Compounding rifampin suspensions with improved injectability for nasogastric enteral feeding tube administration.

PubMed

de Villiers, Melgardt M; Vogel, Laura; Bogenschutz, Monica C; Fingerhut, Bonnie J; D'Silva, Joseph B; Moore, Anne

2010-01-01

Often medications that have to be administered to patients via a nasogastric enteral feeding tubes are only available as tablets and capsules with no suitable commercial liquid alternatives. In such situations, pharmacists and nurses have to compound the tablets and capsule contents into liquid suspension formulations for dosing. The risk of occlusion of the enteral tubes during administration is reduced by employing liquid suspensions that are composed of small and uniform particles, not subject to rapid rates of settling, resistant to caking, and easily and uniformly re-suspended upon agitation. Present techniques often employ a manual process, such as a mortar and pestle, to accomplish the particle size reduction and subsequent incorporation into a suitable liquid diluent. A new compounding device has been invented that employs an automated wet-milling process in a single-use disposable plastic container to compound the suspensions. The two processes were compared using Rifampin capsules and various liquid diluents. A prototype version of the new device was employed in the experiments. The physical characteristics of the compounded suspensions were evaluated by determining sedimentation rate, sedimentation volume, and particle size and shape using laser light scattering, optical microscopy, and scanning electron microscopy techniques. The use characteristic of the compounded suspensions was evaluated using a nasogastric tube inject ability test. The results indicated that suspensions prepared using the new device were more resistant to sedimentation and caking and were easier to re-disperse into a uniform mixture by gentle shaking. The results were a consequence of the particles generated by the new device which were found to be smaller and more uniform in shape and size. The suspensions prepared using the new device did not cause blockage of the enteral feeding tubes in comparison to those prepared using a mortar and pastle. In conclusion, the results indicate

Inflation with air via a facepiece for facilitating insertion of a nasogastric tube: a prospective, randomised, double-blind study.

PubMed

Gupta, D; Agarwal, A; Nath, S S; Goswami, D; Saraswat, V; Singh, P K

2007-02-01

Insertion of a nasogastric tube is a routine procedure but during anaesthesia it is often difficult and time consuming. One hundred and sixty adults undergoing elective surgery under general anaesthesia were randomly divided into two groups. After induction of anaesthesia, neuromuscular blockade and tracheal intubation, a nasogastric tube was inserted through the nose with the head of the patient in the neutral position, either with or without prior inflation with air via a facepiece attached to a self-inflating bag applied firmly with the face. Insertion of the nasogastric tube was successful in 75/78 (96%) following inflation compared with 54/80 (68%) without inflation (p<0.001). In four patients receiving inflation, a fibreoptic endoscope was passed as far as the upper oesophageal sphincter; this revealed opening of the upper oesophageal sphincter during inflation.

[Is oral rehydration with nasogastric tube more efficient than rehydration with spoon? Preliminary study in children with non-severe dehydration in Joseph-Raseta-Befelatanana Hospital, Madagascar].

PubMed

Ravelomanana, T; Rabeatoandro, S; Randrianaivo, N; Ratsimbazafy, A; Raobijaona, H; Barennes, H

2010-05-01

Since its recommendation by WHO, Oral Rehydration Solutions (ORS) contributed in reducing the rate of mortality due to acute gastroenteritis. In Madagascar, the rate of lethality imputed to gastroenteritis is about 3%. Rehydration can be performed either by using spoons which reliability is unsure because of parents' potential inobservance and child's refusal, or by nasogastric tube. The nasogastric tube may resolve these obstacles at the hospital. We realized a preliminary study to evaluate the efficacy and the safety of nasogastric tube and spoon administration of the ORS in rehydration of child with moderate post-gastroenteritis dehydration. This is an open comparative study realized in the Pediatric Unit at the Joseph-Raseta-Befelatanana Hospital from the 21 January to 21 May 2008. Main outcomes was the proportion of rehydrated children at 4 hours, other were: failure at 8 hours, duration and volume of SRO, side effects. Fifty-three children from 4-month to 4-year old among 1306 patients were recruited and forty-seven patients were included. Nine patients failed (4 children received ORS by spoon and 5 children by nasogastric tube). The use of spoon was more effective: 62.5% of the patients were rehydrated at the fourth hour versus 39.3% in nasogastric tube group (P = 0.04). Making debit constant presents difficulties in rehydration with nasogastric tube (44.4 %). Tolerance of nasogastric tube is generally good but 16.7% children get out their tube during this study. No ORS' inhalation was observed with both routes. No false passage or tube or ORS rejection was recorded in both techniques. This study shows that using spoon to rehydrate is more effective for the rehydration of moderate dehydration. The use of nasogastric tube needs more surveillance.

Deaths associated with insertion of nasogastric tubes for enteral nutrition in the medical intensive care unit: Clinical and autopsy findings

PubMed Central

Smith, Avery L.; Santa Ana, Carol A.; Fordtran, John S.; Guileyardo, Joseph M.

2018-01-01

ABSTRACT It is generally assumed that blind insertion of nasogastric tubes for enteral nutrition in patients admitted to medical intensive care units is safe; that is, does not result in life-threatening injury. If death occurs in temporal association with insertion of a nasogastric tube, caregivers typically attribute it to underlying diseases, with little or no consideration of iatrogenic death due to tube insertion. The clinical and autopsy results in three recent cases at Baylor University Medical Center challenge the validity of these notions. PMID:29904295

Determination of a practical pH cutoff level for reliable confirmation of nasogastric tube placement.

PubMed

Gilbertson, Heather Ruth; Rogers, Elizabeth Jessie; Ukoumunne, Obioha Chukwunyere

2011-07-01

Enteral feeding is a common method of nutrition support when oral intake is inadequate. Confirmation of correct nasogastric (NG) tube placement is essential. Risks of morbidity/mortality associated with misplacement in the lung are well documented. Studies indicate that pH ≤ 4 confirms gastric aspirate, but in pediatrics, a pH of gastric aspirate is often >4. The goal of this study was to determine a reliable and practical pH value to confirm NG tube placement, without increasing the risk of not identifying a misplaced NG tube. Pediatric inpatients older than 4 weeks receiving enteral nutrition (nasogastric or gastrostomy) were recruited over 9 months. Aspirate samples were pH tested at NG tube placement and before feedings. If pH >4, NG tube position was confirmed by chest radiograph or further investigations. In addition, intensive care unit (ICU) patients who required endotracheal suctioning were recruited, and endotracheal aspirate samples were pH tested. A total of 4,330 gastric aspirate samples (96% nasogastric) were collected from 645 patients with a median (interquartile range [IQR]) age of 1.0 years (0.3-5.2 years). The mean (standard deviation [SD]) pH of these gastric samples was 3.6 (1.4) (range, 0-9). pH was >4 in 1,339 (30.9%) gastric aspirate samples, and of these, 244 were radiographed, which identified 10 misplaced tubes (1 with pH 5.5). A total of 65 endotracheal aspirate samples were collected from 19 ICU patients with a median (IQR) age of 0.6 years (0.4-5.2 years). The mean (SD) pH of these samples was 8.4 (0.8) (range, 6-9.5). Given that the lowest pH value of endotracheal aspirate sample was 6, and a misplaced NG tube was identified with pH 5.5, it is proposed that a gastric aspirate pH ≤ 5 is a safer, reliable, and practical cutoff in this population.

Successful treatment of severe Clostridium difficile infection by administration of crushed fidaxomicin via a nasogastric tube in a critically ill patient.

PubMed

Arends, Sven; Defosse, Jerome; Diaz, Cori; Wappler, Frank; Sakka, Samir G

2017-02-01

To report the successful use of crushed fidaxomicin via a nasogastric tube for treatment of a severe Clostridium difficile infection in a critically ill patient. Clinical observation of a patient, images of abdominal computed tomography, antimicrobial therapy and course of infection parameters. Relevant information contained in the medical observation of the patient and selection of image and laboratory parameters performed in the patient. We report a case of a 79-year old patient who developed septic shock with an increasing need for norepinephrine and acute renal failure due to a severe Clostridium difficile infection. Antimicrobial therapy with vancomycin via a nasogastric tube and metronidazole i.v. did not lead to improvement, infection parameters further increased, and the clinical condition became increasingly impaired. After 10 days, antimicrobial therapy was changed to fidaxomicin, crushed and administered via nasogastric tube. Within 24hours, infection parameters decreased. Further diarrhoea ceased and stool samples were negative for Clostridium difficile antigen. Our case confirms that administration of fidaxomicin via a nasogastric tube was safe and effective in this patient. Further studies are needed to evaluate the efficacy of this strategy in critically ill patients systematically. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Limitations of Routine Verification of Nasogastric Tube Insertion Using X-Ray and Auscultation: Two Case Reports of Life-Threatening Complications.

PubMed

Nejo, Takahide; Oya, Soichi; Tsukasa, Tsuchiya; Yamaguchi, Naomi; Matsui, Toru

2016-12-01

Several bedside approaches used in combination with thoracoabdominal X-ray are widely used to avoid severe complications that have been reported during nasogastric tube management. Although confirmation by X-ray is considered the gold standard, it is not yet perfect. We present 2 cases of rare complications in which the routine verification methods could not detect all the complications related to the nasogastric tube placement. Case 1 was a 17-year-old male who presented with a brain tumor and repeatedly required nasogastric tube placement. Despite normal auscultatory and X-ray findings, the patient's condition deteriorated rapidly after resuming the enteral nutrition (EN). Computed tomography images showed the presence of hepatic portal venous gas (HPVG). Urgent upper gastrointestinal endoscopy showed esophagogastric submucosal tunneling of the tube that required an emergency open total gastrectomy. Case 2 was a 76-year-old man with long-term EN after stroke. While the last auscultatory verification was normal, he suddenly developed extensive HPVG due to gastric mucosal injury following EN, which resulted in progressive intestinal necrosis, general peritonitis, and death. These 2 cases indicated that routine verification methods consisting of auscultation and X-ray may not be completely reliable, and the awareness of the limitations of these methods should be reaffirmed because expeditious examinations and necessary interventions are critical in preventing life-threatening complications.

Evaluation of intensivist-nurses' knowledge concerning medication administration through nasogastric and enteral tubes.

PubMed

Mota, Maria Lurdemiler Sabóia; Barbosa, Islene Victor; Studart, Rita Mônica Borges; Melo, Elizabeth Mesquita; Lima, Francisca Elisângela Teixeira; Mariano, Fabíola Amaro

2010-01-01

This study evaluates the knowledge of nurses working in intensive care units concerning recommendations for the proper administration of medication through nasogastric and enteral tubes. This exploratory-descriptive study with a quantitative approach was carried out with 49 nurses in an intensive care unit of a tertiary hospital in Fortaleza, CE, Brazil. A total of 36.7% of nurses reported they disregard the dosage forms provided by the pharmacy at the time of administering the medication through tubes. Metal, wood, or a plastic mortar is the method most frequently reported (42.86%) for crushing prescribed solid forms; 32.65% leave the drugs in 20 ml of water until dissolved; 65.3% place the responsibility for choosing the pharmaceutical formulation and its correlation with the tube site, either into the stomach or into the intestine, on the physician. The results indicate there is a gap between specific literature on medication administered through tubes and knowledge of nurses on the subject.

Comparison of complication rates in dogs with nasoesophageal versus nasogastric feeding tubes.

PubMed

Yu, Melissa K; Freeman, Lisa M; Heinze, Cailin R; Parker, Valerie J; Linder, Deborah E

2013-01-01

To compare complication rates between nasoesophageal (NE) and nasogastric (NG) feeding tubes in dogs. Retrospective study. University referral veterinary hospital. A total of 46 dogs that were fed through a NE (n = 28) or NG (n = 18) tube between January 2007 and December 2011 and that also had either thoracic radiography or computed tomography performed so that location of the distal tip of the tube in either the esophagus or stomach could be confirmed. None. The medical record of each eligible case was reviewed and data recorded included signalment, underlying disease, body weight, body condition score, medications, duration of feeding, diet used, and complications observed (ie, vomiting, regurgitation, diarrhea, early tube removal, clogged tube, epistaxis, pulmonary aspiration, hyperglycemia, and refeeding syndrome). Dogs with NE tubes were significantly younger than dogs with NG tubes (P = 0.03) but there were no other significant differences in signalment, underlying disease, medications, duration of anorexia, percent of resting energy requirement achieved, or change in weight during tube feeding. There also was no significant difference between the NE and NG groups for any of the recorded complications. Significantly fewer dogs in the NE group died or were euthanized (3/28) compared to the NG group (7/18; P = 0.02) but outcome was not associated with age, underlying disease, or any of the recorded tube complications. This study did not identify a difference in complication rate between NE and NG feeding tubes in dogs. Additional studies are required to determine the optimal terminal location of feeding tubes in dogs. © Veterinary Emergency and Critical Care Society 2013.

Extraction of the plasticizers diethylhexylphthalate and polyadipate from polyvinylchloride nasogastric tubes through gastric juice and feeding solution.

PubMed

Subotic, Ulrike; Hannmann, Torsten; Kiss, Matthias; Brade, Joachim; Breitkopf, Katja; Loff, Steffan

2007-01-01

Except for polyadipate, which is used as an alternative in polyvinylchloride (PVC) feeding tubes, diethylhexylphthalate (DEHP) is the plasticizer used almost exclusively in PVC medical products. A clear response to the chronic intake of DEHP has been shown in several organ systems from different species. In the present study, we compared the extraction of DEHP and polyadipate from PVC gastric tubes. An in vivo setting was simulated. We used 5 cm of PVC nasogastric tubes containing DEHP or polyadipate, which were incubated with gastric juice for 1 week and a feeding solution for 4 weeks. The leakage of these plasticizers was measured daily in the gastric juice group and weekly in the feeding solution group. The amount of plasticizer extracted was compared between groups and days. In the feeding solution group, the extraction of DEHP ranged from 200 to 542 microg after 1 week and from 660 to 1700 microg after 4 weeks. The extraction of polyadipate was 10 times lower than that of DEHP. In the gastric juice group, extracted DEHP ranged from 635 to 1043 microg, whereas the extraction of polyadipate was 100 times lower. Within 1 week, the extraction of DEHP from a 5-cm PVC tube reaches up to 1 mg. Extrapolated, this represents an in vivo load of up to 4 mg. The load accumulated by a newborn in an intensive care unit can therefore easily reach several milligrams of DEHP per day. Polyadipate nasogastric tubes may therefore be an alternative and help to reduce the daily load of DEHP.

[Study of bacterial flora in the oral cavity and stomach of elderly patients receiving nasogastric tube feeding].

PubMed

Matsuura, T; Suzuki, K; Yamakoshi, M; Yamamoto, T; Yamamoto, T; Yoshitomo, K; Tonegawa, K; Ariga, K; Odawara, F

1997-05-01

To investigate the significance of oropharyngeal flora and gastric flora in elderly patients receiving nasogastric tube feeding, throat secretions and gastric aspirates were cultured and the pH of the latter was measured. Of 116 bacterial isolates from throat secretions of 27 elderly patients, 30 were beta-streptococci and 28 were Pseudomonas aeruginosa. Bacteria isolated from gastric aspirates numbered 86 and 24 (27.9%) of them were the same species as those found in the throat secretions. Patients with gastric pH were below 3.5 had significantly lower concentrations of gram-negative bacili in gastric aspirates. We also studied oropharyngeal flora in 33 elderly patients who were admitted to Nagoyashi Koseiin Geriatric Hospital. The major bacterial isolates from throat swabs of bedridden patients were gram-negative bacilli and beta-streptococci, especially group B streptococci (GBS). We measured the level of antibody to GBS in these patients. Those from whom GBS were isolated had high titers. These results suggest that in elderly patients receiving enteral nasogastric) tube feeding, large numbers of bacteria colonize the oral cavity and stomach. The measurement of type-specific antibody to GBS may be useful in managing such patients.

Interventions for maintaining nasogastric feeding after stroke: An integrative review of effectiveness and acceptability.

PubMed

Mahoney, Catherine; Veitch, Linda

2018-02-01

To investigate the effectiveness and acceptability of interventions for maintaining nasogastric tubes in adult stroke patients. Internationally, incidence of cerebral vascular disease continues to increase and stroke is the largest cause of complex disability in adults. Dysphagia is common following a stroke which necessitates feeding via a nasogastric tube. Nasogastric tubes are not well tolerated by stroke patients and may be frequently dislodged. Hence, interventions such as tape, the nasal bridle/loop or hand mittens may be used to maintain nasogastric tube position. However, evidence around the effectiveness and acceptability of these interventions has not been reviewed and synthesised. Integrative literature review. Database searches in MEDLINE, PubMed, CINAHL, Scopus, Cochrane and EMBASE; manual reference list searches. Seven studies met the eligibility criteria and were included in the review. Evidence for the effectiveness of nasal bridle/loop and hand mittens to maintain nasogastric tube position in patients after a stroke is spare and methodologically poor, and especially limited around hand mittens use. There is insufficient evidence about the acceptability of both nasal bridle/loop and hand mittens among stroke patients. Current clinical practice is underpinned by assumptions around the acceptability of nasal bridle/loop and hand mittens to secure nasogastric tubes. This results in reliance on consensual judgement between professional, patients and their families to guide their use among individuals with dysphagia after stroke. Further research is required to assess the effectiveness of hand mittens and acceptability of both nasal bridle/loop and hand mittens among stroke patients to inform guideline development. Given the lack of evidence on the acceptability of hand mittens and nasal bridle/loop among stroke patients to inform evidence-based guidelines and protocols, healthcare professionals should reach consensus on their use by exercising clinical

Discovering Innovation at the Intersection of Undergraduate Medical Education, Human Factors, and Collaboration: The Development of a Nasogastric Tube Safety Pack.

PubMed

Taylor, Natalie; Bamford, Thomas; Haindl, Cornelia; Cracknell, Alison

2016-04-01

Significant deficiencies exist in the knowledge and skills of medical students and residents around health care quality and safety. The theory and practice of quality and safety should be embedded into undergraduate medical practice so that health care professionals are capable of developing interventions and innovations to effectively anticipate and mitigate errors. Since 2011, Leeds Medical School in the United Kingdom has used case study examples of nasogastric (NG) tube patient safety incidents within the undergraduate patient safety curriculum. In 2012, a medical undergraduate student approached a clinician with an innovative idea after undertaking an NG tubes root cause analysis case study. Simultaneously, a separate local project demonstrated low compliance (11.6%) with the United Kingdom's National Patient Safety Agency NG tubes guideline for use of the correct method to check tube position. These separate endeavors led to interdisciplinary collaboration between a medical student, health care professionals, researchers, and industry to develop the Initial Placement Nasogastric Tube Safety Pack. Human factors engineering was used to inform pack design to allow guideline recommendations to be accessible and easy to follow. A timeline of product development, mapped against key human factors and medical device design principles used throughout the process, is presented. The safety pack has since been launched in five UK National Health Service (NHS) hospitals, and the pack has been introduced into health care professional staff training for NG tubes. A mixed-methods evaluation is currently under way in five NHS organizations.

Continuous nasogastric milk feeding versus intermittent bolus milk feeding for premature infants less than 1500 grams.

PubMed

Premji, Shahirose S; Chessell, Lorraine

2011-11-09

Milk feedings can be given via nasogastric tube either intermittently, typically over 10 to 20 minutes every two or three hours, or continuously, using an infusion pump. Although theoretical benefits and risks of each method have been proposed, effects on clinically important outcomes remain uncertain. To examine the evidence regarding the effectiveness of continuous versus intermittent bolus nasogastric milk feeding in premature infants less than 1500 grams. Searches were performed of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 3, 2011), MEDLINE, CINAHL and HealthSTAR up to July 2011. Randomised and quasi-randomised clinical trials comparing continuous versus intermittent bolus nasogastric milk feeding in premature infants less than 1500 grams. Two review authors independently assessed all trials for relevance and methodologic quality. The standard methods of the Cochrane Neonatal Review Group were used to extract data. Overall, the seven included trials, involving 511 infants, found no differences in time to achieve full enteral feeds between feeding methods (weighted mean difference (WMD) 2 days; 95% CI -0.3 to 3.9) . In the subgroup analysis of those studies comparing continuous nasogastric versus intermittent bolus nasogastric milk feedings the findings remained unchanged (WMD 2 days, 95% CI -0.4 to 4.1). There was no significant difference in somatic growth and incidence of NEC between feeding methods irrespective of tube placement. One study noted a trend toward more apneas during the study period in infants fed by the continuous tube feeding method compared to those fed by intermittent feedings delivered predominantly by orogastric tube placements [mean difference (MD) 14.0 apneas during study period; 95% CI -0.2 to 28.2]. In subgroup analysis based on weight groups, one study suggested that infants less than 1000 grams and 1000 to 1250 grams birth weight gained weight faster when fed by the continuous

Cooperative learning using simulation to achieve mastery of nasogastric tube insertion.

PubMed

Cason, Melanie Leigh; Gilbert, Gregory E; Schmoll, Heidi H; Dolinar, Susan M; Anderson, Jane; Nickles, Barbara Marshburn; Pufpaff, Laurie A; Henderson, Ruth; Lee, Frances Wickham; Schaefer, John J

2015-03-01

Traditionally, psychomotor skills training for nursing students involves didactic instruction followed by procedural review and practice with a task trainer, manikin, or classmates. This article describes a novel method of teaching psychomotor skills to associate degree and baccalaureate nursing students, Cooperative Learning Simulation Skills Training (CLSST), in the context of nasogastric tube insertion using a deliberate practice-to-mastery learning model. Student dyads served as operator and student learner. Automatic scoring was recorded in the debriefing log. Student pairs alternated roles until they achieved mastery, after which they were assessed individually. Median checklist scores of 100% were achieved by students in both programs after one practice session and through evaluation. Students and faculty provided positive feedback regarding this educational innovation. CLSST in a deliberate practice-to-mastery learning paradigm offers a novel way to teach psychomotor skills in nursing curricula and decreases the instructor-to-student ratio. Copyright 2015, SLACK Incorporated.

Implementation of an electromagnetic imaging system to facilitate nasogastric and post-pyloric feeding tube placement in patients with and without critical illness.

PubMed

Windle, E M; Beddow, D; Hall, E; Wright, J; Sundar, N

2010-02-01

Artificial nutrition support is required to optimise nutritional status in many patients. Traditional methods of placing feeding tubes may incur clinical risk and financial costs. A technique facilitating placement of nasogastric and post-pyloric tubes via electromagnetic visual guidance may reduce the need for X-ray exposure, endoscopy time and the use of parenteral nutrition. The present study aimed to audit use of such a system at initial implementation in patients within an acute NHS Trust. A retrospective review was undertaken of dietetic and medical records for the first 14 months of using the Cortrak system. Data were collected on referral origin, preparation of the patient prior to insertion, placement success rates and need for X-ray. Cost analysis was also performed. Referrals were received from primary consultants or consultant intensivists, often on the advice of the dietitian. Fifty-nine percent of patients received prokinetic therapy at the time of placement. Thirty-nine tube placements were attempted. Sixty-nine percent of referrals for post-pyloric tube placement resulted in successful placement. X-ray films were requested for 22% of all attempted post-pyloric placements. Less than half of nasogastric tubes were successfully passed, although none of these required X-ray confirmation. The mean cost per tube insertion attempt was 111 pounds. This system confers advantages, particularly in terms of post-pyloric tube placement, even at this early stage of implementation. A reduction in clinical risk and cost avoidance related to X-ray exposure, the need for endoscopic tube placement and parenteral nutrition have been achieved. The implementation of this system should be considered in other centres.

Confirmation of nasogastric tube position by pH testing.

PubMed

Taylor, S J; Clemente, R

2005-10-01

In 2004, the Medicines and Healthcare products Regulatory Agency (MHRA) advised that nasogastric (NG) tube position should be confirmed using pH strips or paper. However, gastric pH is raised by the use of H2-blockers and proton-pump inhibitors (PPIs) potentially producing false negative pH tests resulting in delayed feeding. In addition, colorimetric differentiation using pH strips may be more prone to bias and inaccuracy than direct pH measurements largely used to establish the threshold. To quantify this problem a 1 day survey of all the patients requiring NG and nasointestinal (NI) feeding was undertaken, to establish the numbers of patients receiving H2-Blockers or PPIs, with or without a safe swallow and the methods currently being used to confirm tube positioning. A second observational study was performed to establish the accuracy of six pH strips available to NHS trusts against four unlabelled pH solutions. Forty-two per cent of patients receiving NG feeding were on H2-blockers or PPIs, including 13% who had a safe swallow for acidic drinks that could be subsequently aspirated to confirm position. In the second study 'testers' correctly identified pH's 3, 4, 5 and 6 with Mackery-Nagel 0-6, BDH 0-6 and 0-14 strips but overestimated pH 4 as pH 5 with Johnson 0-11 paper, underestimated pH 6 as pH 5 with Pehanon 0-12 paper and with Litmus classified pH 3-5 as acid (all), but half also classified pH 6 as acid. Theoretically 29% of NG tube positions could not be confirmed by pH testing because of the usage of PPIs or H2-blockers and lack of swallow. Some pH strips are either inaccurate or their result misinterpreted by staff. Large surveys and trials of the actual efficacy and accuracy of pH testing are required.

[Nasogastric rehydration for treating children with gastroenteritis].

PubMed

Rébeillé-Borgella, B; Barbier, C; Moussaoui, R; Faisant, A; Michard-Lenoir, A-P; Rubio, A

2017-06-01

When oral rehydration is not feasible, enteral rehydration via the nasogastric route has been the ESPGHAN recommended method of rehydration since 2008, rather than intravenous rehydration (IVR), for children with acute gastroenteritis. However, these recommendations are rarely followed in France. Since 2011, in case of failure of oral rehydration, enteral rehydration has been used as a first-line therapy in the Children's Emergency Department at the Grenoble-Alpes University Hospital. The aims of the study were to compare the length of the hospital stay, the duration of initial rehydration, and the incidence of complications and failure with the use of enteral nasogastric versus intravenous rehydration. This study compared two cohorts of children (<3 years of age) with mild-to-moderate dehydration caused by acute gastroenteritis and failure of rehydration via the oral route. The first group (winter 2010-2011) was managed according to the previous protocol (intravenous rehydration). The second group (winter 2011-2012) was managed according the new protocol (nasogastric tube rehydration [NGR]). The rest of the gastroenteritis management was identical in both groups. A total of 132 children were included, 65 were treated with nasogastric tube rehydration (NGR) and 67 with intravenous rehydration. There was a significant reduction in the duration of hospitalization in the post-emergency unit in the NGR group: 23.6h vs 40.1h (P<0.05). The duration of initial rehydration was also significantly reduced (10.5h vs 22.0h). There was no significant difference regarding serious adverse events. However, the NGR group presented more mild adverse events (22 vs 7, P<0.05) and more treatment failures (15.3% vs 3%, P=0.013). Nasogastric rehydration reduces the duration of rehydration and the length of the hospital stay without increasing the incidence of serious adverse events for dehydrated children hospitalized for acute gastroenteritis. Copyright © 2017 Elsevier Masson SAS. All

Gastrostomy versus nasogastric tube feeding for chemoradiation patients with head and neck cancer: the TUBE pilot RCT.

PubMed

Paleri, Vinidh; Patterson, Joanne; Rousseau, Nikki; Moloney, Eoin; Craig, Dawn; Tzelis, Dimitrios; Wilkinson, Nina; Franks, Jeremy; Hynes, Ann Marie; Heaven, Ben; Hamilton, David; Guerrero-Urbano, Teresa; Donnelly, Rachael; Barclay, Stewart; Rapley, Tim; Stocken, Deborah

2018-04-01

Approximately 9000 new cases of head and neck squamous cell cancers (HNSCCs) are treated by the NHS each year. Chemoradiation therapy (CRT) is a commonly used treatment for advanced HNSCC. Approximately 90% of patients undergoing CRT require nutritional support via gastrostomy or nasogastric tube feeding. Long-term dysphagia following CRT is a primary concern for patients. The effect of enteral feeding routes on swallowing function is not well understood, and the two feeding methods have, to date (at the time of writing), not been compared. The aim of this pilot randomised controlled trial (RCT) was to compare these two options. This was a mixed-methods multicentre study to establish the feasibility of a RCT comparing oral feeding plus pre-treatment gastrostomy with oral feeding plus as-required nasogastric tube feeding in patients with HNSCC. Patients were recruited from four tertiary centres treating cancer and randomised to the two arms of the study (using a 1 : 1 ratio). The eligibility criteria were patients with advanced-staged HNSCC who were suitable for primary CRT with curative intent and who presented with no swallowing problems. The primary outcome was the willingness to be randomised. A qualitative process evaluation was conducted alongside an economic modelling exercise. The criteria for progression to a Phase III trial were based on a hypothesised recruitment rate of at least 50%, collection of outcome measures in at least 80% of those recruited and an economic value-of-information analysis for cost-effectiveness. Of the 75 patients approached about the trial, only 17 consented to be randomised [0.23, 95% confidence interval (CI) 0.13 to 0.32]. Among those who were randomised, the compliance rate was high (0.94, 95% CI 0.83 to 1.05). Retention rates were high at completion of treatment (0.94, 95% CI 0.83 to 1.05), at the 3-month follow-up (0.88, 95% CI 0.73 to 1.04) and at the 6-month follow-up (0.88, 95% CI 0.73 to 1.04). No serious adverse

Nasogastric tube versus gastrostomy tube for gastric decompression in abdominal surgery: a prospective, randomized trial comparing patients' tube-related inconvenience.

PubMed

Hoffmann, S; Koller, M; Plaul, U; Stinner, B; Gerdes, B; Lorenz, W; Rothmund, M

2001-11-01

Perioperative decompression of the stomach is still a common procedure and can be achieved using either nasogastric tubes (NTs) or gastrostomy tubes (GTs). While both procedures appear to be equally effective, some authors believe that NTs are less convenient for patients than GTs. However, to date, no reliable prospective data are available on this issue. We conducted a prospective, randomized trial comparing NTs versus GTs with a total of 110 patients undergoing elective colon surgery. The primary outcome measure was the patient's tube-related inconvenience and pain, assessed in a standardized interview on day 2 after surgery and quantified by means of a visual-analog scale (VAS). A questionnaire including the EORTC QLQ-C30 and additional items regarding retrospective tube-related judgements was administered on the day of discharge and 4 weeks after discharge. Secondary endpoints were the therapy-related morbidity and general complications. When patients were asked which of their drainage tubes (all patients had three or four drainage tubes, such as decompression drains, urinary drains, central venous line) was most inconvenient, 43% (CI 33-53%) in the NT group reported that the NT was most inconvenient, while only 4% (CI 1-10%) of the GT patients judged the GT most inconvenient ( P<0.001, Chi(2) test). This effect was also found in VAS ratings of inconvenience and discomfort ( P<0.01). Also postoperatively (p.o.), NT patients evidenced less preference for their tube system (day 2 p.o.: 71%, CI 61-80%; 4 weeks p.o.: 66%, CI 56-75%) than did GT patients (day 2 p.o.: 94%, CI 88-98%; 4 weeks p.o.: 91% CI 84-96%); again, these differences were statistically significant ( P<0.02; Chi(2) test). No differences between groups emerged regarding global quality of life or conventional clinical outcomes. This prospective randomized trial supports the clinical observation that NT causes more subjective inconvenience than GT. In cases when a prolonged postoperative ileus is

Underwater-seal nasogastric tube drainage to relieve gastric distension caused by air swallowing.

PubMed

Solomon, A W; Bramall, J C; Ball, J

2011-02-01

Air swallowing can occur as a psychogenic phenomenon, because of abnormal anatomy, or during non-invasive positive pressure ventilation. Gross distension of the stomach with air can have severe consequences for the respiratory and gastrointestinal systems. We report the case of a 62-year-old man with severe dynamic hyperinflation due to chronic obstructive pulmonary disease, who developed respiratory failure requiring intubation a few hours after radical prostatectomy. Following a percutaneous tracheostomy and weaning of sedation on day six, his abdomen began to enlarge progressively. X-rays revealed massive gastric distension due to air swallowing, which continued despite all efforts to optimise therapy. The use of an underwater seal drainage system on a nasogastric tube improved ventilation and ultimately aided weaning from mechanical support. © 2010 The Authors. Anaesthesia © 2010 The Association of Anaesthetists of Great Britain and Ireland.

Gastric digestion of α-lactalbumin in adult human subjects using capsule endoscopy and nasogastric tube sampling.

PubMed

Sullivan, Louise M; Kehoe, Joseph J; Barry, Lillian; Buckley, Martin J M; Shanahan, Fergus; Mok, K H; Brodkorb, André

2014-08-28

In the present study, structural changes in the milk protein α-lactalbumin (α-LA) and its proteolysis were investigated for the potential formation of protein-fatty acid complexes during in vivo gastric digestion. Capsule endoscopy allowed visualisation of the digestion of the test drinks, with nasogastric tubes allowing sampling of the gastric contents. A total of ten healthy volunteers had nasogastric tubes inserted into the stomach and ingested test drinks containing 50 g/l of sucrose and 25 g/l of α-LA with and without 4 g/l of oleic acid (OA). The samples of gastric contents were collected for analysis at 3 min intervals. The results revealed a rapid decrease in the pH of the stomach of the subjects. The fasting pH of 2·31 (SD 1·19) increased to a pH maxima of pH 6·54 (SD 0·29) after ingestion, with a subsequent decrease to pH 2·22 (SD 1·91) after 21 min (n 8). Fluorescence spectroscopy and Fourier transform IR spectroscopy revealed partial protein unfolding, coinciding with the decrease in pH below the isoelectric point of α-LA. The activity of pepsin in the fasting state was found to be 39 (SD 12) units/ml of gastric juice. Rapid digestion of the protein occurred: after 15 min, no native protein was detected using SDS-PAGE; HPLC revealed the presence of small amounts of native protein after 24 min of gastric digestion. Mirocam® capsule endoscopy imaging and video clips (see the online supplementary material) revealed that gastric peristalsis resulted in a heterogeneous mixture during gastric digestion. Unfolding of α-LA was observed during gastric transit; however, there was no evidence of a cytotoxic complex being formed between α-LA and OA.

Nasogastric feeding tube located in the lung. SENSAR case of the trimester.

PubMed

2017-01-01

A clinical case is presented that was communicated to Spanish Notification System on Safety in Anaesthesia and Recovery (SENSAR). Using this communication and its analysis, a strategy is obtained in order to reduce the risks associated with the insertion of a nasogastric tube (NST) for enteral nutrition in adult patients in the post-surgical recovery unit. A description of the incident is presented, an analysis of its causes, and the measures that were introduced in order to avoid similar incidents in the future, as well as to promote a safety culture in the organisation. A description of associated incidents registered in SENSAR is also given. The aim of this work is to describe, analyse and introduce safety measures arising from incidents notified to SENSAR, associated with the insertion and checking of the nutrition NST in adult patients in the post-surgical recovery unit. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Conservative Surgical Approach to Restore Necrotic Columella in Patients Undergoing Neonatal Usage of Nasogastric Tube.

PubMed

Inchingolo, Francesco; Abenavoli, Fabio Massimo; De Angelis, Francesca; Orefici, Alessandro; Santacroce, Luigi; Dipalma, Gianna

2017-01-01

A common complication, related to the use of nasogastric tube during the 1 st day of life, is the necrosis of the columella. Esthetic damage in the early age typically leads to a healing request with very high result expectations. We aimed to develop and use an innovative surgical technique. We used our technique in four cases. Our technique requires two flaps designed with two paramedian release incisions. The two flaps will be sutured to what remains of the fibrous septum; finally, the two flaps will be sutured together in the medial region. Postoperative course was devoid of any complication. All patients gained esthetic improvements and an increase in the volume of the columella on the sagittal and frontal planes. This technique allows a conservative approach with low donor site morbidity and rapid postoperative course.

Retrospective analysis of insulin responses to standard dosed oral glucose tests (OGTs) via naso-gastric tubing towards definition of an objective cut-off value.

PubMed

Warnken, Tobias; Delarocque, Julien; Schumacher, Svenja; Huber, Korinna; Feige, Karsten

2018-01-19

Insulin dysregulation (ID) with basal or postprandial hyperinsulinemia is one of the key findings in horses and ponies suffering from the equine metabolic syndrome (EMS). Assessment of ID can easily be performed in clinical settings by the use of oral glucose challenge tests. Oral glucose test (OGT) performed with 1 g/kg bodyweight (BW) glucose administered via naso-gastric tube allows the exact administration of a defined glucose dosage in a short time. However, reliable cut-off values have not been available so far. Therefore, the aim of the study was to describe variations in insulin response to OGT via naso-gastric tubing and to provide a clinical useful cut-off value for ID when using the insulin quantification performed with an equine-optimized insulin enzyme-linked immunosorbent assay. Data visualization revealed no clear separation in the serum insulin concentration of insulin sensitive and insulin dysregulated horses during OGT. Therefore, a model based clustering method was used to circumvent the use of an arbitrary limit for categorization. This method considered all data-points for the classification, taking into account the individual insulin trajectory during the OGT. With this method two clusters were differentiated, one with low and one with high insulin responses during OGT. The cluster of individuals with low insulin response was consistently detected, independently of the initialization parameters of the algorithm. In this cluster the 97.5% quantile of insulin is 110 µLU/mL at 120 min. We suggest using this insulin concentration of 110 µLU/mL as a cut-off value for samples obtained at 120 min in OGT. OGT performed with 1 g/kg BW glucose and administration via naso-gastric tubing can easily be performed under clinical settings. Application of the cut-off value of 110 µLU/mL at 120 min allows assessment of ID in horses.

Rivaroxaban crushed tablet suspension characteristics and relative bioavailability in healthy adults when administered orally or via nasogastric tube.

PubMed

Moore, Kenneth T; Krook, Mark A; Vaidyanathan, Seema; Sarich, Troy C; Damaraju, C V; Fields, Larry E

2014-07-01

Because some patients have difficulty swallowing a whole tablet, we investigated the relative bioavailability of a crushed 20 mg rivaroxaban tablet and of 2 alternative crushed tablet dosing strategies. Stability and nasogastric (NG) tube adsorption characteristics of a crushed rivaroxaban tablet were assessed. Then, in 55 healthy adults, relative bioavailability of rivaroxaban administered orally as a whole tablet (Reference [Whole-Oral]), crushed tablet in applesauce suspension (Crushed-Oral), or crushed tablet in water suspension via NG tube (Crushed-NG) were determined. There were no significant changes in mean percent of non-degraded rivaroxaban recovered over 4 hours from crushed tablet suspensions (>98.4% recovery across all suspensions and time points) or after NG tube exposure (recovery: 99.1% for silicone and 98.9% for polyvinyl chloride NG tubes). Relative bioavailability was similar between Crushed-Oral and Reference dosing (Cmax and AUC∞ were within the 80-125% bioequivalence limits). Relative bioavailability was also similar between the Crushed-NG and Reference dosing (AUC∞ was within bioequivalence limits; Cmax [90% CI range: 78.5-85.8%] was only slightly below the 80% lower bioequivalence limit). A crushed rivaroxaban tablet was stable and when administered orally or via NG tube, displayed similar relative bioavailability compared to a whole tablet administered orally. © 2014, The American College of Clinical Pharmacology.

[Nasogastric tube feeding in bulimia. Controlled study with follow-up at 3 months].

PubMed

Rigaud, Daniel; Brayer, Véronique; Biton-Jélic, Violaine; Païs, Vanessa; Pennacchio, Hélène; Brun, Jean-Marcel

2007-10-01

Few effective treatments are available for severe forms of bulimia nervosa, which are accompanied by malnutrition, anxiety, and depressive mood. We previously showed in an open study that nasogastric tube feeding (TF) reduced binges and purging in patients with anorexia nervosa. This prospective randomized trial compared bulimia patients in two treatment groups: one group received TF at home, together with psychotherapy, nutritional counseling and a support group while the control group received only psychotherapy, nutritional counseling, and a support group. Patients in the first group underwent TF for 8 weeks (exclusively for 10 days and associated with meals thereafter). Assessment was based on clinical examination, laboratory results, and a variety of questionnaires (our in-house instrument for measuring binge and vomiting episodes, eating disorder inventory, Beck's depression inventory and the Hamilton rating scale for anxiety), all performed at the onset of treatment and at 8 days, 8 weeks (i.e., the end of TF), and 3 months after treatment began. Binges and vomiting disappeared faster and more frequently in TF patients than in the control group: 65% versus 29% (p<0.01). Three months later, these remained less frequent in the TF group than among controls (52% versus 33%, p=0.064). Nutritional status, depression, and anxiety improved more among the TF than control subjects (p<0.05). Tube feeding was effective in these patients with bulimia nervosa, reducing the number of binge and vomiting episodes and improving nutritional status and mood.

The molecular characterisation of Escherichia coli K1 isolated from neonatal nasogastric feeding tubes.

PubMed

Alkeskas, Aldukali; Ogrodzki, Pauline; Saad, Mohamed; Masood, Naqash; Rhoma, Nasreddin R; Moore, Karen; Farbos, Audrey; Paszkiewicz, Konrad; Forsythe, Stephen

2015-10-26

The most common cause of Gram-negative bacterial neonatal meningitis is E. coli K1. It has a mortality rate of 10-15 %, and neurological sequelae in 30-50 % of cases. Infections can be attributable to nosocomial sources, however the pre-colonisation of enteral feeding tubes has not been considered as a specific risk factor. Thirty E. coli strains, which had been isolated in an earlier study, from the residual lumen liquid and biofilms of neonatal nasogastric feeding tubes were genotyped using pulsed-field gel electrophoresis, and 7-loci multilocus sequence typing. Potential pathogenicity and biofilm associated traits were determined using specific PCR probes, genome analysis, and in vitro tissue culture assays. The E. coli strains clustered into five pulsotypes, which were genotyped as sequence types (ST) 95, 73, 127, 394 and 2076 (Achman scheme). The extra-intestinal pathogenic E. coli (ExPEC) phylogenetic group B2 ST95 serotype O1:K1:NM strains had been isolated over a 2 week period from 11 neonates who were on different feeding regimes. The E. coli K1 ST95 strains encoded for various virulence traits associated with neonatal meningitis and extracellular matrix formation. These strains attached and invaded intestinal, and both human and rat brain cell lines, and persisted for 48 h in U937 macrophages. E. coli STs 73, 394 and 2076 also persisted in macrophages and invaded Caco-2 and human brain cells, but only ST394 invaded rat brain cells. E. coli ST127 was notable as it did not invade any cell lines. Routes by which E. coli K1 can be disseminated within a neonatal intensive care unit are uncertain, however the colonisation of neonatal enteral feeding tubes may be one reservoir source which could constitute a serious health risk to neonates following ingestion.

Gastro-oesophageal reflux in mechanically ventilated patients: effects of an oesophageal balloon.

PubMed

Orozco-Levi, M; Félez, M; Martínez-Miralles, E; Solsona, J F; Blanco, M L; Broquetas, J M; Torres, A

2003-08-01

Gastro-oesophageal reflux (GOR) and bronchoaspiration of gastric content are risk factors linked with ventilator-associated pneumonia. This study was aimed at evaluating the effect of a nasogastric tube (NGT) incorporating a low-pressure oesophageal balloon on GOR and bronchoaspiration in patients receiving mechanical ventilation. Fourteen patients were studied in a semi-recumbent position for 2 consecutive days. Inflation or deflation of the oesophageal balloon was randomised. Samples of blood, gastric content, and oropharyngeal and bronchial secretions were taken every 2 h over a period of 8 h. A radioactively labelled nutritional solution was continuously administered through the NGT. The magnitude of both the GOR and bronchoaspiration was measured by radioactivity counting of oropharyngeal and bronchial secretion samples, respectively. Inflation of the oesophageal balloon resulted in a significant decrease of both GOR and bronchoaspiration of gastric content. This protective effect was statistically significant from 4 h following inflation throughout the duration of the study. This study demonstrates that an inflated oesophageal balloon delays and decreases gastro-oesophageal and bronchial aspiration of gastric content in patients carrying a nasogastric tube and receiving enteral nutrition during mechanical ventilation. Although the method was found to be safe when applied for 8 h, longer times should be considered with caution.

Relative bioavailability of single doses of prolonged-release tacrolimus administered as a suspension, orally or via a nasogastric tube, compared with intact capsules: a phase 1 study in healthy participants.

PubMed

Undre, Nasrullah; Dickinson, James

2017-04-04

Tacrolimus, an immunosuppressant widely used in solid organ transplantation, is available as a prolonged-release capsule for once-daily oral administration. In the immediate postsurgical period, if patients cannot take intact capsules orally, tacrolimus therapy is often initiated as a suspension of the capsule contents, delivered orally or via a nasogastric tube. This study evaluated the relative bioavailability of prolonged-release tacrolimus suspension versus intact capsules in healthy participants. A phase 1, open-label, single-dose, cross-over study. A single clinical research unit. In total, 20 male participants, 18-55 years old, entered and completed the study. All participants received nasogastric administration of tacrolimus 10 mg suspension in treatment period 1, with randomisation to oral administration of suspension or intact capsules in periods 2 and 3. Blood concentration-time profile over 144 hours was used to estimate pharmacokinetic parameters. Primary end point: relative bioavailability of prolonged-release intact capsule versus oral or nasogastric administration of prolonged-release tacrolimus suspension (area under the concentration-time curve (AUC) from time 0 to infinity post-tacrolimus dose (AUC 0-∞ ); AUC measured until the last quantifiable concentration (AUC 0-tz ); maximum observed concentration (C max ); time to C max (T max )). Tolerability was assessed throughout the study. Relative bioavailability of prolonged-release tacrolimus suspension administered orally was similar to intact capsules, with a ratio of least-square means for AUC 0-tz and AUC 0-∞ of 1.05 (90% CI 0.96 to 1.14). Bioavailability was lower with suspension administered via a nasogastric tube versus intact capsules (17%; ratio 0.83; CI 0.76 to 0.92). C max was higher for oral and nasogastric suspension (30% and 28%, respectively), and median T max was shorter (difference 1.0 and 1.5 hours postdose, respectively) versus intact capsules (2.0 hours). Single 10�

Accuracy of biochemical markers for predicting nasogastric tube placement in adults--a systematic review of diagnostic studies.

PubMed

Fernandez, Ritin S; Chau, Janita Pak-Chun; Thompson, David R; Griffiths, Rhonda; Lo, Hoi-Shan

2010-08-01

The objective of this study was to investigate the diagnostic performance of biochemical tests used to determine placement of nasogastric (NG) tubes after insertion in adults. A systematic review of diagnostic studies was undertaken. A literature search of the bibliographic databases and the World Wide Web was performed to locate original diagnostic studies in English or Chinese on biochemical markers for detecting NG tube location. Studies in which one or more different tests were evaluated with a reference standard, and diagnostic values were reported or could be calculated were included. Two reviewers independently checked all abstracts and full text studies for inclusion criteria. Included studies were assessed for their quality using the QUADAS tool. Study features and diagnostic values were extracted from the included studies. Of the 10 studies included in this review, seven investigated the diagnostic accuracy of pH, one investigated the diagnostic accuracy of pH and bilirubin respectively, two a combination of pH and bilirubin and one a combination of pH, pepsin and trypsin levels in identifying NG tube location. All studies used X-rays as the reference standard for comparison. Pooled results demonstrated that a pH of tubes located in the stomach. However, a pH value of tubes in intestine. However, the ability of the test to correctly identify gastric placement of feeding tubes was relatively low (sensitivity<0.90). Due to the heterogeneity of the studies and small sample sizes, conclusions about the diagnostic performance of the different tests cannot be drawn. Better designed studies exploring the accuracy of diagnostic tests are needed to improve

A Comparative Analysis of Nasogastric and Intravenous Fluid Resuscitation in Patients with Malignant Obstructive Jaundice Prior to Endoscopic Biliary Drainage

PubMed Central

Baghel, Kavita; Raj, Saloni; Awasthi, Induja; Gupta, Vishal; Chandra, Abhijit; Srivastava, Rajeshwar Nath

2013-01-01

Background: An alternative to intravenous is nasogastric fluid administration through normal functioning gut. Though not common, this practice has significance in mass causalities and elective situations. Aim: The study was designed to compare nasogastric and intravenous fluid resuscitation in malignant obstructive jaundice (OJ) and their effect on endotoxemia. Materials and Methods: Sixty patients with malignant OJ undergoing endoscopic biliary drainage were randomized into two groups. A total of 4 l of fluid (Ringer's lactate) was administered to Group A through nasogastric tube and to Group B through intravenous route for 48 h. Vital parameters, serum bilirubin, serum creatinine, creatinine clearance rate, electrolytes, and endotoxemia were monitored. Results: Significant improvement in blood pressure (Group A, P = 0.014; Group B, P = 0.020) and significant decrease in serum bilirubin level (Group A, P = 0.001; Group B, P > 0.0001) was observed in both groups after resuscitation. Significantly decreased (P = 0.036) post hydration endotoxin level was observed in Group A as compared to Group B. Febrile events were significantly higher (P = 0.023) in Group B as compared to Group A (6 vs 0). Electrolyte abnormalities were found more in Group B, however statistically insignificant. Conclusion: In OJ patient undergoing biliary drainage, preoperative fluid resuscitation through nasogastric tube may be helpful in reducing postoperative septic complications and endotoxemia. PMID:24251269

Evaluation of crushed ticagrelor tablet doses: recovery following crushing and naso-gastric tube passage ex vivo.

PubMed

Crean, Barry; Finnie, Cindy; Crosby, Anna

2013-06-01

Orally available ticagrelor in combination with low-dose aspirin (75-100 mg/day) is indicated for adult patients with acute coronary syndromes. However, patients with swallowing difficulties may be unable to consume the currently available 90-mg tablet. It is hypothesized that ticagrelor could be given to this patient cohort as a crushed dose administered either orally or via a naso-gastric (NG) tube. To investigate the potential use of crushed ticagrelor tablets (90- and 180-mg doses) for oral dose or NG tube administration. Ticagrelor tablets (90 or 180 mg [two 90-mg tablets]) were prepared to emulate oral and NG tube administration by similar methods. For the oral dose, ticagrelor tablets were crushed using a mortar and pestle and transferred to a dosing cup. 100 mL of water was added to the mortar, stirred, and the contents were transferred to the dosing cup and stirred to form a suspension. At this stage, where the suspension would normally be administered to a patient, it was collected for high performance liquid chromatography (HPLC) analysis. The mortar was then flushed with 100 mL of water, and the contents were again transferred to the dosing cup, stirred, and collected for HPLC analysis. For the NG dose, polyvinylchloride, polyurethane, and silicone size CH10 NG tubes were used. The tablets were crushed using a mortar and pestle, diluted with 50 mL of water, and stirred. At this stage, where the suspension would normally be administered to a patient through an NG tube using a syringe, it was collected for HPLC analysis. The mortar was then flushed with two additional 50 mL aliquots of water and the contents were passed through the NG tube. HPLC analysis examined the recoverability of ticagrelor in each of the dose suspensions and flushes and the stability of the suspension when held in a syringe for up to 2 h. One or two crushed 90-mg ticagrelor tablets, prepared for either oral or NG tube administration, delivers a mean dose of ≥97% of the original

A case report of esophageal perforation: Complication of nasogastric tube placement

PubMed Central

Isik, Arda; Firat, Deniz; Peker, Kemal; Sayar, Ilyas; Idiz, Oguz; Soytürk, Mehmet

2014-01-01

Patient: Male, 70 Final Diagnosis: Esophageal perforation Symptoms: Abdominal pain • nausea • vomiting Medication: — Clinical Procedure: — Specialty: Surgery Objective: Unusual clinical course Background: Esophageal perforation is a well-defined and severe clinical condition. There are several etiologies of esophagus perforation. Case Report: We report the case of a 70-year-old Caucasian man who underwent an emergency cholecystectomy due to acute cholecystitis. Two days after surgery, his condition deteriorated. Thorax computerized tomography revealed an esophageal perforation. Conclusions: Esophageal perforation due to nasogastric application is relatively rare but the consequences are potentially serious. The anatomy of the upper gastrointestinal system should be understood by all healthcare professionals involved in the treatment. PMID:24803977

Nasogastric Hydration in Infants with Bronchiolitis Less Than 2 Months of Age.

PubMed

Oakley, Ed; Bata, Sonny; Rengasamy, Sharmila; Krieser, David; Cheek, John; Jachno, Kim; Babl, Franz E

2016-11-01

To determine whether nasogastric hydration can be used in infants less than 2 months of age with bronchiolitis, and characterize the adverse events profile of these infants compared with infants given intravenous (IV) fluid hydration. A descriptive retrospective cohort study of children with bronchiolitis under 2 months of age admitted for hydration at 3 centers over 3 bronchiolitis seasons was done. We determined type of hydration (nasogastric vs IV fluid hydration) and adverse events, intensive care unit admission, and respiratory support. Of 491 infants under 2 months of age admitted with bronchiolitis, 211 (43%) received nonoral hydration: 146 (69%) via nasogastric hydration and 65 (31%) via IV fluid hydration. Adverse events occurred in 27.4% (nasogastric hydration) and 23.1% (IV fluid hydration), difference of 4.3%; 95%CI (-8.2 to 16.9), P = .51. The majority of adverse events were desaturations (21.9% nasogastric hydration vs 21.5% IV fluid hydration, difference 0.4%; [-11.7 to 12.4], P = .95). There were no pulmonary aspirations in either group. Apneas and bradycardias were similar in each group. IV fluid hydration use was positively associated with intensive care unit admission (38.5% IV fluid hydration vs 19.9% nasogastric hydration; difference 18.6%, [5.1-32.1], P = .004); and use of ventilation support (27.7% IV fluid hydration vs 15.1% nasogastric hydration; difference 12.6 [0.3-23], P = .03). Fewer infants changed from nasogastric hydration to IV fluid hydration than from IV fluid hydration to nasogastric hydration (12.3% vs 47.7%; difference -35.4% [-49 to -22], P < .001). Nasogastric hydration can be used in the majority of young infants admitted with bronchiolitis. Nasogastric hydration and IV fluid hydration had similar rates of complications. Copyright © 2016 Elsevier Inc. All rights reserved.

Implementation of the evidence review on best practice for confirming the correct placement of nasogastric tube in patients in an acute care hospital.

PubMed

Tho, Poh Chi; Mordiffi, Siti; Ang, Emily; Chen, Helen

2011-03-01

Nasogastric (NG) tube is a device passed through the gastrointestinal tract of patients for the purpose of feeding, gastric decompression and medication administration. However, a small risk involved in the process is that the tube may be misplaced into the trachea during insertion or may get displaced at a later stage, leading to disastrous results. Recent adverse incidences arising out of the misplacement of NG tube raised concerns among the nursing and medical community and the Patient Safety Officer of the hospital. The Evidence Based Nursing Unit, in collaboration with some of the key nursing leaders in nursing administration, was tasked to explore and institute the current best practice in confirming the correct placement of NG tube. The aim of this project was to institute the best practice to confirm the correct placement of NG tube in patients in an acute care hospital setting. The project comprised of a few stages. The first stage involved reviewing the existing recommendations and guidelines on the methods for checking correct NG tube placement. The second stage involved incorporation of the change of practice into the clinical setting. The final stage was to monitor and evaluate the impact of the new practice on the patients, nurses and other healthcare professionals. Evidence search from guidelines and journals supported the test that used pH indicator instead of the litmus test. There is no evidence that supports the method of auscultation and bubbling to confirm correct NG tube placement in the absence of aspirate. Radiology remains the 'gold standard' for checking correct NG tube placement. The revised method of NG tube placement and workflow was incorporated in the revised Standard Operating Procedures. A total of 17 roadshows were conducted to create awareness regarding the new method amongst the nurses, and the implementation of the revised method and workflow was commenced on 3 November 2008. The initial audit conducted 1 month after the

Stability and recovery of DIFICID(®) (Fidaxomicin) 200-mg crushed tablet preparations from three delivery vehicles, and administration of an aqueous dispersion via nasogastric tube.

PubMed

Tousseeva, Anna; Jackson, J Derek; Redell, Mark; Henry, Teresa; Hui, Michael; Capurso, Shelley; DeRyke, C Andrew

2014-12-01

Fidaxomicin is approved for the treatment of adults with Clostridium difficile-associated diarrhea, many of whom have difficulty swallowing an intact tablet. The study objective was to evaluate the stability and recovery of crushed DIFICID(®) (fidaxomicin) 200-mg tablets dispersed in water, applesauce, or Ensure(®) brand liquid nutritional supplement, and to determine the recovery of fidaxomicin from the administration of an aqueous dispersion of a crushed DIFICID(®) tablet through a nasogastric (NG) tube. DIFICID(®) tablets were crushed and dispersed in water, applesauce, or Ensure(®). The stability and recovery of fidaxomicin were evaluated over 24 h in these vehicles. In a separate experiment, the ability to recover a full dose of fidaxomicin when administering as an aqueous dispersion through an NG tube was assessed. When DIFICID(®) tablets were crushed and dispersed in water, the active ingredient, fidaxomicin, was stable for up to 2 h at room temperature. Additionally, it was stable for up to 24 h in dispersions with applesauce or Ensure(®). Recovery of fidaxomicin after crushing and dispersing in any of the three vehicles studied ranged from 95 to 108 %, which is within the normal range of individual tablet variability. When crushed, dispersed in water, and administered through an NG tube, the average recovery of fidaxomicin was 96 %. Stability and recovery of fidaxomicin were confirmed when DIFICID(®) tablets were crushed and dispersed in water, applesauce, or Ensure(®). In addition, administration of an aqueous dispersion of a crushed tablet through an NG tube is supported by acceptable recovery of fidaxomicin.

Gastric phytobezoars may be treated by nasogastric Coca-Cola lavage.

PubMed

Ladas, Spiros D; Triantafyllou, Konstantinos; Tzathas, Charalabos; Tassios, Pericles; Rokkas, Theodore; Raptis, Sotirios A

2002-07-01

Large gastric phytobezoars may occur in patients with gastric dysmotility disorders. Treatment options include dissolution with enzymes, endoscopic fragmentation with removal or aspiration, and surgery. We report our experience with nasogastric cola lavage therapy. Over an 8-year period, five consecutive patients were referred to our unit for endoscopic treatment of large gastric phytobezoars. They included one patient with lobectomy for lung cancer and four patients with diabetic gastroparesis. An initial attempt of endoscopic fragmentation and removal was unsuccessful. Patients were treated with 3 l of Coca-Cola nasogastric lavage over 12 h. Nasogastric lavage was very well tolerated by the patients. Complete phytobezoar dissolution was achieved in one session in all cases. There were no procedure-related complications. The dissolution of large gastric phytobezoars with cola nasogastric lavage is a safe, rapid and effective method. Patients may be treated in the medical ward, avoiding therapeutic endoscopy or surgery.

A Non-invasive Real-time Localization System for Enhanced Efficacy in Nasogastric Intubation.

PubMed

Sun, Zhenglong; Foong, Shaohui; Maréchal, Luc; Tan, U-Xuan; Teo, Tee Hui; Shabbir, Asim

2015-12-01

Nasogastric (NG) intubation is one of the most commonly performed clinical procedures. Real-time localization and tracking of the NG tube passage at the larynx region into the esophagus is crucial for safety, but is lacking in current practice. In this paper, we present the design, analysis and evaluation of a non-invasive real-time localization system using passive magnetic tracking techniques to improve efficacy of the clinical NG intubation process. By embedding a small permanent magnet at the insertion tip of the NG tube, a wearable system containing embedded sensors around the neck can determine the absolute position of the NG tube inside the body in real-time to assist in insertion. In order to validate the feasibility of the proposed system in detecting erroneous tube placement, typical reference intubation trajectories are first analyzed using anatomically correct models and localization accuracy of the system are evaluated using a precise robotic platform. It is found that the root-mean-squared tracking accuracy is within 5.3 mm for both the esophagus and trachea intubation pathways. Experiments were also designed and performed to demonstrate that the system is capable of tracking the NG tube accurately in biological environments even in presence of stationary ferromagnetic objects (such as clinical instruments). With minimal physical modification to the NG tube and clinical process, this system allows accurate and efficient localization and confirmation of correct NG tube placement without supplemental radiographic methods which is considered the current clinical standard.

Nasogastric hydration versus intravenous hydration for infants with bronchiolitis: a randomised trial.

PubMed

Oakley, Ed; Borland, Meredith; Neutze, Jocelyn; Acworth, Jason; Krieser, David; Dalziel, Stuart; Davidson, Andrew; Donath, Susan; Jachno, Kim; South, Mike; Theophilos, Theane; Babl, Franz E

2013-04-01

Bronchiolitis is the most common lower respiratory tract infection in infants and the leading cause of hospital admission. Hydration is a mainstay of treatment, but insufficient evidence exists to guide clinical practice. We aimed to assess whether intravenous hydration or nasogastric hydration is better for treatment of infants. In this multicentre, open, randomised trial, we enrolled infants aged 2-12 months admitted to hospitals in Australia and New Zealand with a clinical diagnosis of bronchiolitis during three bronchiolitis seasons (April 1-Oct 31, in 2009, 2010, and 2011). We randomly allocated infants to nasogastric hydration or intravenous hydration by use of a computer-generated sequence and opaque sealed envelopes, with three randomly assigned block sizes and stratified by hospital site and age group (2-<6 months vs 6-12 months). The primary outcome was length of hospital stay, assessed in all randomly assigned infants. Secondary outcomes included rates of intensive-care unit admission, adverse events, and success of insertion. This trial is registered with the Australian and New Zealand clinical trials registry, ACTRN12605000033640. Mean length of stay for 381 infants assigned nasogastric hydration was 86·6 h (SD 58·9) compared with 82·2 h (58·8) for 378 infants assigned intravenous hydration (absolute difference 4·5 h [95% CI -3·9 to 12·9]; p=0·30). Rates of admission to intensive-care units, need for ventilatory support, and adverse events did not differ between groups. At randomisation, seven infants assigned nasogastric hydration were switched to intravenous hydration and 56 infants assigned intravenous hydration were switched to nasogastric hydration because the study-assigned method was unable to be inserted. For those infants who had data available for successful insertion, 275 (85%) of 323 infants in the nasogastric hydration group and 165 (56%) of 294 infants in the intravenous hydration group required only one attempt for successful

Interactive Anatomy-Augmented Virtual Simulation Training.

PubMed

Aebersold, Michelle; Voepel-Lewis, Terri; Cherara, Leila; Weber, Monica; Khouri, Christina; Levine, Robert; Tait, Alan R

2018-02-01

Traditionally, clinical psychomotor skills are taught through videos and demonstration by faculty which does not allow for the visualization of internal structures and anatomical landmarks that would enhance the learner skill performance. Sophomore and junior nursing students attending a large Midwestern Institution (N=69) participated in this mixed methods study. Students demonstrated their ability to place a nasogastric tube (NGT) after being randomly assigned to usual training (Control group) or an iPad anatomy-augmented virtual simulation training module (AR group). The ability of the participants to demonstrate competence in placing the NGT was assessed using a 17-item competency checklist. After the demonstration, students completed a survey to elicit information about students' level of training, prior experience with NGT placement, satisfaction with the AR technology, and perceptions of AR as a potential teaching tool for clinical skills training. The ability to correctly place the NGT through all the checklist items was statistically significant in the AR group compared with the control group (P = 0.011). Eighty-six percent of participants in the AR group rated AR as superior/far superior to other procedural training programs to which they had been exposed, whereas, only 5.9% of participants in the control group rated the control program as superior/far superior (P < 0.001). Overall the AR module was better received compared with the control group with regards to realism, identifying landmarks, visualization of internal organs, ease of use, usefulness, and promoting learning and understanding.

Failure of nasogastric omeprazole suspension in pediatric intensive care patients.

PubMed

Haizlip, Julie A; Lugo, Ralph A; Cash, Jared J; Vernon, Donald D

2005-03-01

To determine the efficacy of nasogastric administration of omeprazole suspension in raising the gastric pH >4 in critically ill pediatric patients and to determine the most appropriate dosing regimen for this indication. Open-label pharmacodynamic study. Twenty-six bed tertiary-care pediatric intensive care unit. Mechanically ventilated children aged 1-18 yrs with an additional risk factor for stress ulcer formation. Continuous gastric pH monitoring was performed during administration and dose titration of omeprazole suspension to achieve the goal of gastric pH >4 for greater than 75% of the dosing interval. Data were collected from 18 patients. Subjects were categorized based on the pharmacologic response to nasogastric administration of 1 mg/kg omeprazole suspension (maximum 20 mg) as rapid (n = 9), late (n = 5), and nonresponders (n = 4). Rapid responders required 0.72 mg/kg per day omeprazole suspension to achieve adequate gastric pH elevation for stress ulcer prophylaxis. Late responders required 1.58 mg/kg per day. Nonresponders did not achieve adequate elevation of gastric pH for stress ulcer prophylaxis. Nasogastric administration of omeprazole suspension has variable efficacy in critically ill pediatric patients. Half of the studied subjects either required significant dose titrations to achieve gastric acid suppression or did not respond to nasogastric administration of omeprazole suspension.

Continuous nasogastric tube feeding: monitoring by combined use of refractometry and traditional gastric residual volumes.

PubMed

Chang, W-K; McClave, S-A; Chao, Y-C

2004-02-01

Traditional use of gastric residual volumes (GRVs) is insensitive and cannot distinguish retained enteral formula from the large volume of endogenous secretions. We designed this prospective study to determine whether refractometry and Brix value (BV) measurements could be used to monitor gastric emptying and tolerance in patients receiving continuous enteral feeding. Thirty-six patients on continuous nasogastric tube feeding were divided into two groups; patients with lower GRVs (<75 ml) in Group 1, patients with higher GRVs (>75 ml) in Group 2. Upon entry, all gastric contents were aspirated, the volume was recorded (Asp GRV), BV measurements were made by refractometry, and then the contents were reinstilled but diluted with 30 ml additional water. Finally, a small amount was reaspirated and repeat BV measurements were made. Three hours later, the entire procedure was repeated a second time. The BV ratio, calculated (Cal) GRV, and volume of formula remaining were calculated by derived equations. Mean BV ratios were significantly higher for those patients in Group 2 compared to those in Group 1. All but one of the 22 patients (95%) in Group 1 had a volume of formula remaining in the stomach estimated on both measurements to be less than the hourly infusion rate (all these patients had BV ratios <70%). In contrast, six of the 14 patients in Group 2 (43%) on both measurements were estimated to have volumes of formula remaining that were greater than the hourly infusion rate (all these patients had BV ratios >70%). Three of the Group 2 patients (21%) whose initial measurement showed evidence for retention of formula, improved on repeat follow-up measurement assuring adequate gastric emptying. The remaining five patients from Group 2 (35%) had a volume of formula remaining that was less than the hourly infusion rate on both measurements. The pattern of Asp GRVs and serial pre- and post-dilution BVs failed to differentiate these patients in Group 2 with potential

Survival times with and without tube feeding in patients with dementia or psychiatric diseases in Japan.

PubMed

Takayama, Keiko; Hirayama, Keisuke; Hirao, Akihiko; Kondo, Keiko; Hayashi, Hideki; Kadota, Koichi; Asaba, Hiroyuki; Ishizu, Hideki; Nakata, Kenji; Kurisu, Kairi; Oshima, Etsuko; Yokota, Osamu; Yamada, Norihito; Terada, Seishi

2017-11-01

It is widely supposed that there has been no evidence of increased survival in patients with advanced dementia receiving enteral tube feeding. However, more than a few studies have reported no harmful outcome from tube feeding in dementia patients compared to in patients without dementia. This was a retrospective study. Nine psychiatric hospitals in Okayama Prefecture participated in this survey. All inpatients fulfilling the entry criteria were evaluated. All subjects suffered from difficulty with oral intake. Attending physicians thought that the patients could not live without long-term artificial nutrition. The physicians decided whether to make use of long-term artificial nutrition between January 2012 and December 2014. We evaluated 185 patients. Their mean age was 76.6 ± 11.4 years. Of all subjects, patients with probable Alzheimer's disease (n = 78) formed the biggest group, schizophrenia patients (n = 44) the second, and those with vascular dementia (n = 30) the third. The median survival times were 711 days for patients with tube feeding and 61 days for patients without tube feeding. In a comparison different types of tube feeding, median survival times were 611 days for patients with a nasogastric tube and more than 1000 days for those with a percutaneous endoscopic gastrostomy tube. Patients with tube feeding survived longer than those without tube feeding, even among dementia patients. This study suggests that enteral nutrition for patients with dementia prolongs survival. Additionally, percutaneous endoscopic gastrostomy tube feeding may be safer than nasogastric tube feeding among patients in psychiatric hospitals. © 2017 Japanese Psychogeriatric Society.

Gastroenteric tube feeding: Techniques, problems and solutions

PubMed Central

Blumenstein, Irina; Shastri, Yogesh M; Stein, Jürgen

2014-01-01

Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake, chronic neurological or mechanical dysphagia or gut dysfunction, and patients who are critically ill. However, despite the benefits and widespread use of enteral tube feeding, some patients experience complications. This review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding, together with associated complications and special aspects. We conducted an extensive literature search on PubMed, Embase and Medline using index terms relating to enteral access, enteral feeding/nutrition, tube feeding, percutaneous endoscopic gastrostomy/jejunostomy, endoscopic nasoenteric tube, nasogastric tube, and refeeding syndrome. The literature showed common routes of enteral access to include nasoenteral tube, gastrostomy and jejunostomy, while complications fall into four major categories: mechanical, e.g., tube blockage or removal; gastrointestinal, e.g., diarrhea; infectious e.g., aspiration pneumonia, tube site infection; and metabolic, e.g., refeeding syndrome, hyperglycemia. Although the type and frequency of complications arising from tube feeding vary considerably according to the chosen access route, gastrointestinal complications are without doubt the most common. Complications associated with enteral tube feeding can be reduced by careful observance of guidelines, including those related to food composition, administration rate, portion size, food temperature and patient supervision. PMID:25024606

Nasogastric feeding tube

MedlinePlus

... chap 16. Ziegler TR. Malnutrition, nutritional assessment, and nutritional support in adult hospitalized patients. In: Goldman L, Schafer ... A.M. Editorial team. Related MedlinePlus Health Topics Nutritional Support Browse the Encyclopedia A.D.A.M., Inc. ...

Compound heterozygosity of the functionally null Cdh23(v-ngt) and hypomorphic Cdh23(ahl) alleles leads to early-onset progressive hearing loss in mice.

PubMed

Miyasaka, Yuki; Suzuki, Sari; Ohshiba, Yasuhiro; Watanabe, Kei; Sagara, Yoshihiko; Yasuda, Shumpei P; Matsuoka, Kunie; Shitara, Hiroshi; Yonekawa, Hiromichi; Kominami, Ryo; Kikkawa, Yoshiaki

2013-01-01

The waltzer (v) mouse mutant harbors a mutation in Cadherin 23 (Cdh23) and is a model for Usher syndrome type 1D, which is characterized by congenital deafness, vestibular dysfunction, and prepubertal onset of progressive retinitis pigmentosa. In mice, functionally null Cdh23 mutations affect stereociliary morphogenesis and the polarity of both cochlear and vestibular hair cells. In contrast, the murine Cdh23(ahl) allele, which harbors a hypomorphic mutation, causes an increase in susceptibility to age-related hearing loss in many inbred strains. We produced congenic mice by crossing mice carrying the v niigata (Cdh23(v-ngt)) null allele with mice carrying the hypomorphic Cdh23(ahl) allele on the C57BL/6J background, and we then analyzed the animals' balance and hearing phenotypes. Although the Cdh23(v-ngt/ahl) compound heterozygous mice exhibited normal vestibular function, their hearing ability was abnormal: the mice exhibited higher thresholds of auditory brainstem response (ABR) and rapid age-dependent elevation of ABR thresholds compared with Cdh23(ahl/ahl) homozygous mice. We found that the stereocilia developed normally but were progressively disrupted in Cdh23(v-ngt/ahl) mice. In hair cells, CDH23 localizes to the tip links of stereocilia, which are thought to gate the mechanoelectrical transduction channels in hair cells. We hypothesize that the reduction of Cdh23 gene dosage in Cdh23(v-ngt/ahl) mice leads to the degeneration of stereocilia, which consequently reduces tip link tension. These findings indicate that CDH23 plays an important role in the maintenance of tip links during the aging process.

Effect of timing and method of enteral tube feeding for dysphagic stroke patients (FOOD): a multicentre randomised controlled trial.

PubMed

Dennis, M S; Lewis, S C; Warlow, C

Undernutrition is common in patients admitted with stroke. We aimed to establish whether the timing and route of enteral tube feeding after stroke affected patients' outcomes at 6 months. The FOOD trials consist of three pragmatic multicentre randomised controlled trials, two of which included dysphagic stroke patients. In one trial, patients enrolled within 7 days of admission were randomly allocated to early enteral tube feeding or no tube feeding for more than 7 days (early versus avoid). In the other, patients were allocated percutaneous endoscopic gastrostomy (PEG) or nasogastric feeding. The primary outcome was death or poor outcome at 6 months. Analysis was by intention to treat. Between Nov 1, 1996, and July 31, 2003, 859 patients were enrolled by 83 hospitals in 15 countries into the early versus avoid trial. Early tube feeding was associated with an absolute reduction in risk of death of 5.8% (95% CI -0.8 to 12.5, p=0.09) and a reduction in death or poor outcome of 1.2% (-4.2 to 6.6, p=0.7). In the PEG versus nasogastric tube trial, 321 patients were enrolled by 47 hospitals in 11 countries. PEG feeding was associated with an absolute increase in risk of death of 1.0% (-10.0 to 11.9, p=0.9) and an increased risk of death or poor outcome of 7.8% (0.0 to 15.5, p=0.05). Early tube feeding might reduce case fatality, but at the expense of increasing the proportion surviving with poor outcome. Our data do not support a policy of early initiation of PEG feeding in dysphagic stroke patients.

Percutaneous transesophageal gastro-tubing (PTEG) as an alternative long-term tube feeding procedure when gastrostomy is not feasible

PubMed Central

Toh Yoon, Ezekiel Wong; Nishihara, Kazuki

2017-01-01

Background: Percutaneous transesophageal gastro-tubing (PTEG) is a minimally invasive technique to access the gut via an esophagostomy. However, this procedure is not well known and the literature available is still fairly limited. This observational study was conducted to evaluate our experience using this method as an alternative long-term tube feeding procedure when gastrostomy is not suitable. Methods: A total of 15 patients (10 males and 5 females) who underwent PTEG at our institution from 2012 to 2016 were observed and analyzed in this study. Results: The average age was 80.1 (71–93) years. Underlying conditions that required PTEG were previous gastric resection in 11 patients, left diaphragm disorder in 2 patients, interposing transverse colon between the abdominal wall and anterior gastric wall in 1 patient, and severe gastrostomy site leakage in 1 patient. Tube placement was successful in all patients by approaching the left side of the neck, using a 15 Fr size tube. The mean postoperative length of stay was 22 (8–48) days. Postoperative adverse events included accidental tube dislodgement in three patients, tracheoesophageal fistula in one patient, inferior thyroid artery injury in one patient and thyroid gland mispuncture in one patient. There was no procedure-related mortality nor mortality at 30 days. Eight patients were discharged with some oral intake. Conclusions: PTEG is feasible in patients requiring long-term tube feeding for whom gastrostomy is unsuitable. It is an effective long-term tube feeding procedure and should be offered as a more comfortable alternative to nasogastric tubing. PMID:29204186

Percutaneous transesophageal gastro-tubing (PTEG) as an alternative long-term tube feeding procedure when gastrostomy is not feasible.

PubMed

Toh Yoon, Ezekiel Wong; Nishihara, Kazuki

2017-12-01

Percutaneous transesophageal gastro-tubing (PTEG) is a minimally invasive technique to access the gut via an esophagostomy. However, this procedure is not well known and the literature available is still fairly limited. This observational study was conducted to evaluate our experience using this method as an alternative long-term tube feeding procedure when gastrostomy is not suitable. A total of 15 patients (10 males and 5 females) who underwent PTEG at our institution from 2012 to 2016 were observed and analyzed in this study. The average age was 80.1 (71-93) years. Underlying conditions that required PTEG were previous gastric resection in 11 patients, left diaphragm disorder in 2 patients, interposing transverse colon between the abdominal wall and anterior gastric wall in 1 patient, and severe gastrostomy site leakage in 1 patient. Tube placement was successful in all patients by approaching the left side of the neck, using a 15 Fr size tube. The mean postoperative length of stay was 22 (8-48) days. Postoperative adverse events included accidental tube dislodgement in three patients, tracheoesophageal fistula in one patient, inferior thyroid artery injury in one patient and thyroid gland mispuncture in one patient. There was no procedure-related mortality nor mortality at 30 days. Eight patients were discharged with some oral intake. PTEG is feasible in patients requiring long-term tube feeding for whom gastrostomy is unsuitable. It is an effective long-term tube feeding procedure and should be offered as a more comfortable alternative to nasogastric tubing.

Health Instruction Packages: Specific Nursing Skills.

ERIC Educational Resources Information Center

Bates, Clarice; And Others

Text, illustrations, and exercises are utilized in a set of five learning modules designed to instruct nursing students in a variety of clinical skills. The first module, "Down the Tube: Insertion of a Nasogastric Tube" by Clarice Bates, describes materials and procedures used to insert a nasogastric tube through the nose and esophagus…

[A project to reduce the incidence of intubation care errors among foreign health aides].

PubMed

Chen, Mei-Ju; Lu, Yu-Hua; Chen, Chiu-Chun; Li, Ai-Cheng

2014-08-01

Foreign health aides are the main providers of care for the elderly and the physically disabled in Taiwan. Correct care skills improve patient safety. In 2010, the incidence of mistakes among foreign health aides in our hospital unit was 58% for nasogastric tube care and 57% for tracheostomy tube care. A survey of foreign health aides and nurses in the unit identified the main causes of these mistakes as: communication difficulties, inaccurate instructions given to patients, and a lack of standard operating procedures given to the foreign health aides. This project was designed to reduce the rates of improper nasogastric tube care and improper tracheostomy tube care to 20%, respectively. This project implemented several appropriate measures. We produced patient instruction hand-outs in Bahasa Indonesia, established a dedicated file holder for Bahasa Indonesian tube care reference information, produced Bahasa Indonesian tube-care-related posters, produced a short film about tube care in Bahasa Indonesian, and established a standardized operating procedure for tube care in our unit. Between December 15th and 31st, 2011, we audited the performance of a total of 32 foreign health aides for proper execution of nasogastric tube care (21 aides) and of proper execution of tracheostomy tube care (11 aides). Patients with concurrent nasogastric and tracheostomy tubes were inspected separately for each care group. The incidence of improper care decreased from 58% to 18% nasogastric intubation and 57% to 18% for tracheostomy intubation. This project decreased significantly the incidence of improper tube care by the foreign health aides in our unit. Furthermore, the foreign health aides improved their tube nursing care skills. Therefore, this project improved the quality of patient care.

[Head and neck cancer patients included at home enteral nutrition by tube].

PubMed

Cots Seignot, I; Cárdenas Lagranja, G; Puiggròs Llop, C; Chicharro Serrano, L; Pérez-Portabella Maristany, C; Planas Vilà, M

2009-01-01

To know characteristics and the patients' evolution with head and neck cancer who received radiotherapy treatment and they were included at a home enteral nutrition (HEN) by feeding tube programme. To analyse the weight evolution according to the start of HEN before or after radiotherapy. Observational study of tube feeding patients with head and neck cancer who were included in HEN programme in our hospital for two years. Variables analysed: gender, age, Body Mass Index (BMI), Karnofsky Index (KI), reason for nutritional support, type of feeding tube, formula used and prescribed caloric contribution, necessity to change access device and HEN days. 62 patients were studied (77.4% men; 22.6% women). Age 64 +/- 10.1 years (rang: 39-90). The dysphagia was the main cause to begin enteral nutrition by feeding tube in these patients. Naso-gastric tube was prevalence (67.7%). The most used formula was polymeric hypercaloric diet with a mean of caloric contribution of 1,629 +/- 267.09 kcal/day. Overall, there was a weight loss in all patients during the study period time. However, patients who began the HEN by feeding tube before the radiotherapy treatment, the BMI did not decrease. All patients who began feeding tube before oncological treatment didn't lose weight for the period of study.

Drain tube migration into the anastomotic site of an esophagojejunostomy for gastric small cell carcinoma: short report

PubMed Central

2010-01-01

Background Intraluminal migration of a drain through an anastomotic site is a rare complication of gastric surgery. Case Presentation We herein report the intraluminal migration of a drain placed after a lower esophagectomy and total gastrectomy with Roux-en-Y anastomosis for gastric small cell carcinoma. Persistent drainage was noted 1 month after surgery, and radiographic studies were consistent with drain tube migration. Endoscopy revealed the drain had migrated into the esophagojejunostomy anastomotic site. The drain was removed from outside of abdominal wound while observing the anastomotic site endoscopically. The patient was treated with suction via a nasogastric tube drain for 5 days, and thereafter had an uneventful recovery. Conclusions Though drain tube migration is a rare occurrence, it should be considered in patients with persistent drainage who have undergone gastric surgery. PMID:20492665

Drain tube migration into the anastomotic site of an esophagojejunostomy for gastric small cell carcinoma: short report.

PubMed

Lai, Peng-Sheng; Lo, Chiao; Lin, Long-Wei; Lee, Po-Chu

2010-05-21

Intraluminal migration of a drain through an anastomotic site is a rare complication of gastric surgery. We herein report the intraluminal migration of a drain placed after a lower esophagectomy and total gastrectomy with Roux-en-Y anastomosis for gastric small cell carcinoma. Persistent drainage was noted 1 month after surgery, and radiographic studies were consistent with drain tube migration. Endoscopy revealed the drain had migrated into the esophagojejunostomy anastomotic site. The drain was removed from outside of abdominal wound while observing the anastomotic site endoscopically. The patient was treated with suction via a nasogastric tube drain for 5 days, and thereafter had an uneventful recovery. Though drain tube migration is a rare occurrence, it should be considered in patients with persistent drainage who have undergone gastric surgery.

[INFLUENCE OF THE NUTRITIONAL COMPOSITION OF DIFFERENT FIBER-ENRICHED ENTERAL NUTRITION FORMULAS ON THE ADMINISTRATION TIME BY GRAVITY AND THE RISK OF TUBE FEEDING OBSTRUCTION].

PubMed

Bonada Sanjaume, Anna; Gils Contreras, Anna; Salas-Salvadó, Jordi

2015-08-01

the administration of enteral nutrition by gravity is a very useful method in clinical practice; nevertheless, it may not be very precise. Indeed, this method presents some important limitations, such as the difficulty in establishing a precise dripping rate and the possibility for the dripping rate decrease depending on the formula. assess the administration time and the risk of clogging of 5 fiber-enriched enteral nutrition formulas with different protein concentrations and caloric density, all administered by gravity through nasogastric (NG) tubes of different sizes. Assess the influence of the composition on the dripping rate, by gravity, of the tested formulas. 5 fiber-enriched EN formulas were compared by using nasogastric tubes of the calibers 8, 10 and 12 Fr. The fluidity of these gravity-administered NE formulas was estimated by timing the complete passage of each formula at full speed, thus allowing one to calculate the mean time of free fall (MTFF) and to register any possible obstruction. Subsequently, an in vitro simulation of a 1 500 ml administration was performed for each formula at a particular speed, so that the administration time was 5 hours. Slowing flow and stagnated flow were detected as indicators of the risk of obstruction. the two products that especially differed in MTFF were the ones with the highest energy concentration. The passage time in free fall of these two products through the 8 Fr tube exceeded four hours. For the rest of the products and NG tubes used, this time was less than 2 hours and 5 minutes. No slowing flow or tube obstruction was detected in free fall and at maximum speed. When the dripping was adjusted to be administered in 5 hours, three of the studied products (those with the least caloric concentration and viscosity) showed slowing flow and, in some cases, the dripping stopped completely. The most important factor associated to the MTFF was the lipid content, followed by viscosity, energy and protein content. The

Learning nursing procedures: the influence of simulator fidelity and student gender on teaching effectiveness.

PubMed

Grady, Janet L; Kehrer, Rosemary G; Trusty, Carole E; Entin, Eileen B; Entin, Elliot E; Brunye, Tad T

2008-09-01

Simulation technologies are gaining widespread acceptance across a variety of educational domains and applications. The current research examines whether basic nursing procedure training with high-fidelity versus low-fidelity mannequins results in differential skill acquisition and perceptions of simulator utility. Fifty-two first-year students were taught nasogastric tube and indwelling urinary catheter insertion in one of two ways. The first group learned nasogastric tube and urinary catheter insertion using high-fidelity and low-fidelity mannequins, respectively, and the second group learned nasogastric tube and urinary catheter insertion using low-fidelity and high-fidelity mannequins, respectively. The dependent measures included student performance on nasogastric tube and urinary catheter insertion testing, as measured by observer-based instruments, and self-report questionnaires probing student attitudes about the use of simulation in nursing education. Results demonstrated higher performance with high-fidelity than with low-fidelity mannequin training. In response to a self-report posttraining questionnaire, participants expressed a more positive attitude toward the high-fidelity mannequin, especially regarding its responsiveness and realism.

Enteral tube feeding for cystic fibrosis.

PubMed

Conway, S P; Morton, A; Wolfe, S

2008-04-16

Enteral tube feeding is routinely used in many cystic fibrosis centres when weight for height percentage is less than 85%, when there has been weight loss for longer than a two-month period or when there has been no weight gain for two to three months (under five years old) or for six months (over five years old). To examine the evidence that in people with cystic fibrosis supplemental enteral tube feeding improves nutritional status, respiratory function, and quality of life without significant adverse effects. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. We also contacted the companies that market enteral feeds and reviewed their databases. Date of the most recent search of the Group's Cystic Fibrosis Trials Register: November 2007. All randomised controlled trials comparing supplemental enteral tube feeding for one month or longer with no specific intervention in people with cystic fibrosis. Thirteen trials were identified by the search; however, none were eligible for inclusion in this review. There are no trials included in this review. Supplemental enteral tube feeding is widely used throughout the world to improve nutritional status in people with cystic fibrosis. The methods mostly used, nasogastric or gastrostomy feeding, are invasive, expensive, and may have a negative effect on self-esteem and body image. Reported use of enteral tube feeding suggests that it results in nutritional and respiratory improvement and it is disappointing that their efficacy has not been fully assessed by randomised controlled trials. With the more frequent recommendations to use enteral tube feeding as an early rather than a late intervention, this systematic review identifies the need for a multicentre, randomised controlled trial assessing both efficacy and possible

Transfer of adult Strongylus vulgaris via stomach tube.

PubMed

Hofing, G L; Bennett, D G

1983-10-01

Patent infections with Strongylus vulgaris were established in 6 of 8 helminth-free ponies given 41 to 101 adult worms via nasogastric tube. The parasites were removed from the cecum and ventral colon and transferred within 1 to 2 hours of the death of the donor horses. Eggs were found in the feces of the recipients in 2 or 3 days; egg counts reached maximum, 28 eggs per gram of feces, at 4 weeks after ponies were inoculated. In 6 ponies euthanatized 3 to 7 weeks after parasitic transfers were done, 28% of the inoculated worms were found alive at necropsy. A 7th pony was maintained as a donor for establishing infections for chemotherapy trials and, although never passing more than 6 eggs per gram of feces, shed infective larvae over a period of 2 years.

Unnecessary gastric decompression in distal elective bowel anastomoses in children: a randomized study.

PubMed

Davila-Perez, Roberto; Bracho-Blanchet, Eduardo; Tovilla-Mercado, Jose Manuel; Hernandez-Plata, Jose Alejandro; Reyes-Lopez, Alfonso; Nieto-Zermeño, Jaime

2010-05-01

The goal of this study was to investigate the role of nasogastric drainage in preventing postoperative complications in children with distal elective bowel anastomosis. Nasogastric drainage has been used as a routine measure after gastrointestinal surgery in children and adults to hasten bowel function, prevent postoperative complications, and shorten hospital stay. However, there has been no study that shows in a scientific manner the benefit of nasogastric drainage in children. We performed a clinical, controlled, randomized trial comprising 60 children who underwent distal elective bowel anastomoses and compared postoperative complications between a group with nasogastric tube in place (n = 29) and one without it (n = 31). Demographic data and diagnoses were comparable in both groups (P = NS). No anastomotic leaks or enterocutaneous fistulae were found in any patient. There were no significant differences between the two groups with respect to abdominal distension, infection, or hospital stay. Only one patient in the experimental group required placement of the nasogastric tube due to persistent abdominal distension (3.2%). The routine use of nasogastric drainage after distal elective intestinal surgery in children can be eliminated. Its use should depend on the individual patient's situation.

[Role of the small intestinal decompression tube and Gastrografin in the treatment of early postoperative inflammatory small bowel obstruction].

PubMed

Li, Wei; Li, Zhixia; An, Dali; Liu, Jing; Zhang, Xiaohu

2014-03-01

To evaluate the role of the small intestinal decompression tube (SIDT) and Gastrografin in the treatment of early postoperative inflammatory small bowel obstruction (EPISBO). Twelve patients presented EPISBO after abdominal surgery in our department from April 2011 to July 2012. Initially, nasogastric tube decompression and other conventional conservative treatment were administrated. After 14 days, obstruction symptom improvement was not obvious, then the SIDT was used. At the same time, Gastrografin was injected into the small bowel through the SIDT in order to demonstrate the site of obstruction of small bowel and its efficacy. In 11 patients after this management, obstruction symptoms disappeared, bowel function recovered within 3 weeks, and oral feeding occurred gradually. Another patient did not pass flatus after 4 weeks and was reoperated. After postoperative follow-up of 6 months, no case relapsed with intestinal obstruction. For severe and long course of early postoperative inflammatory intestinal obstruction, intestinal decompression tube plus Gastrografin is safe and effective, and can avoid unnecessary reoperation.

[A clinical study using octreotide in relieving gastrointestinal symptoms due to bowel obstruction in a terminally ill cancer patient].

PubMed

Shima, Yasuo; Yamaguchi, Kensei; Miyata, Yoshinori; Hyodo, Ichinosuke; Yagi, Yasuo; Honke, Yoshifumi

2004-09-01

Terminally ill cancer patients with complicated bowel obstructions often have poor quality of life (QOL) due to gastrointestinal symptoms such as nausea and vomiting. Many of these patients are inoperable because of poor general conditions, and half of these patients can't be managed by conventional antiemetics. There are many reports indicating octreotide is effective for these patients. In the present study, 13 patients (5 patients without a nasogastric tube and 8 patients with) were administered octreotide at 300 microg/day by 24 hours continuous subcutaneous infusion. Among the effectively evaluable 10 cases, 6 cases (60.0%) were assessed as effective according to the efficacy criteria based on the JCOG toxicity scale. In the 6 cases who had nasogastric tubes, the nasogastric aspirates decreased from 890 ml (550-1,950) to 480 ml (180-1,790). Vomiting was successfully controlled after the removals of nasogastric tubes in 4 out of 6 cases (66.7%), regarding safety, 2 out of 13 cases (15.4%) showed an excess of liver enzymes but no clinically suspected adverse effect was observed. Octreotide is effective and well tolerated in terminally ill cancer patients with malignant bowel obstruction.

Mediastinal hemorrhage: An evaluation of radiographic manifestations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Woodring, J.H.; Loh, F.K.; Kryscio, R.J.

1984-04-01

Eleven common radiographic signs of mediastinal hemorrhage were evaluated by two observers for the following three patient groups: normal subjects, patients with mediastinal hemorrhage and no arterial injury, and patients with major thoracic arterial injury. Supine chest radiographs were studied in all cases. Four major conclusions can be made based upon these finding. M/C ratio (mediastinal width to chest width), tracheal deviation, left hemothorax, paraspinal line widening, and aorto-pulmonary window opacification do not reliably separate these three groups of patients. The diagnosis of mediastinal hemorrhage may be made if the aortic contour is abnormal or if one of the followingmore » signs is positive: abnormal mediastinal width, apical cap, widening of the right paratracheal stripe, or deviation of the nasogastric tube. Due to interobserver variation, there is good agreement between observers for the following four signs only: transverse mediastinal width, tracheal deviation, nasogastric tube deviation, nasogastric tube deviation, and right paratracheal stripe widening.« less

Nutritional recovery after cardiac surgery in children with congenital heart disease.

PubMed

Oyarzún, I; Claveria, C; Larios, G; Le Roy, C

2018-02-01

Malnutrition is common in children with congenital heart disease (CHD). Medical treatment and surgical interventions contribute improving the nutritional status of these children. To describe nutritional recovery in children with CHD and associated factors after surgery. Longitudinal study. 46 Children under 18 years old admitted for CHD surgery between April 2015 and April 2016 were recruited. The following CHD were included: Ventricular septal defect (VSD), Atrial septal defect (ASD), Hypoplastic left heart syndrome (HLHS), Tetralogy of Fallot (TOF), and Transposition of great arteries (dTGA). Children with genetic syndromes and other diseases that could compromise nutritional status were excluded. We obtained demographic, CHD, nasogastric tube use (NGT), nutritional evaluation, and weight and height data at the time of admission and one, three and six months after surgery and. Z-score to assess anthropometric measu res were calculated according to WHO standards. Median age was 8 months (IQR: 3,26), 24 (52%) male, 6 (13%) preterm and 12 (26,1%) small for gestational age (SGA). CHD diagnosis were: 9 (19,6%) VSD, 8 (17,4%) ASD, 12 (26,1%) HLHS, 9 (19,6%) TOF and 8 (17,4%) dTGA. The mean weight-for-heigth-BMI-for-age-z-score (W/H-BMI/AZ) was 0,6 ± 1,5 SD, (28.3% of undernutri tion). The mean heigth-for-age-z-score (H/AZ) was -0,86 ± 1.3sd (21.7% of short stature). We found differences between each CHD and age, use of NGT and been under nutritional follow-up. There was an improvement between H/AZ at admission and 3rd month (p = 0,02), and W/H-BMI/AZ at 3th (p = 0,046) and 6th month (p = 0,001). Use of NGT decreased from admission to 6th month (19 vs 3) (p = 0,0016). We found correlation between admission W/H-BMI/AZ and nutritional recovery (r = -0,7; p < 0,001). There is a high prevalence of prematurity, SGA, undernutrition and short stature use of with weight recovery but not in heigth after cardio-surgery.

Comparison of a novel bedside portable endoscopy device with nasogastric aspiration for identifying upper gastrointestinal bleeding.

PubMed

Choi, Jong Hwan; Choi, Jae Hyuk; Lee, Yoo Jin; Lee, Hyung Ki; Choi, Wang Yong; Kim, Eun Soo; Park, Kyung Sik; Cho, Kwang Bum; Jang, Byoung Kuk; Chung, Woo Jin; Hwang, Jae Seok

2014-07-07

To compare outcomes using the novel portable endoscopy with that of nasogastric (NG) aspiration in patients with gastrointestinal bleeding. Patients who underwent NG aspiration for the evaluation of upper gastrointestinal (UGI) bleeding were eligible for the study. After NG aspiration, we performed the portable endoscopy to identify bleeding evidence in the UGI tract. Then, all patients underwent conventional esophagogastroduodenoscopy as the gold-standard test. The sensitivity, specificity, and accuracy of the portable endoscopy for confirming UGI bleeding were compared with those of NG aspiration. In total, 129 patients who had GI bleeding signs or symptoms were included in the study (age 64.46 ± 13.79, 91 males). The UGI tract (esophagus, stomach, and duodenum) was the most common site of bleeding (81, 62.8%) and the cause of bleeding was not identified in 12 patients (9.3%). Specificity for identifying UGI bleeding was higher with the portable endoscopy than NG aspiration (85.4% vs 68.8%, P = 0.008) while accuracy was comparable. The accuracy of the portable endoscopy was significantly higher than that of NG in the subgroup analysis of patients with esophageal bleeding (88.2% vs 75%, P = 0.004). Food material could be detected more readily by the portable endoscopy than NG tube aspiration (20.9% vs 9.3%, P = 0.014). No serious adverse effect was observed during the portable endoscopy. The portable endoscopy was not superior to NG aspiration for confirming UGI bleeding site. However, this novel portable endoscopy device might provide a benefit over NG aspiration in patients with esophageal bleeding.

Esophageal stricture - benign

MedlinePlus

Esophageal stricture can be caused by: Gastroesophageal reflux (GERD). Eosinophilic esophagitis. Injuries caused by an endoscope . Long-term use of a nasogastric (NG) tube (tube through the nose into the ...

Quality Improvement Initiative to Increase the Use of Nasogastric Hydration in Infants With Bronchiolitis.

PubMed

Srinivasan, Mythili; Pruitt, Cassandra; Casey, Erin; Dhaliwal, Keerat; DeSanto, Cori; Markus, Richard; Rosen, Ayelet

2017-08-01

Intravenous (IV) hydration is used primarily in children with bronchiolitis at our institution. Because nasogastric (NG) hydration can provide better nutrition, the goal of our quality improvement (QI) initiative was to increase the rate of NG hydration in eligible children 1 to 23 months old with bronchiolitis by 20% over 6 months. We used Plan-Do-Study-Act cycles to increase the use of NG hydration in eligible children. Interventions included educational and system-based changes and sharing parental feedback with providers. Chart reviews were performed to identify the rates of NG hydration, which were plotted over time in a statistical process control p chart. The balancing measure was the rate of complications in children with NG versus IV hydration. Two hundred and ninety-three children who were hospitalized with bronchiolitis needed supplemental hydration during the QI initiative (January 2016-April 2016). Ninety-one children were candidates for NG hydration, and 53 (58%) received NG hydration. The rates of NG hydration increased from a baseline of 0% pre-QI bronchiolitis season (January 2015-April 2015) to 58% during the initiative. There was no aspiration and no accidental placement of the NG tube into a child's airway. Nine patients (17%) in the NG group had a progression of disease requiring nil per os status, and 6 of these were transferred to the PICU whereas none of those in the IV group were transferred to the PICU. Post-QI initiative, the majority of nurses (63%) and physicians (95%) stated that they are more likely to consider NG hydration in children with bronchiolitis. We successfully increased the rates of NG hydration in eligible children with bronchiolitis by using educational and system-based interventions. Copyright © 2017 by the American Academy of Pediatrics.

Real-time image-guided nasogastric feeding tube placement: A case series using Kangaroo with IRIS Technology in an ICU.

PubMed

Mizzi, Anna; Cozzi, Silvano; Beretta, Luigi; Greco, Massimiliano; Braga, Marco

2017-05-01

Pulmonary misplacement during the blind insertion of enteral feeding tubes is frequent, particularly in ventilated and neurologically impaired patients. This is probably the first clinical study using the Kangaroo Feeding Tube with IRIS technology (IRIS) which incorporates a camera designed to provide anatomic landmark visualization during insertion. The study aim was to evaluate IRIS performance during bedside gastric placement. This is the first prospective study to collect data on the use of IRIS. Twenty consecutive unconscious patients requiring enteral nutrition were recruited at a single center. IRIS placement was considered complete when a clear image of the gastric mucosa appeared. Correct placement was confirmed using a contrast-enhanced abdominal X-ray. To evaluate the device performance over time, the camera was activated every other day up to 17 d postplacement. In 7 (35%) patients, the trachea was initially visualized, requiring a second placement attempt with the same tube. The IRIS camera allowed recognition of the gastric mucosa in 18 (90%) patients. The esophagogastric junction was identified in one patient, while in a second patient the quality of visualization was poor. Contrast-enhanced X-ray confirmed the gastric placement of IRIS in all patients. IRIS allowed identification of gastric mucosa in 14 (70%) patients 3 d after placement. Performance progressively declined with time (P = 0.006, chi-square for trend). IRIS placement could have spared X-ray confirmation in almost all patients and prevented misplacement into the airway in about one third. Visualization quality needs to be improved, particularly after the first week. Copyright © 2016 Elsevier Inc. All rights reserved.

A prospective randomised trial comparing nasogastric with intravenous hydration in children with bronchiolitis (protocol) The comparative rehydration in bronchiolitis study (CRIB)

PubMed Central

2010-01-01

Background Bronchiolitis is the most common reason for admission of infants to hospital in developed countries. Fluid replacement therapy is required in about 30% of children admitted with bronchiolitis. There are currently two techniques of fluid replacement therapy that are used with the same frequency-intravenous (IV) or nasogastric (NG). The evidence to determine the optimum route of hydration therapy for infants with bronchiolitis is inadequate. This randomised trial will be the first to provide good quality evidence of whether nasogastric rehydration (NGR) offers benefits over intravenous rehydration (IVR) using the clinically relevant continuous outcome measure of duration of hospital admission. Methods/Design A prospective randomised multi-centre trial in Australia and New Zealand where children between 2 and 12 months of age with bronchiolitis, needing non oral fluid replacement, are randomised to receive either intravenous (IV) or nasogastric (NG) rehydration. 750 patients admitted to participating hospitals will be recruited, and will be followed daily during the admission and by telephone 1 week after discharge. Patients with chronic respiratory, cardiac, or neurological disease; choanal atresia; needing IV fluid resuscitation; needing an IV for other reasons, and those requiring CPAP or ventilation are excluded. The primary endpoint is duration of hospital admission. Secondary outcomes are complications, need for ICU admission, parental satisfaction, and an economic evaluation. Results will be analysed using t-test for continuous data, and chi squared for categorical data. Non parametric data will be log transformed. Discussion This trial will define the role of NGR and IVR in bronchiolitis Trail registration The trial is registered with the Australian and New Zealand Clinical Trials Registry - ACTRN12605000033640 PMID:20515467

Comparison of a novel bedside portable endoscopy device with nasogastric aspiration for identifying upper gastrointestinal bleeding

PubMed Central

Choi, Jong Hwan; Choi, Jae Hyuk; Lee, Yoo Jin; Lee, Hyung Ki; Choi, Wang Yong; Kim, Eun Soo; Park, Kyung Sik; Cho, Kwang Bum; Jang, Byoung Kuk; Chung, Woo Jin; Hwang, Jae Seok

2014-01-01

AIM: To compare outcomes using the novel portable endoscopy with that of nasogastric (NG) aspiration in patients with gastrointestinal bleeding. METHODS: Patients who underwent NG aspiration for the evaluation of upper gastrointestinal (UGI) bleeding were eligible for the study. After NG aspiration, we performed the portable endoscopy to identify bleeding evidence in the UGI tract. Then, all patients underwent conventional esophagogastroduodenoscopy as the gold-standard test. The sensitivity, specificity, and accuracy of the portable endoscopy for confirming UGI bleeding were compared with those of NG aspiration. RESULTS: In total, 129 patients who had GI bleeding signs or symptoms were included in the study (age 64.46 ± 13.79, 91 males). The UGI tract (esophagus, stomach, and duodenum) was the most common site of bleeding (81, 62.8%) and the cause of bleeding was not identified in 12 patients (9.3%). Specificity for identifying UGI bleeding was higher with the portable endoscopy than NG aspiration (85.4% vs 68.8%, P = 0.008) while accuracy was comparable. The accuracy of the portable endoscopy was significantly higher than that of NG in the subgroup analysis of patients with esophageal bleeding (88.2% vs 75%, P = 0.004). Food material could be detected more readily by the portable endoscopy than NG tube aspiration (20.9% vs 9.3%, P = 0.014). No serious adverse effect was observed during the portable endoscopy. CONCLUSION: The portable endoscopy was not superior to NG aspiration for confirming UGI bleeding site. However, this novel portable endoscopy device might provide a benefit over NG aspiration in patients with esophageal bleeding. PMID:25009396

The Fate of Fat: Pre-Exposure Fat Losses during Nasogastric Tube Feeding in Preterm Newborns

PubMed Central

Rayyan, Maissa; Rommel, Nathalie; Allegaert, Karel

2015-01-01

Deficient nutritional support and subsequent postnatal growth failure are major covariates of short- and long-term outcome in preterm neonates. Despite its relevance, extrauterine growth restriction (EUGR) is still prevalent, occurring in an important portion of extremely preterm infants. Lipids provide infants with most of their energy needs, but also cover specific supplies critical to growth, development and health. The use of human milk in preterm neonates results in practices, such as milk storage, pasteurization and administration by an infusion system. All of these pre-exposure manipulations significantly affect the final extent of lipid deposition in the intestinal track available for absorption, but the impact of tube feeding is the most significant. Strategies to shift earlier to oral feeding are available, while adaptations of the infusion systems (inversion, variable flow) have only more recently been shown to be effective in “in vitro”, but not yet in “in vivo” settings. Pre-exposure-related issues for drugs and nutritional compounds show similarities. Therefore, we suggest that the available practices for “in vitro” drug evaluations should also be considered in feeding strategies to further reduce pre-exposure losses as a strategy to improve the nutritional status and outcome of preterm neonates. PMID:26230707

Flexible and precise dosing of enalapril maleate for all paediatric age groups utilizing orodispersible minitablets.

PubMed

Thabet, Yasmin; Walsh, Jennifer; Breitkreutz, Joerg

2018-04-25

Enalapril is an off-patent angiotensin-converting enzyme inhibitor for which no paediatric age-appropriate formulation is commercially available in Europe, and enalapril maleate (EM) orodispersible minitablets (ODMTs) have previously been formulated within the LENA (labelling enalapril from neonates to adolescents) project. In this study, a dilution method has been developed by dispersing the lowest dose strength ODMTs to enable flexible and precise EM dosing during the dose titration phase of the therapy. Furthermore, the physicochemical stability of the ODMTs has been investigated in child-friendly beverages and the administration of ODMTs via nasogastric tubes (NGT) of different sizes and materials has been evaluated. The results for the ODMT dilution procedure reveal that dispersion within an oral syringe is preferred over dispersion in a separate container, leading to flexible and precise dosing down to 0.025 mg EM. Although ODMTs were stable in the beverages over the investigated time period, dispersion in tap water only is recommended due to prolonged disintegration times within the other beverages. Dispersed ODMTs can be administered through NGTs of CH5. Almost no adsoprtion of EM on silicone, polyurethane or polyvinyl chloride could be observed. The ODMT concept together with the investigated dispersion method enables the safe administration of EM for all paediatric subpopulations from new-borns to adolescents. Copyright © 2018 Elsevier B.V. All rights reserved.

Intra-cavitary dosimetry for IMRT head and neck treatment using thermoluminescent dosimeters in a naso-oesophageal tube.

PubMed

Gagliardi, F M; Roxby, K J; Engström, P E; Crosbie, J C

2009-06-21

Complex intensity-modulated radiation therapy (IMRT) treatment plans require rigorous quality assurance tests. The aim of this study was to independently verify the delivered dose inside the patient in the region of the treatment site. A flexible naso-gastric tube containing thermoluminescent dosimeters (TLDs) was inserted into the oesophagus via the sinus cavity before the patient's first treatment. Lead markers were also inserted into the tube in order that the TLD positions could be accurately determined from the lateral and anterior-posterior electronic portal images taken prior to treatment. The measured dose was corrected for both daily linac output variations and the estimated dose received from the portal images. The predicted dose for each TLD was determined from the treatment planning system and compared to the measured TLD doses. The results comprise 431 TLD measurements on 43 patients. The mean measured-to-predicted dose ratio was 0.988 +/- 0.011 (95% confidence interval) for measured doses above 0.2 Gy. There was a variation in this ratio when the measurements were separated into low dose (0.2-1.0 Gy), medium dose (1.0-1.8 Gy) and high dose (>1.8 Gy) measurements. The TLD-loaded, naso-oesophageal tube for in vivo dose verification is straightforward to implement, and well tolerated by patients. It provides independent reassurance of the delivered dose for head and neck IMRT.

Intra-cavitary dosimetry for IMRT head and neck treatment using thermoluminescent dosimeters in a naso-oesophageal tube

NASA Astrophysics Data System (ADS)

Gagliardi, F. M.; Roxby, K. J.; Engström, P. E.; Crosbie, J. C.

2009-06-01

Complex intensity-modulated radiation therapy (IMRT) treatment plans require rigorous quality assurance tests. The aim of this study was to independently verify the delivered dose inside the patient in the region of the treatment site. A flexible naso-gastric tube containing thermoluminescent dosimeters (TLDs) was inserted into the oesophagus via the sinus cavity before the patient's first treatment. Lead markers were also inserted into the tube in order that the TLD positions could be accurately determined from the lateral and anterior-posterior electronic portal images taken prior to treatment. The measured dose was corrected for both daily linac output variations and the estimated dose received from the portal images. The predicted dose for each TLD was determined from the treatment planning system and compared to the measured TLD doses. The results comprise 431 TLD measurements on 43 patients. The mean measured-to-predicted dose ratio was 0.988 ± 0.011 (95% confidence interval) for measured doses above 0.2 Gy. There was a variation in this ratio when the measurements were separated into low dose (0.2-1.0 Gy), medium dose (1.0-1.8 Gy) and high dose (>1.8 Gy) measurements. The TLD-loaded, naso-oesophageal tube for in vivo dose verification is straightforward to implement, and well tolerated by patients. It provides independent reassurance of the delivered dose for head and neck IMRT.

Nasogastric feeding at the end of life: a virtue ethics approach.

PubMed

Krishna, Lalit

2011-07-01

The use of Nasogastric (NG) feeding in the provision of artificial nutrition and hydration at the end of life has, for the most part, been regarded as futile by the medical community. This position has been led chiefly by prevailing medical data. In Singapore, however, there has been an increase in its utilization supported primarily by social, religious and cultural factors expressly to prolong life of the terminally ill patient. Here this article will seek to review the ethical and clinical impact of this treatment and provide some understanding for such decisions in the light of the Duty of Palliative Care [DoPC]. Complemented by virtue ethics theory, the DoPC highlights and seeks to realize the individual case specific goals of care that maximize comfort and quality of life of the patient in the face of rapid attenuation of treatment options and the eminence of the final outcome by considering each of these factors individually in order to provide the best outcome for the patient and the family.

Nutrition accesses among patients receiving enteral treatment in the home environment.

PubMed

Sznajder, Janusz; Ślefarska-Wasilewska, Marta; Wójcik, Piotr

2017-10-31

Enteral feeding in the home environment is connected with creating access to digestive tract, and thanks to that, this kind of treatment is possible. The gold standard in enteral nutrition is PEG, other types of access are: nasogastric tube, gastronomy and jejunostomy. In the article 851 patients who were treated nutritionally in the home environment, in the nutrition clinic, Nutrimed Górny Śląsk, were analyzed. It was described how, in practice, the schedule of nutrition access looks like in the nutrition clinic at a time of qualifying patients to the treatment (PEG 47,35%, gastronomy 18,91%, nasogastric tube 17,39%,jejunostomy 16,33%) and how it changes among patients treated in the nutrition clinic during specific period of time - to the treatment there were qualified patients with at least three-month period of therapy ( second evaluation: PEG 37,01%, gastrostomy 31,13%, nasogastric tube 16,98%, jejunostomy 15,86%). The structure of changes was described, also the routine and the place in what exchanging or changing nutrition access was analyzed. The biggest changes in quantity, among all groups of ill people concerned patients with PEG and gastronomy. In most cases the intervention connected with exchanging access to the digestive tract could be implemented at patient's home.

Economic evaluation of nasogastric versus intravenous hydration in infants with bronchiolitis.

PubMed

Oakley, Ed; Carter, Rob; Murphy, Bridie; Borland, Meredith; Neutze, Jocelyn; Acworth, Jason; Krieser, David; Dalziel, Stuart; Davidson, Andrew; Donath, Susan; Jachno, Kim; South, Mike; Babl, Franz E

2017-06-01

Bronchiolitis is the most common lower respiratory tract infection in infants and the leading cause of hospitalisation. We aimed to assess whether intravenous hydration (IVH) was more cost-effective than nasogastric hydration (NGH) as a planned secondary economic analysis of a randomised trial involving 759 infants (aged 2-12 months) admitted to hospital with a clinical diagnosis of bronchiolitis and requiring non-oral hydration. No Australian cost data exist to aid clinicians in decision-making around interventions in bronchiolitis. Cost data collections included hospital and intervention-specific costs. The economic analysis was reduced to a cost-minimisation study, focusing on intervention-specific costs of IVH versus NGH, as length of stay was equal between groups. All analyses are reported as intention to treat. Intervention costs were greater for IVH than NGH ($113 vs $74; cost difference of $39 per child). The intervention-specific cost advantage to NGH was robust to inter-site variation in unit prices and treatment activity. Intervention-specific costs account for <10% of total costs of bronchiolitis admissions, with NGH having a small cost saving across all sites. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Pathogenesis and Treatment of Cerebral Air Embolism and Associated Disorders.

DTIC Science & Technology

1984-04-01

blades) 12. 7.0, 8.0 and 9.0-mm endotracheal tubes 13. Endotracheal tube stylet 14. Esophageal obturator airway 15. Tracheal suction catheters (14F) 17 r...16. Nasogastric suction tube and Tumee syringe 17. Tincture of Benzoin 18. 2-in waterproof tape 19. Precordial stethoscope 20. Esophageal stethoscope...be justified. If an endotracheal tube cannot be passed, an esophageal obturator airway may be useful. If such an airway Is used, the newer models

Effect of saline 0.9% or Plasma-Lyte 148 therapy on feeding intolerance in patients receiving nasogastric enteral nutrition.

PubMed

Reddy, Sumeet; Bailey, Michael; Beasley, Richard; Bellomo, Rinaldo; Mackle, Diane; Psirides, Alex; Young, Paul

2016-09-01

To compare the effect of Plasma-Lyte (PL)-148 and saline 0.9% (saline) on gastrointestinal (GI) feeding intolerance in mechanically ventilated patients receiving nasogastric (NG) feeding in an intensive care unit. A single-centre pilot study, nested within a multicentre, double-blind, cluster-randomised, double-crossover trial, performed in a mixed medical and surgical ICU. All adult patients who required crystalloid fluid therapy as part of the 0.9% Saline versus Plasma-Lyte 148 for Intensive Care Unit Fluid Therapy (SPLIT) trial, were expected to need mechanical ventilation for more than 48 hours and were receiving enteral nutrition exclusively by NG tube were eligible. We enrolled 69 patients and assigned 35 to PL-148 and 34 to saline. We randomly allocated saline or PL-148 for four alternating 7-week blocks, with staff blinded to the solution. The primary outcome was the proportion of patients with GI feeding intolerance, defined as high gastric residual volume (GRV), diarrhoea or vomiting while receiving NG feeding in the ICU. The proportions of patients with each of high GRV, diarrhoea and vomiting were secondary outcomes. In the PL-148 group, 21 of 35 patients (60.0%) developed GI feeding intolerance, compared with 22 of 34 patients (64.7%) in the saline group (odds ratio [OR], 0.82; 95% CI, 0.31-2.17; P = 0.69). A high GRV was seen in four of 35 patients (11.4%) in the PL-148 group, and in 11 of 34 patients (32.4%) in the saline group (OR, 0.27; 95% CI, 0.08-0.96; P = 0.04). Among mechanically ventilated patients receiving NG feeding, the use of PL-148, compared with saline, did not reduce the proportion of patients developing GI feeding intolerance, but was associated with a decreased incidence of high GRV.

Use of proton pump inhibitors is associated with increased mortality due to nosocomial pneumonia in bedridden patients receiving tube feeding.

PubMed

Hamai, Kosuke; Iwamoto, Hiroshi; Ohshimo, Shinichiro; Wakabayashi, Yu; Ihara, Daisuke; Fujitaka, Kazunori; Hamada, Hironobu; Ono, Koichi; Hattori, Noboru

2018-05-22

To investigate the association between the use of proton pump inhibitors (PPI) and nosocomial pneumonia and gastrointestinal bleeding in bedridden patients receiving tube feeding. A total of 116 bedridden hospitalized patients receiving tube feeding, of which 80 were supported by percutaneous endoscopic gastrostomy and 36 by nasogastric tube, were included in the present study. The patients were divided into two groups: 62 patients treated with PPI (PPI group) and 54 patients without PPI (non-PPI group). Mortality due to nosocomial pneumonia was evaluated using the Kaplan-Meier approach and the log-rank test. A total of 36 patients (31%) died of nosocomial pneumonia during the observation period; the mortality rate due to nosocomial pneumonia was significantly higher in the PPI group than in the non-PPI group (P = 0.0395). Cox proportional hazard analysis showed that the use of PPI and lower levels of serum albumin were independent predictors of 2-year mortality due to nosocomial pneumonia. Gastrointestinal bleeding was observed in four patients in the non-PPI group (7.7%) and in one patient in the PPI group (1.6%); there was no significant difference between the two groups. The use of PPI in bedridden tube-fed patients was independently associated with mortality due to nosocomial pneumonia, and the PPI group had a non-significant lower incidence of gastrointestinal bleeding than the non-PPI group. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 The Authors Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

Transient Tachypnea of the Newborn (TTN)

MedlinePlus

... newborn receives IV fluids. Sometimes babies can take breast milk or formula through a nasogastric (NG) or orogastric ( ... of these tubes, ask the doctor about providing breast milk for your baby. Symptoms of transient tachypnea usually ...

SVC obstruction and stridor relieved by nasogastric tube insertion

PubMed Central

Molena, Emma J.; Krishnamoorthy, Ashwin; Praveen, Coimbatore

2016-01-01

Achalasia is an idiopathic motility disorder of the oesophagus of increasing incidence. It is characterized by aperistalsis of the lower oesophagus and failure of relaxation of the lower oesophageal sphincter. Patients classically present with chronic symptoms of dysphagia, chest pain, weight loss and regurgitation, and they commonly suffer pulmonary complications such as recurrent microaspiration of static, retained food contents of the upper oesophagus. However, it has also been described, uncommonly, to present with megaoesophagus and secondary tracheal compression. We present a case of megaoesophagus secondary to achalasia which presented with stridor and signs of acute superior vena caval obstruction. PMID:26933001

SVC obstruction and stridor relieved by nasogastric tube insertion.

PubMed

Molena, Emma J; Krishnamoorthy, Ashwin; Praveen, Coimbatore

2016-03-01

Achalasia is an idiopathic motility disorder of the oesophagus of increasing incidence. It is characterized by aperistalsis of the lower oesophagus and failure of relaxation of the lower oesophageal sphincter. Patients classically present with chronic symptoms of dysphagia, chest pain, weight loss and regurgitation, and they commonly suffer pulmonary complications such as recurrent microaspiration of static, retained food contents of the upper oesophagus. However, it has also been described, uncommonly, to present with megaoesophagus and secondary tracheal compression. We present a case of megaoesophagus secondary to achalasia which presented with stridor and signs of acute superior vena caval obstruction. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2016.

Tube-in-tube thermophotovoltaic generator

DOEpatents

Ashcroft, J.; Campbell, B.; DePoy, D.

1998-06-30

A thermophotovoltaic device includes at least one thermal radiator tube, a cooling tube concentrically disposed within each thermal radiator tube and an array of thermophotovoltaic cells disposed on the exterior surface of the cooling tube. A shell having a first end and a second end surrounds the thermal radiator tube. Inner and outer tubesheets, each having an aperture corresponding to each cooling tube, are located at each end of the shell. The thermal radiator tube extends within the shell between the inner tubesheets. The cooling tube extends within the shell through the corresponding apertures of the two inner tubesheets to the corresponding apertures of the two outer tubesheets. A plurality of the thermal radiator tubes can be arranged in a staggered or an in-line configuration within the shell. 8 figs.

Tube-in-tube thermophotovoltaic generator

DOEpatents

Ashcroft, John; Campbell, Brian; DePoy, David

1998-01-01

A thermophotovoltaic device includes at least one thermal radiator tube, a cooling tube concentrically disposed within each thermal radiator tube and an array of thermophotovoltaic cells disposed on the exterior surface of the cooling tube. A shell having a first end and a second end surrounds the thermal radiator tube. Inner and outer tubesheets, each having an aperture corresponding to each cooling tube, are located at each end of the shell. The thermal radiator tube extends within the shell between the inner tubesheets. The cooling tube extends within the shell through the corresponding apertures of the two inner tubesheets to the corresponding apertures of the two outer tubesheets. A plurality of the thermal radiator tubes can be arranged in a staggered or an in-line configuration within the shell.

Supportive care for children with cancer. Guidelines of the Childrens Cancer Study Group. The use of nutritional therapy.

PubMed

Lukens, J N

1984-01-01

Nutritional support for children with cancer is predicated on the belief that optimal nutrition promotes tolerance of anti-neoplastic therapy and preserves immunologic responsiveness. The use of nutritional support is based on the assumption that there is effective therapy for the primary disease and that there will be a predictable period of nutritional stress. The most common nutritional problem is posed by the failure of sick children willingly to eat enough to maintain nutritional homeostasis. Supplementation of oral intake with a nutritional formula given by a small-bore nasogastric tube is simple, effective, and economical. If the sum of oral and tolerated nasogastric tube feedings is less than that required for optimal nutrition, unmet needs may be satisfied by nutrients given into a peripheral vein. Total parenteral nutrition, given by central vein, is reserved for situations in which the combination of enteral and peripheral venous alimentation is inadequate.

Successful surgical treatment of left atrioesophageal fistula following atrial ablation.

PubMed

Takahashi, Toru; Mohara, Jun; Ogawa, Hiroomi; Igarashi, Takamichi; Motegi, Yoko

2018-01-23

A 69-year-old male had catheter-based ablation for atrial fibrillation. He was admitted with high fever and had neurological disorder; he was diagnosed with atrioesophageal fistula by CT scan. Intraoperative findings showed that the fistula existed adjacent to the left lower pulmonary vein with a vegetation. The esophageal fistula was repaired, and the left atrial fistula was closed. A nasogastric tube tip was placed in the esophagus for decompression and advanced into the stomach for nutritional support. After vomiting, the patient showed loss of consciousness and left hemiplegia. CT scan revealed a micro-air embolism to the brain. The nasogastric tube tip was pulled back into the esophagus. Gastrointestinal fiberscopy showed a pinhole at the fistula, and a percutaneous endoscopic gastrostomy was made. After conservative treatment, the esophageal fistula was closed and mediastinitis was improved. He was discharged with a little neurological deficit.

Survival of Penicillium spp. conidia during deep-frying and baking steps of frozen chicken nuggets processing.

PubMed

Wigmann, Évelin Francine; Moreira, Rafael Chelala; Alvarenga, Verônica Ortiz; Sant'Ana, Anderson S; Copetti, Marina Venturini

2016-05-01

This study aimed at determining whether Penicillium spp. strains could survive through the heat treatment applied during the processing of frozen chicken nuggets. Firstly, it was found that the conidia of Penicillium were not able to survive the heat shock in phosphate buffer at pH 7.2 in thermal death tubes (TDT) at 80 °C/30 min. Subsequently, each Penicillium strain was inoculated in frozen chicken nuggets, which were subjected to the following treatments: i) only deep frying (frying oil at 195-200 °C), ii) only baking (120-130 °C until the internal temperature reached 70 °C) and iii) deep frying followed by baking (frying oil temperature of 195-200 °C and baking temperature of 120-130 °C, until the internal temperature reached 70 °C). The results indicated that Penicillium polonicum NGT 23/12, Penicillium commune NGT 16/12, Penicillium solitum NGT 30/12 and Penicillium crustosum NGT 51/12 were able to survive after the combined treatment (deep frying followed by baking) when inoculated in chicken nuggets. P. polonicum NGT 23/12 was the most resistant strain to the combined treatment (deep frying and baking), as its population was reduced by 3 log cycles CFU/g, when the internal temperature reached 78 °C after 10 min and 30 s of baking. The present data show that if Penicillium spp. is present in high numbers in raw materials, such as breading flours, it will survive the thermal processing applied during chicken nuggets production. Copyright © 2015 Elsevier Ltd. All rights reserved.

Weight-for-height values and limb anthropometric composition of tube-fed children with quadriplegic cerebral palsy.

PubMed

Kong, Chi-Keung; Wong, Heung-Sang Stephen

2005-12-01

Research has shown that growth retardation among children with quadriplegic cerebral palsy (CP) is often attributed to feeding dysfunction and malnutrition. The study compared weight-for-height values and limb anthropometric composition of nasogastric and gastrostomy tube-fed children with quadriplegic CP with those of orally fed children with quadriplegic CP and normal children, to examine the plausible effects of tube feeding on weight-for-height, fat, and muscle values for children with quadriplegic CP. Triceps, anterior mid-thigh, and medial calf skinfold thicknesses and the corresponding circumferences of the right or less affected side were measured. The subjects consisted of 119 normal children and 62 orally fed and 48 tube-fed children with quadriplegic CP. Body weight and height were recorded. For children with CP whose height could not be measured, height was estimated from the ulna length. Weight-for-height z scores, limb skinfold thicknesses, fat areas, skinfold-corrected muscle girths, and muscle areas of the children were compared. Tube-fed children with CP had normal mean weight-for-height z scores. Weight-for-height z scores of the orally fed children with CP were significantly below those of normal children and tube-fed children with CP. For children with CP, whereas triceps skinfold thickness seemed to predict the mid-upper arm fat area correctly, leg skinfold thicknesses seemed to overestimate the corresponding fat areas. Stepwise multiple regression analysis showed that triceps skinfold thicknesses had good correlation (r = 0.86) and the presence of CP had nonsignificant correlation with mid-upper arm fat areas. Multiple regression analysis of fat areas with skinfold thicknesses and the presence of CP, however, showed that CP was correlated negatively (partial correlation of CP: thigh, -0.45; calf, -0.53) with thigh and calf fat areas. Although skinfold-corrected mid-upper arm muscle girths of children with CP were quite similar to those of

Duodenal Loop Obstruction as an Unusual Cause of Acute Pancreatitis: A Case Series.

PubMed

Lee, Hyeonmin; Choi, Yonghyeok; Jeong, Hyewon; Lim, Jae Kyu; Jung, Taeyoung; Han, Joung Ho; Park, Seon Mee

2016-12-25

Duodenal loop obstruction is an unusual cause of acute pancreatitis. Increased intraluminal pressure hinders pancreatic flow, causing dilatation of the pancreatic duct and inducing acute pancreatitis. We experienced three cases of acute pancreatitis that resulted from duodenal loop obstruction after (1) an esophagectomy with gastric pull-up procedure for esophageal cancer, (2) a gastrectomy with Billroth I reconstruction for gastric cancer, and (3) a gastrojejunostomy for abdominal trauma. An abdominal CT scan revealed a distended duodenal loop, dilated pancreatic duct, and inflamed pancreas with fluid collection. Acute pancreatitis with duodenal loop obstruction was diagnosed by abdominal pain, elevated serum amylase/lipase, and abdominal CT findings. Immediate decompression with a nasogastric tube was performed, and all patients showed improvement within one week after admission. Each patient was followed up for more than two years without recurrence. Our findings suggest the usefulness of nasogastric tube decompression as the first line of treatment for acute pancreatitis related to duodenal loop obstruction.

Massive hemorrhage after Kasai portoenterostomy in a patient with a congenital extrahepatic portosystemic shunt, malrotation and a double aortic arch: report of a case.

PubMed

Takazawa, Shinya; Uchida, Hiroo; Kawashima, Hiroshi; Tanaka, Yujiro; Sato, Kaori; Jimbo, Takahiro; Deie, Kyoichi; Koiwai, Kazuki; Nomura, Koji; Iwanaka, Tadashi

2014-08-01

A newborn female was transferred to our hospital presenting with severe respiratory distress. She underwent tracheal intubation and nasogastric tubing. Investigations revealed a congenital extrahepatic portosystemic shunt (CEPS) type 1, biliary atresia, heterotaxia, polysplenia, malrotation and a double aortic arch (DAA). She underwent the Kasai portoenterostomy and the Ladd procedure when she was 29 days old. On postoperative day 20, she developed sudden hematemesis with bright red blood. Endoscopy showed massive bleeding from an esophageal ulcer, and endoscopic therapy was performed successfully. During left thoracotomy, an aortoesophageal fistula (AEF) was detected and repaired by direct suturing. The postoperative course was uneventful. CEPS type 1 is commonly associated with other congenital malformations; however, there have been no previous reports of an association between CEPS and DAA. Nasogastric tube insertion in a patient with DAA can result in catastrophic AEF. The treatment strategy should be carefully considered in patients with CEPS type 1 and multiple congenital fetal anomalies.

Preparation and characterization of spironolactone-loaded nano-emulsions for extemporaneous applications.

PubMed

Hallouard, François; Dollo, Gilles; Brandhonneur, Nolwenn; Grasset, Fabien; Corre, Pascal Le

2015-01-15

In neonates as well as in adults having swallowing difficulty, oral medication is given through a nasogastric tube making liquid formulations preferable. In this study, we present the high potential of nanometric emulsions formulated by spontaneous surfactant diffusion, as extemporaneous formulations of hydrophobic drug. Spironolactone used as hydrophobic drug model, was incorporated in oil before formulation at a concentration of 13.5mg/g oil. Then, all formulations were evaluated from pharmacotechnical and clinical standpoints, for their use in hospital or community pharmacy. The strength of this new liquid formulation lies on the simplicity, efficiency and reproducibility of their low energy process as on clinical aspects: high dose uniformity, facility to be administered through in nasogastric tube without any retention and a stability of 2 months at least compatible for an extemporaneous use. Moreover, this emulsion presented spironolactone content of 3.75 mg/ml among the most concentrated formulations published. Copyright © 2014 Elsevier B.V. All rights reserved.

Avulsed Nasoenteric Bridle System Magnet as an Intranasal Foreign Body.

PubMed

Puricelli, Michael D; Newberry, Christopher Ian; Gov-Ari, Eliav

2016-02-01

Nasoenteric tubes provide short-term nutrition support to patients unable to take an adequate oral diet. Bridling systems may be used to secure tubes to guard against displacement. We present the first case of an avulsed magnet from a bridling system to raise awareness of this potential complication. The primary methods of securing a nasogastric tube are reviewed, and comparative assessment of the 3 main systems is presented. Diagnosis and management of nasal foreign bodies relevant to this case are reviewed and prevention/safety considerations discussed. © 2015 American Society for Parenteral and Enteral Nutrition.

Protective tubes for sodium heated water tubes

DOEpatents

Essebaggers, Jan

1979-01-01

A heat exchanger in which water tubes are heated by liquid sodium which minimizes the results of accidental contact between the water and the sodium caused by failure of one or more of the water tubes. A cylindrical protective tube envelopes each water tube and the sodium flows axially in the annular spaces between the protective tubes and the water tubes.

Risk factors and molecular epidemiology of extended-spectrum β-lactamase-producing Klebsiella pneumoniae in Xiamen, China.

PubMed

Deng, Jie; Li, Yan-Ting; Shen, Xu; Yu, Yi-Wen; Lin, Hui-Ling; Zhao, Qi-Feng; Yang, Tian-Ci; Li, Shu-Lian; Niu, Jian-Jun

2017-12-01

The aim of this study was to evaluate the risk factors for pneumonia due to extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) and to analyse the molecular epidemiology of ESBL-KP in Xiamen, China. A case-control study was conducted at Zhongshan Hospital from January 2014 to August 2015. Medical records of patients with nosocomial pneumonia caused by K. pneumoniae were collected. A total of 40 cases with ESBL-KP infection and 90 controls with non-ESBL-KP infection were included. The sequence types (STs) of the 40 ESBL-KP strains were determined by multilocus sequence typing (MLST). Univariate analysis primarily revealed an association between the following seven risk factors and ESBL-KP infection (P<0.10): length of hospitalisation; use of cephalosporins; use of quinolones; presence of a nasogastric tube; presence of an intravenous catheter; mechanical ventilation; and cerebrospinal fluid drainage. Furthermore, multivariate analysis revealed that use of cephalosporins and presence of a nasogastric tube were independent risk factors for ESBL-KP infection (P<0.05), with adjusted odds ratios of 3.473 [95% confidence interval (CI) 1.105-10.911; P=0.033] and 2.488 (95% CI 1.083-5.715; P=0.032), respectively. MLST identified 28 STs. The main STs were ST23 (10.0%) and ST37 (10.0%); three novel STs were identified. Use of cephalosporins and presence of a nasogastric tube are independent risk factors for ESBL-KP infection. In addition, the discovery of three novel STs serves as a reminder to continuously monitor outbreaks of ESBL-KP infection. Copyright © 2017. Published by Elsevier Ltd.

Pharmacokinetic Profiles of Ticagrelor Orodispersible Tablets in Healthy Western and Japanese Subjects.

PubMed

Teng, Renli; Hammarberg, Maria; Carlson, Glenn F; Bokelund-Singh, Sara; Ruderfelt, Terese; Blychert, Eva

2017-11-01

Ticagrelor is an antiplatelet agent for patients with acute coronary syndrome or a history of myocardial infarction. Two studies compared pharmacokinetic profiles of orodispersible (OD) ticagrelor tablets versus immediate-release (IR) tablets in Western and Japanese subjects. Both studies were open-label, randomized, crossover, single-center trials. Thirty-six healthy subjects (94% white, 6% other race; Western study NCT02400333) and 42 Japanese healthy subjects (Japanese study NCT02436577) received a single 90-mg ticagrelor dose as an OD tablet [with/without water, and via a nasogastric tube (Western study only)], and an IR tablet; washout between treatments was ≥7 days. Assessments included ticagrelor and AR-C124910XX (active metabolite) plasma concentrations for pharmacokinetic analyses, and safety evaluations. In the Western study, the 90% confidence intervals (CIs) of the geometric mean ratios (GMRs) for ticagrelor and AR-C124910XX maximum plasma concentration (C max ) and area under the plasma concentration-time curve (AUC) were within the acceptance interval (80%-125%) for OD tablets (with/without water, via a nasogastric tube) versus the IR tablet; except for an ~15% lowering of ticagrelor C max (90% CI: 76.77%-93.78%) for the OD tablet taken with water. In the Japanese study, 90% CIs of the GMRs for AUC and C max of both ticagrelor and AR-C124910XX were all within the acceptance intervals for the OD (with/without water) versus IR tablet. No new safety issues were identified. Ticagrelor administered as an OD tablet to Western (without water, and via a nasogastric tube) and Japanese (with/without water) subjects was bioequivalent to the IR tablet.

Bioequivalence among three methods of administering pantoprazole granules in healthy subjects.

PubMed

Tammara, Brinda; Weisel, Kathy; Katz, Arie; Meng, Xu

2009-11-01

The bioequivalence among three methods of administering pantoprazole granules was studied in healthy subjects. In this randomized, open-label, three-period, crossover study, 25 healthy adults received a single 40-mg dose of pantoprazole granules with applesauce orally, with apple juice orally, and with apple juice administered via a nasogastric tube. Subjects were randomly assigned to one of six treatment sequences. Blood samples were collected within 2 hours before treatment administration on study day 1 and at 0.33, 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, 16, and 24 hours after treatment administration. Plasma pantoprazole concentrations were analyzed by a validated liquid chromatography-tandem mass spectrometry method. The plasma pantoprazole concentration-time data for each subject were analyzed using noncompartmental methods. The 90% confidence intervals (CIs) for the test:reference geometric mean ratio were calculated for the peak pantoprazole concentration (C(max) ) and area under the concentration-time curve (AUC). Of the 25 subjects enrolled, 100% completed the study. The mean C(max) and AUC values were similar for the three administration methods. The 90% CIs for the ratios of the geometric means of the granules in apple juice orally (92.4-112.5%) and in apple juice administered through a nasogastric tube (102.7-125.2%), relative to the granules administered with applesauce orally, were essentially within the bioequivalent limits of 80-125%. No serious adverse events or study discontinuations occurred. Three methods of administering pantoprazole delayed-release granules for oral suspension-with apple juice orally, with applesauce orally, and with apple juice through a nasogastric tube--were bioequivalent in healthy subjects.

Hannah's Feeding Journey: A Multidisciplinary Treatment Approach to Establishing Oral Acceptance for a Toddler with a Complex Medical History

ERIC Educational Resources Information Center

Dunn, Dena M.; Galbally, Sandra Lynn; Markowitz, Goldie; Pucci, Kristy N.; Brochi, Ligia; Cohen, Sherri Shubin

2017-01-01

This article presents the importance of multidisciplinary, family-centered care, and a developmental bio-psycho-social approach to treating feeding difficulties in a child with a complex medical history. Hannah spent the first 9 months of her life in the hospital and was discharged dependent on nasogastric tube feeding. Her journey to recovery…

Tube support

DOEpatents

Mullinax, Jerry L.

1988-01-01

A tube support for supporting horizontal tubes from an inclined vertical support tube passing between the horizontal tubes. A support button is welded to the vertical support tube. Two clamping bars or plates, the lower edges of one bearing on the support button, are removably bolted to the inclined vertical tube. The clamping bars provide upper and lower surface support for the horizontal tubes.

Tapered pulse tube for pulse tube refrigerators

DOEpatents

Swift, Gregory W.; Olson, Jeffrey R.

1999-01-01

Thermal insulation of the pulse tube in a pulse-tube refrigerator is maintained by optimally varying the radius of the pulse tube to suppress convective heat loss from mass flux streaming in the pulse tube. A simple cone with an optimum taper angle will often provide sufficient improvement. Alternatively, the pulse tube radius r as a function of axial position x can be shaped with r(x) such that streaming is optimally suppressed at each x.

TUBE TESTER

DOEpatents

Gittings, H.T. Jr.; Kalbach, J.F.

1958-01-14

This patent relates to tube testing, and in particular describes a tube tester for automatic testing of a number of vacuum tubes while in service and as frequently as may be desired. In it broadest aspects the tube tester compares a particular tube with a standard tube tarough a difference amplifier. An unbalanced condition in the circuit of the latter produced by excessive deviation of the tube in its characteristics from standard actuates a switch mechanism stopping the testing cycle and indicating the defective tube.

Texture control of zircaloy tubing during tube reduction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nagai, N.; Kakuma, T.; Fujita, K.

1982-01-01

Seven batches of Zircaloy-2 nuclear fuel cladding tubes with different textures were processed from tube shells of the same size, by different reduction routes, using pilger and 3-roll mills. Based on the texture data of these tubes, the texture control of Zircaloy tubing, the texture gradient across the wall, and the texture change during annealing were studied. The deformation texture of Zicaloy-2 tubing was dependent on the tool's curvature and was independent of the dimensions of the mother tubes. The different slopes of texture gradients were observed between the tubing of higher strain ration and that of lower strain ratio.

Single Port Laparoscopic Gastrostomy: description of a technique and initial experience.

PubMed

Palermo, Mariano; Domínguez, Mario Luis; Acquafresca, Pablo; Duza, Guillermo; Giménez, Mariano

2015-12-01

Since the first classic descriptions of surgical gastrostomies for feeding by supra-umbilical medial incisions, patients were operated under general anesthesia, with prolonged time of surgery; these were patients in poor health status, undernourished due to inadequate intake or to neurological or tumor involvement, with prolonged hospitalization, both for the recovery of the intestinal motility as well as for the recovery of post-surgical wounds. Therefore, we describe a new minimally invasive technique as an alternative to the percutaneous or endoscopic gastrostomy, in patients where we are not allowed to place a nasogastric tube to insufflate the stomach. This is mostly seen in patients with tumors, which cause obstruction. Between July 2012 and June 2013, 8 patients underwent a single port laparoscopic gastrostomy. Five were females, mean age: 77 years (range: 67-87). In all the patients, it was impossible to place a nasogastric tube, due to obstructive tumor. The mean time of the procedure was 45 minutes. Seven patients underwent tolerance of dextrose 10% through the catheter after 12 hours and one 24 hours after the procedures. Enteral feeding was indicated after the dextrose 10% tolerance was performed. No complications related to the procedure were observed. Currently, the gold standard technique to perform a gastrostomy is the percutaneous or endoscopic approach. In patients with head and neck tumors, when it is not possible to insert a nasogastric tube to insufflate the stomach, a laparoscopic gastrostomy would be indicated. We describe a new technique, step by step, to perform less invasive laparoscopic surgery by a single port laparoscopic gastrostomy. The diameter created is the same as the one performed with an open technique, but in this case, with a minimally invasive approach, that allows us to start feeding the patient with a high quality of feeding, because of the wider lumen.

Gastric residual volume (GRV) and gastric contents measurement by refractometry.

PubMed

Chang, Wei-Kuo; McClave, Stephen A; Hsieh, Chung-Bao; Chao, You-Chen

2007-01-01

Traditional use of gastric residual volumes (GRVs), obtained by aspiration from a nasogastric tube, is inaccurate and cannot differentiate components of the gastric contents (gastric secretion vs delivered formula). The use of refractometry and 3 mathematical equations has been proposed as a method to calculate the formula concentration, GRV, and formula volume. In this paper, we have validated these mathematical equations so that they can be implemented in clinical practice. Each of 16 patients receiving a nasogastric tube had 50 mL of water followed by 100 mL of dietary formula (Osmolite HN, Abbott Laboratories, Columbus, OH) infused into the stomach. After mixing, gastric content was aspirated for the first Brix value (BV) measurement by refractometry. Then, 50 mL of water was infused into the stomach and a second BV was measured. The procedure of infusion of dietary formula (100 mL) and then water (50 mL) was repeated and followed by subsequent BV measurement. The same procedure was performed in an in vitro experiment. Formula concentration, GRV, and formula volume were calculated from the derived mathematical equations. The formula concentrations, GRVs, and formula volumes calculated by using refractometry and the mathematical equations were close to the true values obtained from both in vivo and in vitro validation experiments. Using this method, measurement of the BV of gastric contents is simple, reproducible, and inexpensive. Refractometry and the derived mathematical equations may be used to measure formula concentration, GRV, and formula volume, and also to serve as a tool for monitoring the gastric contents of patients receiving nasogastric feeding.

Determination of tube-to-tube support interaction characteristics. [PWR

DOE Office of Scientific and Technical Information (OSTI.GOV)

Haslinger, K.H.

Tube-to-tube support interaction characteristics were determined on a multi-span tube geometry representative of the hot-leg side of the C-E, System 80 steam generator design. Results will become input for an autoclave type wear test program on steam generator tubes, performed by Kraftwerk Union (KWU). Correlation of test data reported here with similar data obtained from the wear tests will be performed in an attempt to make predictions about the long-term fretting behavior of steam generator tubes.

Alternate tube plugging criteria for steam generator tubes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cueto-Felgueroso, C.; Aparicio, C.B.

1997-02-01

The tubing of the Steam Generators constitutes more than half of the reactor coolant pressure boundary. Specific requirements governing the maintenance of steam generator tubes integrity are set in Plant Technical Specifications and in Section XI of the ASME Boiler and Pressure Vessel Code. The operating experience of Steam Generator tubes of PWR plants has shown the existence of some types of degradatory processes. Every one of these has an specific cause and affects one or more zones of the tubes. In the case of Spanish Power Plants, and depending on the particular Plant considered, they should be mentioned themore » Primary Water Stress Corrosion Cracking (PWSCC) at the roll transition zone (RTZ), the Outside Diameter Stress Corrosion Cracking (ODSCC) at the Tube Support Plate (TSP) intersections and the fretting with the Anti-Vibration Bars (AVBs) or with the Support Plates in the preheater zone. The In-Service Inspections by Eddy Currents constitutes the standard method for assuring the SG tubes integrity and they permit the monitoring of the defects during the service life of the plant. When the degradation reaches a determined limit, called the plugging limit, the SG tube must be either repaired or retired from service by plugging. Customarily, the plugging limit is related to the depth of the defect. Such depth is typically 40% of the wall thickness of the tube and is applicable to any type of defect in the tube. In its origin, that limit was established for tubes thinned by wastage, which was the predominant degradation in the seventies. The application of this criterion for axial crack-like defects, as, for instance, those due to PWSCC in the roll transition zone, has lead to an excessive and unnecessary number of tubes being plugged. This has lead to the development of defect specific plugging criteria. Examples of the application of such criteria are discussed in the article.« less

Modified endotracheal tube: emergency alternative to paediatric tracheostomy tube.

PubMed

Kurien, M; Raviraj, R; Mathew, J; Kaliaperumal, I; Ninan, S

2011-07-01

In an emergency, the non-availability of a conventional paediatric tracheostomy tube is a therapeutic challenge for the attending surgeon. To describe a simple alternative to a paediatric tracheostomy tube for use in an emergency situation. Case report of a 14-year-old boy who developed tracheomalacia following partial cricotracheal resection for subglottic stenosis. As a suitably sized tracheostomy tube (with a long narrow segment) was not available, an endotracheal tube was modified and used successfully. Details of the modification, and a relevant literature review, are also discussed. In the paediatric age group, when an appropriately sized tracheostomy tube is not available, a modified endotracheal tube is a simple temporary alternative; this may be especially useful in an emergency.

Home enteral nutrition: organisation of services.

PubMed

Green, Sue; Dinenage, Sarah; Gower, Morwenna; Van Wyk, Johanna

2013-05-01

This article discusses how services for people receiving enteral nutrition via a nasogastric or gastrostomy tube at home are organised. The home enteral nutrition team's role is also explored. The National Institute for Health and Care Excellence outlines the need for nutritional support in adults to be high quality and cost effective. It is important therefore that local services are able to provide people receiving enteral nutrition with safe and effective care that they consider satisfactory. The discussion is pertinent to nurses caring for older people because gastrostomy tube placement is increasingly common in people aged over 60. A gastrostomy tube is the usual route by which enteral nutrition is given in the community.

US Army Medical Department Journal, April-June 2005

DTIC Science & Technology

2005-06-01

systematically assess their practice, and identify Medical Education Directorate and the final link in the medical areas where education can effect...syndrome would nasogastric tube was drained intermittently and otherwise mandate decompressive fasciotomies of the affected extremities vented. Urine...AMEDD Continuum of Medical Education 12 COL John M. Powers, MC, USA The Medical Corps Assignment Process 16 COL Jonathan H. Jaffin, MC, USA, et al

A Proposal for a Study of Bulimia Among Women in the United States Air Force

DTIC Science & Technology

1988-12-01

to be effective (7). Activities on many bases are limitless and frequently include softball, basketball, football, baseball, volleyball, soccer ...34most authorities recognize that the recommended body weight of these tables does not provide an accurate assessment of body fat because of the wide...how many die undiagnosed. Starvation, -uic4 - inadequate potassium intake and stomach perforation from insertion of a nasogastric tube are the more

An interaction between levodopa and enteral nutrition resulting in neuroleptic malignant-like syndrome and prolonged ICU stay.

PubMed

Bonnici, André; Ruiner, Carola-Ellen; St-Laurent, Lyne; Hornstein, David

2010-09-01

To describe a probable interaction between enteral feeds and levodopa leading to neuroleptic malignant-like syndrome (NMLS) in a polytrauma patient with Parkinson's disease (PD). A 63-year-old morbidly obese male polytrauma patient with PD and type 2 diabetes mellitus was admitted to our intensive care unit postoperatively. Enteral feeds were administered per nasogastric tube and provided 0.88 g /kg/day of protein based on ideal body weight (IBW). His PD medications (pramipexole, entacapone, and immediate-release levodopa/carbidopa 100 mg/25 mg, 1.5 tablets 4 times daily) were administered via nasogastric tube. To achieve better glycemic control, his enteral feeds were changed to a formula that provided 1.8 g/kg/day of protein based on IBW. In the following 24 hours, the patient's mental status deteriorated and he was reintubated. He developed a high fever (40.5 degrees C), leukocytosis, elevated serum creatine kinase (CK) (480-1801 units/L), and acute renal impairment. His enteral nutrition was changed to decrease protein intake to 1.0 g/kg/day based on IBW and he was given bromocriptine 5 mg 3 times daily via nasogastric tube. Within 24 hours, the patient's mental status improved, his temperature and CK decreased, and his renal function began to improve; the values returned to baseline levels on the 18th day of admission. Withdrawal or dose reduction of levodopa in patients with PD has been reported to precipitate NMLS, which is potentially fatal. Because dietary protein can decrease the absorp0tion of levodopa, a potential for an interaction between levodopa and enteral feedings exists, although published reports of such an interaction are limited. In this patient, the likelihood that a drug-nutrient interaction occurred between levodopa and enteral feedings is considered to be probable based on the Naranjo probability scale and the Horn Drug Interaction Probability Scale. Health-care professionals should be aware of the interaction between levodopa and protein

Laparoscopic versus open repair for perforated peptic ulcer: A meta analysis of randomized controlled trials.

PubMed

Tan, Shanjun; Wu, Guohao; Zhuang, Qiulin; Xi, Qiulei; Meng, Qingyang; Jiang, Yi; Han, Yusong; Yu, Chao; Yu, Zhen; Li, Ning

2016-09-01

The role of laparoscopic surgery in the repair for peptic ulcer disease is unclear. The present study aimed to compare the safety and efficacy of laparoscopic versus open repair for peptic ulcer disease. Randomized controlled trials (RCTs) comparing laparoscopic versus open repair for peptic ulcer disease were identified from MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and references of identified articles and relevant reviews. Primary outcomes were postoperative complications, mortality, and reoperation. Secondary outcomes were operative time, postoperative pain, postoperative hospital stay, nasogastric tube duration, and time to resume diet. Statistical analysis was carried out by Review Manage software. Five RCTs investigating a total of 549 patients, of whom, 279 received laparoscopic repair and 270 received open repair, were included in the final analysis. There were no significant differences between these two procedures in some primary outcomes including overal postoperative complication rate, mortality, and reoperation rate. Subcategory analysis of postoperative complications showed that laparoscopic repair had also similar rates of repair site leakage, intra-abdominal abscess, postoperative ileus, pneumonia, and urinary tract infection as open surgery, except of the lower surgical site infection rate (P < 0.05). In addition, there were also no significant differences between these two procedures in some second outcomes including operative time, postoperative hospital stay, and time to resume diet, but laparoscopic repair had shorter nasogastric tube duration (P < 0.05) and less postoperative pain (P < 0.05) than open surgery. Laparoscopic surgery is comparable with open surgery in the setting of repair for perforated peptic ulcer. The obvious advantages of laparoscopic surgery are the lower surgical site infection rate, shorter nasogastric tube duration and less postoperative pain. However, more higher quality studies should be

Heat tube device

NASA Technical Reports Server (NTRS)

Khattar, Mukesh K. (Inventor)

1990-01-01

The present invention discloses a heat tube device through which a working fluid can be circulated to transfer heat to air in a conventional air conditioning system. The heat tube device is disposable about a conventional cooling coil of the air conditioning system and includes a plurality of substantially U-shaped tubes connected to a support structure. The support structure includes members for allowing the heat tube device to be readily positioned about the cooling coil. An actuatable adjustment device is connected to the U-shaped tubes for allowing, upon actuation thereof, for the heat tubes to be simultaneously rotated relative to the cooling coil for allowing the heat transfer from the heat tube device to air in the air conditioning system to be selectively varied.

Pulse tube cooler having 1/4 wavelength resonator tube instead of reservoir

NASA Technical Reports Server (NTRS)

Gedeon, David R. (Inventor)

2008-01-01

An improved pulse tube cooler having a resonator tube connected in place of a compliance volume or reservoir. The resonator tube has a length substantially equal to an integer multiple of 1/4 wavelength of an acoustic wave in the working gas within the resonator tube at its operating frequency, temperature and pressure. Preferably, the resonator tube is formed integrally with the inertance tube as a single, integral tube with a length approximately 1/2 of that wavelength. Also preferably, the integral tube is spaced outwardly from and coiled around the connection of the regenerator to the pulse tube at a cold region of the cooler and the turns of the coil are thermally bonded together to improve heat conduction through the coil.

Improvement of pump tubes for gas guns and shock tube drivers

NASA Technical Reports Server (NTRS)

Bogdanoff, D. W.

1990-01-01

In a pump tube, a gas is mechanically compressed, producing very high pressures and sound speeds. The intensely heated gas produced in such a tube can be used to drive light gas guns and shock tubes. Three concepts are presented that have the potential to allow substantial reductions in the size and mass of the pump tube to be achieved. The first concept involves the use of one or more diaphragms in the pump tube, thus replacing a single compression process by multiple, successive compressions. The second concept involves a radical reduction in the length-to-diameter ratio of the pump tube and the pump tube piston. The third concept involves shock heating of the working gas by high explosives in a cyclindrical geometry reusable device. Preliminary design analyses are performed on all three concepts and they appear to be quite feasible. Reductions in the length and mass of the pump tube by factors up to about 11 and about 7, respectively, are predicted, relative to a benchmark conventional pump tube.

Composite Pulse Tube

NASA Technical Reports Server (NTRS)

Martin, Jerry L.; Cloyd, Jason H.

2007-01-01

A modification of the design of the pulse tube in a pulse-tube cryocooler reduces axial thermal conductance while preserving radial thermal conductance. It is desirable to minimize axial thermal conductance in the pulse-tube wall to minimize leakage of heat between the warm and cold ends of the pulse tube. At the same time, it is desirable to maximize radial thermal conductance at the cold end of the pulse tube to ensure adequate thermal contact between (1) a heat exchanger in the form of a stack of copper screens inside the pulse tube at the cold end and (2) the remainder of the cold tip, which is the object to which the heat load is applied and from which heat must be removed. The modified design yields a low-heat-leak pulse tube that can be easily integrated with a cold tip. A typical pulse tube of prior design is either a thin-walled metal tube or a metal tube with a nonmetallic lining. It is desirable that the outer surface of a pulse tube be cylindrical (in contradistinction to tapered) to simplify the design of a regenerator that is also part of the cryocooler. Under some conditions, it is desirable to taper the inner surface of the pulse tube to reduce acoustic streaming. The combination of a cylindrical outer surface and a tapered inner surface can lead to unacceptably large axial conduction if the pulse tube is made entirely of metal. Making the pulse-tube wall of a nonmetallic, lowthermal- conductivity material would not solve the problem because the wall would not afford the needed thermal contact for the stack of screens in the cold end. The modified design calls for fabricating the pulse tube in two parts: a longer, nonmetallic part that is tapered on the inside and cylindrical on the outside and a shorter, metallic part that is cylindrical on both the inside and the outside. The nonmetallic part can be made from G-10 fiberglass-reinforced epoxy or other low-thermal-conductivity, cryogenically compatible material. The metallic part must have high

Tube thoracostomy; chest tube implantation and follow up

PubMed Central

Kuhajda, Ivan; Zarogoulidis, Konstantinos; Kougioumtzi, Ioanna; Huang, Haidong; Li, Qiang; Dryllis, Georgios; Kioumis, Ioannis; Pitsiou, Georgia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Papaiwannou, Antonis; Lampaki, Sofia; Papaiwannou, Antonis; Zaric, Bojan; Branislav, Perin; Porpodis, Konstantinos

2014-01-01

Pneumothorax is an urgent medical situation that requires urgent treatment. We can divide this entity based on the etiology to primary and secondary. Chest tube implantation can be performed either in the upper chest wall or lower. Both thoracic surgeons and pulmonary physicians can place a chest tube with minimal invasive techniques. In our current work, we will demonstrate chest tube implantation to locations, methodology and tools. PMID:25337405

Telescoping tube assembly

NASA Technical Reports Server (NTRS)

Sturm, Albert J. (Inventor); Marrinan, Thomas E. (Inventor)

1995-01-01

An extensible and retractable telescoping tube positions test devices that inspect large stationary objects. The tube has three dimensional adjustment capabilities and is vertically suspended from a frame. The tube sections are independently supported with each section comprising U-shaped housing secured to a thicker support plate. Guide mechanisms preferably mounted only to the thicker plates guide each tube section parallel to a reference axis with improved accuracy so that the position of the remote end of the telescoping tube is precisely known.

Bender/Coiler for Tubing

NASA Technical Reports Server (NTRS)

Stoltzfus, J. M.

1983-01-01

Easy-to-use tool makes coils of tubing. Tubing to be bend clamped with stop post. Die positioned snugly against tubing. Operator turns handle to slide die along tubing, pushing tubing into spiral groove on mandrel.

Interventions for dysphagia and nutritional support in acute and subacute stroke.

PubMed

Geeganage, Chamila; Beavan, Jessica; Ellender, Sharon; Bath, Philip M W

2012-10-17

; OR 0.24; 95% CI 0.13 to 0.46; P < 0.0001; I(2) = 0%) and behavioural interventions (t = 5; n = 423; OR 0.52; 95% CI 0.30 to 0.88; P = 0.01; I(2) = 22%). Route of feeding: percutaneous endoscopic gastrostomy (PEG) and nasogastric tube (NGT) feeding did not differ for case fatality or the composite outcome of death or dependency, but PEG was associated with fewer treatment failures (t = 3; n = 72; OR 0.09; 95% CI 0.01 to 0.51; P = 0.007; I(2) = 0%) and gastrointestinal bleeding (t = 1; n = 321; OR 0.25; 95% CI 0.09 to 0.69; P = 0.007), and higher feed delivery (t = 1; n = 30; MD 22.00; 95% CI 16.15 to 27.85; P < 0.00001) and albumin concentration (t = 3; n = 63; MD 4.92 g/L; 95% CI 0.19 to 9.65; P = 0.04; I(2) = 58%). Although looped NGT versus conventional NGT feeding did not differ for end-of-trial case fatality or death or dependency, feed delivery was higher with looped NGT (t = 1; n = 104; MD 18.00%; 95% CI 6.66 to 29.34; P = 0.002). Timing of feeding: there was no difference for case fatality, or death or dependency, with early feeding as compared to late feeding. Fluid supplementation: there was no difference for case fatality, or death or dependency, with fluid supplementation. Nutritional supplementation: there was no difference for case fatality, or death or dependency, with nutritional supplementation. However, nutritional supplementation was associated with reduced pressure sores (t = 2; n = 4125; OR 0.56; 95% CI 0.32 to 0.96; P = 0.03; I(2) = 0%), and, by definition, increased energy intake (t = 3; n = 174; MD 430.18 kcal/day; 95% CI 141.61 to 718.75; P = 0.003; I(2) = 91%) and protein intake (t = 3; n = 174; MD 17.28 g/day; 95% CI 1.99 to 32.56; P = 0.03; I(2) = 92%). There remains insufficient data on the effect of swallowing therapy, feeding, and nutritional and fluid supplementation on functional outcome and death in dysphagic patients with acute or subacute stroke. Behavioural interventions and acupuncture reduced dysphagia, and pharyngeal electrical

Investigation on the Inertance Tubes of Pulse Tube Cryocooler Without Reservoir

NASA Astrophysics Data System (ADS)

Liu, Y. J.; Yang, L. W.; Liang, J. T.; Hong, G. T.

2010-04-01

Phase angle is of vital importance for high-efficiency pulse tube cryocoolers (PTCs). Inertance tube as the main phase shifter is useful for the PTCs to obtain appropriate phase angle. Experiments of inertance tube without reservoir under variable frequency, variable length and diameter of inertance tube and variable pressure amplitude are investigated respectively. In addition, the authors used DeltaEC, a computer program to predict the performance of low-amplitude thermoacoustic engines, to simulate the effects of inertance tube without reservoir. According to the comparison of experiments and theoretical simulations, DeltaEC method is feasible and effective to direct and improve the design of inertance tubes.

Kaumana lava tube

NASA Technical Reports Server (NTRS)

Greeley, R.

1974-01-01

The entrance to Kaumana Lava Tube is in a picnic ground next to Highway 20 (Kaumana Drive) about 6.5 km southwest of Hilo. The area is passed on the way to the Kona Coast via the Saddle Road and is identified by a Hawaii Visitors Bureau sign. Although it is not the largest lava tube in the islands, Kaumana Lava Tube is an interesting geological formation, displaying many of the features typical of lava tube interiors. It is accessible, relatively easy to walk through, and is in an excellent state of preservation. The tube developed in a historic lava flow (1881, from Mauna Loa), and many aspects of lava tube activity are observed.

Multiple tube premixing device

DOEpatents

Uhm, Jong Ho; Naidu, Balachandar; Ziminksy, Willy Steve; Kraemer, Gilbert Otto; Yilmaz, Ertan; Lacy, Benjamin; Stevenson, Christian; Felling, David

2013-08-13

The present application provides a premixer for a combustor. The premixer may include a fuel plenum with a number of fuel tubes and a burner tube with a number of air tubes. The fuel tubes extend about the air tubes.

Multiple tube premixing device

DOEpatents

Uhm, Jong Ho; Varatharajan, Balachandar; Ziminsky, Willy Steve; Kraemer, Gilbert Otto; Yilmaz, Ertan; Lacy, Benjamin; Stevenson, Christian; Felling, David

2012-12-11

The present application provides a premixer for a combustor. The premixer may include a fuel plenum with a number of fuel tubes and a burner tube with a number of air tubes. The fuel tubes extend about the air tubes.

Retrovirus Studies in Nonhuman Primates at Four Regional Primate Research Centers.

DTIC Science & Technology

1990-09-30

inoculation of the vaginal mucosa with SIV-infected splenocytes. The Heterosexual Transmission of AIDS: A Simian Model. The overall objective of this...rhesus macaques. We have previously reported that SIV can be transmitted across the vaginal mucosa of female rhesus macaques (Miller, et. al., 1990). To...infused through a 2.5mm outer diameter (8 French) soft, plastic, pediatric nasogastric feeding tube (American Pharmaseal, Valencia, Ca.) into the 3 vaginal

Torsion Tests of Tubes

NASA Technical Reports Server (NTRS)

Stang, Ambrose H; Ramberg, Walter; Back, Goldie

1937-01-01

This report presents the results of tests of 63 chromium-molybdenum steel tubes and 102 17st aluminum-alloy tubes of various sizes and lengths made to study the dependence of the torsional strength on both the dimensions of the tube and the physical properties of the tube material. Three types of failure are found to be important for sizes of tubes frequently used in aircraft construction: (1) failure by plastic shear, in which the tube material reached its yield strength before the critical torque was reached; (2) failure by elastic two-lobe buckling, which depended only on the elastic properties of the tube material and the dimensions of the tube; and (3) failure by a combination of (1) and (2) that is, by buckling taking place after some yielding of the tube material.

Heat exchanger tube mounts

DOEpatents

Wolowodiuk, W.; Anelli, J.; Dawson, B.E.

1974-01-01

A heat exchanger in which tubes are secured to a tube sheet by internal bore welding is described. The tubes may be moved into place in preparation for welding with comparatively little trouble. A number of segmented tube support plates are provided which allow a considerable portion of each of the tubes to be moved laterally after the end thereof has been positioned in preparation for internal bore welding to the tube sheet. (auth)

Multi-tube arrangement for combustor and method of making the multi-tube arrangement

DOEpatents

Ziminsky, Willy Steve [Simpsonville, SC

2012-07-31

A fuel injector tube includes a one piece, unitary, polygonal tube having an inlet end and an outlet end. The fuel injector tube further includes a fuel passage extending from the inlet end to the outlet end along a longitudinal axis of the polygonal tube, a plurality of air passages extending from the inlet end to the outlet end and surrounding the fuel passage, and a plurality of fuel holes. Each fuel hole connects an air passage with the fuel passage. The inlet end of the polygonal tube is formed into a fuel tube. A fuel injector includes a plurality of fuel injector tubes and a plate. The plurality of fuel tubes are connected to the plate adjacent the inlet ends of the plurality of fuel injector tubes.

49 CFR 230.61 - Arch tubes, water bar tubes, circulators and thermic siphons.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Arch tubes, water bar tubes, circulators and... MAINTENANCE STANDARDS Boilers and Appurtenances Washing Boilers § 230.61 Arch tubes, water bar tubes... water bar tubes shall thoroughly be cleaned mechanically, washed, and inspected. Circulators and thermic...

Gastric emptying of cold beverages in humans: effect of transportable carbohydrates.

PubMed

Shi, X; Bartoli, W; Horn, M; Murray, R

2000-12-01

Eight healthy subjects, aged 39.0 ¿ 2.4 years, consumed four 6% carbohydrate-electrolyte solutions containing either one (glucose or fructose) or two transportable carbohydrates in single (glucose + fructose) or bound (sucrose) forms. Solution osmolalities ranged from 250 to 434 mOsm/kg H2O. The test solutions were ingested at rest in the amount of 6 ml/kg of body weight at a temperature of 12 ¿C. Gastric emptying rate was measured by repeated aspirations via a nasogastric tube using the modified George double-sampling technique. The intragastric temperature was determined by a temperature probe attached to the nasogastric tube. There were no significant differences in gastric emptying rates and gastric volumes among the solutions. Intragastric temperature dropped from 36.5 ¿C to 23.3 ¿ 3 ¿C immediately after beverage ingestion but recovered to above 30 ¿C within 5 min. These data suggest that the gastric emptying rate of the specified beverages is not affected by the number and type of carbohydrates or by solution osmolalities within the tested range. Within 5 min after ingestion, cold beverages are warmed to above 30 C in the stomach. This infers that the effect of cold solution temperature on gastric emptying rate is likely to be small and transitory.

Parents' attitudes toward oral rehydration therapy in children with mild-to-moderate dehydration.

PubMed

Nir, Vered; Nadir, Erez; Schechter, Yaffa; Kline-Kremer, Adi

2013-01-01

According to current guidelines, the first line of treatment for mild-to-moderate dehydration is oral rehydration; the second line is rehydration through a nasogastric tube. Both methods are widely underused. This study was conducted to evaluate parents' attitudes towards rehydration methods used in pediatric emergency departments. 100 questionnaires were distributed to parents of children who visited emergency room due to gastroenteritis and suspected dehydration. 75 of the parents expected their child to get IV fluids. 49 of them would refuse to consider oral rehydration. 75 of the parents would refuse to consider insertion of nasogastric tube. Parents whose children were previously treated intravenously tended to be less likely to agree to oral treatment. Parents were more prone to decline oral rehydration if the main measurement of dehydration was the child's clinical appearance, clinical appearance with vomiting, or child's refusal to drink and were more likely to agree if the main measurement was diarrhea, diarrhea with clinical appearance, or clinical personnel opinion. This is the first study to examine parents' expectations. We found that in the majority of cases, parents' expectations contradict current guidelines. Efforts should be taken to educate parents in order to allow full implementation of the guidelines.

Treatment of acute decompensation of maple syrup urine disease in adult patients with a new parenteral amino-acid mixture.

PubMed

Servais, A; Arnoux, J B; Lamy, C; Hummel, A; Vittoz, N; Katerinis, I; Bazzaoui, V; Dubois, S; Broissand, C; Husson, M C; Berleur, M P; Rabier, D; Ottolenghi, C; Valayannopoulos, V; de Lonlay, P

2013-11-01

Acute decompensation of maple syrup urine disease (MSUD) is usually treated by enteral feeding with an amino-acid mixture without leucine (Leu), valine or isoleucine. However, its administration is ineffective in cases of gastric intolerance and some adult patients refuse enteral feeding via a nasogastric tube. We developed a new parenteral amino-acid mixture for patients with MSUD. Seventeen decompensation episodes in four adult patients with MSUD treated with a parenteral amino-acid mixture (group P) were compared to 18 previous episodes in the same patients treated by enteral feeding (group E). The mean Leu concentration at presentation was similar in the groups P and E (1196.9 μmol/L and 1212.2 μmol/L, respectively). The mean decrease in the Leu concentration during the first 3 days of hospitalisation was significantly higher in group P than group E (p = 0.0026); there were no side effects. The mean duration of hospitalisation was similar (4 vs. 4.5 days, p = NS). No patient in group P deteriorated whereas one patient in group E required dialysis. This new parenteral amino-acid mixture is safe and allows efficient Leu concentration decrease during acute MSUD decompensation episodes in adults. Its use avoids the need for nasogastric tube insertion.

Reduced-vibration tube array

DOEpatents

Bruck, Gerald J.; Bartolomeo, Daniel R.

2004-07-20

A reduced-vibration tube array is disclosed. The array includes a plurality of tubes in a fixed arrangement and a plurality of damping members positioned within the tubes. The damping members include contoured interface regions characterized by bracing points that selectively contact the inner surface of an associated tube. Each interface region is sized and shaped in accordance with the associated tube, so that the damping member bracing points are spaced apart a vibration-reducing distance from the associated tube inner surfaces at equilibrium. During operation, mechanical interaction between the bracing points and the tube inner surfaces reduces vibration by a damage-reducing degree. In one embodiment, the interface regions are serpentine shaped. In another embodiment, the interface regions are helical in shape. The interface regions may be simultaneously helical and serpentine in shape. The damping members may be fixed within the associated tubes, and damping member may be customized several interference regions having attributes chosen in accordance with desired flow characteristics and associated tube properties.

Observation of "YouTube" Language Learning Videos ("YouTube" LLVS)

ERIC Educational Resources Information Center

Alhamami, Munassir

2013-01-01

This paper navigates into the "YouTube" website as one of the most usable online tools to learn languages these days. The paper focuses on two issues in creating "YouTube" language learning videos: pedagogy and technology. After observing the existing "YouTube" LLVs, the study presents a novel rubric that is directed…

[ACUTE MESENTEROAXIAL GASTRIC VOLVULUS: A REPORT ON ONE CASE

PubMed

Díaz, Juan; Martell, Alex; Ramírez, Lisbeth; Ulloa, Delia

1998-01-01

Acute gastric volvulus in children is uncommon. This paper reports a case presented in a 14-year-old female whose diagnosis was suspected preoperatively taking into account the Brouchardt triad (vomiting, epigastric pain and inability to pass the nasogastric tube into the stomach). The child underwent laparatomy and the final diagnosis was mesenteroaxial gastric volvulus complicated with gastric perforation. Closure of the perforation and gastropexy were performed and the operative results were satisfactory.

Heat-shrink plastic tubing seals joints in glass tubing

NASA Technical Reports Server (NTRS)

Del Duca, B.; Downey, A.

1968-01-01

Small units of standard glass apparatus held together by short lengths of transparent heat-shrinkable polyolefin tubing. The tubing is shrunk over glass O-ring type connectors having O-rings but no lubricant.

Microscale shock tube

NASA Astrophysics Data System (ADS)

Mirshekari, Gholamreza

This project aims at the simulation, design, fabrication and testing of a microscale shock tube. A step by step procedure has been followed to develop the different components of the microscale shock tube and then combine them together to realize the final device. The document reports on the numerical simulation of flows in a microscale shock tube, the experimental study of gas flow in microchannels, the design, microfabrication, and the test of a microscale shock tube. In the first step, a one-dimensional numerical model for simulation of transport effects at small-scale, appeared in low Reynolds number shock tubes is developed. The conservation equations have been integrated in the lateral directions and three-dimensional effects have been introduced as carefully controlled sources of mass, momentum and energy, into the one-dimensional model. The unsteady flow of gas behind the shock wave is reduced to a quasi-steady laminar flow solution, similar to the Blasius solution. The resulting one-dimensional equations are solved numerically and the simulations are performed for previously reported low Reynolds number shock tube experiments. Good agreement between the shock structure simulation and the attenuation due to the boundary layers has been observed. The simulation for predicting the performance of a microscale shock tube shows the large attenuation of shock wave at low pressure ratios. In the next step the steady flow inside microchannels has been experimentally studied. A set of microchannels with different geometries were fabricated. These microchannels have been used to measure the pressure drop as a function of flow rate in a steady compressible flow. The results of the experiments confirm that the flow inside the microscale shock tube follows the laminar model over the experiment's range of Knudsen number. The microscale shock tube is fabricated by deposition and patterning of different thin layers of selected materials on the silicon substrate. The direct

Fallopian Tube Catheterization

PubMed Central

Thurmond, Amy Suzanne

2013-01-01

Fallopian tube catheterization is used for treatment of infertility caused by proximal tubal occlusion, and has replaced surgical treatment for this condition. More recently, fallopian tube catheterization has been used for tubal sterilization. Interventional radiologists tested numerous methods for tubal occlusion using the rabbit as an animal model. As a result, a tubal device has recently been Food and Drug Administration approved for permanent sterilization using hysteroscopic guidance; it can also be placed fluoroscopically by fallopian tube catheterization as an “off-label” procedure. This is a 5-year continuation and update on a procedure that has been done by interventional radiologists for 25 years; history of the development of fallopian tube catheterization in women has been published in detail in this journal. Highlighted in this article will be description of the basic components needed for fallopian tube catheterization. PMID:24436565

Development and Technology Transfer of the Syncro Blue Tube (Gabriel) Magnetically Guided Feeding Tube

DTIC Science & Technology

2017-06-01

other documentation. TITLE: Development and Technology Transfer of the Syncro Blue Tube (Gabriel) Magnetically Guided Feeding Tube REPORT DOCUMENTATION...TITLE AND SUBTITLE Development and Technology Transfer of the Syncro Blue Tube (Gabriel) Magnetically Guided Feeding Tube 5a. CONTRACT NUMBER W81XWH-09-2...Technical Abstract: Further Development and Technology Transfer of the Syncro BLUETUBE™ (Gabriel) Magnetically Guided Feeding Tube. New Primary

Spring/dimple instrument tube restraint

DOEpatents

DeMario, Edmund E.; Lawson, Charles N.

1993-01-01

A nuclear fuel assembly for a pressurized water nuclear reactor has a spring and dimple structure formed in a non-radioactive insert tube placed in the top of a sensor receiving instrumentation tube thimble disposed in the fuel assembly and attached at a top nozzle, a bottom nozzle, and intermediate grids. The instrumentation tube thimble is open at the top, where the sensor or its connection extends through the cooling water for coupling to a sensor signal processor. The spring and dimple insert tube is mounted within the instrumentation tube thimble and extends downwardly adjacent the top. The springs and dimples restrain the sensor and its connections against lateral displacement causing impact with the instrumentation tube thimble due to the strong axial flow of cooling water. The instrumentation tube has a stainless steel outer sleeve and a zirconium alloy inner sleeve below the insert tube adjacent the top. The insert tube is relatively non-radioactivated inconel alloy. The opposed springs and dimples are formed on diametrically opposite inner walls of the insert tube, the springs being formed as spaced axial cuts in the insert tube, with a web of the insert tube between the cuts bowed radially inwardly for forming the spring, and the dimples being formed as radially inward protrusions opposed to the springs.

Characterization of Friction Stir Welded Tubes by Means of Tube Bulge Test

NASA Astrophysics Data System (ADS)

D'Urso, G.; Longo, M.; Giardini, C.

2011-05-01

Mechanical properties of friction stir welded joints are generally evaluated by means of conventional tensile test. This testing method might provide insufficient information because maximum strain obtained in tensile test before necking is small; moreover, the application of tensile test is limited when the joint path is not linear or even when the welds are executed on curved surfaces. Therefore, in some cases, it would be preferable to obtain the joints properties from other testing methods. Tube bulge test can be a valid solution for testing circumferential or longitudinal welds executed on tubular workpieces. The present work investigates the mechanical properties and the formability of friction stir welded tubes by means of tube bulge tests. The experimental campaign was performed on tubular specimens having a thickness of 3 mm and an external diameter of 40 mm, obtained starting from two semi-tubes longitudinally friction stir welded. The first step, regarding the fabrication of tubes, was performed combining a conventional forming process and friction stir welding. Sheets in Al-Mg-Si-Cu alloy AA6060 T6 were adopted for this purpose. Plates having a dimension of 225×60 mm were bent (with a bending axis parallel to the main dimension) in order to obtain semi-tubes. A particular care was devoted to the fabrication of forming devices (punch and die) in order to minimize the springback effects. Semi-tubes were then friction stir welded by means of a CNC machine tool. Some preliminary tests were carried out by varying the welding parameters, namely feed rate and rotational speed. A very simple tool having flat shoulder and cylindrical pin was used. The second step of the research was based on testing the welded tubes by means of tube bulge test. A specific equipment having axial actuators with a conical shape was adopted for this study. Some analyses were carried out on the tubes bulged up to a certain pressure level. In particular, the burst pressure and the

Reliability of steam generator tubing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kadokami, E.

1997-02-01

The author presents results on studies made of the reliability of steam generator (SG) tubing. The basis for this work is that in Japan the issue of defects in SG tubing is addressed by the approach that any detected defect should be repaired, either by plugging the tube or sleeving it. However, this leaves open the issue that there is a detection limit in practice, and what is the effect of nondetectable cracks on the performance of tubing. These studies were commissioned to look at the safety issues involved in degraded SG tubing. The program has looked at a numbermore » of different issues. First was an assessment of the penetration and opening behavior of tube flaws due to internal pressure in the tubing. They have studied: penetration behavior of the tube flaws; primary water leakage from through-wall flaws; opening behavior of through-wall flaws. In addition they have looked at the question of the reliability of tubing with flaws during normal plant operation. Also there have been studies done on the consequences of tube rupture accidents on the integrity of neighboring tubes.« less

AMEDD Clinical Psychology Short Course Held at Brooke Army Medical Center, San Antonio, Texas, 5-9 June 1991

DTIC Science & Technology

1991-06-01

off after a while, as the triage and surgical teams can only pretend to start the IV’s and insert the nasogastric and chest tubes , and only get to...clinical psychology; -- To examine AMEDD clinical psychology’s support of the Gulf War; and -- To provide a forum for continuing education , exchange of...also provide actual preventive consultation, education and case evaluations to the medical company and all other nearby units. In some FTXs, when

Method for shaping polyethylene tubing

NASA Technical Reports Server (NTRS)

Kramer, R. C.

1981-01-01

Method forms polyethylene plastic tubing into configurations previously only possible with metal tubing. By using polyethylene in place of copper or stain less steel tubing inlow pressure systems, fabrication costs are significantly reduced. Polyethylene tubing can be used whenever low pressure tubing is needed in oil operations, aircraft and space applications, powerplants, and testing laboratories.

Wall strains produced by waves in water filled latex tubes. Part 1: Tethered tubes

NASA Astrophysics Data System (ADS)

Gerrard, J. H.

1992-05-01

A progress report on measurements of wall strain is presented. The experimental aim is to produce data with which to compare the results of numerical analysis of pulsatile flow in a deformable tube. The computation is a difficult job requiring the solution of the wall and fluid equations and matching them at the interface which moves. The simplest arrangement of a straight distensible tube attached to a rigid tube of the same internal diameter in which a piston starts from rest was consequently chosen. The rubber tube is of finite length and closed and fixed at the far end. Two forms of motion are examined, sinusoidal motion from rest and impulsive motion in which the piston moves a short distance and stops. The simpler case considered is a tethered tube which only executes radial motion; in the second case the horizontal tube is suspended by cotton threads so that it is free to move longitudinally as well. Measurements of the longitudinal and circumferential strains as a function of distance along the tube were made. The measurements were made at low and high frequency and with short and long tubes. With long tubes the end effect can be investigated. The treatment of shorter tubes by numerical analysis present less of a storage problem.

Spring/dimple instrument tube restraint

DOEpatents

DeMario, E.E.; Lawson, C.N.

1993-11-23

A nuclear fuel assembly for a pressurized water nuclear reactor has a spring and dimple structure formed in a non-radioactive insert tube placed in the top of a sensor receiving instrumentation tube thimble disposed in the fuel assembly and attached at a top nozzle, a bottom nozzle, and intermediate grids. The instrumentation tube thimble is open at the top, where the sensor or its connection extends through the cooling water for coupling to a sensor signal processor. The spring and dimple insert tube is mounted within the instrumentation tube thimble and extends downwardly adjacent the top. The springs and dimples restrain the sensor and its connections against lateral displacement causing impact with the instrumentation tube thimble due to the strong axial flow of cooling water. The instrumentation tube has a stainless steel outer sleeve and a zirconium alloy inner sleeve below the insert tube adjacent the top. The insert tube is relatively non-radioactivated inconel alloy. The opposed springs and dimples are formed on diametrically opposite inner walls of the insert tube, the springs being formed as spaced axial cuts in the insert tube, with a web of the insert tube between the cuts bowed radially inwardly for forming the spring, and the dimples being formed as radially inward protrusions opposed to the springs. 7 figures.

TUBE SPLITTING APPARATUS

DOEpatents

Frantz, C.E.; Cawley, W.E.

1961-05-01

A tool is described for cutting a coolant tube adapted to contain fuel elements to enable the tube to be removed from a graphite moderator mass. The tool splits the tube longitudinally into halves and curls the longitudinal edges of the halves inwardly so that they occupy less space and can be moved radially inwardly away from the walls of the hole in the graphite for easy removal from the graphite.

Intercostal drainage tube or intracardiac drainage tube?

PubMed

Anitha, N; Kamath, S Ganesh; Khymdeit, Edison; Prabhu, Manjunath

2016-01-01

Although insertion of chest drain tubes is a common medical practice, there are risks associated with this procedure, especially when inexperienced physicians perform it. Wrong insertion of the tube has been known to cause morbidity and occasional mortality. We report a case where the left ventricle was accidentally punctured leading to near-exsanguination. This report is to highlight the need for experienced physicians to supervise the procedure and train the younger physician in the safe performance of the procedure.

REACTOR COOLANT TUBE SEAL

DOEpatents

Morris, W.J.

1958-12-01

A plle-flattenlng control element and a fluid seal therefore to permit movement of the element into a liquld contnining region of a neutronlc reactor are described. The device consists of flattened, thin-walled aluminum tubing contalnlng a uniform mixture of thermal neutron absorbing material, and a number of soft rubber closures for the process tubes, having silts capable of passing the flattened elements therethrough, but effectively sealing the process tubes against fluld leaknge by compression of the rubber. The flattened tubing is sufficiently flexible to enable it to conform to the configuratlon of the annular spacing surrounding the fuel elements ln the process tubes.

Microhole Tubing Bending Report

DOE Data Explorer

Oglesby, Ken

2012-01-01

A downhole tubing bending study was made and is reported herein. IT contains a report and 2 excel spreadsheets to calculate tubing bending and to estimate contact points of the tubing to the drilled hole wall (creating a new support point).

Learning from YouTube [Video Book

ERIC Educational Resources Information Center

Juhasz, Alexandra

2011-01-01

YouTube is a mess. YouTube is for amateurs. YouTube dissolves the real. YouTube is host to inconceivable combos. YouTube is best for corporate-made community. YouTube is badly baked. These are a few of the things Media Studies professor Alexandra Juhasz (and her class) learned about YouTube when she set out to investigate what actually happens…

COAXIAL TUBE COUPLING

DOEpatents

Niemoth, H.R.

1963-02-26

BS>This patent shows a device for quickly coupling coaxial tubes in metal-to-metal fashion, so as to be suitable for use in a nuclear reactor. A threaded coliar urges a tapered metal extension on the outer coaxial tube into a tapered seat in the device and simultaneously exerts pressure through a coaxial helical spring so that a similar extension on the inner tube seats in a similar seat near the other end. (AEC)

A Comparison of the Tube-Side Performance of Enhanced Heat Transfer Tubing for Naval Condensers.

DTIC Science & Technology

1982-12-01

AD-A126 938 A COMPARISON OF THE TUBE-SIDE PERFORMANCE OF ENHANCEDAD 12693! HEAT TRANSFER TUBING FOR NAVAL CONDENSERS U) NAVAL POSTGRADUATE SCHOOD...COMPARISON OF THE TUBE-SIDE PERFORMANCE OF ENHANCED HEAT TRANSFER TUBING FOR NAVAL CONDENSERS by Ronald Keith Alexander December 1982 Thesis Advisor: P. J...Comparison of the Tube-Side Master’s Thesis Performance of Enhanced Heat Transfer Pma""nG kpA lne Tubing for Naval Condensers ~PU~UN 4 iotwug 1. AU Y..NW41 6

A comparison of tape-tying versus a tube-holding device for securing endotracheal tubes in adults.

PubMed

Murdoch, E; Holdgate, A

2007-10-01

During the transfer of intubated patients, endotracheal tube security is paramount. This study aims to compare two methods of securing an endotracheal tube in adults: tying with a cloth tape versus the Thomas Endotracheal Tube Holder (Laerdal). A manikin-based study was performed using paramedics and critical care doctors (consultants and senior trainees) as participants. Each participant was asked to secure an endotracheal tube that had been placed within the trachea of a manikin a total of six times, the first three times using tied cloth tape and the last three times using a Thomas Endotracheal Tube Holder. Following each 'fixation' and after the participant had left the room, the security of the tube was tested by applying a fixed force laterally and to the right by dropping a 1.25 kg weight a distance of 50 cm. The amount of movement of the tube with respect to the teeth was measured and recorded in millimetres. Two-hundred-and-seventy tube fixations (135 tied vs. 135 tube holder) were performed by 45 participants. The degree of tube movement was significantly higher when the tube was secured with a tie compared with when the tube holder was used (median movement 22 mm vs. 4 mm, P < 0.0001). We have demonstrated that the tube holder device minimised tube movement in a manikin model when compared with conventional tape tying. The use of this device when transporting intubated patients may reduce the risk of tube displacement though further clinical studies are warranted.

Colon perforation due to pathologic aerophagia in an intellectually disabled child.

PubMed

Basaran, Umit N; Inan, Mustafa; Aksu, Burhan; Ceylan, Turan

2007-10-01

Aerophagia, characterized by symptoms related to repetitive swallowing of air, is a functional gastrointestinal disorder. In some cases, severe aerophagia causes massive bowel distention and leads to volvulus, ileus, and even intestinal necrosis and perforation. A 10-year-old intellectually disabled boy was referred to our unit due to severe abdominal distention, bilious vomiting, no passage of feces and flatus during the previous 3 days. He had experienced episodes of severe abdominal distention and flatulence over the past 2-3 years. In the exploratory laparotomy, two old colonic perforations were found. Splenic flexura resection and diverting colostomy were performed. Rectal biopsy showed ganglionic architecture. During the fifth postoperative month, he was admitted to the emergency unit with severe abdominal distention. During this visit, we observed him swallowing air. For this reason, his primary illness was diagnosed as a pathologic aerophagia. The colostomy was closed 11 months following the first operation. His parents did not accept gastrostomy as a desufflator. For this reason, they were taught nasogastric tube installation for gastric distention. Briefly, if abdominal distention increases during the course of the day and increased flatus is observed during sleep, aerophagia could be the primary pathology. If aerophagia could cause complications, gastrostomy should be applied. If the parents refuse gastrostomy, the parents could perform nasogastric tube drainage.

Siphon flows in isolated magnetic flux tubes. IV - Critical flows with standing tube shocks

NASA Technical Reports Server (NTRS)

Thomas, John H.; Montesinos, Benjamin

1991-01-01

Critical siphon flows in arched, isolated magnetic flux tubes are studied within the thin flux tube approximation, with a view toward applications to intense magnetic flux concentrations in the solar photosphere. The results of calculations of the strength and position of the standing tube shock in the supercritical downstream branch of a critical siphon flow are presented, as are calculations of the flow variables all along the flux tube and the equilibrium path of the flux tube in the surrounding atmosphere. It is suggested that arched magnetic flux tubes, with magnetic field strength increased by a siphon flow, may be associated with some of the intense, discrete magnetic elements observed in the solar photosphere.

Expander for Thin-Wall Tubing

NASA Technical Reports Server (NTRS)

Pessin, R.

1983-01-01

Tool locally expands small-diameter tubes. Tube expander locally expands and deforms tube: Compressive lateral stress induced in elastomeric sleeve by squeezing axially between two metal tool parts. Adaptable to situations in which tube must have small bulge for mechanical support or flow control.

Lunar Lava Tube Sensing

NASA Technical Reports Server (NTRS)

York, Cheryl Lynn; Walden, Bryce; Billings, Thomas L.; Reeder, P. Douglas

1992-01-01

Large (greater than 300 m diameter) lava tube caverns appear to exist on the Moon and could provide substantial safety and cost benefits for lunar bases. Over 40 m of basalt and regolith constitute the lava tube roof and would protect both construction and operations. Constant temperatures of -20 C reduce thermal stress on structures and machines. Base designs need not incorporate heavy shielding, so lightweight materials can be used and construction can be expedited. Identification and characterization of lava tube caverns can be incorporated into current precursor lunar mission plans. Some searches can even be done from Earth. Specific recommendations for lunar lava tube search and exploration are (1) an Earth-based radar interferometer, (2) an Earth-penetrating radar (EPR) orbiter, (3) kinetic penetrators for lunar lava tube confirmation, (4) a 'Moon Bat' hovering rocket vehicle, and (5) the use of other proposed landers and orbiters to help find lunar lava tubes.

Dynamic axial crushing of bitubular tubes with curvy polygonal inner-tube sections

NASA Astrophysics Data System (ADS)

Ahmed, Naveed; Xue, Pu; Zafar, Naeem

Bitubular structural configurations, where the outer tube is circular, square and curvy square in shape while the inner-tube section is curvy triangular, square and hexagonal in different proposed configurations, are numerically crushed under dynamic axial loading. The crashworthiness effectiveness for changing inner-tube polygonal cross-section for each of the outer tube sections is studied and compared with changing outer tube shape. The deformation plots and energy absorption (EA) parameters such as peak crushing force (PCF) mean crushing force (MCF), energy absorption and crush force efficiency for each case are evaluated. Most of the configurations showed ovalization with low PCF and MCF and moderate crush force efficiency. Afterwards, effects of L/D and t/R on deformation modes and EA are demonstrated by selecting one of the configurations from each group using published experimental results.

[Prehospital airway management of laryngeal tubes. Should the laryngeal tube S with gastric drain tube be preferred in emergency medicine?].

PubMed

Dengler, V; Wilde, P; Byhahn, C; Mack, M G; Schalk, R

2011-02-01

Laryngeal tubes (LT) are increasingly being used for emergency airway management. This article reports on two patients in whom out-of-hospital intubation with a single-lumen LT was associated with massive pulmonary aspiration in one patient and gastric overinflation in the other. In both cases peak inspiratory pressures exceeded the LT leak pressure of approximately 35 mbar. This resulted in gastric inflation and decreased pulmonary compliance and increased inspiratory pressure further, thereby creating a vicious circle. It is therefore recommended that laryngeal tube suction (LTS) should be used in all cases of emergency airway management and a gastric drain tube be inserted through the dedicated second lumen. Apart from gastric overinflation, incorrect LT/LTS placement must be detected and immediately corrected, e.g. in cases of difficult or impossible gastric tube placement, permanent drainage of air from the gastric tube, decreasing minute ventilation or an ascending capnography curve.

PEG tube insertion -- discharge

MedlinePlus

... be treated with medicine. Caring for the PEG-tube Site Drainage from around the PEG tube is common for the first 1 or 2 ... cotton swab or gauze. Try to remove any drainage or crusting on the skin and tube. Be gentle. If you used soap, gently clean ...

Sapphire tube pressure vessel

DOEpatents

Outwater, John O.

2000-01-01

A pressure vessel is provided for observing corrosive fluids at high temperatures and pressures. A transparent Teflon bag contains the corrosive fluid and provides an inert barrier. The Teflon bag is placed within a sapphire tube, which forms a pressure boundary. The tube is received within a pipe including a viewing window. The combination of the Teflon bag, sapphire tube and pipe provides a strong and inert pressure vessel. In an alternative embodiment, tie rods connect together compression fittings at opposite ends of the sapphire tube.

Neural Tube Defects

MedlinePlus

Neural tube defects are birth defects of the brain, spine, or spinal cord. They happen in the ... that she is pregnant. The two most common neural tube defects are spina bifida and anencephaly. In ...

Tube-Forming Assays.

PubMed

Brown, Ryan M; Meah, Christopher J; Heath, Victoria L; Styles, Iain B; Bicknell, Roy

2016-01-01

Angiogenesis involves the generation of new blood vessels from the existing vasculature and is dependent on many growth factors and signaling events. In vivo angiogenesis is dynamic and complex, meaning assays are commonly utilized to explore specific targets for research into this area. Tube-forming assays offer an excellent overview of the molecular processes in angiogenesis. The Matrigel tube forming assay is a simple-to-implement but powerful tool for identifying biomolecules involved in angiogenesis. A detailed experimental protocol on the implementation of the assay is described in conjunction with an in-depth review of methods that can be applied to the analysis of the tube formation. In addition, an ImageJ plug-in is presented which allows automatic quantification of tube images reducing analysis times while removing user bias and subjectivity.

[Treatment of refractory status epilepticus with topiramate. Report of three cases].

PubMed

Soler, Bernardita; Godoy, Jaime; Mellado Talesnik, Patricio

2009-07-01

Refractory status epilepticus is a catastrophic illness of the central nervous system, with a mortality rate that reaches 50%. We report three patients admitted with refractory status epilepticus: a 24 year-old male that discontinued antiepileptic medications, a 46 year-old male with a focal epilepsy secondary to an encephalitis that discontinued medications due to gastrointestinal problems and a 59 year-old male with an ischemic encephalopathy AH were treated with topiramate, delivered through a nasogastric tube with a good response.

Tracheostomy tube - speaking

MedlinePlus

... most of the air from passing through your vocal cords. Instead, your breath (air) goes out through your tracheostomy tube (trach). At the time of your surgery, the first trach tube will have a balloon ( ...

Performance improvement of multi-stage pulse tube cryocoolers with a self-precooled pulse tube

NASA Astrophysics Data System (ADS)

Qiu, L. M.; Zhi, X. Q.; Han, L.; Cao, Q.; Gan, Z. H.

2012-10-01

Reducing the pulse tube losses is significant for improving the cooling performance of pulse tube cryocoolers (PTCs) in particular for multi-stage ones, although ignored to a certain extent. A simple method called self-precooled pulse tube for multi-stage PTCs is comprehensively studied in order to reduce the entropy flow inside the pulse tube. Different from the complex multi-bypass or extra cryocooler or cryogens for precooling, the key of the idea is to directly precool some part of the lower stage pulse tube by using a small amount of cooling power from the upper stage through a thermal bridge. A two-stage separate Stirling PTC was chosen to demonstrate the effects of self-precooled pulse tube. Theoretical calculation showed that both the precooling temperature and position of the pulse tube affected the performance of the cryocooler. The experiment results showed that the cooling performance of the second stage with self-precooled pulse tube was remarkably improved as the bottom temperature decreased from 26.60 K to 18.02 K. The cooling power was notably increased with minor performance reduction of the first stage. By further optimizing the operation parameters, a no-load temperature of 15.87 K was achieved, which is the lowest temperature ever obtained by a two-stage Stirling PTC with only an inertance shifter. The study proves that the precooled pulse tube can help hot end heat exchanger reject the heat inside pulse tube, reduce the heat losses of the cold end and consequently improve the cooling performance of the cryocooler.

Tube support for moisture separator reheater

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sabatino, R.A.

1987-08-11

In combination with a moisture separator reheater for a nuclear steam generating power plant, a reheater is described comprising: a sealed elongated substantially horizontal tubular shell member, a cycle fluid inlet passing through the shell member in predetermined position, mositure separator means positioned within the shell member proximate the bottom portion thereof, heat exchanger means comprising a plurality of elongated metallic U-shaped members disposed substantially within the shell member, a tube sheet member supporing the U-shaped tube members at one end thereof. The improvement consists of: the tube support member means proximate the U-bend portion of the U-shaped tube membersmore » each comprising an upper movable tube support member and a lower immovable tube support member, the remainder of the tube support means being immovable, the upper movable tube support member spacing and supporting the top leg portions of the U-shaped tube members, the lower immovable tube support member spacing and supporting the bottom leg portions of the U-shaped tube members, whereby the top leg portions of the U-shaped tube members proximate the U-bend are permitted to move to compensate for any increase in radius in the U-bend portion of the U-shaped tube member due to thermal expansion.« less

Collapse characteristics of hydroformed tubes

NASA Astrophysics Data System (ADS)

Kim, Young-Suk; Lee, Young-Moon; Kim, Cheol; Hwang, Sang-Moo

2002-07-01

Tube hydroforming technology (THF) has been extensively applied to auto-body structural members such as the engine cradle and side member in order to meet the urgent need for vehicle weight and cost reduction as well as high quality for collision accidents. In this paper, the mechanical properties for hydroformed tubes with various bulging strians under the plane strain mode are experimentally investigated. Axial compression tests for hydroformed tubes are performed to investigate the collapse load and collapse absorption capacity through the collapse load-displacement curves. Moreover, the collapse absorption capacities are compared and discussed among as-received, hydroformed, and press formed tubes. Results demonstrate that the hydroformed tubes show higher collapse absorption capability in comparison with the as-received tube and the press formed tube because of its high yield strength due to strain hardening.

Liquid-Nitrogen Test for Blocked Tubes

NASA Technical Reports Server (NTRS)

Wagner, W. R.

1984-01-01

Nondestructive test identifies obstructed tube in array of parallel tubes. Trickle of liquid nitrogen allowed to flow through tube array until array accumulates substantial formation of frost from moisture in air. Flow stopped and warm air introduced into inlet manifold to heat tubes in array. Tubes still frosted after others defrosted identified as obstructed tubes. Applications include inspection of flow systems having parallel legs.

Chest Tube Thoracostomy

MedlinePlus

... outside the lung, causing its collapse (called a pneumothorax ). Chest tube thoracostomy involves placing a hollow plastic ... a chest tube is needed include: ■ ■ Collapsed lung (pneumothorax)— This occurs when air has built up in ...

Older Subjects with β-cell Dysfunction have an Accentuated Incretin Release.

PubMed

Garduno-Garcia, José de Jesús; Gastaldelli, Amalia; DeFronzo, Ralph A; Lertwattanarak, Raweewan; Holst, Jens J; Musi, Nicolas

2018-04-16

Insulin secretion declines with age and this contributes to the increased risk of developing impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) in older subjects. Insulin secretion is regulated by the incretin hormones glucagon-like peptide (GLP) 1 and glucose-dependent insulinotropic peptide (GIP). Here we tested the hypotheses that incretin release is reduced in older subjects, and that this decline is associated with β-cell dysfunction. 40 young (25±3 y) and 53 older (74±7 y) lean non-diabetic subjects underwent a 2 h oral glucose tolerance test (OGTT). Based on the OGTT, subjects were divided in 3 groups: young normal glucose tolerant (Y-NGT, n=40), older with NGT (O-NGT, n=32), and older with IGT (O-IGT, n=21). Plasma insulin, C-peptide, GLP-1, and GIP concentrations were measured every 15-30 min. We quantitated insulin sensitivity (Matsuda index) and insulin secretory rate (ISR) by deconvolution of C-peptide with the calculation of β-cell glucose sensitivity. Matsuda index, early phase ISR (0-30min) and parameters of β-cell function were reduced in O-IGT vs. Y-NGT, but not in O-NGT. GLP-1 concentrations were elevated in both older groups [GLP-1_AUC0-120 was 2.8±0.1 in Y-NGT, 3.8±0.5 in O-NGT, and 3.7±0.4 nmol/l∙120 min in O-IGT (P<0.05)] while GIP secretion was elevated in O-NGT vs. Y-NGT [GIP_AUC0-120 was 4.7±0.3 in Y-NGT, 6.0±0.4 in O-NGT, and 4.8±0.3 nmol/l∙120 min in O-IGT (P<0.05)]. Aging is associated with an exaggerated GLP-1 secretory response. However, this was not sufficient to increase insulin first phase release in O-IGT and overcome insulin resistance.

Apparatus for connecting aligned abutted tubes

DOEpatents

Williams, R.E.

1984-11-29

An apparatus for connecting abutted tubes and for maintaining their rotary alignment during connection. The apparatus comprises first and second tubes, a rotation prevention element, a collar and a retainer. Each tube has inside and outside walls, and first and second ends, each end having an inside and outside edge. The first tube has portions defining a first plurality of cavities located at the outside edge of its first end. An external threaded portion is on the outside wall of the first tube and next to the first plurality of cavities. The second tube has portions defining a second plurality of cavities located at the outside edge of its first end. The first plurality has a different number than the second plurality. The first ends of the first and second tubes have substantially the same outside diameter and are abutted during connection so that an orifice is formed whenever first and second tube cavities substantially overlap. A rotation prevension element is placed in the orifice to prevent rotation of the first and second tubes. A collar with an internal threaded portion is slidably disposed about the second tube. The internal threaded portion engages the external threaded portion of the first tube to connect the tubes. A lip connected to the collar prevents separation of the collar from the second tube.

Tubing misconnections: normalization of deviance.

PubMed

Simmons, Debora; Symes, Lene; Guenter, Peggi; Graves, Krisanne

2011-06-01

Accidental connection of an enteral system to an intravenous (IV) system frequently results in the death of the patient. Misconnections are commonly attributed to the presence of universal connectors found in the majority of patient care tubing systems. Universal connectors allow for tubing misconnections between physiologically incompatible systems. The purpose of this review of case studies of tubing misconnections and of current expert recommendations for safe tubing connections was to answer the following questions: In tubing connections that have the potential for misconnections between enteral and IV tubing, what are the threats to safety? What are patient outcomes following misconnections between enteral and IV tubing? What are the current recommendations for preventing misconnections between enteral and IV tubing? Following an extensive literature search and guided by 2 models of threats and errors, the authors analyzed case studies and expert opinions to identify technical, organizational, and human errors; patient-related threats; patient outcomes; and recommendations. A total of 116 case studies were found in 34 publications. Each involved misconnections of tubes carrying feedings, intended for enteral routes, to IV lines. Overwhelmingly, the recommendations were for redesign to eliminate universal connectors and prevent misconnections. Other recommendations were made, but the analysis indicates they would not prevent all misconnections. This review of the published case studies and current expert recommendations supports a redesign of connectors to ensure incompatibility between enteral and IV systems. Despite the cumulative evidence, little progress has been made to safeguard patients from tubing misconnections.

27 CFR 40.352 - Cigarette tubes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Cigarette tubes. 40.352... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.352 Cigarette tubes. Cigarette tubes...

27 CFR 40.352 - Cigarette tubes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Cigarette tubes. 40.352... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.352 Cigarette tubes. Cigarette tubes...

27 CFR 40.352 - Cigarette tubes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Cigarette tubes. 40.352... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.352 Cigarette tubes. Cigarette tubes...

27 CFR 40.352 - Cigarette tubes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Cigarette tubes. 40.352... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.352 Cigarette tubes. Cigarette tubes...

27 CFR 40.352 - Cigarette tubes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Cigarette tubes. 40.352... OF THE TREASURY (CONTINUED) TOBACCO MANUFACTURE OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Manufacture of Cigarette Papers and Tubes Taxes § 40.352 Cigarette tubes. Cigarette tubes...

Resolution of lava tubes with ground penetrating radar: preliminary results from the TubeX project

NASA Astrophysics Data System (ADS)

Esmaeili, S.; Kruse, S.; Garry, W. B.; Whelley, P.; Young, K.; Jazayeri, S.; Bell, E.; Paylor, R.

2017-12-01

As early as the mid 1970's it was postulated that planetary tubes or caves on other planetary bodies (i.e., the Moon or Mars) could provide safe havens for human crews, protect life and shield equipment from harmful radiation, rapidly fluctuating surface temperatures, and even meteorite impacts. What is not clear, however, are the exploration methods necessary to evaluate a potential tube-rich environment to locate suitable tubes suitable for human habitation. We seek to address this knowledge gap using a suite of instruments to detect and document tubes in a terrestrial analog study at Lava Beds National Monument, California, USA. Here we describe the results of ground penetrating radar (GPR) profiles and light detection and ranging (LiDAR) scans. Surveys were conducted from the surface and within four lava tubes (Hercules Leg, Skull, Valentine and, Indian Well Caves) with varying flow composition, shape, and complexity. Results are shown across segments of these tubes where the tubes are <1 m to ranging > 10 m in height and the ceilings are 1 - 10 m below the surface. The GPR profiles over the tubes are, as expected, complex, due to scattering from fractures in roof material and three-dimensional heterogeneities. Point clouds derived from the LiDAR scans of both the interior and exterior of the lava tubes provide precise positioning of the tube geometry and depth of the ceiling and floor with respect to the surface topography. GPR profiles over LiDAR-mapped tube cross-sections are presented and compared against synthetic models of radar response to the measured geometry. This comparison will help to better understand the origins of characteristic features in the radar profiles. We seek to identify the optimal data processing and migration approaches to aid lava tube exploration of planetary surfaces.

Fuel nozzle tube retention

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cihlar, David William; Melton, Patrick Benedict

A system for retaining a fuel nozzle premix tube includes a retention plate and a premix tube which extends downstream from an outlet of a premix passage defined along an aft side of a fuel plenum body. The premix tube includes an inlet end and a spring support feature which is disposed proximate to the inlet end. The premix tube extends through the retention plate. The spring retention feature is disposed between an aft side of the fuel plenum and the retention plate. The system further includes a spring which extends between the spring retention feature and the retention plate.

YouTube and 'psychiatry'.

PubMed

Gordon, Robert; Miller, John; Collins, Noel

2015-12-01

YouTube is a video-sharing website that is increasingly used to share and disseminate health-related information, particularly among younger people. There are reports that social media sites, such as YouTube, are being used to communicate an anti-psychiatry message but this has never been confirmed in any published analysis of YouTube clip content. This descriptive study revealed that the representation of 'psychiatry' during summer 2012 was predominantly negative. A subsequent smaller re-analysis suggests that the negative portrayal of 'psychiatry' on YouTube is a stable phenomenon. The significance of this and how it could be addressed are discussed.

YouTube as an information source for pediatric adenotonsillectomy and ear tube surgery.

PubMed

Sorensen, Jeffrey A; Pusz, Max D; Brietzke, Scott E

2014-01-01

Assess the overall quality of information on adenotonsillectomy and ear tube surgery presented on YouTube (www.youtube.com) from the perspective of a parent or patient searching for information on surgery. The YouTube website was systematically searched on select dates with a formal search strategy to identify videos pertaining to pediatric adenotonsillectomy and ear tube surgery. Only videos with at least 5 (ear tube surgery) or 10 (adenotonsillectomy) views per day were included. Each video was viewed and scored by two independent scorers. Videos were categorized by goal and scored for video/audio quality, accuracy, comprehensiveness, and procedure-specific content. Cross-sectional study. Public domain website. Fifty-five videos were scored for adenotonsillectomy and forty-seven for ear tube surgery. The most common category was educational (65.3%) followed by testimonial (28.4%), and news program (9.8%). Testimonials were more common for adenotonsillectomy than ear tube surgery (41.8% vs. 12.8%, p=0.001). Testimonials had a significantly lower mean accuracy (2.23 vs. 2.62, p=0.02), comprehensiveness (1.71 vs. 2.22, p=0.007), and TA specific content (0.64 vs. 1.69, p=0.001) score than educational type videos. Only six videos (5.9%) received high scores in both video/audio quality and accuracy/comprehensiveness of content. There was no significant association between the accuracy and comprehensive score and views, posted "likes", posted "dislikes", and likes/dislikes ratio. There was an association between "likes" and mean video quality (Spearman's rho=0.262, p=0.008). Parents/patients searching YouTube for information on pediatric adenotonsillectomy and ear tube surgery will generally encounter low quality information with testimonials being common but of significantly lower quality. Viewer perceived quality ("likes") did not correlate to formally scored content quality. Published by Elsevier Ireland Ltd.

Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo)radiotherapy: a systematic review.

PubMed

Langius, Jacqueline A E; Zandbergen, Myrna C; Eerenstein, Simone E J; van Tulder, Maurits W; Leemans, C René; Kramer, Mark H H; Weijs, Peter J M

2013-10-01

We performed a systematic review to examine the effect of nutritional interventions on nutritional status, quality of life (QoL) and mortality in patients with head and neck squamous cell cancer (HNSCC) receiving radiotherapy or chemoradiotherapy. We searched Pubmed, EMBASE, CENTRAL and Cinahl from inception through January 3rd, 2012 to identify randomized controlled trials (RCTs) from a broad range of nutritional interventions in patients with HNSCC during (chemo)radiotherapy. Two reviewers independently assessed study eligibility and risk of bias, and extracted data. Of 1141 titles identified, 12 study reports were finally included, describing 10 different studies with 11 interventions. Four out of 10 studies examined the effects of individualized dietary counseling, and showed significant benefits on nutritional status and QOL compared to no counseling or general nutritional advice by a nurse (p < 0.05). Three studies on oral nutritional supplements (ONS) were inconsistent about the effect on nutritional status compared with no supplementation. One study showed that nasogastric tube feeding had beneficial effects on nutritional status compared to ONS, but not in all patient groups (p < 0.04). One study showed benefits of percutaneous endoscopic gastronomy (PEG) feeding on nutritional status shortly after RT compared with nasogastric feeding (p = 0.001). Two studies showed that prophylactic PEG feeding was not superior over tube feeding if required. This review shows beneficial effects of individualized dietary counseling on nutritional status and QoL, compared to no counseling or standard nutritional advice. Effects of ONS and tube feeding were inconsistent. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Tube failures in moisture separator-reheater tube bundles due to restrained thermal expansion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Heilker, W.J.; Cassell, D.S.

1983-01-01

In a nuclear power plant, moisture separator-reheater components (MSRs) are used to dry and superheat the exhaust steam from the high pressure turbine before admitting this steam to the low pressure turbines. MSRs have experienced numerous problems which have caused loss of plant thermal efficiency, poor unit availability and high maintenance costs. The most serious problem has been the progressive failure of the U-tubes, which has necessitated replacement of MSR tube bundles at several plants. This paper presents an explanation of the failure mode and identifies critical operational and geometric parameters as to their respective roles in the process. Detailedmore » thermal-hydraulic analytic modeling enables the calculation of tube wall temperatures along the length of each tube for selected power levels. These temperature data are input to finite element models of the tube bundle which yield interactive displacements, rotations and stresses. The results of these studies provide the rational basis for the tube failure mechanism, which is supported by data acquired from inspection of in-service MSRs.« less

Small-bore chest tubes seem to perform better than larger tubes in treatment of spontaneous pneumothorax.

PubMed

Iepsen, Ulrik Winning; Ringbæk, Thomas

2013-06-01

The aim of this study was to compare the efficacy and complications of surgical (large-bore) chest tube drainage with smaller and less invasive chest tubes in the treatment of non-traumatic pneumothorax (PT).  This was a retrospective study of 104 cases (94 patients) of non-traumatic PT treated with chest tubes - either by pulmonary physicians (daytime and weekdays) using small-bore chest tubes, or by orthopaedic surgeons (remaining time slots) using large-bore chest tubes.  A total of 62 had primary spontaneous PT, 30 had secondary spontaneous PT and 12 had iatrogenic PT. A total of 62 patients were treated with large-bore (20-28 Fr) chest tubes placed with traditional thoracotomy, 42 patients were treated by a pulmonary physician, and in 30 of these cases a True-Close thoracic vent (11-13 Fr) was inserted. Patients treated with surgical chest tubes were comparable with patients treated with smaller chest tubes in terms of demographic data and type and size of PT. Compared with patients treated with smaller chest tubes, patients with surgical large-bore tubes had more complications (27.4% versus 9.5%; p = 0.026), a lower success rate (56.5% versus 85.7%; p = 0.002), and longer duration of chest tube (8.3 versus 4.9 days; p = 0.001) and of hospitalisation (11.8 versus 6.9 days; p = 0.004).  We found small chest tubes to be superior to large-bore chest tubes with regard to short-term outcomes in the treatment of non-traumatic PT.  not relevant. The project was approved by the Danish Data Protection Agency, file no. 2012-41-0554. 

Comparison of Medpor coated tear drainage tube versus silicon tear drainage tube in conjunctivodacryocystorhinostomy: problems and solutions.

PubMed

Sendul, Selam Yekta; Cagatay, Halil Huseyin; Dirim, Burcu; Demir, Mehmet; Yıldız, Ali Atakhan; Acar, Zeynep; Cinar, Sonmez; Guven, Dilek

2014-01-01

This study aims at comparing two different types of drainage tubes in conjunctivodacryocystorhinostomy, which are used for upper lacrimal system obstruction or damage, with respect to their respective postoperative problems and solutions. Nineteen eyes of 17 patients who underwent conjunctivodacryocystorhinostomy (CDCR) or conjunctivorhinostomy (CR) surgery with a Medpor coated tear drainage tube or silicon tube placement between October, 2010, and February, 2014, were included in this retrospective comparative study. In the initial surgery, Medpor coated tear drainage tubes were used in 11 eyes by CDCR, whereas silicon tear drainage tubes were implanted into 2 eyes by CR and 6 eyes by CDCR. In group 1, proximal and distal obstructions developed postoperatively in 4 eyes, while 1 eye showed tube malposition and 3 eyes developed luminal obstruction by debris 3 times. In group 2, tube extrusion developed in 4 eyes, whereas tube malposition developed in 6 eyes and luminal obstruction by debris developed in 6 eyes at different times, for a total of 20 times. In our study, the most significant complication we observed in the use of silicon tear drainage tubes was tube extrusion,whereas the leading complication related to the use of Medpor coated tear drainage tubes was tube obstruction.

Comparison of Medpor Coated Tear Drainage Tube versus Silicon Tear Drainage Tube in Conjunctivodacryocystorhinostomy: Problems and Solutions

PubMed Central

Sendul, Selam Yekta; Cagatay, Halil Huseyin; Dirim, Burcu; Demir, Mehmet; Yıldız, Ali Atakhan; Acar, Zeynep; Cinar, Sonmez; Guven, Dilek

2014-01-01

Purpose. This study aims at comparing two different types of drainage tubes in conjunctivodacryocystorhinostomy, which are used for upper lacrimal system obstruction or damage, with respect to their respective postoperative problems and solutions. Methods. Nineteen eyes of 17 patients who underwent conjunctivodacryocystorhinostomy (CDCR) or conjunctivorhinostomy (CR) surgery with a Medpor coated tear drainage tube or silicon tube placement between October, 2010, and February, 2014, were included in this retrospective comparative study. Results. In the initial surgery, Medpor coated tear drainage tubes were used in 11 eyes by CDCR, whereas silicon tear drainage tubes were implanted into 2 eyes by CR and 6 eyes by CDCR. In group 1, proximal and distal obstructions developed postoperatively in 4 eyes, while 1 eye showed tube malposition and 3 eyes developed luminal obstruction by debris 3 times. In group 2, tube extrusion developed in 4 eyes, whereas tube malposition developed in 6 eyes and luminal obstruction by debris developed in 6 eyes at different times, for a total of 20 times. Conclusions. In our study, the most significant complication we observed in the use of silicon tear drainage tubes was tube extrusion,whereas the leading complication related to the use of Medpor coated tear drainage tubes was tube obstruction. PMID:25379518

Vacuum and the electron tube industry

NASA Astrophysics Data System (ADS)

Redhead, P. A.

2005-07-01

The electron tube industry started with the patenting of the thermionic diode by John Ambrose Fleming in 1904. The vacuum technology used by the infant tube industry was copied from the existing incandescent lamp industry. The growing demands for electron tubes for the military in the first world war led to major improvements in pumps and processing methods. By the 1920s, mass production methods were developing to satisfy the demands for receiving tubes by the burgeoning radio industry. Further expansion in the 1930s and 1940s resulted in improvements in automatic equipment for pumping vacuum tubes leading to the massive production rates of electron tubes in the second world war and the following two decades. The demand for radar during the war resulted in the development of techniques for large-scale production of microwave tubes and CRTs, the latter technology being put to good use later in TV picture tube production. The commercial introduction of the transistor ended the massive demand for receiving tubes. This review concentrates on the vacuum technology developed for receiving tube production.

The Influence of a Lower Heated Tube on Nucleate Pool Boiling from a Horizontal Tube

DTIC Science & Technology

1992-06-01

9 C. CONDENSER SECTION .................................... 12 D. COOLING SECTION...lower tube kc thermal conductivity of copper L active boiling tube length Lu non-boiling tube length x Nu Nusselt number p tube outside wall perimeter Pr...teflon endplates. 2. A condenser , assembled using a similar Pyrex-glass tee with aluminum endplates. 3. A reservoir for R- 114 liquid storage. 4. A

Wound tube heat exchanger

DOEpatents

Ecker, Amir L.

1983-01-01

What is disclosed is a wound tube heat exchanger in which a plurality of tubes having flattened areas are held contiguous adjacent flattened areas of tubes by a plurality of windings to give a double walled heat exchanger. The plurality of windings serve as a plurality of effective force vectors holding the conduits contiguous heat conducting walls of another conduit and result in highly efficient heat transfer. The resulting heat exchange bundle is economical and can be coiled into the desired shape. Also disclosed are specific embodiments such as the one in which the tubes are expanded against their windings after being coiled to insure highly efficient heat transfer.

Siphon flows in isolated magnetic flux tubes. III - The equilibrium path of the flux-tube arch

NASA Technical Reports Server (NTRS)

Thomas, John H.; Montesinos, Benjamin

1990-01-01

It is shown how to calculate the equilibrium path of a thin magnetic flux tube in a stratified, nonmagnetic atmosphere when the flux tube contains a steady siphon flow. The equilbrium path of a static thin flux tube in an infinite stratified atmosphere generally takes the form of a symmetric arch of finite width, with the flux tube becoming vertical at either end of the arch. A siphon flow within the flux tube increases the curvature of the arched equilibrium path in order that the net magnetic tension force can balance the inertial force of the flow, which tries to straighten the flux tube. Thus, a siphon flow reduces the width of the arched equilibrium path, with faster flows producing narrower arches. The effect of the siphon flow on the equilibrium path is generally greater for flux tubes of weaker magnetic field strength. Examples of the equilibrium are shown for both isothemal and adiabatic siphon flows in thin flux tubes in an isothermal external atmosphere.

Eddy current signal comparison for tube identification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Glass, S. W., E-mail: Bill.Glass@areva.com, E-mail: Ratko.Vojvodic@areva.com; Vojvodic, R., E-mail: Bill.Glass@areva.com, E-mail: Ratko.Vojvodic@areva.com

2015-03-31

Inspection of nuclear power plant steam generator tubes is required to justify continued safe plant operation. The steam generators consist of thousands of tubes with nominal diameters of 15 to 22mm, approximately 1mm wall thickness, and 20 to 30m in length. The tubes are inspected by passing an eddy current probe through the tubes from tube end to tube end. It is critical to know exactly which tube identification (row and column) is associated with each tube's data. This is controlled by a precision manipulator that provides the tube ID to the eddy current system. Historically there have been somemore » instances where the manipulator incorrectly reported the tube ID. This can have serious consequences including lack of inspection of a tube, or if a pluggable indication is detected, the tube is likely to be mis-plugged thereby risking a primary to secondary leak.« less

Control of endemic nosocomial legionnaires' disease by using sterile potable water for high risk patients.

PubMed Central

Marrie, T. J.; Haldane, D.; MacDonald, S.; Clarke, K.; Fanning, C.; Le Fort-Jost, S.; Bezanson, G.; Joly, J.

1991-01-01

In a setting where potable water is contaminated with Legionella pneumophila serogroup 1, we performed two case control studies. The first case control study consisted of 17 cases of nosocomial Legionnaires' disease (LD) and 33 control (the patients who were admitted to the ward where the case was admitted immediately before and after the case) subjects. Cases had a higher mortality rate 65% vs 12% (P less than 0.004); were more likely to have received assisted ventilation (P less than 0.00001); to have nasogastric tubes (P less than 0.0004) and to be receiving corticosteroids or other immunosuppressive therapy (P less than 0.0001). Based on the results of this study, sterile water was used to flush nasogastric tubes and to dilute nasogastric feeds. Only 3 cases of nosocomial LD occurred during the next year compared with 12 the previous year (P less than 0.0001). Nine cases subsequently occurred and formed the basis for the second case-control study. Eighteen control subjects were those patients admitted to the same unit where the case developed LD, immediately before and after the case. The mortality rate for the cases was 89% vs 6% for controls (P less than 0.00003). The only other significant difference was that cases were more likely to be receiving corticosteroids or other immunosuppressive therapy 89% vs 39% (less than 0.01). We hypothesized that microaspiration of contaminated potable water by immunocompromised patients was a risk factor for nosocomial Legionnaires' disease. From 17 March 1989 onwards such patients were given only sterile potable water. Only two cases of nosocomial LD occurred from June 1989 to September 1990 and both occurred on units where the sterile water policy was not in effect. We conclude that aspiration of contaminated potable water is a possible route for acquisition of nosocomial LD in our hospital and that provision of sterile potable water to high risk patients (those who are receiving corticosteroids or other immunosuppressive

Comparison of two methods of measuring gastric pH.

PubMed

Neill, K M; Rice, K T; Ahern, H L

1993-01-01

To assess the agreement between two methods of measuring gastric pH in critically ill patients (multiple band litmus paper-tested aspirations versus a meter-read probe located in the tip of a nasogastric tube) and to compare nurse satisfaction with both methods of measuring pH. Prospective, correlational, nonprobability sample. Mid-Atlantic, semirural Veterans Affairs Medical Center. 39 male, surgical, critical care patients, who were nasogastrically intubated in the operating room and received nothing by mouth. NURSES: Twenty-seven registered nurses on the medical-surgical intensive care staff. Differences in pH units as determined by two methods of measurement and nurse satisfaction scores. Litmus paper-tested aspirations versus a meter-read probe located in the tip of the nasogastric tube, measured every 2 hours for 48 hours. A nurse satisfaction assessment form for both measurement methods at entry, 6 months, and 12 months. All measures of association, Pearson's r (0.79), the concordance coefficient (0.74), and eta (0.88), were high. The concordance coefficient measures indicated sufficient agreement between the two methods at the initial and 24 hour measurement times (Cb) = 0.97, 0.97, and 0.94), but not at 48 hours. The meter method indicated prophylaxis was needed when the paper did not, more often than did the paper method (9.3% vs 5.2%). A significant difference between methods was found only at the last reading at 48 hours (z = -2.24, p < .0249). MANOVA revealed that nurses' preference for the meter method was significant (F = 139.48, df = 1.18) and increased over time (F = 4.77, df = 2,36). The gastric probe method of measuring pH is an accurate substitution up to 48 hours for the litmus-paper aspiration method in the postoperative patient who is receiving nothing by mouth. Nurses prefer the gastric probe method of measuring pH over the litmus-paper method because they judge it to be safer, faster, and more accurate.

21 CFR 872.6570 - Impression tube.

Code of Federal Regulations, 2011 CFR

2011-04-01

... tube is a device consisting of a hollow copper tube intended to take an impression of a single tooth. The hollow tube is filled with impression material. One end of the tube is sealed with a softened...

Hologram recording tubes

NASA Technical Reports Server (NTRS)

Rajchman, J. H.

1973-01-01

Optical memories allow extremely large numbers of bits to be stored and recalled in a matter of microseconds. Two recording tubes, similar to conventional image-converting tubes, but having a soft-glass surface on which hologram is recorded, do not degrade under repeated hologram read/write cycles.

Blind vortex tube as heat-rejecting heat exchanger for pulse tube cryocooler

NASA Astrophysics Data System (ADS)

Mitchell, M. P.; Fabris, D.; Sweeney, R. O.

2002-05-01

This project integrated several unusual design features in a coaxial pulse tube cooler driven by a G-M compressor. Design objectives were simplification of construction and validation of innovative components to replace screens. The MS*2 Stirling Cycle Code was used to develop the thermodynamic design of the cooler. The primary innovation being investigated is the vortex tube that serves as both the orifice and the heat-rejecting heat exchanger at the warm end of the pulse tube. The regenerator is etched stainless steel foil with a developmental etch pattern. The cold heat exchanger is a copper cup with axial slits in its wall. Flow straightening in the cold end of the pulse tube is accomplished in traditional fashion with screens, but flow in the warm end of the pulse tube passes through a diffuser nozzle that is an extension of the cold throat of the vortex tube. The G-M compressor is rated at 2 kW. The custom-built rotary valve permits operation at speeds up to about 12 Hz. A series of adjustments over a period of about 7 months improved cooling performance by an average of almost 20 K per month. A no-load temperature of 65 K has been achieved. Experimental apparatus and results of this patented device [1,2] are described.

Feasibility of protein-sparing modified fast by tube (ProMoFasT) in obesity treatment: a phase II pilot trial on clinical safety and efficacy (appetite control, body composition, muscular strength, metabolic pattern, pulmonary function test).

PubMed

Sukkar, S G; Signori, A; Borrini, C; Barisione, G; Ivaldi, C; Romeo, C; Gradaschi, R; Machello, N; Nanetti, E; Vaccaro, A L

2013-01-01

Anecdotal data in the last few years suggest that protein-sparing modified diet (PSMF) delivered by naso-gastric tube enteral (with continuous feeding) could attain an significant weight loss and control of appetite oral feeding, but no phase II studies on safety and efficacy have been done up to now. To verify the safety and efficacy of a protein-sparing modified fast administered by naso-gastric tube (ProMoFasT) for 10 days followed by 20 days of a low-calorie diet, in patients with morbid obesity (appetite control, fat free mass maintenance, pulmonary function tests and metabolic pattern, side effects), 26 patients with a BMI ≥30 kg/m 2 have been selected. The patients had to follow a protein-sparing fast by enteral nutrition (ProMoFasT) for 24 h/day, for 10 days followed by 20 days of low-calorie diet (LCD). The endpoint was represented by body weight, BMI, abdominal circumference, Haber's appetite test, body composition by body impedance assessment (BIA), handgrip strength test, metabolic pattern, pulmonary function test. Safety was assessed by evaluation of complications and side effects of PSMF and/or enteral nutrition. In this report the results on safety and efficacy are described after 10 and 30 days of treatment. After the recruiting phase, a total of 22 patients out of 26 enrolled [14 (63.6 %) females] were evaluated in this study. Globally almost all clinical parameters changed significantly during first 10 days. Total body weight significantly decreased after 10 days (∆-6.1 ± 2; p  < 0.001) and this decrease is maintained in the following 20 days of LCD (∆ = -5.88 ± 1.79; p  < 0.001). Also the abdominal circumference significantly decreased after 10 days [median (range): -4.5 (-30 to 0); p  < 0.001] maintained then in the following 20 days of LCD [median (range) = -7 (-23.5 to -2); p  < 0.001]. All BIA parameters significantly changed after 10 and 30 days from baseline. All parameters except BF had a significant

Intranasal fluticasone associated with delayed tympanostomy tube placement in children with eustachian tube dysfunction.

PubMed

Crowson, Matthew G; Ryan, Marisa A; Ramprasad, Vaibhav H; Choi, Kevin J; Raynor, Eileen

2017-03-01

Pediatric patient caregivers may prefer to avoid a surgical intervention and request a medical management option for eustachian tube dysfunction (ETD). However, there are limited published data evaluating the efficacy of intranasal fluticasone in the medical management of ETD as an alternative to tympanostomy tube placement. The objectives of this study were to: 1) determine if intranasal fluticasone (INF) prevented tympanostomy tube placement in children with ETD, and 2) describe differences in patient response to INF related to cleft lip and/or palate (CLP) and Down syndrome. Case series with planned chart review at a Tertiary academic hospital. We reviewed pediatric patients treated with INF for ETD. Inclusion criteria included ETD, no prior intranasal or oral steroid therapy, and no prior tympanostomy tube placement. Outcomes included time-to- tympanostomy tube placement with or without INF and therapy compliance. Kaplan-Meier survival analyses with log-rank tests and Fisher's exact tests were used to examine outcome variables. 676 fulfilled inclusion criteria. 393 (58.7%) were male, and 355 (52.5%) Caucasian with mean age of 27.1 months old. 92 (13.6%) had CLP and 46 (6.8%) had Down Syndrome. 266 (39.4%) received INF, and 202 (88.2%) were compliant at their next visit. 474 (70.1%) had tympanostomy tubes placed. Children treated with INF were less likely to have tympanostomy tubes placed than children not treated (52.6% vs. 81.5%; p < 0.0001). Using survival analyses, INF use was associated with significantly longer mean time-to-tympanostomy tube than no INF use (199.4 vs. 133.7 days; p < 0.0001). INF did not reduce time-to-tympanostomy tube in patients with CLP (p = 0.05) or Down Syndrome (p = 0.27). INF significantly reduces the number of children requiring tympanostomy tube placement for ETD. The CLP and Down Syndrome anatomical variants may attenuate INF efficacy. Further in vivo characterization of INF action on eustachian tube tissues will help

Eddy-Current Detection of Cracks in Tubes

NASA Technical Reports Server (NTRS)

Parent, R.; Kettering, D.

1987-01-01

Nondestructive device tests narrow, sharply-bent metal tubes. Eddycurrent probe detects incipient cracks inside small metal tubes. Tube-centering device consisting of pair of opposed bars ensures tube centered on eddy-current coil. Probe moves along length of bent tube to inspect repeatably for cracks. Compatible with tubes of different cross sections, oval, flattened, square, rectangular,or irregular. Adapts for inspecting formed tubes in petrochemical, automotive, nuclear, and medical equipment.

Comparison of digoxin concentration in plastic serum tubes with clot activator and heparinized plasma tubes.

PubMed

Dukić, Lora; Simundić, Ana-Maria; Malogorski, Davorin

2014-01-01

Sample type recommended by the manufacturer for the digoxin Abbott assay is either serum collected in glass tubes or plasma (sodium heparin, lithium heparin, citrate, EDTA or oxalate as anticoagulant) collected in plastic tubes. In our hospital samples are collected in plastic tubes. Our hypothesis was that the serum sample collected in plastic serum tube can be used interchangeably with plasma sample for measurement of digoxin concentration. Our aim was verification of plastic serum tubes for determination of digoxin concentration. Concentration of digoxin was determined simultaneously in 26 venous blood plasma (plastic Vacuette, LH Lithium heparin) and serum (plastic Vacuette, Z Serum Clot activator; both Greiner Bio-One GmbH, Kremsmünster, Austria) samples, on Abbott AxSYM analyzer using the original Abbott Digoxin III assay (Abbott, Wiesbaden, Germany). Tube comparability was assessed using the Passing Bablok regression and Bland-Altman plot. Serum and plasma digoxin concentrations are comparable. Passing Bablok intercept (0.08 [95% CI = -0.10 to 0.20]) and slope (0.99 [95% CI = 0.92 to 1.11]) showed there is no constant or proportional error. Blood samples drawn in plastic serum tubes and plastic plasma tubes can be interchangeably used for determination of digoxin concentration.

Comparison of digoxin concentration in plastic serum tubes with clot activator and heparinized plasma tubes

PubMed Central

Dukić, Lora; Šimundić, Ana-Maria; Malogorski, Davorin

2014-01-01

Introduction: Sample type recommended by the manufacturer for the digoxin Abbott assay is either serum collected in glass tubes or plasma (sodium heparin, lithium heparin, citrate, EDTA or oxalate as anticoagulant) collected in plastic tubes. In our hospital samples are collected in plastic tubes. Our hypothesis was that the serum sample collected in plastic serum tube can be used interchangeably with plasma sample for measurement of digoxin concentration. Our aim was verification of plastic serum tubes for determination of digoxin concentration. Materials and methods: Concentration of digoxin was determined simultaneously in 26 venous blood plasma (plastic Vacuette, LH Lithium heparin) and serum (plastic Vacuette, Z Serum Clot activator; both Greiner Bio-One GmbH, Kremsmünster, Austria) samples, on Abbott AxSYM analyzer using the original Abbott Digoxin III assay (Abbott, Wiesbaden, Germany). Tube comparability was assessed using the Passing Bablok regression and Bland-Altman plot. Results: Serum and plasma digoxin concentrations are comparable. Passing Bablok intercept (0.08 [95% CI = −0.10 to 0.20]) and slope (0.99 [95% CI = 0.92 to 1.11]) showed there is no constant or proportional error. Conclusion: Blood samples drawn in plastic serum tubes and plastic plasma tubes can be interchangeably used for determination of digoxin concentration. PMID:24627723

Eustachian Tube Function.

PubMed

Ars, Bernard; Dirckx, Joris

2016-10-01

The fibrocartilaginous eustachian tube is part of a system of contiguous organs including the nose, palate, rhinopharynx, and middle ear cleft. The middle ear cleft consists of the tympanic cavity, which includes the bony eustachian tube (protympanum) and the mastoid gas cells system. The tympanic cavity and mastoid gas cells are interconnected and allow gaseous exchange and pressure regulation. The fibrocartilaginous eustachian tube is a complex organ consisting of a dynamic conduit with its mucosa, cartilage, surrounding soft tissue, peritubal muscles (ie, tensor and levator veli palatine, salpingopharyngeus and tensor tympani), and superior bony support (the sphenoid sulcus). Copyright © 2016 Elsevier Inc. All rights reserved.

Closed-Tube Barcoding.

PubMed

Sirianni, Nicky M; Yuan, Huijun; Rice, John E; Kaufman, Ronit S; Deng, John; Fulton, Chandler; Wangh, Lawrence J

2016-11-01

Here, we present a new approach for increasing the rate and lowering the cost of identifying, cataloging, and monitoring global biodiversity. These advances, which we call Closed-Tube Barcoding, are one application of a suite of proven PCR-based technologies invented in our laboratory. Closed-Tube Barcoding builds on and aims to enhance the profoundly important efforts of the International Barcode of Life initiative. Closed-Tube Barcoding promises to be particularly useful when large numbers of small or rare specimens need to be screened and characterized at an affordable price. This approach is also well suited for automation and for use in portable devices.

Dermatology on YouTube.

PubMed

Boyers, Lindsay N; Quest, Tyler; Karimkhani, Chante; Connett, Jessica; Dellavalle, Robert P

2014-06-15

YouTube, reaches upwards of six billion users on a monthly basis and is a unique source of information distribution and communication. Although the influence of YouTube on personal health decision-making is well established, this study assessed the type of content and viewership on a broad scope of dermatology related content on YouTube. Select terms (i.e. dermatology, sun protection, skin cancer, skin cancer awareness, and skin conditions) were searched on YouTube. Overall, the results included 100 videos with over 47 million viewers. Advocacy was the most prevalent content type at 24% of the total search results. These 100 videos were "shared" a total of 101,173 times and have driven 6,325 subscriptions to distinct YouTube user pages. Of the total videos, 35% were uploaded by or featured an MD/DO/PhD in dermatology or other specialty/field, 2% FNP/PA, 1% RN, and 62% other. As one of the most trafficked global sites on the Internet, YouTube is a valuable resource for dermatologists, physicians in other specialties, and the general public to share their dermatology-related content and gain subscribers. However, challenges of accessing and determining evidence-based data remain an issue.

Intagliated phosphor screen image tube project

NASA Technical Reports Server (NTRS)

Hertzel, R. J.

1982-01-01

The production and evaluation of a magnetic focus image tube for astronomical photography that has an intagliated phosphor screen is described. The modulation transfer function of such a tube was measured by electronic means and by film tests, and the results compared with tubes of more conventional construction. The physical properties of the image tube and film combination, the analytical model of the optical interface, and the salient features of the intagliated screen tube are described. The results of electronic MTF tests of the intagliated image tube and of the densitometry of the tube and film test samples are presented. It is concluded that the intagliated screen is a help, but that the thickness of the photographic film is also important.

Bacterial Biofilms in Jones Tubes.

PubMed

Ahn, Eric S; Hauck, Matthew J; Kirk Harris, Jonathan; Robertson, Charles E; Dailey, Roger A

To investigate the presence and microbiology of bacterial biofilms on Jones tubes (JTs) by direct visualization with scanning electron microscopy and polymerase chain reaction (PCR) of representative JTs, and to correlate these findings with inflammation and/or infection related to the JT. In this study, prospective case series were performed. JTs were recovered from consecutive patients presenting to clinic for routine cleaning or recurrent irritation/infection. Four tubes were processed for scanning electron microscopy alone to visualize evidence of biofilms. Two tubes underwent PCR alone for bacterial quantification. One tube was divided in half and sent for scanning electron microscopy and PCR. Symptoms related to the JTs were recorded at the time of recovery. Seven tubes were obtained. Five underwent SEM, and 3 out of 5 showed evidence of biofilms (60%). Two of the 3 biofilms demonstrated cocci and the third revealed rods. Three tubes underwent PCR. The predominant bacteria identified were Pseudomonadales (39%), Pseudomonas (16%), and Staphylococcus (14%). Three of the 7 patients (43%) reported irritation and discharge at presentation. Two symptomatic patients, whose tubes were imaged only, revealed biofilms. The third symptomatic patient's tube underwent PCR only, showing predominantly Staphylococcus (56%) and Haemophilus (36%) species. Two of the 4 asymptomatic patients also showed biofilms. All symptomatic patients improved rapidly after tube exchange and steroid antibiotic drops. Bacterial biofilms were variably present on JTs, and did not always correlate with patients' symptoms. Nevertheless, routine JT cleaning is recommended to treat and possibly prevent inflammation caused by biofilms.

Small bore ceramic laser tube inspection light table

DOEpatents

Updike, Earl O.

1990-01-01

Apparatus for inspecting small bore ceramic laser tubes, which includes a support base with one or more support rollers. A fluorescent light tube is inserted within the laser tube and the laser tube is supported by the support rollers so that a gap is maintained between the laser tube and the fluorescent tube to enable rotation of the laser tube. In operation, the ceramic tube is illuminated from the inside by the fluorescent tube to facilitate visual inspection. Centering the tube around the axial light of the fluorescent tube provides information about straightness and wall thickness of the laser tube itself.

Boiling and condensation in microfin tubes

NASA Astrophysics Data System (ADS)

Schlager, Lynn M.

A general overview of microfin tubes and their applications is presented. Manufacturing processes, commercial availability, experimental heat transfer, and pressure drop data for various refrigerants (including alternative refrigerants and refrigerant-oil mixtures), physical mechanisms of enhancement, and the incorporation of microfin tubes in common heat exchanger configurations are discussed. Microfin tubes, also known by various trade names, are characterized by numerous small fins which typically spiral down the inside wall of tubes at angles ranging from 10 to 30 degrees. The number of fins ranges from 48 to 70 with typical fin heights of 0.12 to 0.30 mm (fin height generally less than 3 percent of the inside diameter of the tube). Fin shapes may vary and the inside surface area of microfin tubes is 10 to 70 percent greater than the area of equivalent smooth tubes. Heat transfer can be enhanced by up to a factor of three with microfin tubes.

Managing a chest tube and drainage system.

PubMed

Durai, Rajaraman; Hoque, Happy; Davies, Tony W

2010-02-01

Intercostal drainage tubes (ie, chest tubes) are inserted to drain the pleural cavity of air, blood, pus, or lymph. The water-seal container connected to the chest tube allows one-way movement of air and liquid from the pleural cavity. The container should not be changed unless it is full, and the chest tube should not be clamped unnecessarily. After a chest tube is inserted, a nurse trained in chest-tube management is responsible for managing the chest tube and drainage system. This entails monitoring the chest-tube position, controlling fluid evacuation, identifying when to change or empty the containers, and caring for the tube and drainage system during patient transport. This article provides an overview of indications, insertion techniques, and management of chest tubes. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Improving hydro-formability of stainless steel tubes by tube channel pressing

NASA Astrophysics Data System (ADS)

Kitano, Y.; Yuasa, M.; Miyamoto, H.; Farshidi, M. H.; Bagherpour, E.

2017-05-01

Tube channel pressing (TCP), which is one of the severe plastic deformation (SPD) technologies to refine grain size into submicron size for tubular materials, have been applied to ferritic stainless steel tubes for one pass, in order to alleviate ridging and enhance the hydro-formability. It was found that grain-scale shear bands were introduced by one-pass TCP, and texture and microstructure was successfully modified by promoting recrystallization of deformation microstructure, which is otherwise hard-to-recrystallize, in the post-TCP annealing. Elongation to failure, strain-hardening exponent (n-value) and Lankford values of both longitudinal and circumferential directions increased in comparison to with the tube fabricated by conventional process.

Strong, corrosion-resistant aluminum tubing

NASA Technical Reports Server (NTRS)

Reed, M. W.; Adams, F. F.

1980-01-01

When aluminum tubing having good corrosion resistance and postweld strength is needed, type 5083 alloy should be considered. Chemical composition is carefully controlled and can be drawn into thin-wall tubing with excellent mechanical properties. Uses of tubing are in aircraft, boats, docks, and process equipment.

27 CFR 41.35 - Cigarette tubes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2011-04-01 2011-04-01 false Cigarette tubes. 41.35... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.35 Cigarette tubes. Cigarette tubes are taxed at the following rates...

27 CFR 41.35 - Cigarette tubes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2014-04-01 2014-04-01 false Cigarette tubes. 41.35... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.35 Cigarette tubes. Cigarette tubes are taxed at the following rates...

27 CFR 41.35 - Cigarette tubes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2013-04-01 2013-04-01 false Cigarette tubes. 41.35... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.35 Cigarette tubes. Cigarette tubes are taxed at the following rates...

27 CFR 41.35 - Cigarette tubes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Cigarette tubes. 41.35... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.35 Cigarette tubes. Cigarette tubes are taxed at the following rates...

27 CFR 41.35 - Cigarette tubes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 2 2012-04-01 2011-04-01 true Cigarette tubes. 41.35... OF THE TREASURY (CONTINUED) TOBACCO IMPORTATION OF TOBACCO PRODUCTS, CIGARETTE PAPERS AND TUBES, AND PROCESSED TOBACCO Taxes Tax Rates § 41.35 Cigarette tubes. Cigarette tubes are taxed at the following rates...

Tubing cutter for tight spaces

NASA Technical Reports Server (NTRS)

Girala, A. S.

1980-01-01

Cutter requires few short swings of handle to rotate its cutting edge full 360 around tube. It will cut tubing installed in confined space that prevents free movement of conventional cutter. Cutter is snapped onto tube and held in place by spring-loaded clamp. Screw ratchet advances cutting wheel.

Differences in attitudes to end-of-life care among patients, relatives and healthcare professionals

PubMed Central

Ang, Guat Cheng; Zhang, Di; Lim, Kim Hwa Jim

2016-01-01

INTRODUCTION This study explored and compared the differences in attitudes toward end-of-life care among patients, relatives and healthcare professionals, including doctors and nurses. METHODS We performed a descriptive study on a cross-section of the population of a tertiary hospital in Singapore. Data was collected using a questionnaire survey involving 50 participants from each of the four groups of patients, relatives, doctors and nurses. RESULTS Family members were the most commonly nominated surrogate decision-makers by the patient group (76%) and the majority of the relative group (74%) felt comfortable deciding on end-of-life care for their loved ones. However, the patient and relative groups differed significantly in their preferences on end-of-life care options, including cardiopulmonary resuscitation (CPR) (p = 0.001), intubation (p = 0.003), nasogastric tube feeding (p < 0.001) and the use of antibiotics (p = 0.023). Doctors, nurses and relatives demonstrated differences in preference between end-of-life care for themselves and for their loved ones, especially with regard to the use of nasogastric tube feeding. There was also a difference between patients and doctors in their decisions on CPR (p < 0.001) and intubation (p = 0.008). CONCLUSION This study demonstrated the importance of early planning for end-of-life care. This must be initiated proactively by healthcare professionals to engage patients in a culturally sensitive manner to discuss their preferences, in order to facilitate open communication between the patient and family. PMID:26831313

Medication administration through enteral feeding tubes.

PubMed

Williams, Nancy Toedter

2008-12-15

An overview of enteral feeding tubes, drug administration techniques, considerations for dosage form selection, common drug interactions with enteral formulas, and methods to minimize tube occlusion is given. Enteral nutrition through a feeding tube is the preferred method of nutrition support in patients who have a functioning gastrointestinal tract but who are unable to be fed orally. This method of delivering nutrition is also commonly used for administering medications when patients cannot swallow safely. However, several issues must be considered with concurrent administration of oral medications and enteral formulas. Incorrect administration methods may result in clogged feeding tubes, decreased drug efficacy, increased adverse effects, or drug-formula incompatibilities. Various enteral feeding tubes are available and are typically classified by site of insertion and location of the distal tip of the feeding tube. Liquid medications, particularly elixirs and suspensions, are preferred for enteral administration; however, these formulations may be hypertonic or contain large amounts of sorbitol, and these properties increase the potential for adverse effects. Before solid dosage forms are administered through the feeding tube, it should be determined if the medications are suitable for manipulation, such as crushing a tablet or opening a capsule. Medications should not be added directly to the enteral formula, and feeding tubes should be properly flushed with water before and after each medication is administered. To minimize drug-nutrient interactions, special considerations should be taken when administering phenytoin, carbamazepine, warfarin, fluoroquinolones, and proton pump inhibitors via feeding tubes. Precautions should be implemented to prevent tube occlusions, and immediate intervention is required when blockages occur. Successful drug delivery through enteral feeding tubes requires consideration of the tube size and placement as well as careful

Conduction cooled tube supports

DOEpatents

Worley, Arthur C.; Becht, IV, Charles

1984-01-01

In boilers, process tubes are suspended by means of support studs that are in thermal contact with and attached to the metal roof casing of the boiler and the upper bend portions of the process tubes. The support studs are sufficiently short that when the boiler is in use, the support studs are cooled by conduction of heat to the process tubes and the roof casing thereby maintaining the temperature of the stud so that it does not exceed 1400.degree. F.

Multi-tube fuel nozzle with mixing features

DOEpatents

Hughes, Michael John

2014-04-22

A system includes a multi-tube fuel nozzle having an inlet plate and a plurality of tubes adjacent the inlet plate. The inlet plate includes a plurality of apertures, and each aperture includes an inlet feature. Each tube of the plurality of tubes is coupled to an aperture of the plurality of apertures. The multi-tube fuel nozzle includes a differential configuration of inlet features among the plurality of tubes.

Why do aged fluorescent tubes flicker?

NASA Astrophysics Data System (ADS)

Plihon, Nicolas; Ferrand, Jérémy; Guyomar, Tristan; Museur, Flavien; Taberlet, Nicolas

2017-11-01

Our everyday experience of aged and defective fluorescent tubes or bulbs informs us that they may flicker and emit a clicking sound while struggling to light up. In this article, the physical mechanisms controlling the initial illumination of a functioning fluorescent tube are investigated using a simple and affordable experimental setup. Thermionic emission from the electrodes of the tube controls the startup of fluorescent tubes. The origin of the faulty startup of aged fluorescent tubes is discussed and flickering regimes using functional tubes are artificially produced using a dedicated setup that decreases electron emission by the thermionic effect in a controlled manner. The physical parameters controlling the occurrence of flickering light are discussed, and their temporal statistics are reported.

Tube support grid and spacer therefor

DOEpatents

Ringsmuth, Richard J.; Kaufman, Jay S.

1986-01-01

A tube support grid and spacers therefor provide radially inward preloading of heat exchange tubes to minimize stress upon base welds due to differential thermal expansion. The grid comprises a concentric series of rings and spacers with opposing concave sides for conforming to the tubes and V-shaped ends to provide resilient flexibility. The flexibility aids in assembly and in transmitting seismic vibrations from the tubes to a shroud. The tube support grid may be assembled in place to achieve the desired inwardly radial preloading of the heat exchange tubes. Tab and slot assembly further minimizes stresses in the system. The radii of the grid rings may be preselected to effect the desired radially inward preloading.

Integrated structure vacuum tube

NASA Technical Reports Server (NTRS)

Dimeff, J.; Kerwin, W. J. (Inventor)

1976-01-01

High efficiency, multi-dimensional thin film vacuum tubes suitable for use in high temperature, high radiation environments are described. The tubes are fabricated by placing thin film electrode members in selected arrays on facing interior wall surfaces of an alumina substrate envelope. Cathode members are formed using thin films of triple carbonate. The photoresist used in photolithography aids in activation of the cathodes by carbonizing and reacting with the reduced carbonates when heated in vacuum during forming. The finely powdered triple carbonate is mixed with the photoresist used to delineate the cathode locations in the conventional solid state photolithographic manner. Anode and grid members are formed using thin films of refractory metal. Electron flow in the tubes is between grid elements from cathode to anode as in a conventional three-dimensional tube.

Tube wall temperature monitoring technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Granton, R.L.

1985-07-01

In 1977, Monsanto and Conoco undertook the construction of a new, modern technology ethylene plant at Chocolate Bayou, near Alvin, Texas. This plant included high severity cracking furnaces with potential tube wall temperatures considerably higher than any we had previously experienced. Furnace on-stream time between decokes, a factor in the economics of plant operation, was limited by tube wall temperature, thus requiring its accurate knowledge. Earlier work with other ethylene furnaces had also demonstrated our lack of knowledge concerning high temperature measurements in a furnace firebox environment. This had to change. An outside consultant was called upon to provide amore » threeday workshop on radiant tube temperature sensing. The workshop consisted of two days of formal training in the theory and practice of temperature measurement and one day of field training. This workshop was conducted at a site away from the plant. Approximately 20 engineers (manufacturing and technical groups) attended. The major topics covered by this workshop are as follows: radiant tube temperature sensing, radiation situation of radiant tubes, g.a. method: sample calculations, noncontact sensors: methods of specifying and purchasing, thermal imager strategies, calibration of noncontact sensors, avoiding problems with noncontact sensors, optical aids to radiant tube viewing, tube temperature management and its environmental implications, and contact temperature sensors.« less

Tubing vs. buckets: a cost comparison

Treesearch

Neil K. Huyler

1975-01-01

Equipment investment for tubing-vacuum systems was significantly less than that for bucket systems. Tubing-vacuum systems required about 22 percent less labor input, the major labor input being completed before sap-flow periods. Annual cost of operation was less for tubing-vacuum than the bucket system. Small tubing-vacuum operations showed more profit potential than...

Precision heat forming of tetrafluoroethylene tubing

NASA Technical Reports Server (NTRS)

Ruiz, W. V.; Thatcher, C. S. (Inventor)

1981-01-01

An invention that provides a method of altering the size of tetrafluoroethylene tubing which is only available in limited combination of wall thicknesses and diameter are discussed. The method includes the steps of sliding the tetrafluoroethylene tubing onto an aluminum mandrel and clamping the ends of the tubing to the mandrel by means of clamps. The tetrafluorethylene tubing and mandrel are then placed in a supporting coil which with the mandrel and tetrafluorethylene tubing are then positioned in a insulated steel pipe which is normally covered with a fiber glass insulator to smooth out temperature distribution therein. The entire structure is then placed in an event which heats the tetrafluorethylene tubing which is then shrunk by the heat to the outer dimension of the aluminum mandrel. After cooling the aluminum mandrel is removed from the newly sized tetrafluorethylene tubing by a conventional chemical milling process.

Minimum wear tube support hole design

DOEpatents

Glatthorn, Raymond H.

1986-01-01

A minimum-wear through-bore (16) is defined within a heat exchanger tube support plate (14) so as to have an hourglass configuration as determined by means of a constant radiused surface curvature (18) as defined by means of an external radius (R3), wherein the surface (18) extends between the upper surface (20) and lower surface (22) of the tube support plate (14). When a heat exchange tube (12) is disposed within the tube support plate (14) so as to pass through the through-bore (16), the heat exchange tube (12) is always in contact with a smoothly curved or radiused portion of the through-bore surface (16) whereby unacceptably excessive wear upon the heat exchange tube (12), as normally developed by means of sharp edges, lands, ridges, or the like conventionally part of the tube support plates, is eliminated or substantially reduced.

Enteral Tube Feeding and Pneumonia

ERIC Educational Resources Information Center

Gray, David Sheridan; Kimmel, David

2006-01-01

To determine the effects of enteral tube feeding on the incidence of pneumonia, we performed a retrospective review of all clients at our institution who had gastrostomy or jejunostomy tubes placed over a 10-year period. Ninety-three subjects had a history of pneumonia before feeding tube insertion. Eighty had gastrostomy and 13, jejunostomy…

Siphon flows in isolated magnetic flux tubes. 3: The equilibrium path of the flux tube arch

NASA Technical Reports Server (NTRS)

Thomas, John H.; Montesinis, Benjamin

1989-01-01

The arched equilibrium path of a thin magnetic flux tube in a plane-stratified, nonmagnetic atmosphere is calculated for cases in which the flux tube contains a steady siphon flow. The large scale mechanical equilibrium of the flux tube involves a balance among the magnetic buoyancy force, the net magnetic tension force due to the curvature of the flux tube axis, and the inertial (centrifugal) force due to the siphon flow along curved streamlines. The ends of the flux tube are assumed to be pinned down by some other external force. Both isothermal and adiabatic siphon flows are considered for flux tubes in an isothermal external atmosphere. For the isothermal case, in the absence of a siphon flow the equilibrium path reduces to the static arch calculated by Parker (1975, 1979). The presence of a siphon flow causes the flux tube arch to bend more sharply, so that magnetic tension can overcome the additional straightening effect of the inertial force, and reduces the maximum width of the arch. The curvature of the arch increases as the siphon flow speed increases. For a critical siphon flow, with supercritical flow in the downstream leg, the arch is asymmetric, with greater curvature in the downstream leg of the arch. Adiabatic flow have qualitatively similar effects, except that adiabatic cooling reduces the buoyancy of the flux tube and thus leads to significantly wider arches. In some cases the cooling is strong enough to create negative buoyancy along sections of the flux tube, requiring upward curvature of the flux tube path along these sections and sometimes leading to unusual equilibrium paths of periodic, sinusoidal form.

Oral Feeding Outcome after Analgesic and Sedative Exposure in VLBW Preterm Infant.

PubMed

Astoria, Mark T; Thacker, Leroy; Hendricks-Muñoz, Karen D

2018-06-08

 The objective of this study was to assess the association of analgesics and sedatives on oral feeding function and need for feeding tube at discharge in the very low birth weight (VLBW) (<1,500 g) preterm infant.  A retrospective review of surviving inborn infants < 1,500 g and < 32 weeks' gestation ( n  = 209), discharged between January 1, 2012, and December 31, 2014, from the neonatal intensive care unit identified exposure to analgesic and sedative medications, demographics, medical course, and nasogastric or gastrostomy tube (GT) feeding at discharge. Predictive modeling with logistic regression to identify independent factors associated with discharge on tube feedings.  Out of 209, 45 (21.5%) infants received an analgesic/sedative with 23 out of 45 (51.1%) discharged with tube feedings. Infants discharged with tube feedings were born smaller, of younger gestation, with greater SNAPPE-II scores, periventricular leukomalacia, chronic lung disease, postnatal glucocorticoids, lansoprazole, and longer time intubated. After adjusting for covariates, exposure to analgesic/sedatives (fentanyl, midazolam, or morphine) was independently predictive of discharge on tube feedings.  Analgesic and sedative exposure in VLBW infants is highly associated with poor oral feeding and need for tube feedings at discharge. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Tube wall thickness measurement apparatus

DOEpatents

Lagasse, P.R.

1985-06-21

An apparatus for measuring the thickness of a tube's wall for the tube's entire length and radius by determining the deviation of the tube wall thickness from the known thickness of a selected standard item. The apparatus comprises a base and a first support member having first and second ends. The first end is connected to the base and the second end is connected to a spherical element. A second support member is connected to the base and spaced apart from the first support member. A positioning element is connected to and movable relative to the second support member. An indicator is connected to the positioning element and is movable to a location proximate the spherical element. The indicator includes a contact ball for first contacting the selected standard item and holding it against the spherical element. The contact ball then contacts the tube when the tube is disposed about the spherical element. The indicator includes a dial having a rotatable needle for indicating the deviation of the tube wall thickness from the thickness of the selected standard item.

Tube wall thickness measurement apparatus

DOEpatents

Lagasse, Paul R.

1987-01-01

An apparatus for measuring the thickness of a tube's wall for the tube's entire length and circumference by determining the deviation of the tube wall thickness from the known thickness of a selected standard item. The apparatus comprises a base and a first support member having first and second ends. The first end is connected to the base and the second end is connected to a spherical element. A second support member is connected to the base and spaced apart from the first support member. A positioning element is connected to and movable relative to the second support member. An indicator is connected to the positioning element and is movable to a location proximate the spherical element. The indicator includes a contact ball for first contacting the selected standard item and holding it against the spherical element. The contact ball then contacts the tube when the tube is disposed about the spherical element. The indicator includes a dial having a rotatable needle for indicating the deviation of the tube wall thickness from the thickness of the selected standard item.

Improper tube fixation causing a leaky cuff.

PubMed

Gupta, Babita; Farooque, Kamran; Jain, Divya; Kapoor, Rakesh

2010-04-01

Leaking endotracheal tube cuffs are common problems in intensive care units. We report a case wherein the inflation tube was damaged by the adhesive plaster used for tube fixation and resulted in leaking endotracheal tube cuff. We also give some suggestions regarding the tube fixation and some remedial measures for damaged inflation system.

Pyrotechnic Tubing Connector

NASA Technical Reports Server (NTRS)

Graves, Thomas J.; Yang, Robert A.

1988-01-01

Tool forms mechanical seal at joint without levers or hydraulic apparatus. Proposed tool intended for use in outer space used on Earth by heavily garbed workers to join tubing in difficult environments. Called Pyrotool, used with Lokring (or equivalent) fittings. Piston slides in cylinder when pushed by gas from detonating pyrotechnic charge. Impulse of piston compresses fittings, sealing around butting ends of tubes.

The upper pouch in oesophageal atresia shows proportional growth during late fetal life.

PubMed

Tröbs, R B; Nissen, M; Wald, J

2018-05-12

Oesophageal atresia with trachea-oesophageal fistula is a rare foregut malformation that requires surgery soon after birth. Prenatal ultrasound diagnosis is based on the presence of polyhydramnios, a small or non-visible fetal stomach and the blind ending oesophagus, called the upper pouch (1). Neonates present with salivation, coughing, choking and attacks of cyanosis. A diagnosis of oesophageal atresia is confirmed by inserting a nasogastric tube and a thoraco-abdominal X-ray. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Neural Tube Defects

PubMed Central

Greene, Nicholas D.E.; Copp, Andrew J.

2015-01-01

Neural tube defects (NTDs), including spina bifida and anencephaly, are severe birth defects of the central nervous system that originate during embryonic development when the neural tube fails to close completely. Human NTDs are multifactorial, with contributions from both genetic and environmental factors. The genetic basis is not yet well understood, but several nongenetic risk factors have been identified as have possibilities for prevention by maternal folic acid supplementation. Mechanisms underlying neural tube closure and NTDs may be informed by experimental models, which have revealed numerous genes whose abnormal function causes NTDs and have provided details of critical cellular and morphological events whose regulation is essential for closure. Such models also provide an opportunity to investigate potential risk factors and to develop novel preventive therapies. PMID:25032496

Numerical simulation of tubes-in-tube heat exchanger in a mixed refrigerant Joule-Thomson cryocooler

NASA Astrophysics Data System (ADS)

Damle, R. M.; Ardhapurkar, P. M.; Atrey, M. D.

2017-02-01

Mixed refrigerant Joule-Thomson (MRJT) cryocoolers can produce cryogenic temperatures with high efficiency and low operating pressures. As compared to the high system pressures of around 150-200 bar with nitrogen, the operational pressures with non-azeotropic mixtures (e.g., nitrogen-hydrocarbons) come down to 10-25 bar. With mixtures, the heat transfer in the recuperative heat exchanger takes place in the two-phase region. The simultaneous boiling and condensation of the cold and hot gas streams lead to higher heat transfer coefficients as compared to single phase heat exchange. The two-phase heat transfer in the recuperative heat exchanger drastically affects the performance of a MRJT cryocooler. In this work, a previously reported numerical model for a simple tube-in-tube heat exchanger is extended to a multi tubes-in-tube heat exchanger with a transient formulation. Additionally, the J-T expansion process is also considered to simulate the cooling process of the heat exchanger from ambient temperature conditions. A tubes-in-tube heat exchanger offers more heat transfer area per unit volume resulting in a compact design. Also, the division of flow in multiple tubes reduces the pressure drop in the heat exchanger. Simulations with different mixtures of nitrogen-hydrocarbons are carried out and the numerical results are compared with the experimental data.

Large diameter lasing tube cooling arrangement

DOEpatents

Hall, Jerome P [Livermore, CA; Alger, Terry W [Tracy, CA; Anderson, Andrew T [Livermore, CA; Arnold, Phillip A [Livermore, CA

2004-05-18

A cooling structure (16) for use inside a ceramic cylindrical tube (11) of a metal vapor laser (10) to cool the plasma in the tube (11), the cooling structure (16) comprising a plurality of circular metal members (17, 31) and mounting members (18, 34) that position the metal members (17, 31) coaxially in the tube (11) to form an annular lasing volume, with the metal members (17, 31) being axially spaced from each other along the length of the tube (11) to prevent the metal members from shorting out the current flow through the plasma in the tube (11) and to provide spaces through which the heat from localized hot spots in the plasma may radiate to the other side of the tube (11).

Large Diameter Lasing Tube Cooling Arrangement

DOEpatents

Hall, Jerome P.; Alger, Terry W.; Anderson, Andrew T.; Arnold, Philip A.

2004-05-18

A cooling structure (16) for use inside a ceramic cylindrical tube (11) of a metal vapor laser (10) to cool the plasma in the tube (11), the cooling structure (16) comprising a plurality of circular metal members (17,31) and mounting members (18, 34) that position the metal members (17,31) coaxially in the tube (11) to form an annular lasing volume, with the metal members (17, 31) being axially spaced from each other along the length of the tube (11) to prevent the metal members from shorting out the current flow through the plasma in the tube (11) and to provide spaces through which the heat from localized hot spots in the plasma may radiate to the other side of the tube (11).

Electron tubes for industrial applications

NASA Astrophysics Data System (ADS)

Gellert, Bernd

1994-05-01

This report reviews research and development efforts within the last years for vacuum electron tubes, in particular power grid tubes for industrial applications. Physical and chemical effects are discussed that determine the performance of todays devices. Due to the progress made in the fundamental understanding of materials and newly developed processes the reliability and reproducibility of power grid tubes could be improved considerably. Modern computer controlled manufacturing methods ensure a high reproducibility of production and continuous quality certification according to ISO 9001 guarantees future high quality standards. Some typical applications of these tubes are given as an example.

Tube-wave seismic imaging

DOEpatents

Korneev, Valeri A [Lafayette, CA; Bakulin, Andrey [Houston, TX

2009-10-13

The detailed analysis of cross well seismic data for a gas reservoir in Texas revealed two newly detected seismic wave effects, recorded approximately 2000 feet above the reservoir. A tube-wave (150) is initiated in a source well (110) by a source (111), travels in the source well (110), is coupled to a geological feature (140), propagates (151) through the geological feature (140), is coupled back to a tube-wave (152) at a receiver well (120), and is and received by receiver(s) (121) in either the same (110) or a different receiving well (120). The tube-wave has been shown to be extremely sensitive to changes in reservoir characteristics. Tube-waves appear to couple most effectively to reservoirs where the well casing is perforated, allowing direct fluid contact from the interior of a well case to the reservoir.

Tube-wave seismic imaging

DOEpatents

Korneev, Valeri A [LaFayette, CA

2009-05-05

The detailed analysis of cross well seismic data for a gas reservoir in Texas revealed two newly detected seismic wave effects, recorded approximately 2000 feet above the reservoir. A tube-wave (150) is initiated in a source well (110) by a source (111), travels in the source well (110), is coupled to a geological feature (140), propagates (151) through the geological feature (140), is coupled back to a tube-wave (152) at a receiver well (120), and is and received by receiver(s) (121) in either the same (110) or a different receiving well (120). The tube-wave has been shown to be extremely sensitive to changes in reservoir characteristics. Tube-waves appear to couple most effectively to reservoirs where the well casing is perforated, allowing direct fluid contact from the interior of a well case to the reservoir.

Do Not Burn Your Airway Bridge: A Technique to Safely Exchange a Tracheostomy Tube for a Tracheal Tube.

PubMed

Patiño, Miguel Alejandro; Truong, Dam-Thuy; Truong, Angela; Cata, Juan Pablo

2016-10-01

Tracheostomy is one of the most ancient and commonly performed surgical procedures. When tracheostomized patients require a subsequent intervention, it is usually necessary to exchange the tracheostomy tube for a tracheal tube, which can be dangerous. These potential complications may be overlooked or underestimated by the anesthesia providers. An inability to ventilate the patient and replace the tube after removal of a fresh tracheostomy tube can escalate rapidly to a life-threatening crisis. We present a case in which an airway exchange catheter was used to safely replace a tracheostomy tube with a tracheal tube in a patient with a fresh tracheostomy.

Tubing crimping pliers

DOEpatents

Lindholm, G.T.

1981-02-27

The disclosure relates to pliers and more particularly to pliers for crimping two or more pieces of copper tubing together prior to their being permanently joined by brazing, soldering or the like. A die containing spring-loaded pins rotates within a cammed ring in the head of the pliers. As the die rotates, the pins force a crimp on tubing held within the pliers.

Assessment of insulin resistance in Chinese PCOS patients with normal glucose tolerance.

PubMed

Gao, Jing; Zhou, Li; Hong, Jie; Chen, Chen

2017-11-01

The study aimed to investigate insulin resistance (IR) status in polycystic ovary syndrome (PCOS) women with normal glucose tolerance (NGT), and further to evaluate feasible diagnostic method for those patients. Three hundred and twenty-five PCOS women with NGT and ninety-five healthy age-matched controls were recruited with Rotterdam criterion and 75 g oral glucose tolerance test (OGTT). IR status was estimated following a glycemic and insulinemic OGTT (0, 30, 60, 120, and 180 min). A modified HOMA-IR formula was applied to each time-course value of glycemia and insulinemia. The predictive performance of each IR index was analyzed with the use of ROC curves. Compared with healthy controls, both non-obese and obese PCOS patients with NGT had a higher BMI, serum glucose, insulin value (p < .05). The best predictive index of IR in non-obese PCOS-NGT was a HOMA-M30 value of 20.36 or more (AUC: 0.753). In obese PCOS-NGT population, the best predictive performance was obtained by a HOMA-M60 value of 32.17 or more (AUC: 0.868). IR was common in Chinese PCOS women with NGT, and the early assessment of IR should be heeded. We recommended HOMA-M30 (Cutoff: 20.36) and HOMA-M60 (Cutoff: 32.17) as the best predictive parameters for non-obese and obese PCOS-NGT patients, respectively.

Evaluating a nursing erasmus exchange experience: Reflections on the use and value of the Nominal Group Technique for evaluation.

PubMed

Cunningham, Sheila

2017-09-01

This paper discusses the use of Nominal Group Technique (NGT) for European nursing exchange evaluation at one university. The NGT is a semi-quantitative evaluation method derived from the Delphi method popular in the 1970s and 1980s. The NGT was modified from the traditional version retaining the structured cycles and but adding a broader group discussion. The NGT had been used for 2 successive years but required analysis and evaluation itself for credibility and 'fit' for purpose which is presented here. It aimed to explore nursing students' exchange experiences and aid programme development futures exchanges and closure from exchange. Results varied for the cohorts and students as participants enthusiastically engaged generating ample data which they ranked and categorised collectively. Evaluation of the NGT itself was two fold: by the programme team who considered purpose, audience, inclusivity, context and expertise. Secondly, students were asked for their thoughts using a graffiti board. Students avidly engaged with NGT but importantly also reported an effect from the process itself as an opportunity to reflect and share their experiences. The programme team concluded the NGT offered a credible evaluation tool which made use of authentic student voice and offered interactive group processes. Pedagogially, it enabled active reflection thus aiding reorientation back to the United Kingdom and awareness of 'transformative' consequences of their exchange experiences. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pulsating flow past a tube bundle

NASA Astrophysics Data System (ADS)

Molochnikov, V. M.; Mikheev, N. I.; Vazeev, T. A.; Paereliy, A. A.

2017-11-01

Visualization of the pulsating cross-flow past the in-line and staggered tube bundles has been performed. The frequency and amplitude of forced flow pulsations and the tube pitch in the bundle varied in the experiments. The main attention was focused on the flow pattern in the near wake of the third-row tube. The most indicative regimes of flow past a tube in a bundle have been revealed depending on forced flow unsteadiness parameters. The obtained data have been generalized in the flow maps in the space of dimensionless frequency (Strouhal number, St) and relative pulsation amplitude, β, individually for the in-line and staggered tube arrangement. Three most indicative regimes of pulsating flow past the tubes in a bundle have been singled out in each flow map.

Contrastive Analysis and Research on Negative Pressure Beam Tube System and Positive Pressure Beam Tube System for Mine Use

NASA Astrophysics Data System (ADS)

Wang, Xinyi; Shen, Jialong; Liu, Xinbo

2018-01-01

Against the technical defects of universally applicable beam tube monitoring system at present, such as air suction in the beam tube, line clogging, long sampling time, etc., the paper analyzes the current situation of the spontaneous combustion fire disaster forecast of mine in our country and these defects one by one. On this basis, the paper proposes a research thought that improving the positive pressure beam tube so as to substitute the negative pressure beam tube. Then, the paper introduces the beam tube monitoring system based on positive pressure technology through theoretical analysis and experiment. In the comparison with negative pressure beam tube, the paper concludes the advantage of the new system and draws the conclusion that the positive pressure beam tube is superior to the negative pressure beam tube system both in test result and test time. At last, the paper proposes prospect of the beam tube monitoring system based on positive pressure technology.

Ultrasonic liquid-in-line detector for tubes

DOEpatents

Piper, Thomas C.

1991-01-01

An apparatus and method for detecting the presence of liquid in pipes or tubes using ultrasonic techniques A first piezoelectric crystal is coupled to the outside of the pipe or tube at the location where liquid in the tube is to be detected. A second piezoelectric crystal is coupled to the outside of the pipe or tube at the same location along the tube but circumferentially displaced from the first crystal by an angle around the pipe or tube of less than 180.degree.. Liquid in the pipe or tube is detected by measuring the attenuation of an ultrasonic signal sent by the first piezoelectric crystal and received by the second piezoelectric crystal.

Insert sleeve prevents tube soldering contamination

NASA Technical Reports Server (NTRS)

Stein, J.

1966-01-01

Teflon sleeve insert prevents contamination of internal tube surfaces by solder compound during soldering operations that connect and seal the tube ends. The sleeve insert is pressed into the mating tube ends with a slight interference fit.

Leakproof Swaged Joints in Thin-Wall Tubing

NASA Technical Reports Server (NTRS)

Stuckenberg, F. H.; Crockett, L. K.; Snyder, W. E.

1986-01-01

Tubular inserts reinforce joints, reducing incidence of leaks. In new swaging technique, tubular inserts placed inside ends of both tubes to be joined. Made from thicker-wall tubing with outside diameter that matches inside diameter of thin tubing swaged, inserts support tube ends at joint. They ensure more uniform contact between swage fitting and tubing. New swaging technique developed for Al/Ti/V-alloy hydraulic supply lines.

Numerical investigation of heat transfer in annulus laminar flow of multi tubes-in-tube helical coil

NASA Astrophysics Data System (ADS)

Nada, S. A.; Elattar, H. F.; Fouda, A.; Refaey, H. A.

2018-03-01

In the present study, a CFD analysis using ANSYS-FLUENT 14.5 CFD package is used to investigate the characteristics of heat transfer of laminar flow in annulus formed by multi tubes in tube helically coiled heat exchanger. The numerical results are validated by comparison with previous experimental data and fair agreements were existed. The influences of the design and operation parameters such as heat flux, Reynolds numbers and annulus geometry on the heat transfer characteristics are investigated. Different annulus of different numbers of inner tubes, specifically 1, 2, 3, 4 and 5 tubes, are tested. The Results showed that for all the studied annulus, the heat flux has no effect on the Nusselt number and compactness parameter. The annulus formed by using five inner tubes showed the best heat transfer performance and compactness parameter. Correlation of predicting Nusselt number in terms of Reynolds number and number of inner tubes are presented.

GEIGER-MULLER TYPE COUNTER TUBE

DOEpatents

Fowler, I.L.; Watt, L.A.K.

1959-12-15

A single counter tube capable of responding to a wide range of intensities is described. The counter tube comprises a tubular cathode and an anode extending centrally of the cathode. The spacing between the outer surface of the anode and the inner surface of the cathode is varied along the length of the tube to provide different counting volumes in adjacent portions of the tube. A large counting volume in one portion adjacent to a low-energy absorption window gives adequate sensitivity for measuring lowintensity radiation, while a smaller volume with close electrode spacing is provided in the counter to make possible measurement of intense garnma radiation fields.

YouTube and ‘psychiatry’

PubMed Central

Gordon, Robert; Miller, John; Collins, Noel

2015-01-01

YouTube is a video-sharing website that is increasingly used to share and disseminate health-related information, particularly among younger people. There are reports that social media sites, such as YouTube, are being used to communicate an anti-psychiatry message but this has never been confirmed in any published analysis of YouTube clip content. This descriptive study revealed that the representation of ‘psychiatry’ during summer 2012 was predominantly negative. A subsequent smaller re-analysis suggests that the negative portrayal of ‘psychiatry’ on YouTube is a stable phenomenon. The significance of this and how it could be addressed are discussed. PMID:26755987

Method for producing a tube

DOEpatents

Peterson, Kenneth A [Albuquerque, NM; Rohde, Steven B [Corrales, NM; Pfeifer, Kent B [Los Lunas, NM; Turner, Timothy S [Rio Rancho, NM

2007-01-02

A method is described for producing tubular substrates having parallel spaced concentric rings of electrical conductors that can be used as the drift tube of an Ion Mobility Spectrometer (IMS). The invention comprises providing electrodes on the inside of a tube that are electrically connected to the outside of the tube through conductors that extend between adjacent plies of substrate that are combined to form the tube. Tubular substrates are formed from flexible polymeric printed wiring board materials, ceramic materials and material compositions of glass and ceramic, commonly known as Low Temperature Co-Fired Ceramic (LTCC). The adjacent plies are sealed together around the electrode.

Comparison of laparoscopic jejunostomy tube to percutaneous endoscopic gastrostomy tube with jejunal extension: long-term durability and nutritional outcomes.

PubMed

Haskins, Ivy N; Strong, Andrew T; Baginsky, Mary; Sharma, Gautam; Karafa, Matthew; Ponsky, Jeffrey L; Rodriguez, John H; Kroh, Matthew D

2018-05-01

Enteral access through the jejunum is indicated when patients cannot tolerate oral intake or gastric feeding. While multiple approaches for feeding jejunal access exist, few studies have compared the efficacy of these techniques. The purpose of this study was to investigate the long-term durability, re-intervention rates, and nutritional outcomes following percutaneous endoscopic gastrostomy tubes with jejunal extension tubes (PEG-JET) versus laparoscopic jejunostomy tubes (j-tubes). Retrospective chart review was performed on all patients who underwent PEG-JET or laparoscopic jejunostomy tube placement from January 2005 through December 2015 at our institution. Thirty-day and long-term outcomes were compared between the two groups. A total of 105 patients underwent PEG-JET and 307 patients underwent laparoscopic j-tube placement during the defined study period. In terms of 30-day outcomes, patients who underwent PEG-JET placement were significantly more likely to experience a tube dislodgement event (p = 0.005) and undergo a re-intervention (p < 0.001). Patients who had a laparoscopic j-tube placed were significantly more likely to meet their enteral feeding goals (p = 0.002) and less likely to require nutritional supplementation with total parenteral nutrition (TPN) (p < 0.001). With regard to long-term outcomes, patients who underwent PEG-JET placement were significantly more likely to experience tube occlusion (p < 0.001) and require an endoscopic or surgical tube re-intervention (p < 0.001). Patients who underwent laparoscopic j-tube placement were significantly more likely to experience a tube site leak (p = 0.015) but were less likely to require nutritional supplementation with TPN (p = 0.001). Laparoscopic jejunostomy tubes provide more durable long-term enteral access compared to PEG-JET. Consideration should be given to laparoscopic jejunostomy tube placement in eligible patients who cannot tolerate oral intake or gastric

Tube Failure Mechanisms.

DTIC Science & Technology

studies will be made: ( a ) An investigation of the factors influencing electrical breakdown in a vacuum and across the surface of a dielectric. (b) An...The purpose of this program is to investigate the nature and the principal causes of failures in microwave tubes. In this context, the following...investigation of the various electrical and surface properties of materials commonly used in microwave tubes, i.e., OFHC copper, alumina ceramic, tungsten

Practical acoustic thermometry with twin-tube and single-tube sensors

DOE Office of Scientific and Technical Information (OSTI.GOV)

De Podesta, M.; Sutton, G.; Edwards, G.

2015-07-01

Accurate measurement of high temperatures in a nuclear environment presents unique challenges. All secondary techniques inevitably drift because the thermometric materials in thermocouples and resistance sensors are sensitive not just to temperature, but also their own chemical and physical composition. The solution is to use primary methods that rely on fundamental links between measurable physical properties and temperature. In the nuclear field the best known technique is the measurement of Johnson Noise in a resistor (See Paper 80 at this conference). In this paper we describe the measurement of temperature in terms of the speed of sound in a gasmore » confined in a tube - an acoustic waveguide. Acoustic thermometry is the most accurate technique of primary thermometry ever devised with the best uncertainty of measurement below 0.001 C. In contrast, the acoustic technique described in this work has a much larger uncertainty, approximately 1 deg. C. But the cost and ease of use are improved by several orders of magnitude, making implementation eminently practical. We first describe the basic construction and method of operation of thermometers using twin-tubes and single tubes. We then present results using a twin-tube design showing that showing long term stability (i.e. no detectable drift) at 700 deg. C over periods of several weeks. We then outline how the technique may be developed for different nuclear applications. (authors)« less

Ultra-fast framing camera tube

DOEpatents

Kalibjian, Ralph

1981-01-01

An electronic framing camera tube features focal plane image dissection and synchronized restoration of the dissected electron line images to form two-dimensional framed images. Ultra-fast framing is performed by first streaking a two-dimensional electron image across a narrow slit, thereby dissecting the two-dimensional electron image into sequential electron line images. The dissected electron line images are then restored into a framed image by a restorer deflector operated synchronously with the dissector deflector. The number of framed images on the tube's viewing screen is equal to the number of dissecting slits in the tube. The distinguishing features of this ultra-fast framing camera tube are the focal plane dissecting slits, and the synchronously-operated restorer deflector which restores the dissected electron line images into a two-dimensional framed image. The framing camera tube can produce image frames having high spatial resolution of optical events in the sub-100 picosecond range.

High temperature ceramic-tubed reformer

NASA Astrophysics Data System (ADS)

Williams, Joseph J.; Rosenberg, Robert A.; McDonough, Lane J.

1990-03-01

The overall objective of the HiPHES project is to develop an advanced high-pressure heat exchanger for a convective steam/methane reformer. The HiPHES steam/methane reformer is a convective, shell and tube type, catalytic reactor. The use of ceramic tubes will allow reaction temperature higher than the current state-of-the-art outlet temperatures of about 1600 F using metal tubes. Higher reaction temperatures increase feedstock conversion to synthesis gas and reduce energy requirements compared to currently available radiant-box type reformers using metal tubes. Reforming of natural gas is the principal method used to produce synthesis gas (primarily hydrogen and carbon monoxide, H2 and CO) which is used to produce hydrogen (for refinery upgrading), methanol, as well as several other important materials. The HiPHES reformer development is an extension of Stone and Webster's efforts to develop a metal-tubed convective reformer integrated with a gas turbine cycle.

Development, prevention, and treatment of feeding tube dependency.

PubMed

Krom, Hilde; de Winter, J Peter; Kindermann, Angelika

2017-06-01

Enteral nutrition is effective in ensuring nutritional requirements and growth. However, when tube feeding lasts for a longer period, it can lead to tube dependency in the absence of medical reasons for continuation of tube feeding. Tube-dependent children are unable or refuse to start oral activities and they lack oral skills. Tube dependency has health-, psychosocial-, and economy-related consequences. Therefore, the transition to oral feeding is of great importance. However, this transition can be very difficult and needs a multidisciplinary approach. Most studies for treatment of tube dependency are based on behavioral interventions, such as family therapy, individual behavior therapy, neuro-linguistic programming, and parental anxiety reduction. Furthermore, oral motor therapy and nutritional adjustments can be helpful in tube weaning. The use of medication has been described in the literature. Although mostly chosen as the last resort, hunger-inducing methods, such as the Graz-model and the Dutch clinical hunger provocation program, are also successful in weaning children off tube feeding. The transition from tube to oral feeding is important in tube-dependent children but can be difficult. We present an overview for the prevention and treatment of tube dependency. What is known: • Longer periods of tube feeding can lead to tube dependency. • Tube weaning can be very difficult. What is new: • Weaning as soon as possible and therefore referral to a multidisciplinary team are recommended. • An overview of treatment options for tube dependency is presented in this article.

Ion plated electronic tube device

DOEpatents

Meek, T.T.

1983-10-18

An electronic tube and associated circuitry which is produced by ion plating techniques. The process is carried out in an automated process whereby both active and passive devices are produced at very low cost. The circuitry is extremely reliable and is capable of functioning in both high radiation and high temperature environments. The size of the electronic tubes produced are more than an order of magnitude smaller than conventional electronic tubes.

Dual-Latching, Solenoid-Actuated Tube Valve

NASA Technical Reports Server (NTRS)

Brudnicki, Myron J.

1993-01-01

Tube-type shutoff valve electrically positioned to open or closed state by concentric solenoid. Solenoid dual latching: it holds position until changed electrically or manually. In tube valve, central tube slides axially, closing off flow when held against seat and allowing flow when backed away from seat. Simple to balance pressure on seal between seat and sharp edge of tube. With pressure-balanced seal, only small force needed to hold valve in position, regardless of pressure acting on valve.

Dynamics of explosively imploded pressurized tubes

NASA Astrophysics Data System (ADS)

Szirti, Daniel; Loiseau, Jason; Higgins, Andrew; Tanguay, Vincent

2011-04-01

The detonation of an explosive layer surrounding a pressurized thin-walled tube causes the formation of a virtual piston that drives a precursor shock wave ahead of the detonation, generating very high temperatures and pressures in the gas contained within the tube. Such a device can be used as the driver for a high energy density shock tube or hypervelocity gas gun. The dynamics of the precursor shock wave were investigated for different tube sizes and initial fill pressures. Shock velocity and standoff distance were found to decrease with increasing fill pressure, mainly due to radial expansion of the tube. Adding a tamper can reduce this effect, but may increase jetting. A simple analytical model based on acoustic wave interactions was developed to calculate pump tube expansion and the resulting effect on the shock velocity and standoff distance. Results from this model agree quite well with experimental data.

Segmented instrumentation tube including a locking sleeve for interlocking the segments of the instrumentation tube

DOEpatents

Obermeyer, F.D.

1993-11-16

Segmented instrumentation tube including a locking sleeve for interlocking the segments of the instrumentation tube, so that the threaded ends of the instrumentation tube do not unthread when subjected to vibration, such an instrumentation tube being suitable for use in a nuclear reactor pressure vessel. The instrumentation tube has a first member having a threaded end portion that has a plurality of first holes circumferentially around the outside surface thereof. The instrumentation tube also has a second member having a threaded end portion that has a plurality of second holes circumferentially around the outside surface thereof. The threads of the second member are caused to threadably engage the threads of the first member for defining a threaded joint there between. A sleeve having an inside surface surrounds the end portion of the first member and the end portion of the second member and thus surrounds the threaded joint. The sleeve includes a plurality of first projections and second projections that outwardly extend from the inside surface to engage the first holes and the second holes, respectively. The outside surface of the sleeve is crimped or swaged at the locations of the first projections and second projections such that the first projections and the second projections engage their respective holes. In this manner, independent rotation of the first member with respect to the second member is prevented, so that the instrumentation tube will not unthread at its threaded joint. 10 figures.

Segmented instrumentation tube including a locking sleeve for interlocking the segments of the instrumentation tube

DOEpatents

Obermeyer, Franklin D.

1993-01-01

Segmented instrumentation tube including a locking sleeve for interlocking the segments of the instrumentation tube, so that the threaded ends of the instrumentation tube do not unthread when subjected to vibration, such an instrumentation tube being suitable for use in a nuclear reactor pressure vessel. The instrumentation tube has a first member having a threaded end portion that has a plurality of first holes circumferentially around the outside surface thereof. The instrumentation tube also has a second member having a threaded end portion that has a plurality of second holes circumferentially around the outside surface thereof. The threads of the second member are caused to threadably engage the threads of the first member for defining a threaded joint therebetween. A sleeve having an inside surface surrounds the end portion of the first member and the end portion of the second member and thus surrounds the threaded joint. The sleeve includes a plurality of first projections and second projections that outwardly extend from the inside surface to engage the first holes and the second holes, respectively. The outside surface of the sleeve is crimped or swaged at the locations of the first projections and second projections such that the first projections and the second projections engage their respective holes. In this manner, independent rotation of the first member with respect to the second member is prevented, so that the instrumentation tube will not unthread at its threaded joint.

Fuel transfer tube quick opening hatch

DOE Office of Scientific and Technical Information (OSTI.GOV)

Meuschke, R. E.; Sherwood, D. G.; Silverblatt, B. L.

1985-05-28

A quick opening hatch for use on a transfer tube of a nuclear reactor plant that is adapted to replace the conventional hatch on the transfer tube. A locking ring is provided with a plurality of screw openings that is adapted for connection to the transfer tube, and a hatch cover fitably received within the locking ring for closing-off the transfer tube. To lock the cover to the ring, latches are movably connected with the cover for locking engagement with the locking ring, and a sprocket with a plurality of crank arms is movably connected with the cover and themore » latches for movement thereof into locking engagement with a latch housing on the locking ring for locking the cover to the ring and out of engagement with the latch housing for releasing the cover from the locking ring so as to permit removal of the hatch cover from the locking ring to provide access to the transfer tube. A davit assembly is provided which is connected with the transfer tube and the hatch cover to move the cover away and to provide guidance for closing-off the transfer tube. The locking ring and hatch cover also include cooperating keys and keyways for alignment when closing the transfer tube. The cover is provided with sealing rings and the latch housing and latches include cooperating cam surfaces to provide a tight locking engagement by compressing the sealing rings between the transfer tube and the hatch cover.« less

The single chest tube versus double chest tube application after pulmonary lobectomy: A systematic review and meta-analysis.

PubMed

Zhang, Xuefei; Lv, Desheng; Li, Mo; Sun, Ge; Liu, Changhong

2016-12-01

Draining of the chest cavity with two chest tubes after pulmonary lobectomy is a common practice. The objective of this study was to evaluate whether using two tubes after a pulmonary lobectomy is more effective than using a single tube. We performed a meta-analysis of five randomized studies that compared the single chest tube with double chest tube application after pulmonary lobectomy. The primary end-point was amount of drainage and duration of chest tube drainage. The secondary end-points were the patient's numbers of new drain insertion after operation, hospital stay after operation, the patient's numbers of subcutaneous emphysema after operation, the patient's numbers of residual pleural air space, pain score, the number of patients who need thoracentesis, and cost. Five randomized controlled trials totaling 502 patients were included. Meta-analysis results are as follows: There were statistically significant differences in amount of drainage (risk ratio [RR] = -0.15; 95% confidence interval [CI] = -3.17, -0.12, P = 0. 03), duration of chest tube drainage (RR = -0.43; 95% CI = -0.57, -0.19, P = 0.02), pain score (P < 0.05). Compared with patients receiving the double chest tube group, there were no statistically significant differences between the two groups with regard to the patient's numbers of new drain insertion after operation. Compared with the double chest tube, the single chest tube significantly decreases amount of drainage, duration of chest tube drainage, pain score, the number of patients who need thoracentesis, and cost. Although there is convincing evidence to confirm the results mentioned herein, they still need to be confirmed by large-sample, multicenter, randomized, controlled trials.

Shear design expressions for concrete filled steel tube and reinforced concrete filled tube components.

DOT National Transportation Integrated Search

2016-06-01

Concrete-filled steel tubes (CFSTs) and reinforced concrete-filled steel tubes (RCFSTs) are increasingly : used in transportation structures as piers, piles, caissons or other foundation components. While the axial : and flexural properties of CFTs h...

Tube Thoracostomy: Complications and Its Management

PubMed Central

Kesieme, Emeka B.; Dongo, Andrew; Ezemba, Ndubueze; Irekpita, Eshiobo; Jebbin, Nze; Kesieme, Chinenye

2012-01-01

Background. Tube thoracostomy is widely used throughout the medical, surgical, and critical care specialities. It is generally used to drain pleural collections either as elective or emergency. Complications resulting from tube thoracostomy can occasionally be life threatening. Aim. To present an update on the complications and management of complications of tube thoracostomy. Methods. A review of the publications obtained from Medline search, medical libraries, and Google on tube thoracostomy and its complications was done. Results. Tube thoracostomy is a common surgical procedure which can be performed by either the blunt dissection technique or the trocar technique. Complication rates are increased by the trocar technique. These complications have been broadly classified as either technical or infective. Technical causes include tube malposition, blocked drain, chest drain dislodgement, reexpansion pulmonary edema, subcutaneous emphysema, nerve injuries, cardiac and vascular injuries, oesophageal injuries, residual/postextubation pneumothorax, fistulae, tumor recurrence at insertion site, herniation through the site of thoracostomy, chylothorax, and cardiac dysrhythmias. Infective complications include empyema and surgical site infection. Conclusion. Tube thoracostomy, though commonly performed is not without risk. Blunt dissection technique has lower risk of complications and is hence recommended. PMID:22028963

49 CFR 230.61 - Arch tubes, water bar tubes, circulators and thermic siphons.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Arch tubes, water bar tubes, circulators and thermic siphons. 230.61 Section 230.61 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION STEAM LOCOMOTIVE INSPECTION AND MAINTENANCE STANDARDS Boilers and Appurtenances...

49 CFR 230.61 - Arch tubes, water bar tubes, circulators and thermic siphons.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Arch tubes, water bar tubes, circulators and thermic siphons. 230.61 Section 230.61 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION STEAM LOCOMOTIVE INSPECTION AND MAINTENANCE STANDARDS Boilers and Appurtenances...

49 CFR 230.61 - Arch tubes, water bar tubes, circulators and thermic siphons.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Arch tubes, water bar tubes, circulators and thermic siphons. 230.61 Section 230.61 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION STEAM LOCOMOTIVE INSPECTION AND MAINTENANCE STANDARDS Boilers and Appurtenances...

Local Heat Transfer for Finned-Tube Heat Exchangers using Oval Tubes

DOE Office of Scientific and Technical Information (OSTI.GOV)

O'Brien, James Edward; Sohal, Manohar Singh

2000-08-01

This paper presents the results of an experimental study of forced convection heat transfer in a narrow rectangular duct fitted with either a circular tube or an elliptical tube in crossflow. The duct was designed to simulate a single passage in a fin-tube heat exchanger. Heat transfer measurements were obtained using a transient technique in which a heated airflow is suddenly introduced to the test section. High-resolution local fin-surface temperature distributions were obtained at several times after initiation of the transient using an imaging infrared camera. Corresponding local fin-surface heat transfer coefficient distributions were then calculated from a locally appliedmore » one-dimensional semi-infinite inverse heat conduction model. Heat transfer results were obtained over an airflow rate ranging from 1.56 x 10-3 to 15.6 x 10-3 kg/s. These flow rates correspond to a duct-height Reynolds number range of 630 – 6300 with a duct height of 1.106 cm and a duct width-toheight ratio, W/H, of 11.25. The test cylinder was sized such that the diameter-to-duct height ratio, D/H is 5. The elliptical tube had an aspect ratio of 3:1 and a/H equal to 4.33. Results presented in this paper reveal visual and quantitative details of local fin-surface heat transfer distributions in the vicinity of circular and oval tubes and their relationship to the complex horseshoe vortex system that forms in the flow stagnation region. Fin surface stagnation-region Nusselt numbers are shown to be proportional to the square-root of Reynolds number.« less

Forgotten T-tube in the middle ear.

PubMed

Shakeel, Muhammad; Trinidade, Aaron; Khan, Imran; Ah-See, Kim Wong

2012-05-01

Retention within the middle ear cleft is an unusual complication of T-tube insertion. A 40-year-old woman with Kartagener's Syndrome presented with hearing impairment in the right ear. She was found to have a previously inserted Goode T-tube lying within the middle ear behind an intact drum. She underwent successful removal of the T-tube via a myringotomy, and a new tube was re-inserted. Migration of a T-tube into the middle ear cleft should always be kept in mind in patients who present with otological symptoms and have a history of T-tube insertion, even in the presence of an intact drum.

[Microcuff pediatric tracheal tube. A new tracheal tube with a high volume-low pressure cuff for children].

PubMed

Weiss, M; Dullenkopf, A; Gerber, A C

2004-01-01

Principles and characteristics of the recently introduced Microcuff paediatric tracheal tube (Microcuff, GmbH, Weinheim, Germany) with anatomically based depth markings, cuff-free subglottic tube shaft and short high volume-low pressure cuff with ultrathin cuff membrane are presented. First available tubes (ID 4.0 mm) were evaluated regarding cuff pressures required to seal the trachea and regarding the distance from the tube tip to the carina. After obtaining approval of the local ethical committee, 20 children aged 2-4 years, receiving tracheal intubation under general anaesthesia with muscle paralysis, were included. The tubes were placed during direct laryngoscopy and the glottic depth marking placed between the vocal cords. Cuff pressure to prevent audible air leakage at standardised ventilator settings (PIP 20 cm H(2)O/PEEP 5 cm H(2)O/RR20 x min(-1)) was assessed by means of a cuff pressure manometer within 5 min after intubation. Subsequently, the distance from the tube tip to the tracheal carina was measured by means of fibre bronchoscopy. Data are presented as the median (range). Patient age was 3.0 years (2.0-3.9 years), weight 13.5 kg (9.1-19.2 kg) and body length 95 cm (79-105 cm). The lowest cuff pressure required to seal the trachea ranged from 4-14 cmH(2)O (median 10 cm H(2)O), the distance from tube tip to tracheal carina was to 2.9 cm (2.0-4.5 cm). The new Microcuff paediatric tracheal tube with ultrathin high volume-low pressure cuff required tracheal sealing pressures below tracheal wall pressures usually required with uncuffed tracheal tubes for efficient sealing and ventilation at 20 cm H(2)O peak inspiratory pressure. The distance from the tube tip to carina was in the safe range in all patients.

A comparative Thermal Analysis of conventional parabolic receiver tube and Cavity model tube in a Solar Parabolic Concentrator

NASA Astrophysics Data System (ADS)

Arumugam, S.; Ramakrishna, P.; Sangavi, S.

2018-02-01

Improvements in heating technology with solar energy is gaining focus, especially solar parabolic collectors. Solar heating in conventional parabolic collectors is done with the help of radiation concentration on receiver tubes. Conventional receiver tubes are open to atmosphere and loose heat by ambient air currents. In order to reduce the convection losses and also to improve the aperture area, we designed a tube with cavity. This study is a comparative performance behaviour of conventional tube and cavity model tube. The performance formulae were derived for the cavity model based on conventional model. Reduction in overall heat loss coefficient was observed for cavity model, though collector heat removal factor and collector efficiency were nearly same for both models. Improvement in efficiency was also observed in the cavity model’s performance. The approach towards the design of a cavity model tube as the receiver tube in solar parabolic collectors gave improved results and proved as a good consideration.

Miniature Pulse Tube Cooler

NASA Astrophysics Data System (ADS)

Tward, E.; Nguyen, T.; Godden, J.; Toma, G.

2004-06-01

A high capacity miniature pulse tube cooler for space that is scaled from the High Efficiency Cryocooler (HEC) is being developed. The low mass (1.5 kg) integral pulse tube cryocooler can provide large cooling power over a wide temperature range (e.g., 5 W at 95 K). The cooler is designed to be compatible with the existing HEC flight electronics. A small back-to-back flexure compressor drives a pulse tube cold head which is integrated with the compressor. The cooler has been tested with both linear and coaxial cold heads. A description of the cooler and its performance in both linear and coaxial cold head versions is presented.

21 CFR 888.4230 - Cement ventilation tube.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cement ventilation tube. 888.4230 Section 888.4230...) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4230 Cement ventilation tube. (a) Identification. A cement ventilation tube is a tube-like device usually made of plastic intended to be inserted into...

21 CFR 888.4230 - Cement ventilation tube.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cement ventilation tube. 888.4230 Section 888.4230...) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4230 Cement ventilation tube. (a) Identification. A cement ventilation tube is a tube-like device usually made of plastic intended to be inserted into...

21 CFR 888.4230 - Cement ventilation tube.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cement ventilation tube. 888.4230 Section 888.4230...) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4230 Cement ventilation tube. (a) Identification. A cement ventilation tube is a tube-like device usually made of plastic intended to be inserted into...

21 CFR 888.4230 - Cement ventilation tube.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cement ventilation tube. 888.4230 Section 888.4230...) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4230 Cement ventilation tube. (a) Identification. A cement ventilation tube is a tube-like device usually made of plastic intended to be inserted into...

21 CFR 888.4230 - Cement ventilation tube.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cement ventilation tube. 888.4230 Section 888.4230...) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4230 Cement ventilation tube. (a) Identification. A cement ventilation tube is a tube-like device usually made of plastic intended to be inserted into...

21 CFR 872.6570 - Impression tube.

Code of Federal Regulations, 2010 CFR

2010-04-01

... DEVICES DENTAL DEVICES Miscellaneous Devices § 872.6570 Impression tube. (a) Identification. An impression tube is a device consisting of a hollow copper tube intended to take an impression of a single tooth...) Classification. Class I (general controls). The device is exempt from the premarket notification procedures in...

The Fuge Tube Diode Array Spectrophotometer

ERIC Educational Resources Information Center

Arneson, B. T.; Long, S. R.; Stewart, K. K.; Lagowski, J. J.

2008-01-01

We present the details for adapting a diode array UV-vis spectrophotometer to incorporate the use of polypropylene microcentrifuge tubes--fuge tubes--as cuvettes. Optical data are presented validating that the polyethylene fuge tubes are equivalent to the standard square cross section polystyrene or glass cuvettes generally used in…

Building lab-scale x-ray tube based irradiators

USDA-ARS?s Scientific Manuscript database

The construction of economical x-ray tube based irradiators in a variety of configurations is described using 1000 Watt x-ray tubes. Single tube, double tube, and four tube designs are described, as well as various cabinet construction techniques. Relatively high dose rates were achieved for small s...

DOE Office of Scientific and Technical Information (OSTI.GOV)

Heberlein, Wolf E., E-mail: weheberlein@uams.edu; Goodwin, Whitney J.; Wood, Clint E.

Purpose: Our study evaluated techniques for percutaneous gastrostomy (G)-tube placement without the use of a nasogastric (NG) tube. Instead, direct puncture of a physiologic air bubble or effervescent-enhanced gastric bubble distention was performed in patients with upper digestive tract obstruction (UDTO) or psychological objections to NG tubes. Materials and Methods: A total of 886 patients underwent G-tube placement in our department during a period of 7 years. We present our series of 85 (9.6%) consecutive patients who underwent percutaneous G-tube placement without use of an NG tube. Results: Of these 85 patients, fluoroscopic guided access was attempted by direct puncturemore » of a physiologically present gastric air bubble in 24 (28%) cases. Puncture of an effervescent-induced large gastric air bubble was performed in 61 (72%) patients. Altogether, 82 (97%) of 85 G tubes were successfully placed in this fashion. The three failures comprised refusal of effervescent, vomiting of effervescent, and one initial tube misplacement when a deviation from our standard technique occurred. Conclusion: The described techniques compare favorably with published large series on G-tube placement with an NG tube in place. The techniques are especially suited for patients with UDTO due to head, neck, or esophageal malignancies, but they should be considered as an alternative in all patients. Direct puncture of effervescent-enhanced gastric bubble distention is a safe, patient-friendly and effective technique.« less

Confined Tube Crimp Using Portable Hand Tools

DOE Office of Scientific and Technical Information (OSTI.GOV)

Reynolds, Joseph James; Pereyra, R. A.; Archuleta, Jeffrey Christopher

2016-04-04

The Lawrence Radiation Laboratory developed handheld tools that crimp a 1/16 inch OD tube, forming a leak tight seal1 (see Figure 1). The leak tight seal forms by confining the 1/16 inch OD tubing inside a die while applying crimp pressure. Under confined pressure, the tube walls weld at the crimp. The purpose of this study was to determine conditions for fabricating a leak tight tube weld. The equipment was used on a trial-and-error basis, changing the conditions after each attempt until successful welds were fabricated. To better confine the tube, the die faces were polished. Polishing removed a fewmore » thousandths of an inch from the die face, resulting in a tighter grip on the tubing wall. Using detergent in an ultrasonic bath, the tubing was cleaned. Also, the time under crimp pressure was increased to 30 seconds. With these modifications, acceptable cold welds were fabricated. After setting the conditions for an acceptable cold weld, the tube was TIG welded across the crimped face.« less

Micro-tube mass production device for microbial culture.

PubMed

Fujimoto, K; Ogawa, M; Higashi, K; Miki, N

2016-08-01

This paper describes mass production system of micro-tubes for microbial culture in an open environment. Microbes are used in many fields, such as food, medicine, environmental and energy. We proposed a microbe culture system using hydrogel micro-tubes, which can protect the target microbes inside from competitive microbes outside of the tubes while allow oxygen and nutrition to diffuse through. The hydrogel micro-tubes can be produced by a microfluidic device, which can precisely control the flow and therefore, the tube geometry. For practical applications of the micro-tube-based microbial culture, one of the biggest challenges is the scale-up of the micro-tube-based culture system, or mass production of the tubes. We developed a fluidic system that can produce multiple micro-tubes in parallel. We characterized the mass-produced micro channels and verified the effectiveness of the system.

Self-shielding flex-circuit drift tube, drift tube assembly and method of making

DOEpatents

Jones, David Alexander

2016-04-26

The present disclosure is directed to an ion mobility drift tube fabricated using flex-circuit technology in which every other drift electrode is on a different layer of the flex-circuit and each drift electrode partially overlaps the adjacent electrodes on the other layer. This results in a self-shielding effect where the drift electrodes themselves shield the interior of the drift tube from unwanted electro-magnetic noise. In addition, this drift tube can be manufactured with an integral flex-heater for temperature control. This design will significantly improve the noise immunity, size, weight, and power requirements of hand-held ion mobility systems such as those used for explosive detection.

Recirculating wedges for metal-vapor plasma tubes

DOEpatents

Hall, Jerome P.; Sawvel, Robert M.; Draggoo, Vaughn G.

1994-01-01

A metal vapor laser is disclosed that recycles condensed metal located at the terminal ends of a plasma tube back toward the center of the tube. A pair of arcuate wedges are incorporated on the bottom of the plasma tube near the terminal ends. The wedges slope downward toward the center so that condensed metal may be transported under the force of gravity away from the terminal ends. The wedges are curved to fit the plasma tube to thereby avoid forming any gaps within the tube interior.

21 CFR 868.5975 - Ventilator tubing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ventilator tubing. 868.5975 Section 868.5975 Food... DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5975 Ventilator tubing. (a) Identification. Ventilator tubing is a device intended for use as a conduit for gases between a ventilator and a patient...

Sampling Artifacts from Conductive Silicone Tubing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Timko, Michael T.; Yu, Zhenhong; Kroll, Jesse

2009-05-15

We report evidence that carbon impregnated conductive silicone tubing used in aerosol sampling systems can introduce two types of experimental artifacts: 1) silicon tubing dynamically absorbs carbon dioxide gas, requiring greater than 5 minutes to reach equilibrium and 2) silicone tubing emits organic contaminants containing siloxane that adsorb onto particles traveling through it and onto downstream quartz fiber filters. The consequence can be substantial for engine exhaust measurements as both artifacts directly impact calculations of particulate mass-based emission indices. The emission of contaminants from the silicone tubing can result in overestimation of organic particle mass concentrations based on real-time aerosolmore » mass spectrometry and the off-line thermal analysis of quartz filters. The adsorption of siloxane contaminants can affect the surface properties of aerosol particles; we observed a marked reduction in the water-affinity of soot particles passed through conductive silicone tubing. These combined observations suggest that the silicone tubing artifacts may have wide consequence for the aerosol community and should, therefore, be used with caution. Gentle heating, physical and chemical properties of the particle carriers, exposure to solvents, and tubing age may influence siloxane uptake. The amount of contamination is expected to increase as the tubing surface area increases and as the particle surface area increases. The effect is observed at ambient temperature and enhanced by mild heating (<100 oC). Further evaluation is warranted.« less

Lava Tube Seismicity at Kilauea

NASA Astrophysics Data System (ADS)

Hoblitt, R. P.; Battaglia, J.; Kauahikaua, J. P.; Okubo, P. G.

2002-12-01

We have begun to collect seismic data on lava tubes at Kilauea volcano in an effort to develop a real-time method for monitoring lava tube flux. Utilizing seismometers whose responses collectively vary from about 1 Hz to 1000 Hz, we find that most tube signals range between about 1 to 150 Hz, though some sites exhibit transient signals that range upward to several hundred Hz or more. Part of the lower frequency band--perhaps 1-10 Hz--may be volcanic tremor from Pu`u `O`o, the source of the lava flowing in the tubes. We attribute the higher frequencies to flowing lava, though wind noise and helicopter noise complicate interpretation. At a given site, both the amplitude and frequency spectrum change with time. We strongly suspect that at least some of the changes are related to changes in lava velocity and/or lava flux. Our strongest evidence that the part of the spectrum greater than 10 Hz contains velocity/flux information is that the signal amplitude of this band decreased by about 90 percent when the independently measured VLF (Very Low Frequency) tube flux decreased from about 300,000 m3/day in early February, 2002 to less than 5,000 m3/day in late August. Qualitative field observations of this tube system are in agreement with the VLF measurements.

Elevated 1-h post-challenge plasma glucose levels in subjects with normal glucose tolerance or impaired glucose tolerance are associated with whole blood viscosity.

PubMed

Marini, Maria Adelaide; Fiorentino, Teresa Vanessa; Andreozzi, Francesco; Mannino, Gaia Chiara; Perticone, Maria; Sciacqua, Angela; Perticone, Francesco; Sesti, Giorgio

2017-08-01

It has been suggested that glucose levels ≥155 mg/dl at 1-h during an oral glucose tolerance test (OGTT) may predict development of type 2 diabetes and cardiovascular events among adults with normal glucose tolerance (NGT 1 h-high). Studies showed a link between increased blood viscosity and type 2 diabetes. However, whether blood viscosity is associated with dysglycemic conditions such as NGT 1 h-high, impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) is unsettled. 1723 non-diabetic adults underwent biochemical evaluation and OGTT. A validated formula based on hematocrit and total plasma proteins was employed to estimate whole blood viscosity. Subjects were categorized into NGT with 1 h glucose <155 mg/dL (NGT-1 h-low), NGT-1 h-high, IFG and/or IGT. Hematocrit and blood viscosity values appeared significantly higher in individuals with NGT 1 h-high, IFG and/or IGT as compared to NGT 1 h-low subjects. Blood viscosity was significantly correlated with age, waist circumference, blood pressure, HbA1c, fasting, 1- and 2-h post-challenge insulin levels, total cholesterol and low-density lipoprotein, triglycerides, fibrinogen, white blood cell, and inversely correlated with high-density lipoprotein and insulin sensitivity. Of the four glycemic parameters, 1-h post-challenge glucose showed the strongest correlation with blood viscosity (β = 0.158, P < 0.0001) in a multivariate regression analysis model including several atherosclerosis risk factors. Our results demonstrate a positive relationship between blood viscosity and 1-h post-challenge plasma glucose. They also suggest that a subgroup of NGT individuals with 1-h post-challenge plasma >155 mg/dl have increased blood viscosity comparable to that observed in subjects with IFG and/or IGT.

Research on temperature control and influence of the vacuum tubes with inserted tubes solar heater

NASA Astrophysics Data System (ADS)

Xiao, L. X.; He, Y. T.; Hua, J. Q.

2017-11-01

A novel snake-shape vacuum tube with inserted tubes solar collector is designed in this paper, the heat transfer characteristics of the collector are analyzed according to its structural characteristics, and the influence of different working temperature on thermal characteristics of the collector is studied. The solar water heater prototype consisting of 14 vacuum tubes with inserted tubes is prepared, and the hot water storage control subsystem is designed by hysteresis comparison algorithm. The heat characteristic of the prototype was experimentally studied under hot water output temperature of 40-45°C, 50-55°C and 60-65°C. The daily thermal efficiency was 64%, 50% and 46%, respectively. The experimental results are basically consistent with the theoretical analysis.

Inspection tool for butt-welded tubing

NASA Technical Reports Server (NTRS)

Horman, D. P.

1977-01-01

Inspection tool for tubing consists of metal casing housing elastic collar. Collar is clamped around weld site under test. Leakage through weld is contained within chamber and is bled to detector via tubing attached to fitting. Tool, originally designed to detect fluid leakage in tubing, can be used to detect gas leaks.

Ceramic vacuum tubes for geothermal well logging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kelly, R.D.

1977-01-12

The results of investigations carried out into the availability and suitability of ceramic vacuum tubes for the development of logging tools for geothermal wells are summarized. Design data acquired in the evaluation of ceramic vacuum tubes for the development of a 500/sup 0/C instrumentation amplifier are presented. The general requirements for ceramic vacuum tubes for application to the development of high temperature well logs are discussed. Commercially available tubes are described and future contract activities that specifically relate to ceramic vacuum tubes are detailed. Supplemental data is presented in the appendix. (MHR)

Recirculating wedges for metal-vapor plasma tubes

DOEpatents

Hall, J.P.; Sawvel, R.M.; Draggoo, V.G.

1994-06-28

A metal vapor laser is disclosed that recycles condensed metal located at the terminal ends of a plasma tube back toward the center of the tube. A pair of arcuate wedges are incorporated on the bottom of the plasma tube near the terminal ends. The wedges slope downward toward the center so that condensed metal may be transported under the force of gravity away from the terminal ends. The wedges are curved to fit the plasma tube to thereby avoid forming any gaps within the tube interior. 8 figures.

Clinical tube weaning supported by hunger provocation in fully-tube-fed children.

PubMed

Hartdorff, Caroline M; Kneepkens, C M Frank; Stok-Akerboom, Anita M; van Dijk-Lokkart, Elisabeth M; Engels, Michelle A H; Kindermann, Angelika

2015-04-01

Children with congenital malformations, mental retardation, and complex early medical history frequently have feeding problems. Although tube feeding is effective in providing the necessary energy and nutrients, it decreases the child's motivation to eat and may lead to oral aversion. In this study, we sought to confirm our previous results, showing that a multidisciplinary clinical hunger provocation program may lead to quick resumption of oral feeding. In a crossover study, 22 children of 9 to 24 months of age who were fully dependent on tube feeding were randomly assigned to one of two groups: group A, intervention group (2-week multidisciplinary clinical hunger provocation program); and group B, control group (4-week outpatient treatment by the same multidisciplinary team). Patients failing one treatment were reassigned to the other treatment group. Primary outcome measures were at least 75% orally fed at the conclusion of the intervention and fully orally fed and gaining weight 6 months after the intervention. In group A, 9/11 patients were successfully weaned from tube feeding (2 failures: 1 developed ulcerative colitis, 1 drop-out). In group B, only 1 patient was weaned successfully; 10/11 were reassigned to the clinical hunger provocation program, all being weaned successfully. Six months after the intervention, 1 patient had to resume tube feeding. In total, in the control group, 1/11 (9%) was weaned successfully as compared with 18/21 (86%) in the hunger provocation group (P < 0.001). Multidisciplinary clinical hunger provocation is an effective short-term intervention for weaning young children from tube feeding.

Invariant structures of magnetic flux tubes

NASA Astrophysics Data System (ADS)

Solovev, A. A.

1982-04-01

The basic properties of a screened magnetic flux tube possessing a finite radius of curvature are discussed in order to complement the findings of Parker (1974, 1976) and improve their accuracy. Conditions of equilibrium, twisting equilibrium, and twisting oscillations are discussed, showing that a twisted magnetic loop or arch is capable of executing elastic oscillations about an equilibrium state. This property can in particular be used in the theory of solar flares. Invariant structures of a force-free magnetic tube are analyzed, showing that invariant structures of the field preserve their form when the geometrical parameters of the flux tube are changed. In a quasi-equilibrium transition of the tube from one state to another the length and pitch of the tube spiral change in proportion to the radius of its cross section.

Applying a tapered electrode on a porous ceramic support tube by masking a band inside the tube and drawing in electrode material from the outside of the tube by suction

DOEpatents

Vasilow, T.R.; Zymboly, G.E.

1991-12-17

An electrode is deposited on a support by providing a porous ceramic support tube having an open end and closed end; masking at least one circumferential interior band inside the tube; evacuating air from the tube by an evacuation system, to provide a permeability gradient between the masked part and unmasked part of the tube; applying a liquid dispersion of solid electrode particles to the outside surface of the support tube, where liquid flows through the wall, forming a uniform coating over the unmasked support part and a tapered coating over the masked part. 2 figures.

Manual tube-to-tubesheet welding torch

DOEpatents

Kiefer, Joseph H.; Smith, Danny J.

1982-01-01

A welding torch made of a high temperature plastic which fits over a tube intermediate the ends thereof for welding the juncture between the tube and the back side of a tube plate and has a ballooned end in which an electrode, filler wire guide, fiber optic bundle, and blanketing gas duct are disposed.

Baerveldt drainage tube motility in the anterior chamber.

PubMed

Tan, Annelie N; De Witte, Pauline M; Webers, Carroll A B; Berendschot, Tos T J M; De Brabander, John; Schouten, Johannes S A G; Beckers, Henny J M

2014-01-01

To investigate the stability in position of the Baerveldt glaucoma drainage tube over time and to study movement of the drainage tube in the anterior chamber (AC) under varying light conditions. This prospective study included 70 eyes with implantation of a Baerveldt glaucoma drainage tube in the anterior chamber. Anterior segment optical coherence tomography (AS-OCT) images were made preoperatively to quantify AC depth. AS-OCT images were made twice under photopic and twice under scotopic conditions, in the angle parallel to the Baerveldt tube to quantify drainage tube position, at 3, 6, 12, and 24 months postoperatively. Tube-corneal (T-C) and tube-iris (T-I) distances were measured. Additionally, the central AC depth and the peripheral angle opening (AOD 500) were determined. Two subgroups were distinguished according to tube position: free in the AC (group 1, n = 48) and transiridal (group 2, n = 22). After 24 months of follow-up, the drainage tube was found to move statistically significantly closer (0.12 mm) to the corneal endothelium in group 1 (p<0.01). There was no statistically significant difference in T-C distance over time in group 2. The T-C distance did not differ under photopic versus scotopic circumstances (p = 0.32). In both groups, the T-I distance was larger under scotopic conditions, a result of pupil dilation. The Baerveldt glaucoma drainage tube remained in a stable position when a transiridal implantation was performed, whereas the tube moved closer to the endothelium when placed free into the AC. Transiridal implantation of the Baerveldt tube seems a safe alternative for tube implantation with respect to tube motility.

Predictors of Physical Restraint Use in Hospitalized Veterans at End of Life: An Analysis of Data from the BEACON Trial.

PubMed

Kvale, Elizabeth; Dionne-Odom, J Nicholas; Redden, David T; Bailey, F Amos; Bakitas, Marie; Goode, Patricia S; Williams, Beverly R; Haddock, Kathlyn Sue; Burgio, Kathryn L

2015-06-01

The use of physical restraints in dying patients may be a source of suffering and loss of dignity. Little is known about the prevalence or predictors for restraint use at end of life in the hospital setting. The objective was to determine the prevalence and predictors of physical restraint use at the time of death in hospitalized adults. Secondary analysis was performed on data from the "Best Practices for End-of-Life Care for Our Nation's Veterans" (BEACON) trial conducted between 2005 and 2011. Medical record data were abstracted from six Veterans Administration Medical Centers (VAMCs). Data on processes of care in the last seven days of life were abstracted from the medical records of 5476 who died in the six VAMCs. We prospectively identified potential risk factors for restraint use at the time of death from among the variables measured in the parent trial, including location of death, medications administered, nasogastric tube, intravenous (IV) fluids, family presence, and receipt of a palliative care consultation. Physical restraint use at time of death was documented in 890 decedents (16.3%). Restraint use varied by location of death, with patients in intensive settings being at higher risk. Restraint use was significantly more likely in patients with a nasogastric tube and those receiving IV fluids, benzodiazepines, or antipsychotics. This is the first study to document that one in six hospitalized veterans were restrained at the time of death and to identify predictors of restraint use. Further research is needed to identify intervention opportunities.

Predictors of Physical Restraint Use in Hospitalized Veterans at End of Life: An Analysis of Data from the BEACON Trial

PubMed Central

Dionne-Odom, J. Nicholas; Redden, David T.; Bailey, F. Amos; Bakitas, Marie; Goode, Patricia S.; Williams, Beverly R.; Haddock, Kathlyn Sue; Burgio, Kathryn L.

2015-01-01

Abstract Background: The use of physical restraints in dying patients may be a source of suffering and loss of dignity. Little is known about the prevalence or predictors for restraint use at end of life in the hospital setting. Objective: The objective was to determine the prevalence and predictors of physical restraint use at the time of death in hospitalized adults. Methods: Secondary analysis was performed on data from the “Best Practices for End-of-Life Care for Our Nation's Veterans” (BEACON) trial conducted between 2005 and 2011. Medical record data were abstracted from six Veterans Administration Medical Centers (VAMCs). Data on processes of care in the last seven days of life were abstracted from the medical records of 5476 who died in the six VAMCs. We prospectively identified potential risk factors for restraint use at the time of death from among the variables measured in the parent trial, including location of death, medications administered, nasogastric tube, intravenous (IV) fluids, family presence, and receipt of a palliative care consultation. Results: Physical restraint use at time of death was documented in 890 decedents (16.3%). Restraint use varied by location of death, with patients in intensive settings being at higher risk. Restraint use was significantly more likely in patients with a nasogastric tube and those receiving IV fluids, benzodiazepines, or antipsychotics. Conclusions: This is the first study to document that one in six hospitalized veterans were restrained at the time of death and to identify predictors of restraint use. Further research is needed to identify intervention opportunities. PMID:25927909

Safety of Ultrasound-Guided Botulinum Toxin Injections for Sialorrhea as Performed by Pediatric Otolaryngologists.

PubMed

Shariat-Madar, Bahbak; Chun, Robert H; Sulman, Cecille G; Conley, Stephen F

2016-05-01

To evaluate incidence of complications and hospital readmission as a result of ultrasound-guided botulinum toxin injections to manage sialorrhea. Case series with chart review. Children's Hospital of Wisconsin. A case series with chart review was performed of all cases of ultrasound-guided injection of botulinum toxin by pediatric otolaryngologists from March 5, 2010, to September 26, 2014,. Primary outcomes included complications such as dysphagia, aspiration pneumonia, and motor paralysis. Secondary outcomes included hospitalization, intubation, and nasogastric tube placement. There were 48 patients, 111 interventions, and 306 intraglandular injections identified. Botulinum toxin type A and type B were utilized in 4 and 107 operative interventions, respectively. Type A was injected into 4 parotid and 4 submandibular glands, utilizing doses of 20 U per parotid and 30 U per submandibular gland. Type B was injected into 98 parotid and 200 submandibular glands, with average dosing of 923 U per parotid and 1170 U per submandibular gland, respectively. There were 2 instances of subjectively worsening of baseline dysphagia that self-resolved. No cases were complicated by aspiration pneumonia or motor paralysis. No patients required hospital readmission, intubation, or nasogastric tube placement. Prior published data indicated 16% complication incidence with ultrasound-guided injection of botulinum toxin. Our study found a low complication rate (0.6%) with ultrasound-guided injections of botulinum toxin to manage sialorrhea, without cases of aspiration pneumonia or motor paralysis. Of 306 intraglandular injections, there were 2 cases of worsening baseline subjective dysphagia that self-resolved. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Practical management of periprosthetic leakage in patients rehabilitated with a Provox® 2 voice prosthesis after total laryngectomy.

PubMed

Friedlander, Eviatar; Pinacho Martínez, Paloma; Poletti Serafini, Daniel; Martín-Oviedo, Carlos; Martínez Guirado, Tomás; Scola Yurrita, Bartolomé

Periprosthetic leakage of liquids is a common complication in patients rehabilitated with voice prostheses. Our objective was to describe and review the results of procedures for treating periprosthetic leakage. This was a retrospective analysis of 41 patients rehabilitated with Provox® 2 voice prostheses between 1997 and 2015. We describe 3 techniques: periprosthetic silicon collar placement, injection of hyaluronic acid into the tracheoesophageal wall and the combination of the 2 techniques. We present a method to reduce the diameter of the tracheoesophageal fistula by removing the voice prosthesis and placing a nasogastric tube through the fistula. In the 3 groups treated with silicone collar (n=5, 13 procedures), hyaluronic acid injection (n=5, 9 procedures) and the combination of both techniques (n=3, 5 procedures), we observed an increase in prosthesis lifespan of an average of 56 days (range 7-118 days), 32 days (range 3-55 days) and 63 days (range 28-136 days), respectively. The tracheoesophageal fistula diameter reduction was performed in 100% (n=6) of patients. The use of silicone collars, injection of hyaluronic acid into the tracheoesophageal wall and the combination of both techniques for the treatment of periprosthesis leakage increase the lifespan of the prosthesis. Temporary prosthesis removal and placement of nasogastric tube has also been shown effective in our experience. These techniques are simple, inexpensive and reproducible, thereby reducing healthcare costs. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Ultimate Temperature of Pulse Tube Cryocoolers

NASA Technical Reports Server (NTRS)

Kittel, Peter

2009-01-01

An ideal pulse tube cryocooler using an ideal gas can operate at any temperature. This is not true for real gases. The enthalpy flow resulting from the real gas effects of He-3, He-4, and their mixtures in ideal pulse tube cryocoolers puts limits on the operating temperature of pulse tube cryocoolers. The discussion of these effects follows a previous description of the real gas effects in ideal pulse tube cryocoolers and makes use of models of the thermophysical properties of He-3 and He-4. Published data is used to extend the analysis to mixtures of He-3 and He-4. The analysis was done for pressures below 2 MPa and temperatures below 2.5 K. Both gases and their mixtures show low temperature limits for pulse tube cryocoolers. These limits are in the 0.5-2.2 K range and depend on pressure and mixture. In some circumstances, even lower temperatures may be possible. Pulse tube cryocoolers using the two-fluid properties of dilute 3He in superfluid He-4 appear to have no limit.

Ultimate Temperature of Pulse Tube Cryocoolers

NASA Technical Reports Server (NTRS)

Kittel, Peter

2009-01-01

An ideal pulse tube cryocooler using an ideal gas can operate at any temperature. This is not true for real gases. The enthalpy flow resulting from the real gas effects of 3He, 4He, and their mixtures in ideal pulse tube cryocoolers puts limits on the operating temperature of pulse tube cryocoolers. The discussion of these effects follows a previous description of the real gas effects in ideal pulse tube cryocoolers and makes use of models of the thermophysical properties of 3He and 4He. Published data is used to extend the analysis to mixtures of 3He and 4He. The analysis was done for pressures below 2 MPa and temperatures below 2.5 K. Both gases and their mixtures show low temperature limits for pulse tube cryocoolers. These limits are in the 0.5-2.2 K range and depend on pressure and mixture. In some circumstances, even lower temperatures may be possible. Pulse tube cryocoolers using the ha-fluid properties of dilute 3He in superfluid 4He appear to have no limit.

Pulse tube cryocoolers for industrial applications

NASA Astrophysics Data System (ADS)

Martin, J. L.; Martin, C. M.

2002-05-01

Stirling-type, high frequency pulse tube cryocoolers have received considerable interest in the past decade due to their high reliability, low vibration, and high efficiency. Most of the previous development of Stirling-type pulse tube cryocoolers has focused on relatively small machines with cooling powers in the range of 5 W at 80 K. In this paper, we discuss the extension of Stirling-type pulse tube cryocoolers to higher capacities for industrial applications. Mesoscopic Devices is currently developing a family of pulse tube cryocoolers with capacities ranging from 10 W at 80 K to over 1300 W at 80 K. Each of these machines uses a 50 or 60 Hz moving magnet linear compressor, inertance tube phase shift network, and either in-line or coaxial pulse tube expanders. With input powers of up to 20 kW, these large cryocoolers require different heat exchanger and regenerator designs to efficiently exchange heat with the load and environment. Design and construction techniques for the expander and heat exchangers are discussed.

Electron tube

DOEpatents

Suyama, Motohiro [Hamamatsu, JP; Fukasawa, Atsuhito [Hamamatsu, JP; Arisaka, Katsushi [Los Angeles, CA; Wang, Hanguo [North Hills, CA

2011-12-20

An electron tube of the present invention includes: a vacuum vessel including a face plate portion made of synthetic silica and having a surface on which a photoelectric surface is provided, a stem portion arranged facing the photoelectric surface and made of synthetic silica, and a side tube portion having one end connected to the face plate portion and the other end connected to the stem portion and made of synthetic silica; a projection portion arranged in the vacuum vessel, extending from the stem portion toward the photoelectric surface, and made of synthetic silica; and an electron detector arranged on the projection portion, for detecting electrons from the photoelectric surface, and made of silicon.

Modeling of Multi-Tube Pulse Detonation Engine Operation

NASA Technical Reports Server (NTRS)

Ebrahimi, Houshang B.; Mohanraj, Rajendran; Merkle, Charles L.

2001-01-01

The present paper explores some preliminary issues concerning the operational characteristics of multiple-tube pulsed detonation engines (PDEs). The study is based on a two-dimensional analysis of the first-pulse operation of two detonation tubes exhausting through a common nozzle. Computations are first performed to assess isolated tube behavior followed by results for multi-tube flow phenomena. The computations are based on an eight-species, finite-rate transient flow-field model. The results serve as an important precursor to understanding appropriate propellant fill procedures and shock wave propagation in multi-tube, multi-dimensional simulations. Differences in behavior between single and multi-tube PDE models are discussed, The influence of multi-tube geometry and the preferred times for injecting the fresh propellant mixture during multi-tube PDE operation are studied.

The local clinical validation of a new lithium heparin tube with a barrier: BD Vacutainer® Barricor LH Plasma tube.

PubMed

Arslan, Fatma Demet; Karakoyun, Inanc; Basok, Banu Isbilen; Aksit, Merve Zeytinli; Baysoy, Anil; Ozturk, Yasemin Kilic; Guclu, Yusuf Adnan; Duman, Can

2017-10-15

Although serum-providing blood tubes with a barrier are still widely used due to their significant advantages, the use of blood tubes with a barrier to provide plasma is becoming widespread. We compared 22 analytes in a BD Vacutainer® Barricor LH Plasma tube for local clinical validation of this new lithium heparin tube with a barrier. Samples from 44 volunteers were collected in different tubes (Becton Dickinson and Company): Z tube without additive (reference), clot-activator tube with gel (SST), lithium heparin tube without gel (LiH), and lithium heparin tube with barrier (Barricor). Analyte concentrations in different tubes were compared with the reference tube. All tubes were also evaluated according to additional testing (different centrifugation durations, blood-sampling techniques and individual differences). Aspartate aminotransferase (AST), glucose (Glc), potassium (K), lactate dehydrogenase (LD), sodium (Na), and total protein (TP) had a significant bias in Barricor (9.19%, - 3.24%, - 4.88%, 21.60%, - 0.40%, 5.03%, respectively) relative to the reference tube. There was no statistical difference between different centrifugation durations and individual differences for AST, K and LD in LiH and/or Barricor (P > 0.05). There was a significant bias for LD between LiH and Barricor in terms of blood-sampling techniques (21.2% and 12.4%, respectively). Recently, the use of plasma has become prominent due to some of its advantages. In this study, plasma AST, K, LD, Glc and TP levels in Barricor were clinically different in comparison to serum. The results of additional tests showed that higher levels of LD in Barricor did not result from haemolysis, and they might be related to other factors including number of platelets, cellular fragility, or functional environment.

Lava tubes - Potential shelters for habitats

NASA Astrophysics Data System (ADS)

Horz, F.

Natural caverns occur on the moon in the form of 'lava tubes', which are the drained conduits of underground lava rivers. The inside dimensions of these tubes measure tens to hundreds of meters, and their roofs are expected to be thicker than 10 meters. Consequently, lava tube interiors offer an environment that is naturally protected from the hazards of radiation and meteorite impact. Further, constant, relatively benign temperatures of -20 C prevail. These are extremely favorable environmental conditions for human activities and industrial operations. Significant operational, technological, and economical benefits might result if a lunar base were constructed inside a lava tube.

Failure Analysis of a Service Tube

NASA Astrophysics Data System (ADS)

Xie, Zhongdong; Cai, Weiguo; Li, Zhenxing; Guan, YiMing; Zhang, Baocheng; Yang, XiaoTong

2017-12-01

One tube was cracked used in the primary reformer furnace in a fertilizer plant for two and half years. In order to find out the causes of cracking, the methods for chemical composition analysis, macro- and microstructure analysis, penetrant testing, weld analysis, crack and surface damage analysis, mechanics property analysis, high temperature endurance performance analysis, stress and wall thickness calculation were adopted. The integrated assessment results showed that the carbon content of the tube was in the lower limit of the standard range; the tube effective wall thickness was too small; local overheating leads to tube cracking in use process.

Enhanced Evaporation and Condensation in Tubes

NASA Astrophysics Data System (ADS)

Honda, Hiroshi

A state-of-the-art review of enhanced evaporation and condensation in horizontal microfin tubes and micro-channels that are used for air-conditioning and refrigeration applications is presented. The review covers the effects of flow pattern and geometrical parameters of the tubes on the heat transfer performance. Attention is paid to the effect of surface tension which leads to enhanced evaporation and condensation in the microfin tubes and micro-channels. A review of prior efforts to develop empirical correlations of the heat transfer coefficient and theoretical models for evaporation and condensation in the horizontal microfin tubes and micro-channels is also presented.

Tubing For Sampling Hydrazine Vapor

NASA Technical Reports Server (NTRS)

Travis, Josh; Taffe, Patricia S.; Rose-Pehrsson, Susan L.; Wyatt, Jeffrey R.

1993-01-01

Report evaluates flexible tubing used for transporting such hypergolic vapors as those of hydrazines for quantitative analysis. Describes experiments in which variety of tubing materials, chosen for their known compatibility with hydrazine, flexibility, and resistance to heat.

Turbine nozzle stage having thermocouple guide tube

DOEpatents

Schotsch, Margaret Jones; Kirkpatrick, Francis Lawrence; Lapine, Eric Michael

2002-01-01

A guide tube is fixed adjacent opposite ends in outer and inner covers of a nozzle stage segment. The guide tube is serpentine in shape between the outer and inner covers and extends through a nozzle vane. An insert is disposed in the nozzle vane and has apertures to accommodate serpentine portions of the guide tube. Cooling steam is also supplied through chambers of the insert on opposite sides of a central insert chamber containing the guide tube. The opposite ends of the guide tube are fixed to sleeves, in turn fixed to the outer and inner covers.

Nephrostomy tube-free versus nephrostomy tube for renal drainage after percutaneous nephrolithotomy: a systematic review and meta-analysis.

PubMed

Shen, Pengfei; Liu, Yong; Wang, Jia

2012-01-01

Historically, percutaneous nephrostomy drainage following percutaneous nephrolithotomy (PNL) has been considered the standard of care. More recently, however, an increasing number of centers are performing tubeless (with insertion of JJ ureteric stent) or totally tubeless (with no internal or external drainage) PNL with impressive outcome data. This systematic review is to compare the clinical therapeutic efficacy and safety of nephrostomy tube-free (NT-free) and standard PNL. We searched PubMed (1966 to April 2011), Embase (1966 to April 2011), and the Cochrane Library without language restriction. All randomized controlled trials that compared NT-free PNL (using a double-J stent) with standard PNL were enrolled in this review. The Cochrane Collaboration's RevMan5.0.2 software was used for statistical analysis. Nine studies involving 547 patients were included. Patients were divided into 4 groups: NT-free group, small tube group (8-9 Fr), middle tube group (16-18 Fr), and large tube group (20-24 Fr). Meta-analysis showed that: (1) with regard to hospital stay (h) and visual analog scale scores for postoperative pain on day 1, there was no significant difference between the NT-free group and the small tube group, but there were differences between the NT-free group versus the middle and large tube groups; (2) for puncture site urinary leakage, no significant difference was found between the NT-free group and the small and middle tube groups; (3) no significant difference was found with regard to transfusion, fever or infection, operative time between the NT-free group and the 3 tube groups. The clinical efficacy and safety of NT-free and small tube are similar in all measurements. Compared with the middle and large tubes, NT-free PNL could reduce hospital stay and postoperative analgesia requirement without increasing other complications. Copyright © 2012 S. Karger AG, Basel.

Heat removal capability of divertor coaxial tube assembly

NASA Astrophysics Data System (ADS)

Shibui, Masanao; Nakahira, Masataka; Tada, Eisuke; Takatsu, Hideyuki

1994-05-01

To deal with high power flowing in the divertor region, an advanced divertor concept with gas target has been proposed for use in ITER/EDA. The concept uses a divertor channel to remove the radiated power while allowing neutrals to recirculate. Candidate channel wall designs include a tube array design where many coaxial tubes are arranged in the toroidal direction to make louver. The coaxial tube consists of a Be protection tube encases many supply tubes wound helically around a return tube. V-alloy and hardened Cu-alloy have been proposed for use in the supply and return tubes. Some coolants have also been proposed for the design including pressurized He and liquid metals, because these coolants are consistent with the selection of coolants for the blanket and also meet the requirement of high temperature operation. In the coaxial tube design, the coolant area is restricted and brittle Be material is used under severe thermal cyclings. Thus, to obtain the coaxial tube with sufficient safety margin for the expected fusion power excursion, it is essential to understand its applicability limit. The paper discusses heat removal capability of the coaxial tube and recommends some design modifications.

[Research on the application of "H shaped" single-tube double-lumen drainage tube in the treatment of chronic subdural hematoma].

PubMed

Sun, T; Jiang, Z Q; Zhang, S J; Lou, F Y; Zhang, T; Han, Y; Zheng, X L

2016-04-05

To explore the effect of chronic subdural hematoma external drainage surgery using self-made "H shaped" flush type single-tube double-lumen drainage tube. There were 56 cases chosen from the First Affiliated Hospital of Bengbu Medical College between Jan 2013 and Aug 2015. These patients with unilateral chronic subdural hematoma requiring surgery to place drilling external drainage catheter were randomly divided into group A (21 cases, using self-made single-tube double lumen "H shaped" drainage tube) and group B (35 cases, traditional silicone drainage tube), then the residual liquid volume after drainage on the first day, the days that the tube stay in body and the residual fluid volume after removing the tube were compared between the two groups. The residual liquid volume after drainage on the first day in group A was (23±15)ml, in group B was (31±15)ml. The days that the tube stay in body in group A was (2.7±1.0)d, in group B was (3.3±1.1)d, the two groups had statistical differences (P<0.05). The residual fluid volume after removing the tube in group A was (13±7) ml, in group B was (16±8)ml, but the data in these two groups had no significantly statistical differences (P>0.05). The effect of self-made "H shaped" flush type single-tube double-lumen drainage tube in the drainage of chronic subdural hematoma drainage is good, with short tube stay in the body; therefore, it is a safe and effective way to treat chronic subdural hematoma, and is worthy of clinical application.

Simulation studies on Tube End Expansion of AA2014 Alloy Tubes

NASA Astrophysics Data System (ADS)

Venugopal, L.; Prasad, N. E. C.; Geeta Krishna, P.; Praveen, L.

2018-03-01

End forming is defined as forming the end of tubular forms either by inverting the tube or by expanding it. It finds application in many fields such as in automotive and aerospace sectors as power transmission elements, fuel lines, exhaust pipes etc. The main aim of the present work is to expand the AA2014 alloy tubes with different die sets without any fracture. Deform 2D software was used for performing simulations on expanding the tubes with different die set (punch) values having differed forming angles (α = 15°, 30° and 45°) and expansion ratios (rp/r0 = 1.39, 1.53 and 1.67). Experiments were also conducted and the results correlate with the simulation results. The results shows that for the punch having less cone angle (α) values the linear displacement is more rather than higher cone angles. But in the case of higher cone angles the radial displacement is more than the linear displacement.

In-bed tube bank for a fluidized-bed combustor

DOEpatents

Hemenway, Jr., Lloyd F.

1990-01-01

An in-bed tube bank (10) for a fluidized bed combustor. The tube bank (10) of the present invention comprises one or more fluid communicating boiler tubes (30) which define a plurality of selectively spaced boiler tube sections (32). The tube sections (32) are substantially parallel to one another and aligned in a common plane. The tube bank (10) further comprises support members (34) for joining adjacent tube sections (32), the support members (34) engaging and extending along a selected length of the tube sections (32) and spanning the preselected space therebetween.

Applying a tapered electrode on a porous ceramic support tube by masking a band inside the tube and drawing in electrode material from the outside of the tube by suction

DOEpatents

Vasilow, Theodore R.; Zymboly, Gregory E.

1991-01-01

An electrode is deposited on a support by providing a porous ceramic support tube (10) having an open end (14) and closed end (16); masking at least one circumferential interior band (18 and 18') inside the tube; evacuating air from the tube by an evacuation system (30), to provide a permeability gradient between the masked part (18 and 18') and unmasked part (20) of the tube; applying a liquid dispersion of solid electrode particles to the outside surface of the support tube, where liquid flows through the wall, forming a uniform coating (42) over the unmasked support part (20) and a tapered coating over the masked part (18 and 18').

Successful Intervention for Pressure Ulcer by Nutrition Support Team: A Case Report

PubMed Central

Inui, Shigeki; Konishi, Yuko; Yasui, Yoko; Harada, Toshiko; Itami, Satoshi

2010-01-01

A 23-year-old woman with heart failure developed pressure ulcer on her sacral area due to a long-term bed rest and impaired hemodynamics. The ulcer improved only slightly after 2 months with povidone-iodine sugar ointment because of severe nausea and anorexia. Then, the nutrition support team (NST) started intervention and estimated the patient's malnutrition from her body weight (30.1 kg), body mass index (BMI) (13.9), triceps skinfold thickness (TSF) (3.5 mm), arm circumference (AC) (17.2 cm) and serum albumin (2.6 g/dl). The NST administrated an enteral nutrition formula through a nasogastric tube and tried to provide meals according to the patient's taste. Although DESIGN score improved to 7 (DESIGN: d2e1s2i1g1n0 = 7) 2 months later, severe nausea prevented the patient from taking any food perorally. However, after nasogastric decannulation, her appetite improved and 1 month later her body weight increased to 32.8 kg, her BMI to 15.2, TSF to 7.5 mm, AC to 19.7 cm and serum albumin to 4.1 g/dl, and the wound completely healed. PMID:20689636

Randomised clinical trial investigating the effects of combined administration of octreotide and methylglucamine diatrizoate in the older persons with adhesive small bowel obstruction.

PubMed

Zhang, Y; Gao, Y; Ma, Q; Dang, C; Wei, W; De Antoni, F; Rocci, R; Chen, W

2006-03-01

To investigate the effects of combined administration of octreotide and methylglucamine diatrizoate in the older persons with adhesive small bowel obstruction. One hundred and sixty-two consecutive patients who had suffered from adhesive intestinal obstruction without clinical evidence of strangulation or gangrene were randomised into two groups, a control group (treated conservatively, n=82) and a contrast group (treated with combined administration of octreotide and methylglucamine diatrizoate, n=80). A laparotomy was performed in both the two groups if symptoms of strangulation developed or the obstruction did not resolve spontaneously after 72 h. Statistically significant rapid reduction in pain score, lower amount of nasogastric drainage, shorter hospital stay, lower operative rate and lower postoperative morbidity were observed in the contrast group. Among the non-operative patients, earlier passage of stool and gas, earlier first oral intake and shorter duration of nasogastric tube placement were significantly more frequently observed in the contrast group. No difference in the rate of readmission was found between the two groups. Combined administration of octreotide and methylglucamine diatrizoate accelerates resolution of small bowel obstruction by a specific therapeutic effect and is safe for the older persons.

Comparative Tests of Pitot-static Tubes

NASA Technical Reports Server (NTRS)

Merriam, Kenneth G; Spaulding, Ellis R

1935-01-01

Comparative tests were made on seven conventional Pitot-static tubes to determine their static, dynamic, and resultant errors. The effect of varying the dynamic opening, static opening, wall thickness, and inner-tube diameter was investigated. Pressure-distribution measurements showing stem and tip effects were also made. A tentative design for a standard Pitot-static tube for use in measuring air velocity is submitted.

Kundt's Tube: An Acoustic Gas Analyzer

ERIC Educational Resources Information Center

Aristov, Natasha; Habekost, Gehsa; Habekost, Achim

2011-01-01

A Kundt tube is normally used to measure the speed of sound in gases. Therefore, from known speeds of sound, a Kundt tube can be used to identify gases and their fractions in mixtures. In these experiments, the speed of sound is determined by measuring the frequency of a standing sound wave at a fixed tube length, temperature, and pressure. This…

Ceramic vacuum tubes for geothermal well logging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kelly, R.D.

1977-01-01

Useful design data acquired in the evaluation of ceramic vacuum tubes for the development of a 500/sup 0/C instrumentation amplifier are presented. The general requirements for ceramic vacuum tubes are discussed for application to the development of high temperature well logs. Commercially available tubes are described and future contract activities that specifically relate to ceramic vacuum tubes are detailed. Supplemental data are presented in the appendix.

The use of the nominal group technique as an evaluative tool in medical undergraduate education.

PubMed

Lloyd-Jones, G; Fowell, S; Bligh, J G

1999-01-01

In the present state of flux affecting UK medical undergraduate education, there is a pressing need for evaluative methods which will identify relevant outcomes both expected and unanticipated. The student perspective is now legitimately accepted to form part of any evaluative exercise but qualitative methods commonly used for this purpose are expensive in time and analytical skills. The nominal group technique (NGT) has been used for various purposes, including course evaluation, and appears well suited to this application. It combines qualitative and quantitative components in a structured interaction, which minimizes the influences of the researcher, and of group dynamics. The sequence and mechanics of the NGT process are described as applied to an end of first year evaluation in a novel undergraduate course. Doubts have been raised as to whether the results of NGT can be generalized to the larger group. In this paper, this problem is overcome by compiling a questionnaire based on the NGT items which was distributed throughout the class. Nominal group technique with questionnaire development. The medical school at The University of Liverpool. Medical students. Previous claims made on behalf of the NGT, such as the focus on the student voice, the minimizing of leadership influence and the richness of the data, are upheld in this report. Broad agreement was found with the NGT items but two items (10%) did not display any consensus. The questionnaire extension of the NGT provides back-up evidence of the reliability of the data derived from the technique and enables it to be applied to the larger groups typical of undergraduate medicine.

'Poppy seeds' in stomach aspirates: is oral omeprazole extemporaneous dispersion bioavailable?

PubMed

Tuleu, Catherine; Arenas-Lopez, Sara; Robinson, Chris; McCarthy, David; Paget, Richard I J; Tibby, Shane; Taylor, Kevin M G

2008-07-01

We report the appearance of 'poppy seed'-like structures found in the aspirated stomach contents and faeces of a 3-month-old infant receiving an omeprazole liquid via nasogastric tube, prepared by dispersing an omeprazole tablet (10 mg MUPS(R)) in water. Electron microscopy and mass spectroscopy indicated that these particles were hollow, dark purple coloured spheres comprising undissolved omeprazole and its degradation products. These observations suggest rapid degradation of omeprazole in the acid stomach contents, with compromised absorption of active drug. Consequently, dispersion of omeprazole in water may be an inappropriate formulation in this setting.

Segmented lasing tube for high temperature laser assembly

DOEpatents

Sawicki, Richard H.; Alger, Terry W.; Finucane, Raymond G.; Hall, Jerome P.

1996-01-01

A high temperature laser assembly capable of withstanding operating temperatures in excess of 1500.degree. C. is described comprising a segmented cylindrical ceramic lasing tube having a plurality of cylindrical ceramic lasing tube segments of the same inner and outer diameters non-rigidly joined together in axial alignment; insulation of uniform thickness surround the walls of the ceramic lasing tube; a ceramic casing, preferably of quartz, surrounding the insulation; and a fluid cooled metal jacket surrounds the ceramic casing. In a preferred embodiment, the inner surface of each of the ceramic lasing tube segments are provided with a pair of oppositely spaced grooves in the wall thereof parallel to the center axis of the segmented cylindrical ceramic lasing tube, and both of the grooves and the center axis of the segmented cylindrical ceramic lasing tube lie in a common plane, with the grooves in each ceramic lasing tube segment in circumferential alignment with the grooves in the adjoining ceramic lasing tube segments; and one or more ceramic plates, all lying in a common plane to one another and with the central axis of the segmented ceramic lasing tube, are received in the grooves to provide additional wall area in the segmented ceramic lasing tube for collision and return to ground state of metastable metal atoms within the segmented ceramic lasing tube.

Fluid mechanics and heat transfer spirally fluted tubing

NASA Astrophysics Data System (ADS)

Larue, J. C.; Libby, P. A.; Yampolsky, J. S.

1981-08-01

The objective of this program is to develop both a qualitative and a quantitative understanding of the fluid mechanics and heat transfer mechanisms that underlie the measured performance of the spirally fluted tubes under development at General Atomic. The reason for the interest in the spirally fluted tubes is that results to date have indicated three advantages to this tubing concept: The fabrication technique of rolling flutes on strip and subsequently spiralling and simultaneously welding the strip to form tubing results in low fabrication costs, approximately equal to those of commercially welded tubing. The heat transfer coefficient is increased without a concomitant increase of the friction coefficient on the inside of the tube. In single-phase axial flow of water, the helical flutes continuously induce rotation of the flow both within and without the tube as a result of the effect of curvature. An increase in condensation heat transfer on the outside of the tube is achieved. In a vertical orientation with fluid condensing on the outside of the helically fluted tube, the flutes provide a channel for draining the condensed fluid.

Hand tool permits shrink sizing of assembled tubing

NASA Technical Reports Server (NTRS)

Millett, A.; Odor, M.

1966-01-01

Portable tool sizes tubing ends without disassembling the tubing installation. The shrink sizing tool is clamped to the tubing and operated by a ratchet wrench. A gear train forces the tubing end against an appropriate die or mandrel to effect the sizing.

Tubing Cutter is Activated Hydraulically

NASA Technical Reports Server (NTRS)

Mcsmith, D. G.; Richardson, J. I.

1983-01-01

Hydraulically-actuated tubing cutter severs tubing when operator squeezes handle grip. "Gooseneck" extension enables cutter to be used in areas where accessiblity is limited. Cutter has potential as flight-line tool and is useful in automobile and fire rescue work.

Micro-blast waves using detonation transmission tubing

NASA Astrophysics Data System (ADS)

Samuelraj, I. Obed; Jagadeesh, G.; Kontis, K.

2013-07-01

Micro-blast waves emerging from the open end of a detonation transmission tube were experimentally visualized in this study. A commercially available detonation transmission tube was used (Nonel tube, M/s Dyno Nobel, Sweden), which is a small diameter tube coated with a thin layer of explosive mixture (HMX + traces of Al) on its inner side. The typical explosive loading for this tube is of the order of 18 mg/m of tube length. The blast wave was visualized using a high speed digital camera (frame rate 1 MHz) to acquire time-resolved schlieren images of the resulting flow field. The visualization studies were complemented by computational fluid dynamic simulations. An analysis of the schlieren images showed that although the blast wave appears to be spherical, it propagates faster along the tube axis than along a direction perpendicular to the tube axis. Additionally, CFD analysis revealed the presence of a barrel shock and Mach disc, showing structures that are typical of an underexpanded jet. A theory in use for centered large-scale explosions of intermediate strength (10 < Δ {p}/{p}_0 ≲ 0.02) gave good agreement with the blast trajectory along the tube axis. The energy of these micro-blast waves was found to be 1.25 ± 0.94 J and the average TNT equivalent was found to be 0.3. The repeatability in generating these micro-blast waves using the Nonel tube was very good (± 2 %) and this opens up the possibility of using this device for studying some of the phenomena associated with muzzle blasts in the near future.

Is tube feeding futile in advanced dementia?

PubMed Central

Lynch, Matthew C.

2016-01-01

It is controversial whether tube feeding in people with dementia improves nutritional status or prolongs survival. Guidelines published by several professional societies cite observational studies that have shown no benefit and conclude that tube feeding in patients with advanced dementia should be avoided. However, all studies on tube feeding in dementia have major methodological flaws that invalidate their findings. The present evidence is not sufficient to justify general guidelines. Patients with advanced dementia represent a very heterogeneous group, and evidence demonstrates that some patients with dementia benefit from tube feeding. However, presently available guidelines make a single recommendation against tube feeding for all patients. Clinicians, patients, and surrogates should be aware that the guidelines and prior commentary on this topic tend both to overestimate the strength of evidence for futility and to exaggerate the burdens of tube feeding. Shared decision making requires accurate information tailored to the individual patient's particular situation, not blanket guidelines based on flawed data. Lay Summary: Many doctors believe that tube feeding does not help people with advanced dementia. Scientific studies suggest that people with dementia who have feeding tubes do not live longer or gain weight compared with those who are carefully hand fed. However, these studies are not very helpful because of flaws in design, which are discussed in this article. Guidelines from professional societies make a blanket recommendation against feeding tubes for anyone with dementia, but an individual approach that takes each person's situation into account seems more appropriate. Patients and surrogates should be aware that the guidelines on this topic tend both to underestimate the benefit and exaggerate the burdens of tube feeding. PMID:27833208

Improved drainage with active chest tube clearance.

PubMed

Shiose, Akira; Takaseya, Tohru; Fumoto, Hideyuki; Arakawa, Yoko; Horai, Tetsuya; Boyle, Edward M; Gillinov, A Marc; Fukamachi, Kiyotaka

2010-05-01

This study was performed to evaluate the efficacy of a novel chest drainage system. This system employs guide wire-based active chest tube clearance to improve drainage and maintain patency. A 32 Fr chest tube was inserted into pleural cavities of five pigs. On the left, a tube was connected to the chest canister, and on the right, the new system was inserted between the chest tube and chest canister. Acute bleeding was mimicked by periodic infusion of blood. The amount of blood drained from each chest cavity was recorded every 15 min for 2 h. After completion of the procedure, all residual blood and clots in each chest cavity were assessed. The new system remained widely patent, and the amount of drainage achieved with this system (670+/-105 ml) was significantly (P=0.01) higher than that with the standard tube (239+/-131 ml). The amount of retained pleural blood and clots with this system (150+/-107 ml) was significantly (P=0.04) lower than that with the standard tube (571+/-248 ml). In conclusion, a novel chest drainage system with active tube clearance significantly improved drainage without tube manipulations. 2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

Hollow-tube chimes

NASA Astrophysics Data System (ADS)

Oliver, D. L. R.

1998-04-01

This note describes a simple and inexpensive method of designing and constructing a musical instrument. Often teachers of the physical sciences are called upon to advise students who are designing musical instrument prototypes. This article discusses the relationship between frequency and tube length for hollow metal tube chimes. A method is explained by which a set of chimes may be designed and constructed so that they cover all standard tones for a range of one or two octaves. The cost of materials will range from 3 to 6.

Necrotizing enterocolitis - classification and two initial steps towards prevention.

PubMed

Juhl, Sandra Meinich

2017-06-01

human donor milk in stimulating gut immunity and digestive functions.   Hence, in study II we aimed to design a pilot study of bovine colostrum used as a supplement to maternal milk in the first days of life and to determine if the study was feasible. In the paper, we present the protocol and the results of the first two phases of the Precolos study in which 12 infants were included and received pasteurized, spray-dried and reconstituted bovine colostrum during the first days of life as the first infants in the world. We found that the infants tolerated bovine colostrum without clinical adverse effects, but we also observed a transient hypertyrosinemia on day seven of life in five infants. The results were evaluated by a safety management board which encouraged us to continue the pilot study with the last phase, which was a randomized controlled trial of 20+20 infants comparing supplementation with bovine colostrum to supplementation with standard nutrition. The randomized trial has just finished recruitment.   At last, we wanted to shed light on a possible microbiological angle of NEC prevention. Dysbiosis and bacterial translocation are believed to play a crucial role in the development of NEC as intestinal pneumatosis, which occurs when bacteria produce gas inside the intestinal wall, is a pathognomonic radiographic finding. In a quality improvement study from the US published in 2014, NEC incidence was significantly reduced after the implementation of several quality improvement interventions. Standardized weekly exchange of nasogastric feeding tubes was suggested as one of the potential NEC-reducing interventions.   In the neonatal unit at Rigshospitalet, Denmark, preterm infants are fed 8-12 times daily through a resident nasogastric feeding tube which is exposed to body temperature, contains milk residuals from the last meal and is handled by both parents and personnel. Since bacterial pollution of milk given through the nasogastric feeding tube might be NEC

[How to do - the chest tube drainage].

PubMed

Klopp, Michael; Hoffmann, Hans; Dienemann, Hendrik

2015-03-01

A chest tube is used to drain the contents of the pleural space to reconstitute the physiologic pressures within the pleural space and to allow the lungs to fully expand. Indications for chest tube placement include pneumothorax, hemothorax, pleural effusion, pleural empyema, and major thoracic surgery. The most appropriate site for chest tube placement is the 4th or 5th intercostal space in the mid- or anterior- axillary line. Attention to technique in placing the chest tube is vital to avoid complications from the procedure. Applying the step-by-step technique presented, placement of a chest tube is a quick and safe procedure. Complications - frequently occurring when the tube is inserted with a steel trocar - include hemothorax, dislocation, lung lacerations, and injury to organs in the thoracic or abdominal cavity." © Georg Thieme Verlag KG Stuttgart · New York.

Reducing gain shifts in photomultiplier tubes

DOEpatents

Cohn, Charles E.

1976-01-01

A means is provided for reducing gain shifts in multiplier tubes due to varying event count rates. It includes means for limiting the number of cascaded, active dynodes of the multiplier tube to a predetermined number with the last of predetermined number of dynodes being the output terminal of the tube. This output is applied to an amplifier to make up for the gain sacrificed by not totally utilizing all available active stages of the tube. Further reduction is obtained by illuminating the predetermined number of dynodes with a light source of such intensity that noise appearing at the output dynode associated with the illumination is negligible.

21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is... through the cardiopulmonary bypass circuit. (b) Classification. Class II (performance standards). ...

21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is... through the cardiopulmonary bypass circuit. (b) Classification. Class II (performance standards). ...

Literature search for ceramic vacuum tubes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cannon, W.

1977-01-12

The NTIS and Engineering Index files were searched for citations relating to Ceramic and/or Metal Electron Tubes and High Temperature Electronics. A total of 24 citations were found relating directly to ceramic tubes and 24 to high temperature electronics. A search for electron tubes in general was examined for high temperature applications and 39 were obtained. Computer printouts of the abstracts are included in appendices. (MHR)

Schizophrenia on YouTube.

PubMed

Nour, Matthew M; Nour, Murraih H; Tsatalou, Olga-Maria; Barrera, Alvaro

2017-01-01

YouTube ( www.youtube.com ) is the most popular video-sharing Web site on the Internet and is used by medical students as a source of information regarding mental health conditions, including schizophrenia. The accuracy and educational utility of schizophrenia presentations on YouTube are unknown. The purpose of this study was to analyze the accuracy of depictions of psychosis in the context of a diagnosis of schizophrenia (referred to in this article as "acute schizophrenia") on YouTube and to assess the utility of these videos as educational tools for teaching medical students to recognize the clinical features of acute schizophrenia. YouTube was searched for videos purporting to show acute schizophrenia. Eligible videos were independently rated by two consultant psychiatrists on two separate occasions 22 days apart for diagnostic accuracy, psychopathology, and educational utility. Videos (N=4,200) were assessed against predefined inclusion and exclusion criteria. The majority were not eligible for further analysis, mostly because they did not claim to show a patient with schizophrenia (74%) or contained duplicated content (11%). Of 35 videos that met the eligibility and adequacy criteria, only 12 accurately depicted acute schizophrenia. Accurate videos were characterized by persecutory delusions (83%), inappropriate affect (75%), and negative symptoms (83%). Despite the fact that 83% of accurate videos were deemed to have good educational utility compared with 15% of inaccurate videos, accurate and inaccurate videos had similar view counts (290,048 versus 186,124). Schizophrenia presentations on YouTube offer a distorted picture of the condition.

Preliminary Study on Biosynthesis of Bacterial Nanocellulose Tubes in a Novel Double-Silicone-Tube Bioreactor for Potential Vascular Prosthesis.

PubMed

Hong, Feng; Wei, Bin; Chen, Lin

2015-01-01

Bacterial nanocellulose (BNC) has demonstrated a tempting prospect for applications in substitute of small blood vessels. However, present technology is inefficient in production and BNC tubes have a layered structure that may bring danger after implanting. Double oxygen-permeable silicone tubes in different diameters were therefore used as a tube-shape mold and also as oxygenated supports to construct a novel bioreactor for production of the tubular BNC materials. Double cannula technology was used to produce tubular BNC via cultivations with Acetobacter xylinum, and Kombucha, a symbiosis of acetic acid bacteria and yeasts. The results indicated that Kombucha gave higher yield and productivity of BNC than A. xylinum. Bacterial nanocellulose was simultaneously synthesized both on the inner surface of the outer silicone tube and on the outer surface of the inner silicone tube. Finally, the nano BNC fibrils from two directions formed a BNC tube with good structural integrity. Scanning electron microscopy inspection showed that the tubular BNC had a multilayer structure in the beginning but finally it disappeared and an intact BNC tube formed. The mechanical properties of BNC tubes were comparable with the reported value in literatures, demonstrating a great potential in vascular implants or in functional substitutes in biomedicine.

Preliminary Study on Biosynthesis of Bacterial Nanocellulose Tubes in a Novel Double-Silicone-Tube Bioreactor for Potential Vascular Prosthesis

PubMed Central

Wei, Bin; Chen, Lin

2015-01-01

Bacterial nanocellulose (BNC) has demonstrated a tempting prospect for applications in substitute of small blood vessels. However, present technology is inefficient in production and BNC tubes have a layered structure that may bring danger after implanting. Double oxygen-permeable silicone tubes in different diameters were therefore used as a tube-shape mold and also as oxygenated supports to construct a novel bioreactor for production of the tubular BNC materials. Double cannula technology was used to produce tubular BNC via cultivations with Acetobacter xylinum, and Kombucha, a symbiosis of acetic acid bacteria and yeasts. The results indicated that Kombucha gave higher yield and productivity of BNC than A. xylinum. Bacterial nanocellulose was simultaneously synthesized both on the inner surface of the outer silicone tube and on the outer surface of the inner silicone tube. Finally, the nano BNC fibrils from two directions formed a BNC tube with good structural integrity. Scanning electron microscopy inspection showed that the tubular BNC had a multilayer structure in the beginning but finally it disappeared and an intact BNC tube formed. The mechanical properties of BNC tubes were comparable with the reported value in literatures, demonstrating a great potential in vascular implants or in functional substitutes in biomedicine. PMID:26090420

Adaptive Nonparametric Kinematic Modeling of Concentric Tube Robots.

PubMed

Fagogenis, Georgios; Bergeles, Christos; Dupont, Pierre E

2016-10-01

Concentric tube robots comprise telescopic precurved elastic tubes. The robot's tip and shape are controlled via relative tube motions, i.e. tube rotations and translations. Non-linear interactions between the tubes, e.g. friction and torsion, as well as uncertainty in the physical properties of the tubes themselves, e.g. the Young's modulus, curvature, or stiffness, hinder accurate kinematic modelling. In this paper, we present a machine-learning-based methodology for kinematic modelling of concentric tube robots and in situ model adaptation. Our approach is based on Locally Weighted Projection Regression (LWPR). The model comprises an ensemble of linear models, each of which locally approximates the original complex kinematic relation. LWPR can accommodate for model deviations by adjusting the respective local models at run-time, resulting in an adaptive kinematics framework. We evaluated our approach on data gathered from a three-tube robot, and report high accuracy across the robot's configuration space.

Tracheopleuropulmonary injuries following enteral tube insertion.

PubMed Central

Odocha, O.; Lowery, R. C.; Mezghebe, H. M.; Siram, S. M.; Warner, O. G.

1989-01-01

Eighty-three cases of tracheopleuropulmonary injuries complicating enteral tube feeding are analyzed to identify the patterns of injury, and precipitating factors and ways to avoid them. Six new cases observed by the authors and 77 other cases cited in British literature between 1976 and 1987 are presented. In recent years, reports of this complication have been increasing, apparently in a geometrical progression: 8%, 18%, and 74% were reported between 1976 to 1979, 1980 to 1983, and 1984 to 1987, respectively. Sixty-one percent occurred in patients aged 60 years or older. Most of the patients (84%) were seriously ill, which compounded their complications. Seventy-four percent of all injuries were committed by house staff; the narrow bore tube with guide wire was used in 77% of cases. Less than reliable methods were used to confirm tube position in most instances. The presence of cuffed endotracheal tubes did not offer protection. The patients on mechanical ventilation tended to deteriorate if they developed a pneumothorax once the malpositioned tubes were removed. Of the cases reviewed for this report, 18 deaths occurred; 72% being directly related to the tube injuries. Lack of awareness, inadequate confirmatory methods, and insufficient supervision accounted for most of these preventable complications. Educating house/nursing staff in the use of the new tubes, closer supervision, and the application of equal measures of care and caution as employed in other invasive and potentially dangerous procedures are recommended to avoid disastrous outcome. PMID:2496234

Resonant oscillations in open axisymmetric tubes

NASA Astrophysics Data System (ADS)

Amundsen, D. E.; Mortell, M. P.; Seymour, B. R.

2017-12-01

We study the behaviour of the isentropic flow of a gas in both a straight tube of constant cross section and a cone, open at one end and forced at or near resonance at the other. A continuous transition between these configurations is provided through the introduction of a geometric parameter k associated with the opening angle of the cone where the tube corresponds to k=0. The primary objective is to find long-time resonant and near-resonant approximate solutions for the open tube, i.e. k→ 0. Detailed analysis for both the tube and cone in the limit of small forcing (O(ɛ 3)) is carried out, where ɛ 3 is the Mach number of the forcing function and the resulting flow has Mach number O(ɛ ). The resulting approximate solutions are compared with full numerical simulations. Interesting distinctions between the cone and the tube emerge. Depending on the damping and detuning, the responses for the tube are continuous and of O(ɛ ). In the case of the cone, the resonant response involves an amplification of the fundamental resonant mode, usually called the dominant first-mode approximation. However, higher modes must be included for the tube to account for the nonlinear generation of higher-order resonances. Bridging these distinct solution behaviours is a transition layer of O(ɛ 2) in k. It is found that an appropriately truncated set of modes provides the requisite modal approximation, again comparing well to numerical simulations.

Survival period after tube feeding in bedridden older patients.

PubMed

Kosaka, Yoichi; Nakagawa-Satoh, Takuma; Ohrui, Takashi; Fujii, Masahiko; Arai, Hiroyuki; Sasaki, Hidetada

2012-04-01

We prospectively studied survival periods after tube feeding. Participants were 163 bedridden older patients suffering from dysphagia. A wide range of survival periods after tube feeding were observed within half a year without tube feeding after being bedridden. After this initial period, survival periods after tube feeding were limited to approximately half a year. Survival periods after tube feeding were positively proportional to the length of time patients were free from pneumonia after tube feeding. After tube feeding, patients died from pneumonia within half a year, and the frequency of pneumonia was 3.1 ± 2.7 times (mean ± SD) before death. Survival periods after tube feeding for less than 1 year were primarily determined by being bedridden for more than half a year without tube feeding and once pneumonia occurred; patients who were tube fed did not survive for more than half a year. © 2012 Japan Geriatrics Society.

TUBE SHEARING VALVE

DOEpatents

Wilner, L.B.

1960-05-24

Explosive operated valves can be used to join two or more containers in fluid flow relationship, one such container being a sealed reservoir. The valve is most simply disposed by mounting it on the reservoir so thst a tube extends from the interior of the reservoir through the valve body, terminating at the bottom of the bore in a closed end; other containers may be similarly connected or may be open connected, as desired. The piston of the valve has a cutting edge at its lower end which shears off the closed tube ends and a recess above the cutting edge to provide a flow channel. Intermixing of the fluid being transferred with the explosion gases is prevented by a copper ring at the top of the piston which is force fitted into the bore at the beginning of the stroke. Although designed to avoid backing up of the piston at pressures up to 10,000 psi in the transferred fluid, proper operation is independent of piston position, once the tube ends were sheared.

Traveling-Wave Tubes

NASA Technical Reports Server (NTRS)

Kory, Carol L.

1998-01-01

The traveling-wave tube (TWT) is a vacuum device invented in the early 1940's used for amplification at microwave frequencies. Amplification is attained by surrendering kinetic energy from an electron beam to a radio frequency (RF) electromagnetic wave. The demand for vacuum devices has been decreased largely by the advent of solid-state devices. However, although solid state devices have replaced vacuum devices in many areas, there are still many applications such as radar, electronic countermeasures and satellite communications, that require operating characteristics such as high power (Watts to Megawatts), high frequency (below 1 GHz to over 100 GHz) and large bandwidth that only vacuum devices can provide. Vacuum devices are also deemed irreplaceable in the music industry where musicians treasure their tube-based amplifiers claiming that the solid-state and digital counterparts could never provide the same "warmth" (3). The term traveling-wave tube includes both fast-wave and slow-wave devices. This article will concentrate on slow-wave devices as the vast majority of TWTs in operation fall into this category.

Substantially oxygen-free contact tube

NASA Technical Reports Server (NTRS)

Pike, James F. (Inventor)

1993-01-01

A device for arc welding is provided in which a continuously-fed electrode wire is in electrical contact with a contact tube. The contact tube is improved by using a substantially oxygen-free conductive alloy in order to reduce the amount of electrical erosion.

Substantially Oxygen-Free Contact Tube

NASA Technical Reports Server (NTRS)

Pike, James F. (Inventor)

1991-01-01

A device for arc welding is provided in which a continuously-fed electrode wire is in electrical contact with a contact tube. The contact tube is improved by using a substantially oxygen-free conductive alloy in order to reduce the amount of electrical erosion.

Microphone Detects Boiler-Tube Leaks

NASA Technical Reports Server (NTRS)

Parthasarathy, S. P.

1985-01-01

Unit simple, sensitive, rugged, and reliable. Diaphragmless microphone detects leaks from small boiler tubes. Porous plug retains carbon granules in tube while allowing pressure changes to penetrate to granules. Has greater life expectancy than previous controllers and used in variety of hot corrosive atmospheres.

Management of chest drainage tubes after lung surgery.

PubMed

Satoh, Yukitoshi

2016-06-01

Since chest tubes have been routinely used to drain the pleural space, particularly after lung surgery, the management of chest tubes is considered to be essential for the thoracic surgeon. The pleural drainage system requires effective drainage, suction, and water-sealing. Another key point of chest tube management is that a water seal is considered to be superior to suction for most air leaks. Nowadays, the most common pleural drainage device attached to the chest tube is the three-bottle system. An electronic chest drainage system has been developed that is effective in standardizing the postoperative management of chest tubes. More liberal use of digital drainage devices in the postoperative management of the pleural space is warranted. The removal of chest tubes is a common procedure occurring almost daily in hospitals throughout the world. Extraction of the tube is usually done at the end of full inspiration or at the end of full expiration. The tube removal technique is not as important as how it is done and the preparation for the procedure. The management of chest tubes must be based on careful observation, the patient's characteristics, and the operative procedures that had been performed.

Expansion tube test time predictions

NASA Technical Reports Server (NTRS)

Gourlay, Christopher M.

1988-01-01

The interaction of an interface between two gases and strong expansion is investigated and the effect on flow in an expansion tube is examined. Two mechanisms for the unsteady Pitot-pressure fluctuations found in the test section of an expansion tube are proposed. The first mechanism depends on the Rayleigh-Taylor instability of the driver-test gas interface in the presence of a strong expansion. The second mechanism depends on the reflection of the strong expansion from the interface. Predictions compare favorably with experimental results. The theory is expected to be independent of the absolute values of the initial expansion tube filling pressures.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koyfman, Shlomo A., E-mail: koyfmas@ccf.org; Adelstein, David J.

Definitive chemoradiation therapy has evolved as the preferred organ preservation strategy in the treatment of locally advanced head-and-neck cancer (LA-HNC). Dry mouth and dysphagia are among the most common and most debilitating treatment-related toxicities that frequently necessitate the placement of enteral feeding tubes (FT) in these patients to help them meet their nutritional requirements. The use of either a percutaneous endoscopic gastrostomy tube or a nasogastric tube, the choice of using a prophylactic vs a reactive approach, and the effects of FTs on weight loss, hospitalization, quality of life, and long-term functional outcomes are areas of continued controversy. Considerable variationsmore » in practice patterns exist in the United States and abroad. This critical review synthesizes the current data for the use of enteral FTs in this patient population and clarifies the relative advantages of different types of FTs and the timing of their use. Recent developments in the biologic understanding and treatment approaches for LA-HNC appear to be favorably impacting the frequency and severity of treatment-related dysphagia and may reduce the need for enteral tube feeding in the future.« less

21 CFR 864.6150 - Capillary blood collection tube.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Capillary blood collection tube. 864.6150 Section... blood collection tube. (a) Identification. A capillary blood collection tube is a plain or heparinized glass tube of very small diameter used to collect blood by capillary action. (b) Classification. Class I...

21 CFR 864.6150 - Capillary blood collection tube.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Capillary blood collection tube. 864.6150 Section... blood collection tube. (a) Identification. A capillary blood collection tube is a plain or heparinized glass tube of very small diameter used to collect blood by capillary action. (b) Classification. Class I...

21 CFR 864.6150 - Capillary blood collection tube.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Capillary blood collection tube. 864.6150 Section... blood collection tube. (a) Identification. A capillary blood collection tube is a plain or heparinized glass tube of very small diameter used to collect blood by capillary action. (b) Classification. Class I...

21 CFR 864.6150 - Capillary blood collection tube.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Capillary blood collection tube. 864.6150 Section... blood collection tube. (a) Identification. A capillary blood collection tube is a plain or heparinized glass tube of very small diameter used to collect blood by capillary action. (b) Classification. Class I...

21 CFR 864.6150 - Capillary blood collection tube.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Capillary blood collection tube. 864.6150 Section... blood collection tube. (a) Identification. A capillary blood collection tube is a plain or heparinized glass tube of very small diameter used to collect blood by capillary action. (b) Classification. Class I...

Magnetic merging in colliding flux tubes

NASA Technical Reports Server (NTRS)

Zweibel, Ellen G.; Rhoads, James E.

1995-01-01

We develop an analytical theory of reconnection between colliding, twisted magnetic flux tubes. Our analysis is restricted to direct collisions between parallel tubes and is based on the collision dynamics worked out by Bogdan (1984). We show that there is a range of collision velocities for which neutral point reconnection of the Parker-Sweet type can occur, and a smaller range for which reconnection leads to coalescence. Mean velocities within the solar convection zone are probably significantly greater than the upper limit for coalescence. This suggests that the majority of flux tube collisions do not result in merging, unless the frictional coupling of the tubes to the background flow is extremely strong.

Fuel cell tubes and method of making same

DOEpatents

Borglum, Brian P.

1999-11-30

A method of manufacturing porous ceramic tubes for fuel cells with improved properties and higher manufacturing yield is disclosed. The method involves extruding a closed end fuel cell tube, such as an air electrode of a solid oxide fuel cell, in which the closed end also functions as the sintering support. The resultant fuel cell tube has a superior porosity distribution which allows improved diffusion of oxygen at the closed end of the tube during operation of the fuel cell. Because this region has the highest current density, performance enhancement and improved reliability of the fuel cell tube result. Furthermore, the higher manufacturing yield associated with the present method decreases the overall fuel cell cost. A method of manufacturing porous ceramic tubes for fuel cells with improved properties and higher manufacturing yield is disclosed. The method involves extruding a closed end fuel cell tube, such as an air electrode of a solid oxide fuel cell, in which the closed end also functions as the sintering support. The resultant fuel cell tube has a superior porosity distribution which allows improved diffusion of oxygen at the closed end of the tube during operation of the fuel cell. Because this region has the highest current density, performance enhancement and improved reliability of the fuel cell tube result. Furthermore, the higher manufacturing yield associated with the present method decreases the overall fuel cell cost.

The N-linking glycosylation system from Actinobacillus pleuropneumoniae is required for adhesion and has potential use in glycoengineering

PubMed Central

Bossé, Janine T.; Abouelhadid, Sherif; Li, Yanwen; Lin, Chia-Wei; Vohra, Prerna; Tucker, Alexander W.; Rycroft, Andrew N.; Maskell, Duncan J.; Aebi, Markus; Langford, Paul R.

2017-01-01

Actinobacillus pleuropneumoniae is a mucosal respiratory pathogen causing contagious porcine pleuropneumonia. Pathogenesis studies have demonstrated a major role for the capsule, exotoxins and outer membrane proteins. Actinobacillus pleuropneumoniae can also glycosylate proteins, using a cytoplasmic N-linked glycosylating enzyme designated NGT, but its transcriptional arrangement and role in virulence remains unknown. We investigated the NGT locus and demonstrated that the putative transcriptional unit consists of rimO, ngt and a glycosyltransferase termed agt. From this information we used the A. pleuropneumoniae glycosylation locus to decorate an acceptor protein, within Escherichia coli, with a hexose polymer that reacted with an anti-dextran antibody. Mass spectrometry analysis of a truncated protein revealed that this operon could add up to 29 repeat units to the appropriate sequon. We demonstrated the importance of NGT in virulence, by creating deletion mutants and testing them in a novel respiratory cell line adhesion model. This study demonstrates the importance of the NGT glycosylation system for pathogenesis and its potential biotechnological application for glycoengineering. PMID:28077594

The N-linking glycosylation system from Actinobacillus pleuropneumoniae is required for adhesion and has potential use in glycoengineering.

PubMed

Cuccui, Jon; Terra, Vanessa S; Bossé, Janine T; Naegeli, Andreas; Abouelhadid, Sherif; Li, Yanwen; Lin, Chia-Wei; Vohra, Prerna; Tucker, Alexander W; Rycroft, Andrew N; Maskell, Duncan J; Aebi, Markus; Langford, Paul R; Wren, Brendan W

2017-01-01

Actinobacillus pleuropneumoniae is a mucosal respiratory pathogen causing contagious porcine pleuropneumonia. Pathogenesis studies have demonstrated a major role for the capsule, exotoxins and outer membrane proteins. Actinobacillus pleuropneumoniae can also glycosylate proteins, using a cytoplasmic N-linked glycosylating enzyme designated NGT, but its transcriptional arrangement and role in virulence remains unknown. We investigated the NGT locus and demonstrated that the putative transcriptional unit consists of rimO, ngt and a glycosyltransferase termed agt. From this information we used the A. pleuropneumoniae glycosylation locus to decorate an acceptor protein, within Escherichia coli, with a hexose polymer that reacted with an anti-dextran antibody. Mass spectrometry analysis of a truncated protein revealed that this operon could add up to 29 repeat units to the appropriate sequon. We demonstrated the importance of NGT in virulence, by creating deletion mutants and testing them in a novel respiratory cell line adhesion model. This study demonstrates the importance of the NGT glycosylation system for pathogenesis and its potential biotechnological application for glycoengineering. © 2017 The Authors.

NMDA Receptor Signaling Is Important for Neural Tube Formation and for Preventing Antiepileptic Drug-Induced Neural Tube Defects.

PubMed

Sequerra, Eduardo B; Goyal, Raman; Castro, Patricio A; Levin, Jacqueline B; Borodinsky, Laura N

2018-05-16

Failure of neural tube closure leads to neural tube defects (NTDs), which can have serious neurological consequences or be lethal. Use of antiepileptic drugs (AEDs) during pregnancy increases the incidence of NTDs in offspring by unknown mechanisms. Here we show that during Xenopus laevis neural tube formation, neural plate cells exhibit spontaneous calcium dynamics that are partially mediated by glutamate signaling. We demonstrate that NMDA receptors are important for the formation of the neural tube and that the loss of their function induces an increase in neural plate cell proliferation and impairs neural cell migration, which result in NTDs. We present evidence that the AED valproic acid perturbs glutamate signaling, leading to NTDs that are rescued with varied efficacy by preventing DNA synthesis, activating NMDA receptors, or recruiting the NMDA receptor target ERK1/2. These findings may prompt mechanistic identification of AEDs that do not interfere with neural tube formation. SIGNIFICANCE STATEMENT Neural tube defects are one of the most common birth defects. Clinical investigations have determined that the use of antiepileptic drugs during pregnancy increases the incidence of these defects in the offspring by unknown mechanisms. This study discovers that glutamate signaling regulates neural plate cell proliferation and oriented migration and is necessary for neural tube formation. We demonstrate that the widely used antiepileptic drug valproic acid interferes with glutamate signaling and consequently induces neural tube defects, challenging the current hypotheses arguing that they are side effects of this antiepileptic drug that cause the increased incidence of these defects. Understanding the mechanisms of neurotransmitter signaling during neural tube formation may contribute to the identification and development of antiepileptic drugs that are safer during pregnancy. Copyright © 2018 the authors 0270-6474/18/384762-12$15.00/0.

Square tubing reduces cost of telescoping bridge crane hoist

NASA Technical Reports Server (NTRS)

Bernstein, G.; Graae, J.; Schraidt, J.

1967-01-01

Using standard square tubing in a telescoping arrangement reduces the cost of a bridge crane hoist. Because surface tolerances of square tubing need not be as accurate as the tubing used previously and because no spline is necessary, the square tubing is significantly less expensive than splined telescoping tubes.

Forisome performance in artificial sieve tubes.

PubMed

Knoblauch, Michael; Stubenrauch, Mike; van Bel, Aart J E; Peters, Winfried S

2012-08-01

In the legume phloem, sieve element occlusion (SEO) proteins assemble into Ca(2+)-dependent contractile bodies. These forisomes presumably control phloem transport by forming reversible sieve tube plugs. This function, however, has never been directly demonstrated, and appears questionable as forisomes were reported to be too small to plug sieve tubes, and failed to block flow efficiently in artificial microchannels. Moreover, plugs of SEO-related proteins in Arabidopsis sieve tubes do not affect phloem translocation. We improved existing procedures for forisome isolation and storage, and found that the degree of Ca(2+)-driven deformation that is possible in forisomes of Vicia faba, the standard object of earlier research, has been underestimated substantially. Forisomes deform particularly strongly under reducing conditions and high sugar concentrations, as typically found in sieve tubes. In contrast to our previous inference, Ca(2+)-inducible forisome swelling certainly seems sufficient to plug sieve tubes. This conclusion was supported by 3D-reconstructions of forisome plugs in Canavalia gladiata. For a direct test, we built microfluidics chips with artificial sieve tubes. Using fluorescent dyes to visualize flow, we demonstrated the complete blockage of these biomimetic microtubes by Ca(2+)-induced forisome plugs, and concluded by analogy that forisomes are capable of regulating phloem flow in vivo. © 2012 Blackwell Publishing Ltd.

Dimensional Measurements of Three Tubes by Computed Tomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schneberk, D J; Martz, Jr., H E; Brown, W D

2004-10-05

Low density polyethylene (LDPE), copper (Cu), and gold (Au) tubes were scanned on KCAT to identify and evaluate the impact of phase effects on quantitative object recovery. These tubes are phantoms for high energy density capsules.[Logan, et al. 2004] Digital radiographs for each tube are shown in Figure 1. The LDPE tube was scanned at 60 kV, while the Cu and the Au tubes were scanned at 140 kV. All tubes were scanned at a magnification of 3, with approximately 100-mm distance between the exit plane of the tube and the scintillator. Notice the prominence of the outer bright andmore » inner dark edges for the LDPE tube DR, and their absence from the Cu and Au tube DRs. The bright and dark edges are a result of change in phase of the x-rays. The x-ray fluence is partly attenuated and partly refracted. The location near the outer edge of the tube appears to be more attenuating since those x-rays have refracted to locations just outside the tube. Alternatively, the added counts from the refraction result in intensities that are greater than the incident intensity effectively representing a ''negative attenuation''. This results in more counts in that location than in the incident intensity image violating the ''positive-definite'' requirement for standard CT reconstruction methodologies. One aspect of our CT processing techniques remove some of this signal on the outside of the object. The goal of this paper is to evaluate the accuracy of our dimensional measurement methods for mesoscale object inspection.« less

Large co-axial pulse tube preliminary results

NASA Astrophysics Data System (ADS)

Emery, N.; Caughley, A.; Meier, J.; Nation, M.; Tanchon, J.; Trollier, T.; Ravex, A.

2014-01-01

We report that Callaghan Innovation, formally known as Industrial Research Ltd (IRL), has designed and built its largest of three high frequency single-stage co-axial pulse tubes, closely coupled to a metal diaphragm pressure wave generator (PWG). The previous pulse tube achieved 110 W of cooling power @ 77 K, with an electrical input power of 3.1 kW from a 90 cc swept volume PWG. The pulse tubes have all been tuned to operate at 50 Hz, with a mean helium working pressure of 2.5 MPa. Sage pulse tube simulation software was used to model the latest pulse tube and predicted 280 W of cooling power @ 77 K. The nominal 250 W cryocooler was designed to be an intermediate step to up-scale pulse tube technology for our 1000 cc swept-volume PWG, to provide liquefaction of gases and cooling for HTS applications. Details of the modeling, design, development and preliminary experimental results are discussed.

Autologous patch graft in tube shunt surgery.

PubMed

Aslanides, I M; Spaeth, G L; Schmidt, C M; Lanzl, I M; Gandham, S B

1999-10-01

To evaluate an alternate method of covering the subconjunctival portion of the tube in aqueous shunt surgery. Evidence of tube erosion, graft-related infection, graft melting, or other associated intraocular complications were evaluated. A retrospective study of 16 patients (17 eyes) who underwent tube shunt surgery at Wills Eye Hospital between July 1991 and October 1996 was conducted. An autologous either "free" or "rotating" scleral lamellar graft was created to cover the subconjunctival portion of the tube shunt. All patients were evaluated for at least 6 months, with a mean follow-up of 14.8 months (range 6-62 months). All eyes tolerated the autologous graft well, with no clinical evidence of tube erosion, or graft-related or intraocular complications. Autologous patch graft in tube shunt surgery appears--in selected cases--to be an effective, safe and inexpensive surgical alternative to allogenic graft materials. It also offers ease of availability, and eliminates the risk of transmitting infectious disease.

Geology of selected lava tubes in the Bend Area, Oregon

NASA Technical Reports Server (NTRS)

Greely, R.

1971-01-01

Longitudinal profiles representing 5872.5 m of mapped lava tubes and a photogeologic map relating lava tubes to surface geology, regional structure and topography are presented. Three sets of lava tubes were examined: (1) Arnold Lava Tube System (7km long) composed of collapsed and uncollapsed tube segments and lava ponds, (2) Horse Lava Tube System (11 km long) composed of parallel and anastomosing lava tube segments, and (3) miscellaneous lava tubes. Results of this study tend to confirm the layered lava hypothesis of Ollier and Brown (1965) for lava tube formation; however, there are probably several modes of formation for lava tubes in general. Arnold System is a single series of tubes apparently formed in a single basalt flow on a relatively steep gradient. The advancing flow in which the tubes formed was apparently temporarily halted, resulting in the formation of lava ponds which were inflated and later drained by the lava tube system. Horse System probably formed in multiple, interconnected flows. Pre-flow gradient appears to have been less than for Arnold System, and resulted in meandrous, multiple tube networks.

Progesterone and norgestrel alter transcriptional expression of genes along the hypothalamic-pituitary-thyroid axis in zebrafish embryos-larvae.

PubMed

Liang, Yan-Qiu; Huang, Guo-Yong; Ying, Guang-Guo; Liu, Shuang-Shuang; Jiang, Yu-Xia; Liu, Shan

2015-01-01

The aim of this study was to investigate the effects of progestins on the hypothalamic-pituitary-thyroid (HPT) axis in the early stage of zebrafish. Zebrafish embryos were exposed to progesterone (P4) or norgestrel (NGT) at 5, 50 and 100 ng L(-1) for 144 h post fertilization (hpf), and the transcriptional levels of target genes along the hypothalamic-pituitary-thyroid axis were determined daily. The results showed that P4 had only minor effects on the mRNA expression of thyroglobulin (Tg), iodothyronine deiodinase type Ι (Dio1) and thyroid hormone receptor β (Thrb) genes. Similarly, the effects of NGT on transcripts of thyrotropin-releasing hormone (Trh), Dio1, iodothyronine deiodinase type II (Dio2) and thyroid hormone receptor α (Thra) genes were generally low. In addition, NGT resulted in some alterations of Tg and Thrb transcripts at different time points. However, a strong induction of Nis mRNA by P4 and NGT was observed in zebrafish embryos-larvae. The overall results showed that besides Nis no effects on the hypothalamic-pituitary-thyroid (HPT) axis are observed following exposure to P4 and NGT, which imply that both P4 and NGT have potential effects on the thyroid endocrine system by inducing transcript of Nis gene during the early stage of zebrafish. Copyright © 2014 Elsevier Inc. All rights reserved.

Preparation of nitrogen-doped carbon tubes

DOEpatents

Chung, Hoon Taek; Zelenay, Piotr

2015-12-22

A method for synthesizing nitrogen-doped carbon tubes involves preparing a solution of cyanamide and a suitable transition metal-containing salt in a solvent, evaporating the solvent to form a solid, and pyrolyzing the solid under an inert atmosphere under conditions suitable for the production of nitrogen-doped carbon tubes from the solid. Pyrolyzing for a shorter period of time followed by rapid cooling resulted in a tubes with a narrower average diameter.

Nonlinear acoustic streaming in straight and tapered tubes

NASA Astrophysics Data System (ADS)

Tuttle, Brian C.

In thermoacoustic and Stirling devices such as the pulse-tube refrigerator, efficiency is diminished by the formation of a second-order mean velocity known as Rayleigh streaming. This flow emerges from the interaction of the working gas with the wall of the tube in a thin boundary layer. Recent studies have suggested that streaming velocity can be decreased in a tube by tapering it slightly. This research investigates that claim through the development of a numerical model of Rayleigh streaming in variously tapered tubes. It is found that the numerical simulation of streaming in a straight tube compares well with theory, and the application of different thermal boundary conditions at the tube wall shows that for pressurized helium, inner streaming vortices which appear near an adiabatic tube wall do not develop near an isothermal wall. An order analysis indicates that the temperature dependence of viscosity and thermal conductivity contributes appreciably to an accurate numerical model of streaming. Comparison of Rayleigh streaming in tapered tubes shows the effects of taper angle on the circulation and velocity of the mean flow.

Energy Absorption of Expansion Tube Considering Local Buckling Characteristics

NASA Astrophysics Data System (ADS)

Ahn, Kwang-Hyun; Kim, Jin-Sung; Huh, Hoon

This paper deals with the crash energy absorption and the local buckling characteristics of the expansion tube during the tube expanding processes. In order to improve energy absorption capacity of expansion tubes, local buckling characteristics of an expansion tube must be considered. The local buckling load and the absorbed energy during the expanding process were calculated for various types of tubes and punch shapes with finite element analysis. The energy absorption capacity of the expansion tube is influenced by the tube and the punch shape. The material properties of tubes are also important parameter for energy absorption. During the expanding process, local buckling occurs in some cases, which causes significant decreasing the absorbed energy of the expansion tube. Therefore, it is important to predict the local buckling load accurately to improve the energy absorption capacity of the expansion tube. Local buckling takes place relatively easily at the large punch angle and expansion ratio. Local buckling load is also influenced by both the tube radius and the thickness. In prediction of the local buckling load, modified Plantema equation was used for strain hardening and strain rate hardening. The modified Plantema equation shows a good agreement with the numerical result.

Laparoscopic insertion of the Moss feeding tube.

PubMed

Albrink, M H; Hagan, K; Rosemurgy, A S

1993-12-01

Placement of enteral feeding tubes is an important part of a surgeon's skill base. Surgical insertion of feeding tubes has been performed safely for many years with very few modifications. With the recent surge in interest and applicability of other laparoscopic procedures, it is well within the skills of the average laparoscopic surgeon to insert feeding tubes. We describe herein a simple technique for the insertion of the Moss feeding tube. The procedure described has a minimum of invasion, along with simplicity, safety, and accuracy.

Cell-Cell Interactions during pollen tube guidance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Daphne Preuss

The long-term goal of this research is to identify the signaling molecules that mediate plant cell-cell interactions during pollination. The immediate goals of this project are to perform genetic and molecular analysis of pollen tube guidance. Specifically, we proposed to: 1. Characterize the pistil components that direct pollen tube navigation using the Arabidopsis thaliana in vitro pollen tube guidance system 2. Identify pistil signals that direct pollen tube guidance by a) using microarrays to profile gene expression in developing pistils, and b) employing proteomics and metabolomics to isolate pollen tube guidance signals. 3. Explore the genetic basis of natural variationmore » in guidance signals, comparing the in vitro interactions between pollen and pistils from A. thaliana and its close relatives.« less

The structural stability of lunar lava tubes

NASA Astrophysics Data System (ADS)

Blair, David M.; Chappaz, Loic; Sood, Rohan; Milbury, Colleen; Bobet, Antonio; Melosh, H. Jay; Howell, Kathleen C.; Freed, Andrew M.

2017-01-01

Mounting evidence from the SELENE, LRO, and GRAIL spacecraft suggests the presence of vacant lava tubes under the surface of the Moon. GRAIL evidence, in particular, suggests that some may be more than a kilometer in width. Such large sublunarean structures would be of great benefit to future human exploration of the Moon, providing shelter from the harsh environment at the surface-but could empty lava tubes of this size be stable under lunar conditions? And what is the largest size at which they could remain structurally sound? We address these questions by creating elasto-plastic finite element models of lava tubes using the Abaqus modeling software and examining where there is local material failure in the tube's roof. We assess the strength of the rock body using the Geological Strength Index method with values appropriate to the Moon, assign it a basaltic density derived from a modern re-analysis of lunar samples, and assume a 3:1 width-to-height ratio for the lava tube. Our results show that the stability of a lava tube depends on its width, its roof thickness, and whether the rock comprising the structure begins in a lithostatic or Poisson stress state. With a roof 2 m thick, lava tubes a kilometer or more in width can remain stable, supporting inferences from GRAIL observations. The theoretical maximum size of a lunar lava tube depends on a variety of factors, but given sufficient burial depth (500 m) and an initial lithostatic stress state, our results show that lava tubes up to 5 km wide may be able to remain structurally stable.

Insulated laser tube structure and method of making same

DOEpatents

Dittbenner, Gerald R.

1999-01-01

An insulated high temperature ceramic laser tube having substantially uniform insulation along the length of the tube is disclosed having particulate ceramic insulation positioned between the outer wall of the ceramic laser tube and the inner surface of tubular ceramic fiber insulation which surrounds the ceramic laser tube. The particulate ceramic insulation is preferably a ceramic capable of sintering to the outer surface of the ceramic laser tube and to the inner surface of the tubular ceramic fiber insulation. The addition of the particulate ceramic insulation to fill all the voids between the ceramic laser tube and the fibrous ceramic insulation permits the laser tube to be operated at a substantially uniform temperature throughout the length of the laser tube.

Clinical use and material wear of polymeric tracheostomy tubes.

PubMed

Björling, Gunilla; Axelsson, Sara; Johansson, Unn-Britt; Lysdahl, Michael; Markström, Agneta; Schedin, Ulla; Aune, Ragnhild E; Frostell, Claes; Karlsson, Sigbritt

2007-09-01

The objectives were to compare the duration of use of polymeric tracheostomy tubes, i.e., silicone (Si), polyvinyl chloride (PVC), and polyurethane (PU), and to determine whether surface changes in the materials could be observed after 30 days of patient use. Data were collected from patient and technical records for all tracheostomized patients attending the National Respiratory Center in Sweden. In the surface study, 19 patients with long-term tracheostomy were included: six with Bivona TTS Si tubes, eight with Shiley PVC tubes, and five with Trachoe Twist PU tubes. All tubes were exposed in the trachea for 30 days before being analyzed by scanning electron microscopy (SEM) and attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR). New tubes and tubes exposed in phosphate-buffered saline were used as reference. Si tubes are used for longer periods of time than those made of PVC (P<.0001) and PU (P=.021). In general, all polymeric tubes were used longer than the recommended 30-day period. Eighteen of the 19 tubes exposed in patients demonstrated, in one or more areas of the tube, evident surface changes. The morphologic changes identified by SEM correlate well with the results obtained by ATR-FTIR. Si tracheostomy tubes are in general used longer than those made of PVC and PU. Most of the tubes exposed in the trachea for 30 days suffered evident surface changes, with degradation of the polymeric chains as a result.

Advanced evacuated tube collectors

NASA Astrophysics Data System (ADS)

Schertz, W. W.; Hull, J. R.; Winston, R.; Ogallagher, J.

1985-04-01

The essence of the design concept for these new collectors is the integration of moderate levels of nonimaging concentration inside the evacuated tube itself. This permanently protects the reflection surfaces and allows the use of highly reflecting front surface mirrors with reflectances greater than 95%. Previous fabrication and long term testing of a proof-of-concept prototype has established the technical success of the concept. Present work is directed toward the development of a manufacturable unit that will be suitable for the widest possible range of applications. Design alternatives include scaling up the original prototype's tube diameter from 5 cm to 10 cm, using an internal shaped metal concentrating reflector, using a variety of profile shapes to minimize so-called gap losses and accommodate both single ended and double-ended flow geometries, and allowing the use of heat pipes for the absorber tube.

Inertance Tube Modeling and the Effects of Temperature

DTIC Science & Technology

2010-01-01

fluid dynamics. In one application in multistage cryocoolers , the performance of inertance tubes at the cryogenic temperatures is of interest. One... cryocoolers , the performance of inertance tubes at the cryogenic temperatures is of interest. One purpose of this paper is to understand how...acoustic power. KEYWORDS: Inertance tube, cryocoolers , pulse tube refrigerators, oscillating flow, computational fluid dynamics INTRODUCTION Pulse

Study on convection improvement of standard vacuum tube

NASA Astrophysics Data System (ADS)

He, J. H.; Du, W. P.; Qi, R. R.; He, J. X.

2017-11-01

For the standard all-glass vacuum tube collector, enhancing the vacuum tube axial natural convection can improve its thermal efficiency. According to the study of the standard all-glass vacuum tube, three kinds of guide plates which can inhibit the radial convection and increase axial natural convection are designed, and theory model is established. Experiments were carried out on vacuum tubes with three types of baffles and standard vacuum tubes without the improvement. The results show that T-type guide plate is better than that of Y-type guide plate on restraining convection and increasing axial radial convection effect, Y type is better than that of flat plate type, all guide plates are better than no change; the thermal efficiency of the tube was 2.6% higher than that of the unmodified standard vacuum tube. The efficiency of the system in the experiment can be increased by 3.1%.

Mineralization of Alvinella polychaete tubes at hydrothermal vents.

PubMed

Georgieva, M N; Little, C T S; Ball, A D; Glover, A G

2015-03-01

Alvinellid polychaete worms form multilayered organic tubes in the hottest and most rapidly growing areas of deep-sea hydrothermal vent chimneys. Over short periods of time, these tubes can become entirely mineralized within this environment. Documenting the nature of this process in terms of the stages of mineralization, as well as the mineral textures and end products that result, is essential for our understanding of the fossilization of polychaetes at hydrothermal vents. Here, we report in detail the full mineralization of Alvinella spp. tubes collected from the East Pacific Rise, determined through the use of a wide range of imaging and analytical techniques. We propose a new model for tube mineralization, whereby mineralization begins as templating of tube layer and sublayer surfaces and results in fully mineralized tubes comprised of multiple concentric, colloform, pyrite bands. Silica appeared to preserve organic tube layers in some samples. Fine-scale features such as protein fibres, extracellular polymeric substances and two types of filamentous microbial colonies were also found to be well preserved within a subset of the tubes. The fully mineralized Alvinella spp. tubes do not closely resemble known ancient hydrothermal vent tube fossils, corroborating molecular evidence suggesting that the alvinellids are a relatively recent polychaete lineage. We also compare pyrite and silica preservation of organic tissues within hydrothermal vents to soft tissue preservation in sediments and hot springs. © 2014 The Authors. Geobiology Published by John Wiley & Sons Ltd.

Pulsar polarization measurements and the nonsymmetric gravitational theory

NASA Technical Reports Server (NTRS)

Krisher, Timothy P.

1991-01-01

Because of the breakdown of the Einstein equivalence principle in the nonsymmetric gravitational theory (NGT) of Moffat, orthogonally polarized electromagnetic waves can propagate at different velocities in a gravitational field. Moffat has proposed that galactic dark matter, in the form of cosmions, may act as a significant source of gravity in the NGT. We discuss how observations of the highly polarized radiation from distant pulsars could provide significant limits on the strength of the coupling of cosmions in the NGT.

Elevated 1-hour postload plasma glucose levels identify subjects with normal glucose tolerance but impaired β-cell function, insulin resistance, and worse cardiovascular risk profile: the GENFIEV study.

PubMed

Bianchi, Cristina; Miccoli, Roberto; Trombetta, Maddalena; Giorgino, Francesco; Frontoni, Simona; Faloia, Emanuela; Marchesini, Giulio; Dolci, Maria A; Cavalot, Franco; Cavallo, Gisella; Leonetti, Frida; Bonadonna, Riccardo C; Del Prato, Stefano

2013-05-01

In subjects with normal glucose tolerance (NGT) 1-hour postload plasma glucose (1-h oral glucose tolerance test [OGTT]) of >155 mg/dL predicts type 2 diabetes (T2DM) and is associated with subclinical atherosclerosis. The purpose of this study was to evaluate β-cell function, insulin resistance, and cardiovascular risk profile in subjects with NGT with a 1-h OGTT glucose of >155 mg/dL. The GENFIEV (Genetics, PHYsiopathology, and Evolution of Type 2 diabetes) study is a multicenter study recruiting individuals at high risk of T2DM. A total of 926 subjects underwent a 75-g OGTT for assessment of plasma glucose and C-peptide for mathematical modeling of β-cell function (derivative and proportional control). Fasting insulin, lipid profile, and clinical parameters were determined as well. A 1-hour OGTT glucose of >155 mg/dL was found in 39% of subjects with NGT, 76% with impaired fasting glucose (IFG), 90% with impaired glucose tolerance (IGT), and 99% and 98% with IFG + IGT or newly diagnosed T2DM, respectively. Among subjects with NGT (n = 474), those with 1-hour OGTT glucose of >155 mg/dL were more insulin-resistant and had worse β-cell function than those with 1-hour OGTT glucose of ≤155 mg/dL. Moreover, glycosylated hemoglobin, blood pressure, low-density lipoprotein cholesterol, and triglycerides were higher in subjects with NGT with 1-hour OGTT glucose of >155 mg/dL, whereas high-density lipoprotein cholesterol was lower compared with that in subjects with NGT with 1-hour OGTT glucose of ≤155 mg/dL. Compared with subjects with IGT, those with NGT with 1-hour OGTT glucose of >155 mg/dL had comparable cardiovascular risk profile and insulin resistance but slightly better β-cell function. Among subjects with NGT, those with 1-hour OGTT glucose of >155 mg/dL showed lower insulin sensitivity, impaired β-cell function, and worse cardiovascular risk profile and therefore are at greater risk of developing T2DM and cardiovascular disease.

PEG tubes: dealing with complications.

PubMed

Malhi, Hardip; Thompson, Rosie

A percutaneous endoscopic gastronomy tube can be used to deliver nutrition, hydration and medicines directly into the patient's stomach. Patients will require a tube if they are unable to swallow safely, putting them at risk of aspiration of food, drink and medicines into their lungs. It is vital that nurses are aware of the complications that may arise when caring for a patient with a PEG tube. It is equally important that nurses know how to deal with these complications or from where tc seek advice. This article provides a quick troubleshooting guide to help nurses deal with complications that can arise with PEG feeding.

GRID BLACKOUT IN VACUUM TUBES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hardin, K.D.

1961-06-01

A method which gives quantitative data is presented which allows for characterization of the grid blackout effect and is applicable to calculation of circuit degradation. Data are presented for several tube types which show developed bias and discharge time constants as a function of pulse input conditions. Blackout can seriously change the performance of any vacuum tube circuit which utilizes the tube in positive grid operation. The effects on CW oscillators and UHF mixers are discussed. An equivalent circuit which simulates some portions of the blackout phenomenon is presented and used to calculate effective capacitance and resistance associated with themore » grid surface. (auth)« less

dc-plasma-sprayed electronic-tube device

DOEpatents

Meek, T.T.

1982-01-29

An electronic tube and associated circuitry which is produced by dc plasma arc spraying techniques is described. The process is carried out in a single step automated process whereby both active and passive devices are produced at very low cost. The circuitry is extremely reliable and is capable of functioning in both high radiation and high temperature environments. The size of the electronic tubes produced are more than an order of magnitude smaller than conventional electronic tubes.

Eddy current measurement of tube element spacing

DOEpatents

Latham, Wayne Meredith; Hancock, Jimmy Wade; Grut, Jayne Marie

1998-01-01

A method of electromagnetically measuring the distance between adjacent tube elements in a heat exchanger. A cylindrical, high magnetic permeability ferrite slug is placed in the tube adjacent the spacing to be measured. A bobbin or annular coil type probe operated in the absolute mode is inserted into a second tube adjacent the spacing to be measured. From prior calibrations on the response of the eddy current coil, the signals from the coil, when sensing the presence of the ferrite slug, are used to determine the spacing between the tubes.

Proximal suction tracheotomy tube reduces aspiration volume.

PubMed

Coffman, Heather M S; Rees, Catherine J; Sievers, Ann E F; Belafsky, Peter C

2008-04-01

Conventional cuffed tracheotomy tubes do not prevent aspiration of secretions. Aspiration of saliva may be decreased with the use of a subglottic suction port. Prospective. Shiley Disposable Cuffed Tracheotomy (DCT) tubes sizes 4, 6, and 8 (Tyco Healthcare, Pleasanton, CA) were compared to Portex Blue Line Ultra Suctionaid (BLUS) tracheotomy tubes sizes 6, 7, and 8 (Fig 1; Smiths Medical, Watford, UK). All tubes were tested in a simulated tracheal model using 10 cc of human saliva with no suction, intermittent suction, and constant suction (15 minutes). There was a significant decrease in aspirate between the larger Shiley and BLUS tubes with intermittent suction (mean 8.38 mL Shiley 6 vs 1.60 mL BLUS 7; 8.50 mL Shiley 8 vs 2.80 mL BLUS 8). There was a significant decrease in aspirate between all sizes of Shiley and BLUS tubes with continuous suction. For BLUS 7 and 8, there was a significant difference between intermittent suction (mean, 1.60 mL, 2.80 mL, respectively) and continuous suction (mean, 0.20 mL, 0.60 mL respectively). Shiley and BLUS without suction were equivalent. Subglottic suction tracheotomy tubes reduce the risk of aspiration beyond the cuff in a bench-top model.

Origami tubes with reconfigurable polygonal cross-sections.

PubMed

Filipov, E T; Paulino, G H; Tachi, T

2016-01-01

Thin sheets can be assembled into origami tubes to create a variety of deployable, reconfigurable and mechanistically unique three-dimensional structures. We introduce and explore origami tubes with polygonal, translational symmetric cross-sections that can reconfigure into numerous geometries. The tubular structures satisfy the mathematical definitions for flat and rigid foldability, meaning that they can fully unfold from a flattened state with deformations occurring only at the fold lines. The tubes do not need to be straight and can be constructed to follow a non-linear curved line when deployed. The cross-section and kinematics of the tubular structures can be reprogrammed by changing the direction of folding at some folds. We discuss the variety of tubular structures that can be conceived and we show limitations that govern the geometric design. We quantify the global stiffness of the origami tubes through eigenvalue and structural analyses and highlight the mechanical characteristics of these systems. The two-scale nature of this work indicates that, from a local viewpoint, the cross-sections of the polygonal tubes are reconfigurable while, from a global viewpoint, deployable tubes of desired shapes are achieved. This class of tubes has potential applications ranging from pipes and micro-robotics to deployable architecture in buildings.

Origami tubes with reconfigurable polygonal cross-sections

PubMed Central

Filipov, E. T.; Paulino, G. H.; Tachi, T.

2016-01-01

Thin sheets can be assembled into origami tubes to create a variety of deployable, reconfigurable and mechanistically unique three-dimensional structures. We introduce and explore origami tubes with polygonal, translational symmetric cross-sections that can reconfigure into numerous geometries. The tubular structures satisfy the mathematical definitions for flat and rigid foldability, meaning that they can fully unfold from a flattened state with deformations occurring only at the fold lines. The tubes do not need to be straight and can be constructed to follow a non-linear curved line when deployed. The cross-section and kinematics of the tubular structures can be reprogrammed by changing the direction of folding at some folds. We discuss the variety of tubular structures that can be conceived and we show limitations that govern the geometric design. We quantify the global stiffness of the origami tubes through eigenvalue and structural analyses and highlight the mechanical characteristics of these systems. The two-scale nature of this work indicates that, from a local viewpoint, the cross-sections of the polygonal tubes are reconfigurable while, from a global viewpoint, deployable tubes of desired shapes are achieved. This class of tubes has potential applications ranging from pipes and micro-robotics to deployable architecture in buildings. PMID:26997894

21 CFR 874.1925 - Toynbee diagnostic tube.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Toynbee diagnostic tube. 874.1925 Section 874.1925...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Diagnostic Devices § 874.1925 Toynbee diagnostic tube. (a) Identification. The toynbee diagnostic tube is a listening device intended to determine the degree of openness of...

21 CFR 874.1925 - Toynbee diagnostic tube.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Toynbee diagnostic tube. 874.1925 Section 874.1925...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Diagnostic Devices § 874.1925 Toynbee diagnostic tube. (a) Identification. The toynbee diagnostic tube is a listening device intended to determine the degree of openness of...

A study of tape adhesive strength on endotracheal tubes.

PubMed

Fenje, N; Steward, D J

1988-03-01

A method of assessing the adhesive bond of tapes used to secure endotracheal (ET) tubes is described. Five kinds of tape and six different ET tubes including two silicone rubber, wire-reinforced tubes were tested. There are significant differences in the adhesive strength of different tapes, and in the adhesive bond formed by different ET tube materials. On the Portex clear ET tube, silk tape adhered best (p less than 0.001), followed by waterproof, cloth, dermiclear, and micropore tapes. Adhesive bonding by silk tape was significantly greater (p less than 0.001) for the three clear ET tubes (Portex clear, NCC clear, and Portex ivory) than for the Portex blue and the silicone rubber, wire-reinforced ET tubes. All tapes showed very poor or negligible adhesion to the Sheridan and Portex reinforced ET tubes. Adhesion to these tubes was greatly improved by wrapping them tightly with an "op site" dressing prior to applying tape.

Bore tube assembly for steam cooling a turbine rotor

DOEpatents

DeStefano, Thomas Daniel; Wilson, Ian David

2002-01-01

An axial bore tube assembly for a turbine is provided to supply cooling steam to hot gas components of the turbine wheels and return the spent cooling steam. A pair of inner and outer tubes define a steam supply passage concentric about an inner return passage. The forward ends of the tubes communicate with an end cap assembly having sets of peripheral holes communicating with first and second sets of radial tubes whereby cooling steam from the concentric passage is supplied through the end cap holes to radial tubes for cooling the buckets and return steam from the buckets is provided through the second set of radial tubes through a second set of openings of the end cap into the coaxial return passage. A radial-to-axial flow transitioning device, including anti-swirling vanes is provided in the end cap. A strut ring adjacent the aft end of the bore tube assembly permits axial and radial thermal expansion of the inner tube relative to the outer tube.

Design and Control of Concentric-Tube Robots

PubMed Central

Dupont, Pierre E.; Lock, Jesse; Itkowitz, Brandon; Butler, Evan

2010-01-01

A novel approach toward construction of robots is based on a concentric combination of precurved elastic tubes. By rotation and extension of the tubes with respect to each other, their curvatures interact elastically to position and orient the robot’s tip, as well as to control the robot’s shape along its length. In this approach, the flexible tubes comprise both the links and the joints of the robot. Since the actuators attach to the tubes at their proximal ends, the robot itself forms a slender curve that is well suited for minimally invasive medical procedures. This paper demonstrates the potential of this technology. Design principles are presented and a general kinematic model incorporating tube bending and torsion is derived. Experimental demonstration of real-time position control using this model is also described. PMID:21258648

Teaching Shakespeare with YouTube

ERIC Educational Resources Information Center

Desmet, Christy

2009-01-01

YouTube, the video sharing website that allows viewers to upload video content ranging from cute dog tricks to rare rock videos, also supports a lively community devoted to the performance of Shakespeare and Shakespearean adaptations. YouTube is also a popular site for student producers of Shakespeare performances, parodies, and other artistic…

Tube construction for fluidized bed combustor

DOEpatents

De Feo, Angelo; Hosek, William

1984-01-01

A fluidized bed combustor comprises a reactor or a housing which has a windbox distributor plate adjacent the lower end thereof which contains a multiplicity of hole and air discharge nozzles for discharging air and coal into a fluidized bed which is maintained above the distributor plate and below a take-off connection or flue to a cyclone separator in which some of the products of combustion are treated to remove the dust which is returned into the fluidized bed. A windbox is spaced below the fluidized bed and it has a plurality of tubes passing therethrough with the passage of combustion air and fluidizing air which passes through an air space so that fluidizing air is discharged into the reaction chamber fluidized bed at the bottom thereof to maintain the bed in a fluidized condition. A fluid, such as air, is passed through the tubes which extend through the windbox and provide a preheating of the combustion air and into an annular space between telescoped inner and outer tubes which comprise heat exchanger tubes or cooling tubes which extend upwardly through the distributor plate into the fluidized bed. The heat exchanger tubes are advantageously arranged so that they may be exposed in groups within the reactor in a cluster which is arranged within holding rings.

Development of composite tube protective coatings

NASA Technical Reports Server (NTRS)

Dursch, H.; Hendricks, C.

1986-01-01

Protective coatings for graphite/epoxy (Gr/Ep) tubular structures proposed for the Space Station are evaluated. The program was divided into four parts; System Definition, Coating Concept Selection and Evaluation, Scale-up and Assembly, and Reporting. System Definition involved defining the structural and environmental properties required of the Gr/Ep tubes. The prepreg and ply sequence selected was a P75S/934 (O2, + or - 20, O2)sub s layup which meets the various structural requirements of the Space Station. Coating Concept and Selection comprised the main emphasis of the effort. Concepts for protectively coating the Gr/Ep tubes included the use of metal foil and electroplating. The program results demonstrated that both phosphoric and chromic acid anodized Al foil provided adequate adhesion to the Gr/Ep tubes and stability of optical properties when subjected to atomic oxygen and thermal cycling representative of the LEO environment. SiO2/Al coatings sputtered onto Al foils also resulted in an excellent protective coating. The electroplated Ni possessed unacceptable adhesion loss to the Gr/Ep tubes during atomic oxygen testing. Scale-Up and Assembly involved fabricating and wrapping 8-ft-long by 2-in-diameter Gr/EP tubes with chromic acid anodized foil and delivering these tubes, along with representative Space Station erectable end fittings, to NASA LaRC.

Intermittent chest tube clamping may shorten chest tube drainage and postoperative hospital stay after lung cancer surgery: a propensity score matching analysis.

PubMed

Yan, Shi; Wang, Xing; Wang, Yaqi; Lv, Chao; Wang, Yuzhao; Wang, Jia; Yang, Yue; Wu, Nan

2017-12-01

Postoperative pleural drainage markedly influences the length of hospital stay and the financial costs of medical care. The safety of chest tube clamping before removal has been documented. This study aims to determine if intermittent chest tube clamping shortens the duration of chest tube drainage and hospital stay after lung cancer surgery. We retrospectively analyzed 285 consecutive patients with operable lung cancer treated using lobectomy and systematic mediastinal lymphadenectomy. The chest tube management protocol in our institution was changed in January 2014, and thus, 222 patients (clamping group) were managed with intermittent chest tube clamping, while 63 patients (control group) were managed with a traditional protocol. Propensity score matching at a 1:1 ratio was applied to balance variables potentially affecting the duration of chest tube drainage. Analyses were performed to compare drainage duration and postoperative hospital stay between the two groups in the matched cohort. Multivariate logistic regression analyses were performed to predict the factors associated with chest tube drainage duration. The rates of thoracocentesis after chest tube removal were similar between the clamping and control groups in the whole cohort (0.5% vs. 1.6%, P=0.386). The rates of pyrexia were also comparable in the two groups (2.3% vs. 3.2%, P=0.685). After propensity score matching, 61 cases remained in each group. Both chest tube drainage duration (3.9 vs. 4.8 days, P=0.001) and postoperative stay (5.7 vs. 6.4 days, P=0.025) were significantly shorter in the clamping group than in the control group. Factors significantly associated with shorter chest tube drainage duration were female sex, chest tube clamping, left lobectomy, and video-assisted thoracoscopic surgery (VATS) (P<0.05). Intermittent postoperative chest tube clamping may decrease the duration of chest tube drainage and postoperative hospital stay while maintaining patient safety.

COMMODITY SCALE SYNTHESIS OF 1-METHYLIMIDAZOLE BASED IONIC LIQUIDS USING A SPINNING TUBE-IN-TUBE REACTOR

EPA Science Inventory

The continuous large-scale preparation of several 1-methylimidazole based ionic liquids was carried out using a Spinning Tube-in-Tube (STT) reactor (manufactured by Kreido Laboratories). This reactor, which embodies and facilitates the use of Green Chemistry principles and Proce...

Sniffin' Away the Feeding Tube - The Influence of Olfactory Stimulation on Oral Food Intake in Newborns and Premature Infants.

PubMed

Schriever, Valentin A; Gellrich, Janine; Rochor, Nora; Croy, Ilona; Cao-Van, Helene; Rüdiger, Mario; Hummel, Thomas

2018-06-02

Because of their immaturity many premature infants are fed via nasogastric tube. One objective of the neonatal care is to feed infants orally early. The olfactory function of premature infants is developed before birth and odorants have a significant impact on nutrition in infants. The aim of the study was to test whether odor stimulation has a positive effect on the transition from gavage to oral feeding in infants. Participants were premature infants with gestational age of more than 27 weeks, with full or partial gavage feeding, stable vital parameters and without invasive ventilation. Before each feeding procedure an odorant was presented in front of the infant's nose. Infants were randomized into one of three groups and received either rose odor (not food-associated), vanilla odor (food-associated) or placebo (no odor). The primary outcome of the study was defined as the time until complete oral nutrition. 150 children born at a postnatal age of 9.5±7.8 days were included in this study. The duration until complete oral nutrition was reached after 11.8±7.7 (vanilla), 12.2±7.7 (rose) and 12.9±8.8 (control) days. A nearly linear relation between odor presentation frequency and effect size was detectable. For infants that received the intervention for more than 66.7% of the time the length of gavage feeding (8±5.4) and hospitalization (11±6.5) was significantly lower in the vanilla group when compared with control (15±7.3 and 21±13.7 respectively). Odor stimulation with vanilla has an impact on oral feeding in premature infants, however the odor has to be presented on regular basis.

Hydrogen isotope exchange in a metal hydride tube

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robinson, David B.

2014-09-01

This report describes a model of the displacement of one hydrogen isotope within a metal hydride tube by a different isotope in the gas phase that is blown through the tube. The model incorporates only the most basic parameters to make a clear connection to the theory of open-tube gas chromatography, and to provide a simple description of how the behavior of the system scales with controllable parameters such as gas velocity and tube radius. A single tube can be seen as a building block for more complex architectures that provide higher molar flow rates or other advanced design goals.

YouTube, "Drug Videos" and Drugs Education

ERIC Educational Resources Information Center

Manning, Paul

2013-01-01

Aims: This article reports on findings to emerge from a project examining YouTube "drug videos" in the light of an emerging literature on the relationship between YouTube and health education. The aim of this article is to describe the variety of discourses circulated by the "drug videos" available on YouTube and to consider…

"Cool" Engagements with YouTube: Part 1

ERIC Educational Resources Information Center

Trier, James

2007-01-01

This article discusses the participatory potential of YouTube, a social website that allows users to upload, view, and share video clips. The author provides examples of how YouTube was incorporated into a course as part of a "mosh-pit" pedagogy that involved both students and teachers in engaging with a variety of YouTube videos.

21 CFR 868.5730 - Tracheal tube.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5730 Tracheal tube. (a) Identification. A tracheal tube is a device inserted into a patient's trachea via the nose or mouth and used to maintain an open airway. (b...

Possible test at Jupiter of the nonsymmetric gravitational theory

NASA Technical Reports Server (NTRS)

Krisher, Timothy P.

1989-01-01

Radiometric data generated during spacecraft flybys of Jupiter have the capability to provide an interesting constraint on the coupling of cosmions in the nonsymmetric gravitational theory (NGT) of Moffat. It is shown that the close flyby of Jupiter by Pioneer 11 could imply a possible limit on the NGT l parameter of the sun of solar l less than 2800 km, a limit which could affect the ability of the NGT to account for the precession of the perihelion of Mercury with a large solar quadrupole moment.

A Role for YouTube in Telerehabilitation

PubMed Central

Manasco, M. Hunter; Barone, Nicholas; Brown, Amanda

2010-01-01

YouTube (http://youtube.com) is a free video sharing website that allows users to post and view videos. Although there are definite limitations in the applicability of this website to telerehabilitation, the YouTube technology offers potential uses that should not be overlooked. For example, some types of therapy, such as errorless learning therapy for certain language and cognitive deficits can be provided remotely via YouTube. In addition, the website’s social networking capabilities, via the asynchronous posting of comments and videos in response to posted videos, enables individuals to gain valuable emotional support by communicating with others with similar health and rehabilitation challenges. This article addresses the benefits and limitations of YouTube in the context of telerehabilitation and reports patient feedback on errorless learning therapy for aphasia delivered via videos posted on YouTube. PMID:25945173

Fluid Mechanics and Heat Transfer Spirally Fluted Tubing.

DTIC Science & Technology

1984-12-01

of the tube and the convective transport, due to the secondary flow produced by the spiral flutes. It is well known that the Nusselt number of fully...data for the convective heat transfer behaviour. The computed Nusselt numbers for air show a 120% increase over the smooth tube values while the...The Prediction of Convective Heat Transfer in Spirally Fluted Tubes FIGURES 1. Shell side NU-REY correlation . . . . . . . . . . . . . . . 5 2. Tube

Places to Go: YouTube

ERIC Educational Resources Information Center

Downes, Stephen

2008-01-01

Founded in 2005 by three former PayPal employees, YouTube has revolutionized the Internet, marking a change from the static Internet to the dynamic Internet. In this edition of Places to Go, Stephen Downes discusses how the rise of a ubiquitous media format--Flash video--has made YouTube's success possible and argues that Flash video has important…

Impulse generation by detonation tubes

NASA Astrophysics Data System (ADS)

Cooper, Marcia Ann

Impulse generation with gaseous detonation requires conversion of chemical energy into mechanical energy. This conversion process is well understood in rocket engines where the high pressure combustion products expand through a nozzle generating high velocity exhaust gases. The propulsion community is now focusing on advanced concepts that utilize non-traditional forms of combustion like detonation. Such a device is called a pulse detonation engine in which laboratory tests have proven that thrust can be achieved through continuous cyclic operation. Because of poor performance of straight detonation tubes compared to conventional propulsion systems and the success of using nozzles on rocket engines, the effect of nozzles on detonation tubes is being investigated. Although previous studies of detonation tube nozzles have suggested substantial benefits, up to now there has been no systematic investigations over a range of operating conditions and nozzle configurations. As a result, no models predicting the impulse when nozzles are used exist. This lack of data has severely limited the development and evaluation of models and simulations of nozzles on pulse detonation engines. The first experimental investigation measuring impulse by gaseous detonation in plain tubes and tubes with nozzles operating in varying environment pressures is presented. Converging, diverging, and converging-diverging nozzles were tested to determine the effect of divergence angle, nozzle length, and volumetric fill fraction on impulse. The largest increases in specific impulse, 72% at an environment pressure of 100 kPa and 43% at an environment pressure of 1.4 kPa, were measured with the largest diverging nozzle tested that had a 12° half angle and was 0.6 m long. Two regimes of nozzle operation that depend on the environment pressure are responsible for these increases and were first observed from these data. To augment this experimental investigation, all data in the literature regarding

Piping and tubing technology: A compilation

NASA Technical Reports Server (NTRS)

1971-01-01

A compilation on the devices, techniques, and methods used in piping and tubing technology is presented. Data cover the following: (1) a number of fittings, couplings, and connectors that are useful in joining tubing and piping and various systems, (2) a family of devices used where flexibility and/or vibration damping are necessary, (3) a number of devices found useful in the regulation and control of fluid flow, and (4) shop hints to aid in maintenance and repair procedures such as cleaning, flaring, and swaging of tubes.

Repair boundary for parent tube indications within the upper joint zone of hybrid expansion joint (HEJ) sleeved tubes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cullen, W.K.; Keating, R.F.

1997-02-01

In the Spring and Fall of 1994, and the Spring of 1995, crack-like indications were found in the upper hybrid expansion joint (HEJ) region of Steam Generator (S/G) tubes which had been sleeved using Westinghouse HEJ sleeves. As a result of these findings, analytic and test evaluations were performed to assess the effect of the degradation on the structural, and leakage, integrity of the sleeve/tube joint relative to the requirements of the United States Nuclear Regulatory Commission`s (NRC) draft Regulatory Guide (RG) 1.121. The results of these evaluations demonstrated that tubes with implied or known crack-like circumferential parent tube indicationsmore » (PTIs) located 1.1 inches or farther below the bottom of the hardroll upper transition, have sufficient, and significant, integrity relative to the requirements of RG 1.121. Thus, the purpose of this report is to provide background information related to the justification of the modified tube repair boundary.« less

Chemical recombination in an expansion tube

NASA Technical Reports Server (NTRS)

Bakos, Robert J.; Morgan, Richard G.

1994-01-01

The note describes the theoretical basis of chemical recombination in an expansion tube which simulates energy, Reynolds number, and stream chemistry at near-orbital velocities. Expansion tubes can satisfy ground-based hypersonic propulsion and aerothermal testing requirements.

Clinics in diagnostic imaging (168).

PubMed

Lai, Yusheng Keefe; Mahmood, Rameysh Danovani

2016-05-01

A 16-year-old Chinese male patient presented with constipation lasting five days, colicky abdominal pain, lethargy, weakness and body aches. He was able to pass flatus. Abdominal radiography showed a distended stomach causing inferior displacement of the transverse colon. Computed tomography revealed a dilated oesophagus, stomach and duodenum up to its third portion, with a short aortomesenteric distance and narrow angle. There was also consolidation in the lungs bilaterally. Based on the constellation of clinical and imaging findings, a diagnosis of superior mesenteric artery syndrome complicated by aspiration pneumonia was made. The patient was subsequently started on intravenous hydration, nasogastric tube aspiration and antibiotics. Following stabilisation of his acute condition, a nasojejunal feeding tube was inserted and a feeding plan was implemented to promote weight gain. The clinical presentation, differentials, diagnosis and treatment of superior mesenteric artery syndrome are discussed. Copyright: © Singapore Medical Association.

Future ultra-speed tube-flight

NASA Astrophysics Data System (ADS)

Salter, Robert M.

1994-05-01

Future long-link, ultra-speed, surface transport systems will require electromagnetically (EM) driven and restrained vehicles operating under reduced-atmosphere in very straight tubes. Such tube-flight trains will be safe, energy conservative, pollution-free, and in a protected environment. Hypersonic (and even hyperballistic) speeds are theoretically achievable. Ultimate system choices will represent tradeoffs between amoritized capital costs (ACC) and operating costs. For example, long coasting links might employ aerodynamic lift coupled with EM restraint and drag make-up. Optimized, combined EM lift, and thrust vectors could reduce energy costs but at increased ACC. (Repulsive levitation can produce lift-over-drag l/d ratios a decade greater than aerodynamic), Alternatively, vehicle-emanated, induced-mirror fields in a conducting (aluminum sheet) road bed could reduce ACC but at substantial energy costs. Ultra-speed tube flight will demand fast-acting, high-precision sensors and computerized magnetic shimming. This same control system can maintain a magnetic 'guide way' invariant in inertial space with inertial detectors imbedded in tube structures to sense and correct for earth tremors. Ultra-speed tube flight can complete with aircraft for transit time and can provide even greater passenger convenience by single-model connections with local subways and feeder lines. Although cargo transport generally will not need to be performed at ultra speeds, such speeds may well be desirable for high throughput to optimize channel costs. Thus, a large and expensive pipeline might be replaced with small EM-driven pallets at high speeds.