration or ammonia release from the splanchnic region but reduced renal ammonia release into the circulation (P < 0.05) to values that were not different from zero. TIPSS resulted in a tendency toward increased venous-arterial ammonia concentration differences across leg muscle. Post-TIPSS ammonia efflux via portasystemic shunts was estimated to be seven times higher than renal efflux. Kidneys have the ability to acutely diminish systemic ammonia release after portacaval shunting. Diminished renal ammonia release and enhanced muscle ammonia uptake are important mechanisms by which the cirrhotic patient maintains ammonia homeostasis after portasystemic shunting. PMID:16455791

  3. Surgical portosystemic shunts and the Rex bypass in children: a single-centre experience

    PubMed Central

    Emre, Sukru; Dugan, Christina; Frankenberg, Tamara; Hudgins, Lisa Cooper; Gagliardi, Rosemarie; Artis, A Tarik; Rodriguez-Laiz, Gonzalo; Gondolesi, Gabriel; Shneider, Benjamin L; Kerkar, Nanda

    2009-01-01

    Objectives: This study aimed to illustrate the indications for, and types and outcomes of surgical portosystemic shunt (PSS) and/or Rex bypass in a single centre. Methods: Data were collected from children with a PSS and/or Rex bypass between 1992 and 2006 at Mount Sinai Medical Center, New York. Results: Median age at surgery was 10.7 years (range 0.3–22.0 years). Indications included: (i) refractory gastrointestinal bleeding in portal hypertension associated with (a) compensated cirrhosis (n= 12), (b) portal vein thrombosis (n= 10), (c) hepatoportal sclerosis (n= 3); (ii) refractory ascites secondary to Budd–Chiari syndrome (n= 3), and (iii) familial hypercholesterolaemia (n= 4). There were 20 distal splenorenal, four portacaval, three Rex bypass, two mesocaval, two mesoatrial and one proximal splenorenal shunts. At the last follow-up (median 2.9 years, range 0.1–14.1 years), one shunt (Rex bypass) was thrombosed. Two patients had died and two had required a liver transplant. These had a patent shunt at last imaging prior to death or transplant. Conclusions: Portosystemic shunts and Rex bypass have been used to manage portal hypertension with excellent outcomes. In selected children with compensated liver disease, PSS may act as a bridge to liver transplantation or represent an attractive alternative. PMID:19590656

  4. Vesical calculi formation on the slit valves of a migrated distal end of ventriculoperitoneal shunt

    PubMed Central

    Gupta, Rahul; Dagla, Rajan; Agrawal, Lila Dhar; Sharma, Pramila

    2015-01-01

    Various complications of distal end of the ventriculoperitoneal (VP) shunt have been described in the literature. We present, here, an extremely rare and potentially severe complication of vesical calculi formation on the slit valves of distal end of VP shunt which erosively migrated into the urinary bladder. Suprapubic cystolithotomy performed, peritoneal end of the tube found to be eroding and entering into the bladder with two calculi firmly stuck to slit valves in the distal end of the tubing were removed. Shunt was functional, therefore, it was pulled out and repositioned on the superior aspect of the liver; the urinary bladder was repaired. Patient did well postoperatively. This complication was revealed 1.5 years after the shunt was implanted. Although there were symptoms of dysuria and dribbling of urine of short duration, the patient did not show obvious peritoneal signs; suggesting that, penetration of a VP shunt into the urinary bladder can remain asymptomatic for a long period of time, disclosed late and can lead to considerable morbidity. Careful follow-up is important and management should be individualized.

  5. Ventriculoperitoneal shunt-related infections caused by Staphylococcus epidermidis: pathogenesis and implications for treatment.

    PubMed

    Stevens, Niall T; Greene, Catherine M; O'Gara, James P; Bayston, Roger; Sattar, Muhammad T A; Farrell, Michael; Humphreys, Hilary

    2012-12-01

    The insertion of medical devices, such as intraventricular shunts, is often complicated by infection leading to ventriculitis. Frequently, such infections result from colonisation and subsequent biofilm formation on the surfaces of the shunts by Staphylococcus epidermidis. The pathogenesis of neurosurgical shunt-related infection is complex with interactions between the pathogen, the device and the unique local immunological environment of the central nervous system (CNS). An ability to form biofilm, the main virulence determinant of Staphylococcus epidermidis, facilitates protection of the organism from the host defences while still initiating an immunological response. The presence of the blood brain barrier (BBB) and the biofilm itself also complicates treatment, which presents many challenges when managing shunt infections. A greater understanding of the interplay between S. epidermidis and the CNS could potentially improve the diagnosis, treatment and management of such infections. This review describes the pathogenesis, treatment and implications of S. epidermidis ventriculoperitoneal shunt-related infections, concentrating on recent research and the implications for treatment. PMID:22303864

  6. A 20 ampere shunt regulator for controlling individual magnets in a seriesed string

    SciTech Connect

    Martin, E.J.; Dobeck, N.; Jones, G.S.; O`Sullivan, M.K.

    1996-08-01

    At the CEBAF accelerator, groups of dipole magnets are often connected together in series and powered from a single large constant-current regulated D-C supply, referred to locally as a {open_quotes}box{close_quotes} supply. Besides the economy realized, this configuration promotes correct field tracking of all elements of a beam transport channel. However, it is often desirable to vary the current in one element of a string independently of the others, particularly at the entrance and exits of transport channels. A 20 ampere programmable current shunt is described. Installed in parallel with the desired magnet, it permits shunting (bypassing) up to 5% of the string current around that magnet. The shunt regulator consists of a bank of MOSFET power transistors operated in linear mode. Regulation of current through the passbank is obtained by feedback from a manganin shunt maintained at a constant temperature for stability. The module is designed for remote operation and provides readbacks of various parameters useful for maintenance. To achieve complete electrical isolation, an onboard microprocessor provides remote communications via an opto-isolated serial data link. Constructional details and initial operating experience with the plug-in shunt are described.

  7. Hypoxia and GABA shunt activation in the pathogenesis of Alzheimer's disease.

    PubMed

    Salminen, Antero; Jouhten, Paula; Sarajärvi, Timo; Haapasalo, Annakaisa; Hiltunen, Mikko

    2016-01-01

    We have previously observed that the conversion of mild cognitive impairment to definitive Alzheimer's disease (AD) is associated with a significant increase in the serum level of 2,4-dihydroxybutyrate (2,4-DHBA). The metabolic generation of 2,4-DHBA is linked to the activation of the γ-aminobutyric acid (GABA) shunt, an alternative energy production pathway activated during cellular stress, when the function of Krebs cycle is compromised. The GABA shunt can be triggered by local hypoperfusion and subsequent hypoxia in AD brains caused by cerebral amyloid angiopathy. Succinic semialdehyde dehydrogenase (SSADH) is a key enzyme in the GABA shunt, converting succinic semialdehyde (SSA) into succinate, a Krebs cycle intermediate. A deficiency of SSADH activity stimulates the conversion of SSA into γ-hydroxybutyrate (GHB), an alternative route from the GABA shunt. GHB can exert not only acute neuroprotective activities but unfortunately also chronic detrimental effects which may lead to cognitive impairment. Subsequently, GHB can be metabolized to 2,4-DHBA and secreted from the brain. Thus, the activation of the GABA shunt and the generation of GHB and 2,4-DHBA can have an important role in the early phase of AD pathogenesis. PMID:26617286

  8. Intracerebral monoamine concentration after ventriculoperitoneal shunting in the congenital hydrocephalus rat.

    PubMed

    Otsubo, Y; Ito, H; Shibuya, T

    1997-09-01

    This study investigated the relationship between neurotransmitters and improvement of symptoms after ventriculoperitoneal shunting in congenital hydrocephalus (LEW-HYR) rats. Twenty-four patent hydrocephalus rats, aged 12-14 days, were randomly assigned to the following four groups: ventriculoperitoneal shunt group, obstructed shunt group, burr hole group, and no treatment group. In addition, six normal rats served as control group. Head to body length ratio was measured before and 7 days after the procedures. Coordination movement was evaluated on the 7th postoperative day. High performance liquid chromatography (HPLC) was used to measure the concentrations of dopamine (DA), norepinephrine (NE), serotonin, homovanillic acid (HVA), 3-methoxyl-4-hydroxyphenylenglycol, 5-hydroxy-indolacetic acid (5-HIAA), and 3,4-dihydroxyphenylacetic acid in the whole cerebral cortex, the thalamus and hypothalamus, the midbrain, the lower brainstem, the cerebellum, and the striatum. Fluorohistochemical studies were also performed. Significant improvements were observed in body proportion and coordination movement in the ventriculoperitoneal shunt group compared to the burr hole group and the no treatment group. HPLC and fluorohistochemical studies revealed that concentrations of NE in the thalamus and hypothalamus and DA in the striatum were significantly lower in the burr hole group and the no treatment group. Concentrations of HVA and 5-HIAA in the cerebellum were significantly lower in the control group. The present study indicates that ventriculoperitoneal shunting may improve the changes in concentrations of neurotransmitter in specific neurons caused by hydrocephalus, and this may contribute to the improvement of the symptoms. PMID:9330530

  9. Circulating and PBMC Lp-PLA2 Associate Differently with Oxidative Stress and Subclinical Inflammation in Nonobese Women (Menopausal Status)

    PubMed Central

    Kim, Oh Yoen; Lee, Yonghee; Jeong, Tae-Sook; Sweeney, Gary; Jang, Yangsoo; Lee, Jong Ho

    2012-01-01

    Background This study aimed to determine the association of lipoprotein-associated phospholipase A2 (Lp-PLA2) activity in circulation and peripheral blood mononuclear cells (PBMCs) with inflammatory and oxidative stress markers in nonobese women and according to menopausal status. Lp-PLA2 activity, a marker for cardiovascular risk is associated with inflammation and oxidative stress. Methodology/Principal Findings Eighty postmenopausal women (53.0±4.05 yr) and 96 premenopausal women (39.7±9.25 yr) participated in this study. Lp-PLA2 activities, interleukin (IL)-6, tumor necrosis factor (TNF)-?, and IL-1? in plasma as well as in PBMCs were measured. Plasma ox-LDL was also measured. Postmenopausal women demonstrated higher circulating levels of ox-LDL and IL-6, as well as IL-6, TNF-?, and IL-1? in PBMCs, than premenopausal women. In both groups, plasma Lp-PLA2 activity positively correlated with Lp-PLA2 activity in PBMCs and plasma ox-LDL. In premenopausal women, Lp-PLA2 activities in plasma and PBMCs positively correlated with IL-6, TNF-?, and IL-1? in PBMCs. In postmenopausal women, plasma ox-LDL positively correlated with PBMC cytokine production. In subgroup analysis of postmenopausal women according to plasma ox-LDL level (median level: 48.715 U/L), a significant increase in Lp-PLA2 activity in the plasma but not the PBMCs was found in the high ox-LDL subgroup. Plasma Lp-PLA2 activity positively correlated with unstimulated PBMC Lp-PLA2 activity in the low ox-LDL subgroup (r?=?0.627, P<0.001), whereas in the high ox-LDL circulating Lp-PLA2 activity positively correlated with plasma ox-LDL (r?=?0.390, P?=?0.014) but not with Lp-PLA2 activity in PBMCs. Conclusions/Significance The lack of relation between circulating Lp-PLA2 activity and Lp-PLA2 activity in PBMCs was found in postmenopausal women with high ox-LDL. This may indicate other sources of circulating Lp-PLA2 activity except PBMC in postmenopausal women with high ox-LDL. We also demonstrated that circulating Lp-PLA2 and PBMC secreted Lp-PLA2 associate differently with markers of oxidative stress and sub clinical inflammation in nonobese women, particularly according to the menopausal states. PMID:22359537

  10. [Does Lp-PLA2 determination help predict atherosclerosis and cardiocerebrovascular disease?].

    PubMed

    Serti?, Jadranka; Skori?, Bosko; Lovri?, Jasna; Bozina, Tamara; Reiner, Zeljko

    2010-10-01

    Thorough control of risk factors is pivotal for cardiocerebrovascular diseases. As classic risk assessment accounts for only 50% of risk variability and due to the role of inflammatory processes in endothelial dysfunction and atherosclerotic plaque rupture, it is necessary to identify new biomarkers for risk prediction. In addition to the inflammatory marker high sensibility C-reactive protein (hs-CRP), lipoprotein associated phospholipase A2 (Lp-PLA2) is gaining increasing significance, since it is directly involved in the pathogenesis of atherosclerotic plaque progression. Lp-PLA2 is highly specific for vascular inflammation, has low biological variability, and plays a causative role in atherosclerotic plaque inflammation. It belongs to the group of intracellular and secretory phospholipase enzymes that can hydrolyze sn-2 phospholipid ester bond of cellular membranes and lipoproteins. Lp-PLA2 enzyme is formed by macrophages and foam cells in atherosclerotic plaque, and is associated primarily with LDL particles in blood. Lp-PLA2 that is bound to LDL is the sole enzyme responsible for hydrolysis of oxidized phospholipids (oxPL) on LDL particles. Lp-PLA2 hydrolyzes oxPL at the surface of lipoproteins, but has weak activity against non-oxPL. Lp-PLA2 is also the enzyme that hydrolyzes oxPL on HDL particles, where it may have a role in the antioxidative function of HDL. The distribution of Lp-PLA2 between LDL and HDL particles depends on the extent of Lp-PLA2 glycosylation, which may affect the activity of Lp-PLA2 in plasma. Stable atherosclerotic plaques contain few inflammatory cells and a small amount of Lp-PLA2. In contrast, unstable plaques most often do not have significant impact on arterial lumen but may be detected by its thin connective tissue cap, low collagen and high lipid content. A distinguishing factor between stable and unstable atherosclerotic plaque may also be the presence of activated inflammatory cells and increased Lp-PLA2 concentration in unstable plaque. These new insights indicate that Lp-PLA2 may be a risk factor, which is important for the formation of atherosclerotic plaque but also for its rupture. The purpose of applying markers of inflammation is to improve stratification of patients at risk, so that treatment intensity may be adjusted to the risk level. Lp-PLA2 inhibition is associated with decreased cytokines. Lipid-affecting drugs stabilize atherosclerotic plaque by reducing the central lipid core, decreasing macrophage infiltration, and thickening of the connective tissue cap. These drugs reduce Lp-PLA2 concentration and the frequency of cardiocerebrovascular events as well. Besides acting as a specific marker of atherosclerotic plaque inflammation, Lp-PLA2 has a significant prognostic value because of its direct role in the formation of rupture-prone atherosclerotic plaque, unlike classic risk factors, for example lipid measurement or vascular imaging, which do not directly estimate acute ischemic potential in the arterial wall. Studies have demonstrated correlation between increased Lp-PLA2 concentrations and enhanced risk of cardiocerebrovascular events, even after multivariate adjustment to classic risk factors. In addition to its high specificity for vascular inflammation, Lp-PLA2 concentration is stable in terms of time, unlike, for instance, CRP levels. Lp-PLA2 has been confirmed as an independent risk predictor, which is complementary to hsCRP. It could be used in clinical practice for improved risk assessment in patients with transient cardiocerebrovascular risk, particularly in those with metabolic syndrome (obese patients with mixed dyslipidemia, hyperglycemia, insulin resistance, and arterial hypertension). Lp-PLA2 levels allow for further risk stratification of high-risk patients into a very high risk group where more aggressive therapy is recommended, as well as the achievement of LDL-cholesterol levels < 2.5 or, even better, < 2.0 mmol/L as a feasible therapeutic target. Similar to hsCRP, the levels of Lp-PLA2 are reduced by lipid-affecting drugs, while its low concen

  11. Lp-PLA2 Inhibitors for the Reduction of Cardiovascular Events.

    PubMed

    Steen, Dylan L; O'Donoghue, Michelle L

    2013-12-01

    Evidence suggests that inflammation plays a central role in the pathogenesis of atherosclerosis (Libby, Nature 420:868-874, 2002). Inflammation is a physiologic process with highly regulated and often redundant mechanisms to balance pro-inflammatory and anti-inflammatory responses. The complexity of these networks has made it challenging to identify those specific pathways or key enzymes that contribute directly to atherogenesis and could act as a valuable therapeutic target. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a member of the phospholipase A2 family of enzymes and is believed to contribute to atherosclerotic plaque progression and instability by promoting inflammation. A large number of epidemiologic studies have demonstrated that elevated levels of Lp-PLA2 are associated with an increased risk of cardiovascular events across diverse patient populations, independent of established risk factors including low-density lipoprotein cholesterol. Further, a growing number of preclinical and genetic studies support a causal role for Lp-PLA2 in atherosclerosis. The development of a novel therapeutic agent that directly inhibits the Lp-PLA2 enzyme has provided a unique opportunity to directly test the hypothesis that inhibition of this inflammatory enzyme will translate into improved clinical outcomes. In this article, we will review the evidence to support the notion that Lp-PLA2 is causally implicated in the pathobiology of atherogenesis and discuss the potential utility of inhibiting this enzyme as a therapeutic target. PMID:25135391

  12. Analysis of error floor of LDPC codes under LP decoding over the BSC

    SciTech Connect

    Chertkov, Michael; Chilappagari, Shashi; Vasic, Bane; Stepanov, Mikhail

    2009-01-01

    We consider linear programming (LP) decoding of a fixed low-density parity-check (LDPC) code over the binary symmetric channel (BSC). The LP decoder fails when it outputs a pseudo-codeword which is not a codeword. We propose an efficient algorithm termed the instanton search algorithm (ISA) which, given a random input, generates a set of flips called the BSC-instanton and prove that: (a) the LP decoder fails for any set of flips with support vector including an instanton; (b) for any input, the algorithm outputs an instanton in the number of steps upper-bounded by twice the number of flips in the input. We obtain the number of unique instantons of different sizes by running the ISA sufficient number of times. We then use the instanton statistics to predict the performance of the LP decoding over the BSC in the error floor region. We also propose an efficient semi-analytical method to predict the performance of LP decoding over a large range of transition probabilities of the BSC.

  13. Destruction of LP XM46 using the molten salt destruction process. Revision 1

    SciTech Connect

    Upadhye, R.S.; Watkins, B.E.

    1994-04-01

    The preliminary experimental work done on the destruction of the liquid gun propellant LP XM46 (the new designation for LGP-1846) using the Molten Salt Destruction (MSD) Process at the Lawrence Livermore National Laboratory (LLNL) for the US Army is described in this report. A series of 18 continuous experimental runs were made wherein a solution of LP XM46 and water was injected into a bed of molten salt comprising the carbonates of sodium, potassium and lithium, along with air. The purpose of these initial Phase 1 runs was to collect information on the applicability of the Molten Salt Destruction Process for the destruction of LP XM46, identify the key technical uncertainties, and to plan future runs. The tentative results from these experiments, described in detail in the main body of this report, indicate that: (1) LP XM46 can be safely and completely destroyed in a bed of molten salt at temperatures well below those needed for incineration; and (2) under optimum operating conditions, less than 1% of the chemically bound nitrogen in the LP XM46 is converted to NOx, and less than 1% carbon is converted to CO.

  14. Small quasi-static displacements associated with shallow LP seismic sources

    NASA Astrophysics Data System (ADS)

    Thun, J.; Bean, C. J.; Lokmer, I.

    2014-12-01

    Seismic long-period (LP) events are still not completely understood, in part because our source models are poorly constrained. In particular individual LP events are usually inverted using a very limited bandwidth, which might mask important aspects of the source. Following advances from earthquake seismology where sources are inverted using joint static and dynamic data we investigate the possibility of using seismometers as deformation sensors, where 'static' displacements are hypothesised to be in the micrometre range (Bean et al. 2014). We use data from high-density networks on a variety of volcanoes. The first component of this study focuses on the extraction of small static displacement steps from seismometer data. The main challenges we face include low signal-to-noise ratios and ambiguity of the extracted ground motion due to the tilt-sensitivity of the instruments. We use a combination of laboratory experiments on seismometers and numerical simulations to investigate the processing steps needed to perform the 'step' extraction task and to guide the interpretation of the resulting data. The method is applied to signals recorded near the summits of Turrialba volcano (Costa Rica) and Mt Etna (Italy), which exhibit ramp-like displacement waveforms, coincidently associated by 'dynamic' LP recordings. Our interim conclusion is that these LP sources likely have a measurable static component in the source. Our next step is to use this static component to better constrain LP source inversions.

  15. PI and fuzzy logic controllers for shunt Active Power Filter--a report.

    PubMed

    P, Karuppanan; Mahapatra, Kamala Kanta

    2012-01-01

    This paper presents a shunt Active Power Filter (APF) for power quality improvements in terms of harmonics and reactive power compensation in the distribution network. The compensation process is based only on source current extraction that reduces the number of sensors as well as its complexity. A Proportional Integral (PI) or Fuzzy Logic Controller (FLC) is used to extract the required reference current from the distorted line-current, and this controls the DC-side capacitor voltage of the inverter. The shunt APF is implemented with PWM-current controlled Voltage Source Inverter (VSI) and the switching patterns are generated through a novel Adaptive-Fuzzy Hysteresis Current Controller (A-F-HCC). The proposed adaptive-fuzzy-HCC is compared with fixed-HCC and adaptive-HCC techniques and the superior features of this novel approach are established. The FLC based shunt APF system is validated through extensive simulation for diode-rectifier/R-L loads. PMID:21982358

  16. Cerebrospinal shunt flow in adults: radionuclide quantitation with emphasis on patient position

    SciTech Connect

    Brendel, A.J.; Wynchank, S.; Castel, J.P.; Barat, J.L.; Leccia, F.; Ducassou, D.

    1983-12-01

    Radionuclide quantitation of cerebrospinal fluid (CSF) flow through a ventricular shunt using a Cordis-Hakim valve was performed in 78 adults (138 studies). All remained supine for at least two hours before the study to avoid possible depletion of ventricular CSF. The absolute flow rate distinguished shunt adequacy from patency by defining flow of less than 0.1 ml/min. as abnormal. Measurements were performed with the patient first supine and then erect. When abnormal supine flow was the criterion of malfunction, all obstructions were detected but there were 6 false positives. When abnormal erect flow was considered, there were 5 false negatives. Abnormal flow in both supine and erect positions is a reliable indication of malfunction. The authors conclude that this technique is valuable for neurosurgical management of ventricular shunts.

  17. Percutaneous vesicoamniotic shunting versus conservative management for fetal lower urinary tract obstruction (PLUTO): a randomised trial

    PubMed Central

    Morris, Rachel K; Malin, Gemma L; Quinlan-Jones, Elisabeth; Middleton, Lee J; Hemming, Karla; Burke, Danielle; Daniels, Jane P; Khan, Khalid S; Deeks, Jon; Kilby, Mark D

    2013-01-01

    Summary Background Fetal lower urinary tract obstruction (LUTO) is associated with high perinatal and long-term childhood mortality and morbidity. We aimed to assess the effectiveness of vesicoamniotic shunting for treatment of LUTO. Methods In a randomised trial in the UK, Ireland, and the Netherlands, women whose pregnancies with a male fetus were complicated by isolated LUTO were randomly assigned by a central telephone and web-based randomisation service to receive either the intervention (placement of vesicoamniotic shunt) or conservative management. Allocation could not be masked from clinicians or participants because of the invasive nature of the intervention. Diagnosis was by prenatal ultrasound. The primary outcome was survival of the baby to 28 days postnatally. All primary analyses were done on an intention-to-treat basis, but these results were compared with those of an as-treated analysis to investigate the effect of a fairly large proportion of crossovers. We used Bayesian methods to estimate the posterior probability distribution of the effectiveness of vesicoamniotic shunting at 28 days. The study is registered with the ISRCTN Register, number ISRCTN53328556. Findings 31 women with singleton pregnancies complicated by LUTO were included in the trial and main analysis, with 16 allocated to the vesicoamniotic shunt group and 15 to the conservative management group. The study closed early because of poor recruitment. There were 12 livebirths in each group. In the vesicoamniotic shunt group one intrauterine death occurred and three pregnancies were terminated. In the conservative management group one intrauterine death occurred and two pregnancies were terminated. Of the 16 pregnancies randomly assigned to vesicoamniotic shunting, eight neonates survived to 28 days, compared with four from the 15 pregnancies assigned to conservative management (intention-to-treat relative risk [RR] 1·88, 95% CI 0·71–4·96; p=0·27). Analysis based on treatment received showed a larger effect (3·20, 1·06–9·62; p=0·03). All 12 deaths were caused by pulmonary hypoplasia in the early neonatal period. Sensitivity analysis in which non-treatment-related terminations of pregnancy were excluded made some slight changes to point estimates only. Bayesian analysis in which the trial data were combined with elicited priors from experts suggested an 86% probability that vesicoamniotic shunting increased survival at 28 days and a 25% probability that it had a large, clinically important effect (defined as a relative increase of 55% or more in the proportion of neonates who survived). There was substantial short-term and long-term morbidity in both groups, including poor renal function—only two babies (both in the shunt group) survived to 2 years with normal renal function. Seven complications occurred in six fetuses from the shunt group, including spontaneous ruptured membranes, shunt blockage, and dislodgement. These complications resulted in four pregnancy losses. Interpretation Survival seemed to be higher in the fetuses receiving vesicoamniotic shunting, but the size and direction of the effect remained uncertain, such that benefit could not be conclusively proven. Our results suggest that the chance of newborn babies surviving with normal renal function is very low irrespective of whether or not vesicoamniotic shunting is done. Funding UK National Institute of Health Research, Wellbeing of Women, Hannah Eliza Guy Charity (Birmingham Children's Hospital Charity). PMID:23953766

  18. A 100 GHz Josephson mixer using resistively-shunted Nb tunnel junctions

    NASA Technical Reports Server (NTRS)

    Schoelkopf, R. J.; Phillips, T. G.; Zmuidzinas, J.

    1993-01-01

    The authors describe preliminary mixer results using resistively shunted Nb/AlO(x)/Nb tunnel junctions in a 100-GHz waveguide mixer mount. The mixer utilizes robust, lithographically defined devices which have nonhysteretic I-V curves. A receiver temperature of 390 K (DSB) has been obtained with a conversion loss of -6.5 dB. The receiver's behavior agrees qualitatively with the behavior predicted by the resistively shunted junction model. Substantial improvements in performance are expected with the use of better-optimized shunted junctions, and numerical simulations suggest that, if devices with higher ICRN (critical current-normal state resistance) products can be obtained, Josephson effect mixers could be competitive with SIS mixers at high frequencies.

  19. Design of Class DE Amplifier with Nonlinear Shunt Capacitances for Any Output Q

    NASA Astrophysics Data System (ADS)

    Ezawa, Toru; Sekiya, Hiroo; Yahagi, Takashi

    This paper investigates the design curves of the class DE amplifier with the nonlinear shunt capacitances for any output Q and any grading coefficient m of the diode junction in the MOSFET. The design curves are derived by the numerical calculation using Spice. The results of this paper have two important meanings. Firstly, it is clarified that the nonlinearities of the shunt capacitances affect the design curves of the class DE amplifier, especially, for low output Q. Moreover, the supply voltage is a quite important parameter to design the class DE amplifier with the nonlinear shunt capacitances. Secondly, it is also clarified that the numerical design tool using Spice, which is proposed by authors, can be applied to the derivation of the design curves. This shows the possibility of the algorithm to be a powerful tool for the analysis of the class E switching circuits. The waveforms from Spice simulations denote the validity of the design curves.

  20. Changes in brain glutamine synthetase activity in congenital hydrocephalic rats (LEW-HYR) after ventriculoperitoneal shunt.

    PubMed

    Yamada, Y; Ito, H; Watanabe, Y

    1997-09-01

    Significantly reduced activities of glutamine synthetase (GS), which is predominantly present in glial cells, occur in the early stage of congenital hydrocephalic rat (LEW-HYR) brain development. GS activity is reported to be related to brain dysfunction. The effect of ventriculoperitoneal (VP) shunt on the suppression of GS activity was studied in the LEW-HYR. VP shunting improved the attenuation of GS activity in the LEW-HYR and the response of GS activity to methionine sulfoximine (a competitive GS inhibitor) treatment was similar to that seen in normal siblings. However, no enhancement of GS activity by hydrocortisone could be detected, although this enhancement occurs in the normal siblings. These results suggest that VP shunting is not completely effective in improving the suppression of brain GS activity in the LEW-HYR, since the suppression of GS activity in the LEW-HYR might be programmed genetically. PMID:9330529

  1. Wave propagation in beams with anti-symmetric piezoelectric shunting arrays

    NASA Astrophysics Data System (ADS)

    Sheng-Bing, Chen; Gang, Wang

    2016-03-01

    Piezoelectric shunting arrays are employed to control the wave propagation in flexible beams. Contrary to conventional symmetric configuration, a substrate beam with anti-symmetric shunting arrays is investigated by adapted transfer matrix method. Compared with symmetric scheme, the anti-symmetric one demonstrates some distinctive characteristics. Primarily, the longitudinal and flexural waves are coupled, so they are correlated and must be considered simultaneously. Moreover, the attenuation of flexural wave is much stronger in anti-symmetric scenario, while the longitudinal wave demonstrates the converse side. As a result, the anti-symmetric scheme can be utilized to improve the vibration isolation capability of shunting arrays. Finally, the theoretical analyses are validated by finite element simulations. Project supported by the National Natural Science Foundation of China (Grant No. 51322502).

  2. Pure pancreaticocutaneous fistula shunted into the urinary bladder. Lesson learned by an incomplete, original attempt.

    PubMed

    Violi, Vincenzo; Salvemini, Carlo; Darecchio, Antonio; Detullio, Paolo; Costi, Renato

    2014-01-01

    Because pancreaticocystostomy is a method of exocrine secretion management in pancreas transplantation, a legitimate question is whether a pure pancreatic fistula could be shunted into the bladder. After duodenopancreatectomy for cancer, a pancreaticojejunostomy leakage was treated by pancreas-saving anastomosis disconnection. The resulting pure pancreaticocutaneous fistula was later diverted into the bladder using a Denver valved-pump device. Technical problems necessitated redoing the shunt using a modified technique and device. Although the system did work, catheter displacement outside the bladder finally caused device takedown and external fistula restoration. Our attempt did not succeed mostly because of our inexperience in dealing with an altogether novel issue without appropriate technology. Supposing its feasibility, a pancreatic-bladder shunt might have a role in treating pure pancreatic fistulas or creating an external fistula whenever the pancreatic remnant is unreliable for an anastomosis, or when a leaked anastomosis' disconnection is preferable to completion pancreatectomy. PMID:24833149

  3. Application considerations and compensation characteristics of shunt active and series active filters in power systems

    SciTech Connect

    Peng, Fang Zheng; Lai, Jih-Sheng

    1996-10-01

    This paper characterizes typical nonlinear loads into two types of harmonic sources -harmonic current source and harmonic voltage source, which produce highly distorted currents and voltages, respectively. The conventional approach of active harmonic compensation has been the parallel type or `shunt active filter.` It is shown in this paper that the shunt active filter is effective only to harmonic current sources but not to harmonic voltage sources. On the other hand, the active filter connected in series with the system or `series active filter` is very effective in suppression of the harmonic voltage sources. General compensation characteristics of shunt active filters and series active filters are given analytically. The features, required operation conditions, and application considerations of both filters are described analytically and demonstrated experimentally.

  4. Elevation of intracranial pressure following transjugular intrahepatic portosystemic stent-shunt for variceal haemorrhage.

    PubMed

    Jalan, R; Dabos, K; Redhead, D N; Lee, A; Hayes, P C

    1997-11-01

    Increased intracranial pressure and cerebral oedema in patients with chronic liver disease is rare and is more typical of acute liver failure. Transjugular intrahepatic portosystemic stent-shunt is being increasingly used in the management of uncontrolled variceal haemorrhage in patients with cirrhosis. In our institution, a total of 160 patients has undergone transjugular intrahepatic porto-systemic stent-shunt for variceal haemorrhage; 56 of these procedures were emergencies for uncontrolled variceal haemorrhage. Four of these 56 patients developed features of acute liver failure, with marked deterioration in liver function tests and elevated intracranial pressure. This unusual but important complication of transjugular intrahepatic portosystemic stent-shunt has not been reported in the literature previously, and may have important consequences both for clinical practice and in the provision of further clues to understanding the pathogenesis of increased intracranial pressure in patients with liver diseases. PMID:9382983

  5. Comparative study of two structures of shunt active filter suppressing particular harmonics

    NASA Astrophysics Data System (ADS)

    Benchaita, L.; Salem Nia, A.; Saadate, S.

    1998-07-01

    This paper deals with the study of shunt active filters used for suppressing particular harmonics generated by nonlinear loads in utility distribution power systems. Both structures of shunt active filter, voltage source active filter (VSAF) and current source active filter (CSAF), are considered. The analytical study of specific harmonics identification in a given spectrum is first presented. For simulation as well as experimentation the nonlinear load is a conventional three phase thyristor rectifier and harmonics 5 and 7 are selected to be eliminated by active filter. The whole system consisting of the ac power supply network, the SCR rectifier and the shunt active filter (VSAF/CSAF) is then simulated. The simulation results are discussed and the efficiency of the two kinds of active filter are compared. Finally, for the first structure, VSAF, the simulation results are confirmed by experimental test realized by means of a fully digital control active power filter developed in our laboratory.

  6. Pregnancy and vaginal delivery in epidural analgesia in woman with cerebrospinal fluid shunt.

    PubMed

    Bursac, Danijel; Kulas, Tomislav; Persec, Jasminka; Persec, Zoran; Dui?, Zeljko; Partl, Jasenka Zmijanac; Glavi?, Zeljko; Hrgovi?, Zlatko; Bojani?, Katarina

    2013-12-01

    Hydrocephalus is a medical condition characterized by enlargement of cerebral ventricles due to abnormal cerebrospinal fluid accumulation. Hydrocephalic women with cerebrospinal fluid (CSF) shunts are now surviving to reproductive age, but still there are doubts regarding the mode of delivery, analgesia and anesthesia. Postpartal complications are more frequently described in deliveries ended by cesarean section than in spontaneous vaginal deliveries. We present a case of labor in the 32-year old woman, with congenital hydrocephalus and a preexisting ventriculoperitoneal (VP) shunt. After thorough review of current literature, we came to conclusion that without absolute neurosurgical indication or acute development of listed symptoms (headaches, irritability, light sensitivity, hyperesthesia nausea, vomiting, vertigo, migraines, seizures, weakness in the arms or legs, strabismus and double vision) the best way to finish the pregnancy of woman with VP shunt is spontaneous vaginal delivery with the use of epidural analgesia, mediolateral episiotomy and vacuum extraction. PMID:24611354

  7. Advanced LP turbine installation at 1300 MW nuclear power station Unterweser

    SciTech Connect

    Jacobsen, G. ); Oeynhausen, H. ); Termuehlen, H. )

    1991-01-01

    This paper reports on Preussen Elektra AG's Unterweser power plant. The steam turbine-generator features a disk-type LP turbine rotor design developed in the late 1960's to early 1970's. This rotor design has been installed in 19 nuclear power plants. The 47 rotors in these plants have been in operation for an average of almost 10 years. The design of the 1970 vintage nuclear LP turbine rotors was based on extensive experience gained with disk-type rotors of fossil turbines built in the 1950's. When EPRI reported about corrosion cracking in nuclear LP turbines, a program was initiated by Siemens/KWU as original steam turbine supplier to ultrasonically inspect all their disk-type rotors in nuclear power plats. Indications on one rotor disk in the Unterweser plant was found. This single event was the only one found out of 310 disks inspected in nuclear power plants.

  8. Lp stability for entropy solutions of scalar conservation laws with strict convex flux

    NASA Astrophysics Data System (ADS)

    Adimurthi; Ghoshal, Shyam Sundar; Veerappa Gowda, G. D.

    Here we consider the scalar convex conservation laws in one space dimension with strictly convex flux which is in C1. Existence, uniqueness and L1 contractivity were proved by Kružkov [14]. Using the relative entropy method, Leger showed that for a uniformly convex flux and for the shock wave solutions, the L2 norm of a perturbed solution relative to the shock wave is bounded by the L2 norm of the initial perturbation. Here we generalize the result to Lp norm for all 1?pLp norm of the perturbed solution relative to the modified N-wave is bounded by the Lp norm of the initial perturbation for all 1?p

  9. Congenital Portosystemic Shunts: Clinic Heterogeneity Requires an Individual Management of the Patient.

    PubMed

    Chocarro, Gloria; Amesty, María Virginia; Encinas, Jose Luis; Sánchez, Alejandra Vilanova; Hernandez, Francisco; Andres, Ane M; Gamez, Manolo; Tovar, Juan Antonio; Santamaria, Manuel Lopez

    2016-02-01

    Introduction?Congenital portosystemic shunt (CPSS) is a rare entity without insufficiency in treatment issues. The aim of this article is to show our experience in the heterogeneity of this condition. Material and Methods?A retrospective study of 25 CPSS in the period 1995 to 2014 was conducted. Description of the morphology, clinical impact, and treatment is given. Results?According to the imaging techniques (IT), the shunt was apparently intrahepatic in 14 patients, extrahepatic in 10 patients, and mixed in 1 patient. In 14 children, IT showed hepatic portal circulation. In total shunts in which radiological examination was performed, invasive radiological techniques were able to demonstrate intrahepatic portal vein. In other patients, it was not investigated as they are asymptomatic. A child presented multiorgan failure with fulminant hepatic failure at birth. The shunt was radiologically closed and clinical impairment reversed rapidly. He is now asymptomatic with no longer images of CPSS in ultrasound scan controls. Also, seven children are asymptomatic at this time and are monitored periodically. Seven children had prenatal diagnosis, in five the shunt closed spontaneously. Nine children were symptomatic in their evolution (hyperammonemia, regenerative nodules, cholestasis, gastrointestinal bleeding). Of these, in five we performed balloon test occlusion, tolerated in all patients, followed by radiological closure. In our experience, the advancement of interventional radiology techniques avoided surgery to close the shunt. Conclusions?Morphologically, the CPSS is extremely heterogeneous, with multiple possible connections established. CPSS has multiple clinical presentations, from asymptomatic patients to acute liver failure. The therapeutic approach should be individualized and therefore held in overspecialized centers. PMID:26528850

  10. Electrospun polyurethane as an alternative ventricular catheter and in vitro model of shunt obstruction

    PubMed Central

    Suresh, Supraja

    2015-01-01

    Intracranial pressure and volume vary considerably between hydrocephalic patients, and with age, health and haemodynamic status; if left untreated, intracranial pressure rises and the ventricular system expands to accommodate the excess cerebrospinal fluid, with significant morbidity and mortality. Cerebrospinal fluid shunts in use today have a high incidence of failure with shunt obstruction being the most serious. Conventional proximal shunt catheters are made from poly(dimethyl)siloxane, the walls of which are perforated with holes for the cerebrospinal fluid to pass through. The limited range of catheters, in terms of material selection and flow distribution, is responsible in large part for their poor performance. In this study, we present an alternative design of proximal catheter made of electrospun polyether urethane, and evaluate its performance in the presence of glial cells, which are responsible for shunt blockage. The viability and growth of cells on catheter materials such as poly(dimethyl)siloxane and polyurethane in the form of cast films, microfibrous mats and porous sponges were studied in the presence of proteins present in cerebrospinal fluid after 48?h and 96?h in culture. The numbers of viable cells on each substrate were comparable to untreated poly(dimethyl)siloxane, both in the presence and absence of serum proteins found in cerebrospinal fluid. A cell culture model of shunt obstruction was developed in which cells on electrospun polyether urethane catheters were subjected to flow during culture in vitro, and the degree of obstruction quantified in terms of hydraulic permeability after static and perfusion culture. The results indicate that a catheter made of electrospun polyether urethane would be able to maintain cerebrospinal fluid flow even with the presence of cells for the time period chosen for this study. These findings have implications for the design and deployment of microporous shunt catheter systems for the treatment of hydrocephalus. PMID:25245779

  11. Electrospun polyurethane as an alternative ventricular catheter and in vitro model of shunt obstruction.

    PubMed

    Suresh, Supraja; Black, Richard A

    2015-02-01

    Intracranial pressure and volume vary considerably between hydrocephalic patients, and with age, health and haemodynamic status; if left untreated, intracranial pressure rises and the ventricular system expands to accommodate the excess cerebrospinal fluid, with significant morbidity and mortality. Cerebrospinal fluid shunts in use today have a high incidence of failure with shunt obstruction being the most serious. Conventional proximal shunt catheters are made from poly(dimethyl)siloxane, the walls of which are perforated with holes for the cerebrospinal fluid to pass through. The limited range of catheters, in terms of material selection and flow distribution, is responsible in large part for their poor performance. In this study, we present an alternative design of proximal catheter made of electrospun polyether urethane, and evaluate its performance in the presence of glial cells, which are responsible for shunt blockage. The viability and growth of cells on catheter materials such as poly(dimethyl)siloxane and polyurethane in the form of cast films, microfibrous mats and porous sponges were studied in the presence of proteins present in cerebrospinal fluid after 48 h and 96 h in culture. The numbers of viable cells on each substrate were comparable to untreated poly(dimethyl)siloxane, both in the presence and absence of serum proteins found in cerebrospinal fluid. A cell culture model of shunt obstruction was developed in which cells on electrospun polyether urethane catheters were subjected to flow during culture in vitro, and the degree of obstruction quantified in terms of hydraulic permeability after static and perfusion culture. The results indicate that a catheter made of electrospun polyether urethane would be able to maintain cerebrospinal fluid flow even with the presence of cells for the time period chosen for this study. These findings have implications for the design and deployment of microporous shunt catheter systems for the treatment of hydrocephalus. PMID:25245779

  12. Association of Carotid Plaque Lp-PLA2 with Macrophages and Chlamydia pneumoniae Infection among Patients at Risk for Stroke

    PubMed Central

    Atik, Berna; Johnston, S. Claiborne; Dean, Deborah

    2010-01-01

    Background We previously showed that the burden of Chlamydia pneumoniae in carotid plaques was significantly associated with plaque interleukin (IL)-6, and serum IL-6 and C-reactive protein (CRP), suggesting that infected plaques contribute to systemic inflammatory markers in patients with stroke risk. Since lipoprotein-associated phospholipase A2 (Lp-PLA2) mediates inflammation in atherosclerosis, we hypothesized that serum Lp-PLA2 mass and activity levels and plaque Lp-PLA2 may be influenced by plaque C. pneumoniae infection. Methodology/Principal Findings Forty-two patients underwent elective carotid endarterectomy. Tissue obtained at surgery was stained by immunohistochemistry for Lp-PLA2 grade, macrophages, IL-6, C. pneumoniae and CD4+ and CD8+ cells. Serum Lp-PLA2 activity and mass were measured using the colorimetric activity method (CAM™) and ELISA, respectively. Serum homocysteine levels were measured by HPLC. Eleven (26.2%) patients were symptomatic with transient ischemic attacks. There was no correlation between patient risk factors (smoking, coronary artery disease, elevated cholesterol, diabetes, obesity, hypertension and family history of genetic disorders) for atherosclerosis and serum levels or plaque grade for Lp-PLA2. Plaque Lp-PLA2 correlated with serum homocysteine levels (p?=?0.013), plaque macrophages (p<0.01), and plaque C. pneumoniae (p<0.001), which predominantly infected macrophages, co-localizing with Lp-PLA2. Conclusions The significant association of plaque Lp-PLA2 with plaque macrophages and C. pneumoniae suggests an interactive role in accelerating inflammation in atherosclerosis. A possible mechanism for C. pneumoniae in the atherogenic process may involve infection of macrophages that induce Lp-PLA2 production leading to upregulation of inflammatory mediators in plaque tissue. Additional in vitro and in vivo research will be needed to advance our understanding of specific C. pneumoniae and Lp-PLA2 interactions in atherosclerosis. PMID:20543948

  13. Prognostic value of serum LP-PLA2 and hs-CRP in unstable atherosclerotic plaques.

    PubMed

    Du, Yimeng; Wei, Fengtao; Dong, Zhaoqiang; Liu, Junni; Jiang, Weidong; Lu, Qinghua

    2011-01-01

    To evaluate the prognostic value of LP-PLA2 and hs-CRP to the stability of atherosclerotic plaques. Forty-eight New Zealand White rabbits were randomly divided into control group, stable plaque group, P53 group, and P53 + drug group. Rabbits in the control group were fed a regular diet. Rabbits in stable plaque group, P53 group, and P53 + drug group underwent balloon-induced arterial wall injury and then were fed a diet of 1% cholesterol. Then the rabbits in the P53 group and P53 + drug group underwent Ad5-CMV P53 transfection in the 10th week; The P53 + drug group underwent pharmacologic triggering with Russell's viper venom (RVV) and histamine in 24 h and 48 h before euthanized. Intravascular ultrasound (IVUS) was used before sacrificing of the animal. In the 0 week and 12th week, rabbits underwent fast blood collection from the medium-sized artery of the ears, and the serum LP-PLA2 and hs-CRP level was determined. The animal altherosclerotic (AS) model was successfully gained and the rules of serum LP-PLA2 and hs-CRP level in instable plaque were discovered: serum LP-PLA2 in P53 group and P53 + drug group were significantly different from the control group and the stable group, while hs-CRP failed to differ between the control group and the stable group and succeeded in different degrees of unstable plague. The relationship analysis of serum and IVUS results revealed LP-PLA2 might predict an instability of plaque. Combining serum Lp-PLA2 and hs-CRP has higher specificity in predicting the vulnerability of the plaque. PMID:21269060

  14. Capillary tone: cyclooxygenase, shear stress, luminal glycocalyx, and hydraulic conductivity (Lp).

    PubMed

    Williams, Donna A; Flood, Mary H

    2015-04-01

    Control of capillary hydraulic conductivity (Lp) is the physiological mechanism that underpins systemic hydration. Capillaries form the largest surface of endothelial cells in any species with a cardiovascular system and all capillaries are exposed to the flow-induced force, shear stress (?). Vasoactive molecules such as prostacyclin (cyclooxygenase product, COX) are released from endothelial cells in response to ?. Little is known about how COX activity impacts capillary Lp. The purpose here was to assess Lp in situ following an acute ?? stimulus and during COX1/COX2 inhibition. Mesenteric true capillaries (TC) of Rana pipiens (pithed) were cannulated for Lp assessment using the modified Landis technique. Rana were randomized into Control and Test groups. Two capillaries per animal were used (perfusate, 10 mg·mL(-1) BSA/frog Ringer's; superfusate, frog Ringer's or indomethacin (10(-5) mol·L(-1)) mixed in frog Ringer's solution). Three distinct responses of Lp to indomethacin (TC2) were demonstrated (TC1 and TC2 medians: Test Subgroup 1, 3.0 vs. 1.8; Test Subgroup 2, 18.2 vs. 2.2; Test Subgroup 3, 4.2 vs. 10.2 × 10(-7) cm·sec(-1)·cm H2O(-1)). Multiple regression analysis revealed a relationship between capillary Lp and systemic red blood cell concentration or hematocrit, plasma protein concentration, and ?? (Test Subgroup 1, R(2) = 0.59, P < 0.0001; Test Subgroup 2, R(2) = 0.96, P = 0.002), but only during COX inhibition. Maintaining red blood cell and plasma protein levels within a normal range may control barrier function in a healthy state. Recovering barrier function may be an unrecognized benefit of transfusions during blood loss or edema formation. PMID:25896981

  15. Capillary tone: cyclooxygenase, shear stress, luminal glycocalyx, and hydraulic conductivity (Lp)

    PubMed Central

    Williams, Donna A; Flood, Mary H

    2015-01-01

    Control of capillary hydraulic conductivity (Lp) is the physiological mechanism that underpins systemic hydration. Capillaries form the largest surface of endothelial cells in any species with a cardiovascular system and all capillaries are exposed to the flow-induced force, shear stress (?). Vasoactive molecules such as prostacyclin (cyclooxygenase product, COX) are released from endothelial cells in response to ?. Little is known about how COX activity impacts capillary Lp. The purpose here was to assess Lp in situ following an acute ?? stimulus and during COX1/COX2 inhibition. Mesenteric true capillaries (TC) of Rana pipiens (pithed) were cannulated for Lp assessment using the modified Landis technique. Rana were randomized into Control and Test groups. Two capillaries per animal were used (perfusate, 10 mg·mL?1 BSA/frog Ringer's; superfusate, frog Ringer's or indomethacin (10?5 mol·L?1) mixed in frog Ringer's solution). Three distinct responses of Lp to indomethacin (TC2) were demonstrated (TC1 and TC2 medians: Test Subgroup 1, 3.0 vs. 1.8; Test Subgroup 2, 18.2 vs. 2.2; Test Subgroup 3, 4.2 vs. 10.2 × 10?7 cm·sec?1·cm H2O?1). Multiple regression analysis revealed a relationship between capillary Lp and systemic red blood cell concentration or hematocrit, plasma protein concentration, and ?? (Test Subgroup 1, R2 = 0.59, P < 0.0001; Test Subgroup 2, R2 = 0.96, P = 0.002), but only during COX inhibition. Maintaining red blood cell and plasma protein levels within a normal range may control barrier function in a healthy state. Recovering barrier function may be an unrecognized benefit of transfusions during blood loss or edema formation. PMID:25896981

  16. Beneficial effect on serum apo AI, apo B and Lp AI levels of Ramadan fasting.

    PubMed

    Adlouni, A; Ghalim, N; Saïle, R; Hda, N; Parra, H J; Benslimane, A

    1998-03-23

    In order to investigate for the first time in Morocco the effect of fasting in Ramadan, the ninth lunar month of the muslim year, on lipoprotein metabolism, we determined the levels of serum apolipoproteins; apolipoprotein AI (apo AI), apo B, apo AIV and those of lipoprotein particles; apo AI-containing lipoprotein particles (Lp AI) and also apo AI and apo AII containing lipoprotein particles (Lp AI:AII) in a group of 32 healthy, volunteer adult males. Determination of all these parameters was carried out on each week of the month of Ramadan and the results are compared with the pre-fasting and the post-fasting values. Ramadan fasting reduces significantly serum apo B (P < 0.05), while serum apo AI is significantly increased (P < 0.05) compared with the pre-fasting period. The increase of apo AI occurred on day 29 of Ramadan by 11.8%. Serum apo AIV was unchanged during the fasting period indicating that food intake during Ramadan is not based on lipid diet. The observed diet pattern during Ramadan showed an increase of total energy intake based on carbohydrates (+1.4% of total energy), proteins (+0.4% of total energy) but not on fat (-0.7% of total energy), compared with a usual diet used in the rest of the year. The fat diet is high in monounsaturated (P < 0.05) and polyunsaturated fatty acid in contrast to saturated fatty acid which decreased (P < 0.05) during Ramadan. On the other hand, analysis of serum Lp AI and Lp AI:AII showed that the levels of Lp AI:AII were unchanged but those of Lp AI were significantly increased (P < 0.01) at the end of Ramadan. These findings show that feeding behaviour that occurs during Ramadan beneficially affects serum apolipoprotein metabolism and may contribute to prevention of cardiovascular diseases. PMID:9565333

  17. Semi-active control of piezoelectric coating's underwater sound absorption by combining design of the shunt impedances

    NASA Astrophysics Data System (ADS)

    Sun, Yang; Li, Zhaohui; Huang, Aigen; Li, Qihu

    2015-10-01

    Piezoelectric shunt damping technology has been applied in the field of underwater sound absorption in recent years. In order to achieve broadband echo reduction, semi-active control of sound absorption of multi-layered piezoelectric coating by shunt damping is significant. In this paper, a practical method is proposed to control the underwater sound absorption coefficients of piezoelectric coating layers by combining design of the shunt impedance that allows certain sound absorption coefficients at setting frequencies. A one-dimensional electro-acoustic model of the piezoelectric coating and the backing is established based on the Mason equivalent circuit theory. First, the shunt impedance of the coating is derived under the constraint of sound absorption coefficient at one frequency. Then, taking the 1-3 piezoelectric composite coating as an example, the sound absorption properties of the coating shunted to the designed shunt impedance are investigated. Next, on the basis of that, an iterative method for two constrained frequencies and an optimizing algorithm for multiple constrained frequencies are provided for combining design of the shunt impedances. At last, an experimental sample with four piezoelectric material layers is manufactured, of which the sound absorption coefficients are measured in an impedance tube. The experimental results show good agreement with the finite element simulation results. It is proved that a serial R-L circuit can control the peak frequency, maximum and bandwidth of the sound absorption coefficient and the combining R-L circuits shunted to multiple layers can control the sound absorption coefficients at multiple frequencies.

  18. Anatomical Closure of Left-to-Right Shunts in Premature Infants with Bronchopulmonary Dysplasia and Pulmonary Hypertension: A Cautionary Tale

    PubMed Central

    Dereddy, Narendra R.; Chilakala, Sandeep R.; Rana, Divya

    2015-01-01

    Closure of a systemic to pulmonary shunt in premature infants with bronchopulmonary dysplasia may be beneficial, but in the presence of pulmonary hypertension is controversial. Here, we discuss two premature infants with pulmonary hypertension who developed acute pulmonary hypertensive crisis after closure of these shunts and hence advise caution. PMID:26495162

  19. Systemic to pulmonary venous communication (right-to-left shunt) in superior vena cava obstruction demonstrated by spiral CT.

    PubMed

    Ho, H T; Horowitz, A L; Ho, A C

    1999-07-01

    An unusual case of systemic vein to pulmonary vein communication in superior vena cava obstruction is reported. This was a right-to-left shunt, demonstrated by spiral CT and aided by three-dimensional reconstruction. The pulmonary venous shunts were mainly seen in fibro-atelectatic lung where prominent bridging veins were concentrated. PMID:10624332

  20. Effect of Shunting of Collateral Flow into the Venous System on Arteriogenesis and Angiogenesis in Rabbit Hind Limb

    PubMed Central

    Yang, Bao-lin; Wu, Song; Wu, Xiaoqiong; Li, Ming Bo; Zhu, Wu; Guan, Yinglu; Liu, Li-Hua; Luo, Ming-ying; Cai, Wei-Jun; Schaper, Jutta; Schaper, Wolfgang

    2013-01-01

    The aim of this study was to characterize the vascular remodeling in the external iliac artery (EIA) and the lower leg muscles in a rabbit shunt model created between the distal stump of the occluded femoral artery and the accompanying vein. Histology and immunoconfocal microscopy were used in this study. We found that: 1) both endothelial nitric oxide synthase (eNOS) and phosphorylated eNOS (P-eNOS) proteins were significantly increased in the shunt-side EIA; 2) matrix metalloproteinase-2 (MMP-2) expression was 5.5 times in shunt side EIA over that in normal EIA; 3) intercellular adhension molecule-1 (ICAM-1) expression was strongly induced in endothelial cells (EC) and vascular adhension molecule-1 (VCAM-1) expression was significantly increased in both EC and the adventitia of the shunt-side EIA; 4) augmentation of cell proliferation and extracellular proteolysis by macrophage infiltration was observed in shunt-side EIA; 5) cell proliferation was active in shunt side EIA, but quiet in shunt side lower leg’s arterial vessels; 6) capillary density in shunt side lower leg muscles was 2 times over that in normal side. In conclusion, our data demonstrate the paradigm that the power of shear stress takes the reins in arteriogenesis, whereas ischemia in angiogenesis, but not in arteriogenesis. PMID:23554534

  1. Exercise-Induced Intrapulmonary Arteriovenous Shunt in a Patient Complaining of Dyspnea during Strenuous Exercise

    PubMed Central

    Kim, Tae-Jun; Hong, Seong-Eun; Jung, Dong-Min; Choi, Nan-Young; Kim, Yong-Kyun; Park, Seung-Ah; Kim, Soon-Young; Park, Woo-Jung

    2014-01-01

    A 51-year-old highly fit man presented for dyspnea with strenuous aerobic exercise. The patient was asymptomatic and all tests were normal at rest. With increasing exercise intensity, he suddenly complained of dyspnea and showed a severe exercise-induced hypoxemia with an excessive alveolar-arterial oxygen tension difference. In agitated saline contrast echocardiography at peak exercise, a large amount of left to right shunt was identified after > 5 cardiac cycles, which suggests the presence of exercise-induced intrapulmonary arteriovenous shunt in this patient. PMID:25031800

  2. Synchronous Rectified, Single Diode Sequential Shunt Switching Reglator (S3R)

    NASA Astrophysics Data System (ADS)

    Tonicello, Ferdinando; Llavona, Leticia Busto; Keller, Sylvain

    2011-10-01

    The present paper regards an improvement to the power system based on Sequential Shunt Switching Regulator (S3R) and derived topologies, in order to minimise the relevant power dissipation and finally allow an extreme miniaturisation of the relevant power cells, with reduction of the temperature stress and consequent advantages. The idea begins in the removal of one of the two serial diodes that are normally introduced on the power line to avoid that a failure in short circuit of a single diode would result in the short circuit of the main bus through the shunt device (Figure 1).

  3. Pancreaticoportal fistula and disseminated fat necrosis after revision of a transjugular intrahepatic portosystemic shunt.

    PubMed

    Klein, Seth J; Saad, Nael; Korenblat, Kevin; Darcy, Michael D

    2013-04-01

    A 59-year old man with alcohol related cirrhosis and portal hypertension was referred for transjugular intrahepatic portosystemic shunt (TIPS) to treat his refractory ascites. Ten years later, two sequential TIPS revisions were performed for shunt stenosis and recurrent ascites. After these revisions, he returned with increased serum pancreatic enzyme levels and disseminated superficial fat necrosis; an iatrogenic pancreaticoportal vein fistula caused by disruption of the pancreatic duct was suspected. The bare area of the TIPS was subsequently lined with a covered stent-graft, and serum enzyme levels returned to baseline. In the interval follow-up period, the patient has clinically improved. PMID:22526102

  4. Current redistribution during quench in a SMES coil with separated conductor and dump shunt

    NASA Astrophysics Data System (ADS)

    Bulc, Ales M.; Hassenzahl, William V.; Zeljeznov, Miljutin

    1994-07-01

    Some designs for large Superconducting Magnetic Energy Storage (SMES) coils have two or more parallel current carrying paths. During normal operation only the path with superconductor (conductor) carries current. During a quench, however, current transfers out of the conductor into an alternate current path (dump shunt). Timely current transfer must be assured to prevent damage to the coil. Current transfer is delayed due to local coil inductances if the conductor and shunt are separated. This paper describes a computer program LDELAY that calculates the transient current distribution. Results obtained for transient current redistribution in SMES/ETM and GEM magnets during a coil quench are presented.

  5. Pancreaticoportal Fistula and Disseminated Fat Necrosis After Revision of a Transjugular Intrahepatic Portosystemic Shunt

    SciTech Connect

    Klein, Seth J. Saad, Nael; Korenblat, Kevin; Darcy, Michael D.

    2013-04-15

    A 59-year old man with alcohol related cirrhosis and portal hypertension was referred for transjugular intrahepatic portosystemic shunt (TIPS) to treat his refractory ascites. Ten years later, two sequential TIPS revisions were performed for shunt stenosis and recurrent ascites. After these revisions, he returned with increased serum pancreatic enzyme levels and disseminated superficial fat necrosis; an iatrogenic pancreaticoportal vein fistula caused by disruption of the pancreatic duct was suspected. The bare area of the TIPS was subsequently lined with a covered stent-graft, and serum enzyme levels returned to baseline. In the interval follow-up period, the patient has clinically improved.

  6. Meso-Rex shunt for immediate portal revascularization in pediatric liver transplantation: first report.

    PubMed

    Rivera, Jairo; Fusaro, Fabio; de Magnée, Catherine; Clapuyt, Philippe; Reding, Raymond

    2012-09-01

    We describe the case of a 13-month-old girl transplanted for biliary atresia with PV hypoplasia. She received the left liver lobe of her mother and presented intraoperative portal thrombosis. Because of technical reasons, the opportunity to have conventional PV reconstruction using the donor left PV stump was lost. Immediate conversion to a meso-Rex shunt, using the recipient jugular vein as a bridge between the superior mesenteric vein and the graft Rex recessus, allowed excellent portal revascularization of the transplant. We suggest that synchronous meso-Rex shunt may constitute a valid alternative to truncal PV anastomosis during pediatric LT. PMID:21923884

  7. Intratumoral Vascular Shunting: Biomarker of Clinical Outcome and Source of Circulating Tumor Cells?

    PubMed

    Deipolyi, Amy R; Zhu, Andrew X; Oklu, Rahmi

    2015-12-01

    Predicting which patients will benefit from radioembolization remains a challenge, as reliable prognostic indicators are not defined. Abnormal tumor vascular anatomy could not only impact the ability of cancer therapies to penetrate tumors, but may also contribute to a lesion's metastatic potential. Specifically, intratumoral vascular shunts could allow circulating tumor cells to initiate metastases by allowing them to gain access to distant sites in the body, bypassing capillary beds. Here, we describe how tumoral angiogenesis occurs and how intratumoral vascular shunts may form. PMID:25333732

  8. [Alterations of skull development in shunt-treated hydrocephalus. Analysis of pathogenic factors (author's transl)].

    PubMed

    Abad Rico, J M; Fuenmayor, P; Lucaya, J

    1981-05-01

    Skull roentgenograms of 184 children with hydrocephalus treated with shunts were revised. Radiological abnormalities of the skull related to CSF drainage were found in 49,5% of cases. Presence of X-ray abnormalities was correlated with the age of patients at operation, sex, etiology of hydrocephalus, type of shunt device, head circumference at operation and follow-up. Results were submitted to statistical analysis. In this study it is clearly demonstrated that age and head circumference before operation have a strong influence in the pathogenesis of this picture. PMID:7294521

  9. Enhanced Expression of Lp-PLA2 and Lysophosphatidylcholine in Symptomatic Carotid Atherosclerotic Plaques

    PubMed Central

    Mannheim, Dallit; Herrmann, Joerg; Versari, Daniele; Gössl, Mario; Meyer, Fredric B.; McConnell, Joseph P.; Lerman, Lilach O.; Lerman, Amir

    2015-01-01

    Background and Purpose Circulating lipoprotein-associated phospholipase A2 (Lp-PLA2) has emerged as a novel biomarker for cardiovascular diseases. However, the correlation between the plaque expression of Lp-PLA2 and plaque oxidative stress, inflammation, and stability as well as the clinical presentation remains poorly defined, especially for cerebrovascular disease. Therefore, this study was performed to test the hypothesis that Lp-PLA2 expression is higher in symptomatic than in asymptomatic carotid plaques of patients undergoing carotid endarterectomy. Methods The expression of Lp-PLA2 in 167 carotid artery plaques was determined by immunoblotting and immunostaining. Plaque oxidative stress, inflammation, and stability were quantified by NAD(P)H oxidase p67phox and MMP-2 immunoblotting, oxidized LDL (oxLDL) immunoreactivity, macrophage and Sirius red collagen staining. Lysophosphatidylcholine 16:0 (lysoPC) concentration was measured in 55 plaques using liquid chromatography tandem mass spectrometry. Results Lp-PLA2 expression was significantly higher in plaques of symptomatic patients than asymptomatic patients (1.66±0.19 versus 1.14±0.10, P<0.05) and localized mainly to shoulder and necrotic lipid core areas in colocalization with oxLDL and macrophage content. Similarly, Lp-PLA2 expression was related to collagen content, which was lower in plaques from symptomatic patients than in plaques from asymptomatic patients (9.1±2.2 versus 18.5±1.7% of staining/field, P<0.001). LysoPC plaque concentration was significantly higher in plaques of symptomatic than asymptomatic patients (437.0±57.91 versus 228.84±37.00 mmol/L, P<0.05). Conclusions Symptomatic carotid artery plaques are characterized by increased levels of Lp-PLA2 and its product lysoPC in correlation with markers of tissue oxidative stress, inflammation, and instability. These findings strongly support a role for Lp-PLA2 in the pathophysiology and clinical presentation of cerebrovascular disease. PMID:18356547

  10. Long Period (LP) volcanic earthquake source location at Merapi volcano by using dense array technics

    NASA Astrophysics Data System (ADS)

    Metaxian, Jean Philippe; Budi Santoso, Agus; Laurin, Antoine; Subandriyo, Subandriyo; Widyoyudo, Wiku; Arshab, Ghofar

    2015-04-01

    Since 2010, Merapi shows unusual activity compared to last decades. Powerful phreatic explosions are observed; some of them are preceded by LP signals. In the literature, LP seismicity is thought to be originated within the fluid, and therefore to be representative of the pressurization state of the volcano plumbing system. Another model suggests that LP events are caused by slow, quasi-brittle, low stress-drop failure driven by transient upper-edifice deformations. Knowledge of the spatial distribution of LP events is fundamental for better understanding the physical processes occurring in the conduit, as well as for the monitoring and the improvement of eruption forecasting. LP events recorded at Merapi have a spectral content dominated by frequencies between 0.8 and 3 Hz. To locate the source of these events, we installed a seismic antenna composed of 4 broadband CMG-6TD Güralp stations. This network has an aperture of 300 m. It is located on the site of Pasarbubar, between 500 and 800 m from the crater rim. Two multi-parameter stations (seismic, tiltmeter, S-P) located in the same area, equipped with broadband CMG-40T Güralp sensors may also be used to complete the data of the antenna. The source of LP events is located by using different approaches. In the first one, we used a method based on the measurement of the time delays between the early beginnings of LP events for each array receiver. The observed differences of time delays obtained for each pair of receivers are compared to theoretical values calculated from the travel times computed between grid nodes, which are positioned in the structure, and each receiver. In a second approach, we estimate the slowness vector by using MUSIC algorithm applied to 3-components data. From the slowness vector, we deduce the back-azimuth and the incident angle, which give an estimation of LP source depth in the conduit. This work is part of the Domerapi project funded by French Agence Nationale de la Recherche (https://sites.google.com/site/domerapi2).

  11. Successful living donor liver transplant in a child with Abernethy malformation with biliary atresia, ventricular septal defect and intrapulmonary shunting.

    PubMed

    Singhal, Ashish; Srivastava, Ajitabh; Goyal, Neerav; Vij, Vivek; Wadhawan, Manav; Bera, Motilal; Gupta, Subash

    2009-12-01

    Congenital portosystemic shunts are the anomalies in which the mesenteric venous drainage bypasses the liver and drains directly into the systemic circulation. This is a report of a rare case of LDLT in a four-yr old male child suffering with biliary atresia (post-failed Kasai procedure) associated with (i) a large congenital CEPSh from the spleno-mesentric confluence to the LHV, (ii) intrapulmonary shunts, (iii) perimembranous VSD. The left lobe graft was procured from the mother of the child. Recipient IVC and the shunt vessel were preserved during the hepatectomy, and the caval and shunt clamping were remarkably short while performing the HV and portal anastomosis. Post-operative course was uneventful; intrapulmonary shunts regressed within three months after transplantation and currently after 18 months following transplant child is doing well with normal liver functions. CEPSh has been extensively discussed and all the published cases of liver transplantation for CEPSh were reviewed. PMID:19254272

  12. The elevation of apoB in hypercholesterolemic patients is primarily attributed to the relative increase of apoB/Lp-PLA2

    PubMed Central

    Tellis, Constantinos C.; Moutzouri, Eliza; Elisaf, Moses; Wolfert, Robert L.; Tselepis, Alexandros D.

    2013-01-01

    Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a risk factor of cardiovascular disease. Plasma Lp-PLA2 is mainly associated with apolipoprotein (apo)B-containing lipoproteins, primarily with low density lipoproteins (LDLs). Importantly, only a proportion of circulating lipoproteins contain Lp-PLA2. We determined the plasma levels of Lp-PLA2-bound apoB (apoB/Lp-PLA2) in patients with primary hypercholesterolemia. The effect of simvastatin therapy was also addressed. The plasma apoB/Lp-PLA2 concentration in 50 normolipidemic controls and 53 patients with primary hypercholesterolemia at baseline and at 3 months posttreatment with simvastatin (40 mg/day) was determined by an enzyme-linked immunosorbent assay. The concentration of the apoB-containing lipoproteins that do not bind Lp-PLA2 [apoB/Lp-PLA2(?)] was calculated by subtracting the apoB/Lp-PLA2 from total apoB. The apoB/Lp-PLA2 levels were 3.6-fold higher, while apoB/Lp-PLA2(?) were 1.3-fold higher in patients compared with controls. After 3 months of simvastatin treatment apoB/Lp-PLA2 and apoB/Lp-PLA2(?) levels were reduced by 52% and 33%, respectively. The elevation in apoB-containing lipoproteins in hypercholesterolemic patients is mainly attributed to the relative increase in the proatherogenic apoB/Lp-PLA2, while simvastatin reduces these particles to a higher extent compared with apoB/Lp-PLA2(?). Considering that Lp-PLA2 is proatherogenic, the predominance of apoB/Lp-PLA2 particles in hypercholesterolemic patients may contribute to their higher atherogenicity and incidence of cardiovascular disease. PMID:24092915

  13. 77 FR 11618 - Solutions Capital I, L.P.; Notice Seeking Exemption Under the Small Business Investment Act...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-27

    ... from MCG Capital Corporation in Advanced Sleep Concepts, Inc., 195 Chatillon Road NE., Rome, GA, 30162... Solutions Capital I, L.P., has a greater than 10% equity interest in Advanced Sleep Concepts, Inc., thereby making Advanced Sleep Concepts, Inc., an Associate of Solutions Capital I, L.P., as defined in Sec....

  14. 76 FR 22695 - Yuba City Cogenerations Partners, LP; Supplemental Notice That Initial Market-Based Rate Filing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-22

    ... From the Federal Register Online via the Government Printing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Yuba City Cogenerations Partners, LP; Supplemental Notice That Initial... notice in the above-referenced proceeding of Yuba City Cogeneration Partners, LP's application for...

  15. Lipoprotein-Associated Phospholipase A2 (Lp-PLA2): A Novel and Promising Biomarker for Cardiovascular Risks Assessment

    PubMed Central

    Cai, Anping; Zheng, Dongdan; Qiu, Ruofeng; Mai, Weiyi; Zhou, Yingling

    2013-01-01

    Atherosclerosis and its manifestations namely cardiovascular diseases (CVD) are still the leading cause of morbidity and mortality worldwide. Although intensified interventions have been applied, the residual cardiovascular (CV) risks are still very high. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a novel and unique biomarker highly specific for vascular inflammation and atherosclerosis. Both pro-atherogenic property of Lp-PLA2 and positive correlation with CV events have already been demonstrated by a large number of scientific and clinical studies. Currently, in the Adult Treatment Panel III (ATP III) guideline, Lp-PLA2 has been recommended as an adjunct to traditional risk factors in assessing future CV risks. Encouragingly, darapladib, an orally Lp-PLA2 specific inhibitor, has been tested in basic research and preclinical trials and the outcomes are quite striking. Additionally, there are two phase III ongoing clinical trials in evaluating the efficacy and safety of darapladib on cardiovascular outcomes. With regard to the potential values of Lp-PLA2 in risk stratification, therapeutic regimen establishment and prognosis evaluation in patients with moderate or high risk, our present review is going to summarize the relevant data about the bio-chemical characteristics of Lp-PLA2, the actions of Lp-PLA2 on atherosclerosis and the results of Lp-PLA2 in scientific research and clinical studies. PMID:23478277

  16. 76 FR 9808 - U.S. Customs and Border Protection Accreditation and Approval of Saybolt LP, as a Commercial...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ... SECURITY U.S. Customs and Border Protection Accreditation and Approval of Saybolt LP, as a Commercial Gauger and Laboratory AGENCY: U.S. Customs and Border Protection, Department of Homeland Security. ACTION..._scientific_svcs/commercial_gaugers/ . DATES: The accreditation and approval of Saybolt LP, as...

  17. 78 FR 67359 - Rigby Energy Resources, LP; Supplemental Notice That Initial Market-Based Rate Filing Includes...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-12

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Rigby Energy Resources, LP; Supplemental Notice That Initial Market-Based... above-referenced proceeding, of Rigby Energy Resources, LP's application for market-based rate...

  18. 75 FR 19644 - West Oaks Energy NY/NE, LP; Supplemental Notice That Initial Market-Based Rate Filing Includes...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-15

    ... Energy Regulatory Commission West Oaks Energy NY/NE, LP; Supplemental Notice That Initial Market-Based... supplemental notice in the above-referenced proceeding of West Oaks Energy NY/NE LP's application for market... Commission, 888 First Street, NE., Washington, DC 20426, in accordance with Rules 211 and 214 of...

  19. 76 FR 64939 - Windpower Partners 1993, L.P.; Supplemental Notice That Initial Market-Based Rate Filing Includes...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-19

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Windpower Partners 1993, L.P.; Supplemental Notice That Initial Market-Based... above-referenced proceeding of Windpower Partners 1993, LP's application for market-based rate...

  20. 75 FR 57017 - Enbridge Pipelines (North Dakota) LLC; Enbridge Pipelines (Bakken) L.P.; Notice of Petition for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Enbridge Pipelines (North Dakota) LLC; Enbridge Pipelines (Bakken) L.P...), Enbridge Pipelines (North Dakota) LLC (EPND) and Enbridge Pipelines (Bakken) L.P. (Enbridge Bakken...