Sample records for nasolacrimal duct office-based

  1. Office probing for treatment of nasolacrimal duct obstruction in infants.

    PubMed

    Miller, Aaron M; Chandler, Danielle L; Repka, Michael X; Hoover, Darren L; Lee, Katherine A; Melia, Michele; Rychwalski, Paul J; Silbert, David I; Beck, Roy W; Crouch, Eric R; Donahue, Sean; Holmes, Jonathan M; Quinn, Graham E; Sala, Nick A; Schloff, Susan; Wallace, David K; Foster, Nicole C; Frick, Kevin D; Golden, Richard P; Lambert, Scott R; Tien, D Robbins; Weakley, David R

    2014-02-01

    To determine whether demographic or clinical factors are associated with the outcome of office-based nasolacrimal duct probing for the treatment of congenital nasolacrimal duct obstruction (NLDO). In two multicenter prospective studies, 384 eyes of 304 children aged 6 to <15 months with NLDO underwent a nasolacrimal duct probing performed in the office using topical anesthesia. Treatment success, defined as no clinical signs of NLDO (epiphora, increased tear lake, or mucous discharge) and no reoperation, was assessed 1 month after probing in one study and 6 months after probing in the other study. Data from both studies were pooled to evaluate associations between baseline characteristics and treatment success. Office probing was successful in 75% of eyes overall (95% CI, 70%-80%). The procedure was less successful in eyes of children with bilateral NLDO compared with unilateral NLDO (63% vs 80%; relative risk = 0.78 [95% CI, 0.66-0.92]) and in eyes that had 2 or 3 clinical signs of NLDO compared with one (71% vs 83%; relative risk = 0.88 [95% CI, 0.81-0.96]). Treatment success did not appear to be related to age, specific clinical signs of NLDO, prior treatment, or research study. Performing nasolacrimal duct probing in the office successfully treats NLDO in the majority of cases in children aged 6 to <15 months. The success rate is lower with bilateral disease or when more than one clinical sign of NLDO is present. Copyright © 2014 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  2. Balloon catheter dilation and nasolacrimal duct intubation for treatment of nasolacrimal duct obstruction after failed probing.

    PubMed

    Repka, Michael X; Chandler, Danielle L; Holmes, Jonathan M; Hoover, Darren L; Morse, Christine L; Schloff, Susan; Silbert, David I; Tien, D Robbins

    2009-05-01

    To compare the outcomes of balloon catheter dilation and nasolacrimal intubation as treatment for congenital nasolacrimal duct obstruction after failed probing in children younger than 4 years. We conducted a prospective, nonrandomized, multicenter study that enrolled 159 children aged 6 months to younger than 48 months who had a history of a single failed nasolacrimal duct probing and at least 1 of the following clinical signs of nasolacrimal duct obstruction: epiphora, mucous discharge, or increased tear lake. One hundred ninety-nine eyes underwent either balloon catheter nasolacrimal duct dilation or nasolacrimal duct intubation. Treatment success was defined as absence of epiphora, mucous discharge, or increased tear lake at the outcome visit 6 months after surgery. Treatment success was reported in 65 of 84 eyes (77%; 95% confidence interval, 65%-85%) in the balloon catheter dilation group compared with 72 of 88 eyes (84% after adjustment for intereye correlation; 74%-91%) in the nasolacrimal intubation group (risk ratio for success for intubation vs balloon dilation, 1.08; 0.95-1.22). Both balloon catheter dilation and nasolacrimal duct intubation alleviate the clinical signs of persistent nasolacrimal duct obstruction in a similar percentage of patients.

  3. An isolated nasolacrimal duct osteoma.

    PubMed

    Kim, Joo Yeon; Kwon, Jae Hwan

    2013-07-01

    Osteomas of the nose and paranasal sinus are common benign tumors that can extend to surrounding structures and result in orbital or intracranial involvement. Presenting symptoms include facial pain, headache, cerebral symptoms, ocular symptoms, and so on, depending on the location and size of the tumor. They commonly occur within the frontal, ethmoid, maxillary, and sphenoid sinuses; however, there are rare cases of reported osteomas in the nasal cavity, turbinate, or orbit. Our case report describes a patient with nasolacrimal duct osteoma who presented with ipsilateral ocular pain, epiphora, and medial canthal swelling. We performed intranasal dacryocystorhinostomy using a nasal endoscope and removed the lacrimal duct osteoma. This report describes symptoms and management of an isolated nasolacrimal duct stone with a review of the literature.

  4. Endoscopic medial maxillectomy with preservation of inferior turbinate and nasolacrimal duct.

    PubMed

    Nakayama, Tsuguhisa; Asaka, Daiya; Okushi, Tetsushi; Yoshikawa, Mamoru; Moriyama, Hiroshi; Otori, Nobuyoshi

    2012-01-01

    Endoscopic medial maxillectomy (EMM) is a safe and effective procedure for treatment of inverted papilloma (IP) originating from the maxillary sinus. However, EMM usually removes the inferior turbinate and nasolacrimal duct. The inferior turbinate has a critical function in conditioning of the nasal airflow, and resection of the nasolacrimal ducts has a risk of epiphora. We developed a newly derived surgical technique, endoscopic modified medial maxillectomy (EMMM), which enables preservation of the inferior turbinate and nasolacrimal duct. A retrospective case series of six patients with IP and nine patients with mucoceles of the maxillary sinus after a Caldwell-Luc operation, who underwent surgery using the EMMM technique, were reviewed. In patients with IP, there were no recurrences for a mean follow-up of 16.7 months. Eight of nine patients with mucoceles of the maxillary sinus showed patency. All patients showed preservation of the inferior turbinate. One patient with mucocele was referred for dacryocystorhinostomy because of epiphora. EMMM produces access to the maxillary sinus identically to conventional EMM, despite preservation of the inferior turbinate and nasolacrimal duct.

  5. Iodine-131 Therapy and Nasolacrimal Duct Obstructions: What We Know and What We Need to Know.

    PubMed

    Ali, Mohammad Javed

    2016-01-01

    The aims of the current review are to summarize the etiopathogenesis, symptomatology, management, complications, and outcomes of iodine-131-induced nasolacrimal duct obstructions, to propose a screening protocol and elucidate the potential avenues of future research. The authors performed an electronic database (PubMed, MEDLINE, EMBASE, and Cochrane Library) search of all articles published in English on nasolacrimal duct obstructions following radioiodine therapy. These articles were reviewed along with their relevant cross references. Data reviewed included demographics, presentations, investigations, management, complications, and outcomes. In addition, based on relevant unanswered questions and current lacunae in literature, potential avenues for further research have been elucidated. The frequency of nasolacrimal duct obstruction is reported to range from 2.2% to 18% following I-131 therapy. They are mostly bilateral and noted in patients who receive more than 150 mCi radioiodine. Exact etiopathogenesis is unknown but radiotoxicity to lacrimal sac and nasolacrimal duct is believed to be mediated through a sodium-iodine symporter protein. Although uncommon, it is important to increase awareness among treating physicians and patients receiving radioiodine therapy about the potential side effect of nasolacrimal duct obstruction. Imaging modalities are useful adjuncts in the diagnosis. Dacryocystorhinostomy is the most common modality of management with good outcomes. Nasolacrimal duct obstruction following radioiodine treatment is a distinct clinical entity. Increased awareness would facilitate timely diagnosis, management, and an enhanced quality of life for the patients.

  6. Evaluation of Polyurethane Nasolacrimal Duct Stents: In Vivo Studies in New Zealand Rabbits

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

    Wilhelm, K.E., E-mail: wilhelm@uni-bonn.de; Grabolle, B.; Urbach, H.

    2006-10-15

    The purpose of this study was to evaluate the radiographic and biological effects of different polyurethane nasolacrimal duct stents in an animal model. Fifteen polyurethane nasolacrimal duct stents (n = 5 mushroom-type stents, n = 5 newly designed S-shaped TearLeader stents without hydrophilic coating, and n = 5 S-shaped TearLeader stents with hydrophilic coating) were implanted in the nasolacrimal ducts of eight unaffected New Zealand rabbits. One nasolacrimal system served as control. Clinical and radiographic follow-up was performed at 1-, 2-, and 4-week intervals, then after a 3-month interval, after which the animals were euthanized. All stents were implanted withoutmore » major periprocedural complications. The stents proved to be patent by the end of the procedure. During follow-up, all mushroom-type stents were occluded at 4 weeks. None of these stents opened to forced irrigation. Clinically, all rabbits demonstrated severe dacryocystitis. Three out of five TearLeader stents without hydrophilic coating were blocked at 4 weeks; one out of five was open to irrigation. Best results were observed in the stent group with hydrophilic coating. Follow-up dacryocystography demonstrated patent stents in nasolacrimal ducts of all animals after 4 weeks. In only one of five cases, the coated stent became partially occluded after 2 months. These animals were free of clinical symptoms. After 3 months, at least three out of five stents still opened to forced irrigation and only one stent was completely blocked. Dislocation of the stents was not observed. Refinement of the stent surface and stent design improves the results of nasolacrimal duct stenting in this animal model. Implantation of hydrophilic-coated S-shaped stents is highly superior to conventional mushroom-type stents and noncoated stent types. Hydrophilic coating seems to prevent foreign-body reactions, resulting in maximized stent patency.« less

  7. Lymphoepithelial Carcinoma of the Nasolacrimal Duct: Clinical, Radiologic, and Immunopathologic Features.

    PubMed

    Jakobiec, Frederick A; Stagner, Anna M; Rubin, Peter A D

    Undifferentiated lymphoepithelial carcinoma (exhibiting both begin lymphoid and malignant epithelial components) most commonly arises in the head and neck, especially in the nasopharynx. It may also be encountered in various ocular adnexal sites, including the nasolacrimal duct. A 63-year-old woman developed a swelling in the region of the right lacrimal sac accompanied by epiphora. CT scanning revealed an enlargement of the nasolacrimal duct from the lacrimal sac to the inferior nasal meatus. A biopsy during dacryocystorhinostomy for symptomatic epiphora revealed hypercellular sheets of small lymphocytes which were interpreted as evidence for a chronic dacryocystitis. Two years later the subtotally excised lesion had substantially grown in size. Repeat CT scans demonstrated an inferonasal anterior orbital mass with further enlargement of the nasolacrimal duct with a solid mass in its lumen, and bone erosion. The biopsy combined a rich background of lymphocytes within which were clusters of undifferentiated carcinoma cells that were cytokeratin and p63 positive. Critical review of the earlier biopsy led to the detection of the same cells, but in smaller numbers, that had been overlooked. An awareness of the possibility of lymphoepithelial carcinoma of the lacrimal sac/duct should improve diagnostic accuracy with the aid of immunohistochemistry. Radiation therapy is often successful in managing this highly sensitive malignant tumor.

  8. Surgical treatment of recurrent dacryocystitis secondary to cystic dilatation of the nasolacrimal duct in a dog.

    PubMed

    Lussier, Bertrand; Carrier, Michel

    2004-01-01

    A 3-year-old, castrated male golden retriever was presented for evaluation of recurrent ocular discharge of 4 months' duration from the left eye. Dacryocystorhinography was performed and demarcated a cystic dilatation of the left nasolacrimal duct with obstruction of the duct distal to the cystic cavity. Surgical exploration of the left maxillary sinus was performed to confirm the diagnosis and reestablish drainage into the nasal cavity. Recovery was uneventful, and the dog has been asymptomatic for >36 months postoperatively. This report documents the third published case of surgical treatment for cystic dilatation of the nasolacrimal duct.

  9. Bloody tears and recurrent nasolacrimal duct obstruction due to a retained silicone stent.

    PubMed

    Kemp, Pavlina S; Allen, Richard C

    2014-06-01

    A 6-year-old girl with a history of bilateral nasolacrimal duct obstruction presented with recurrent tearing, discharge, and bloody tears from the right eye. The patient had a history of multiple prior probing and stenting procedures on the right nasolacrimal system. Endoscopic dacryocystorhinotomy revealed a retained portion of a prior stent and accompanying pyogenic granuloma, removal of which resolved her symptoms. Copyright © 2014 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  10. Transection of Nasolacrimal Duct in Endoscopic Medial Maxillectomy: Implication on Epiphora.

    PubMed

    Imre, Abdulkadir; Imre, Seher Saritepe; Pinar, Ercan; Ozkul, Yilmaz; Songu, Murat; Ece, Ahmet Ata; Aladag, Ibrahim

    2015-10-01

    Management of the nasolacrimal system is usually recommended during medial maxillectomy via external approach because of reported higher rates of postoperative epiphora. Association of the endoscopic medial maxillectomy (EMM) with epiphora, however, is not clearly stated. In this study, we attempted to evaluate whether patients develop epiphora after simple transection of the nasolacrimal duct during EMM. Medical records of 26 patients who underwent endoscopic tumor resection for inverted papilloma (IP) were retrospectively reviewed. Patients who underwent EMM with nasolacrimal canal transection were included and recalled for lacrimal system evaluation. Twelve patients were eligible for inclusion and fluorescein dye disappearance test (FDDT) was performed for each patient. Patient demographics, tumor data, surgical procedures, and follow-up time were recorded. Of the 12 patients included in the study, 6 underwent canine fossa transantral approach concurrently with EMM. The mean duration of follow-up was 21.1 months (range, 6-84 months). Eight patients were graded as 0, whereas 4 patients were graded as 1 according to FDDT. All test results were interpreted as negative for epiphora. All patients were completely symptom free of epiphora. Epiphora after EMM with nasolacrimal canal transection among patients with sinonasal tumors appears to be uncommon. Therefore, prophylactic concurrent management of nasolacrimal system including stenting, dacryocystorhinostomy (DCR), or postoperative lacrimal lavage are not mandatory for all patients.

  11. Probing of congenital nasolacrimal duct obstruction with dacryoendoscope

    PubMed Central

    Kato, Kumiko; Matsunaga, Koichi; Takashima, Yuko; Kondo, Mineo

    2014-01-01

    Background A congenital nasolacrimal duct obstruction (CNLDO) is a relatively common disease in infants. We evaluated the results of probing three patients with CNLDO, under direct view, with a dacryoendoscope. Methods Three cases of CNLDO were examined and treated by probing with a dacryoendoscope, under intravenous anesthesia. The diameter of the dacryoendoscope probe was 0.7 mm, and we were able to observe the inner walls of the lacrimal duct and able to guide the probe through the duct. Results In all cases, the site of obstruction was detected, and the probe was used to remove the obstruction. At 2 weeks after the removal of the obstruction, there was no epiphora or mucopurulent discharge in any of the cases. No complications were detected intra- and postoperatively. Conclusion Although only three cases were studied, we believe that probing with a dacryoendoscope is a safe and effective method of treating a CNLDO. More cases need to be studied. PMID:24876765

  12. Minimally invasive medial maxillectomy and the position of nasolacrimal duct: the CT study.

    PubMed

    Sieskiewicz, Andrzej; Buczko, Krzysztof; Janica, Jacek; Lukasiewicz, Adam; Lebkowska, Urszula; Piszczatowski, Bartosz; Olszewska, Ewa

    2017-03-01

    Several minimally invasive modifications of endoscopic medial maxillectomy have been proposed recently, with the least traumatic techniques utilizing the lacrimal recess as a route to enter the sinus. The aim of the study was to analyze the anatomy of medial maxillary wall in the region of nasolacrimal canal and, thus, to determine the capability of performing minimally invasive approach to the maxillary sinus leading through the lacrimal recess. The course of nasolacrimal canal and the distance between the anterior maxillary wall and the nasolacrimal canal (the width of lacrimal recess) were evaluated in 125 randomly selected computed tomography (CT) head examinations. The proportion of cases with unfavorable anatomical conditions (lacrimal recess too narrow to accept a 4 mm optic) to perform minimally invasive middle maxillectomy was assessed. The width of lacrimal recess, measured at the level of the inferior turbinate attachment, varied between 0 and 15.2 mm and was related to slanted course of nasolacrimal canal. The more perpendicular the axis of the canal to the nasal flor, the narrower the lacrimal recess. In about 16% of cases, lacrimal recess width was less than 4 mm and in 14.4% it was missing. The endoscopic approach to maxillary sinus leading through lacrimal recess is possible in about 70% of patients. In the remaining group of patients when the lacrimal recess is too narrow, this type of approach may be difficult to perform without damaging the piriform aperture rim or bony framework of nasolacrimal duct, or it may be impracticable when lacrimal recess is missing.

  13. Transcanalicular Laser-Assisted Dacryocystorhinostomy With Endonasal Augmentation in Primary Nasolacrimal Duct Obstruction: Our Experience.

    PubMed

    Goel, Ruchi; Nagpal, Smriti; Kumar, Sushil; Meher, Ravi; Kamal, Saurabh; Garg, Sonam

    To evaluate and compare the success rate of transcanalicular laser-assisted dacryocystorhinostomy with endonasal augmentation, with and without intubation, in patients suffering from primary acquired nasolacrimal duct obstruction, at 1 year of follow up. A prospective, randomized interventional pilot study was conducted at a tertiary care center, in accordance with the guidelines of Declaration of Helsinki. Sixty eyes of 60 adult patients with primary acquired nasolacrimal duct obstruction were included. The participants were divided randomly into 2 equal groups (A and B-without and with bicanalicular intubation, respectively). An osteotomy was first created using 980 nm diode laser (set at 8W continuous mode) transcanalicularly and then enlarged intranasally using Blakesley's nasal forceps, followed by bicanalicular silicon intubation in group B patients. The tubes were removed at the end of 8 weeks. The ostium size was assessed endoscopically at 8 weeks and again at the end of follow up, at 1 year. A successful outcome was defined in terms of ostium patency at the end of 1 year. The results were analyzed at the end of a follow up of 1 year, using various statistical tests (p < 0.05). The mean age of the patients was 35.3 ± 15.89 years, with 23 male and 37 female patients, the 2 groups having a similar male:female ratio. An overall success rate of 90% was achieved at the end of 1 year with no statistically significant difference between the groups. Postoperative complications like tube displacement and punctal, canalicular injury were more in the intubated group. The average osteotomy size was 8.06 ± 5.4 mm at the end of 1 year. Transcanalicular laser-assisted dacryocysto rhinostomy, with endonasal augmentation, is a scarless, effective, daycare procedure, for treatment of primary acquired nasolacrimal duct obstruction with no additional advantage offered by silicone intubation.

  14. The Association of Neonatal Dacryocystoceles and Infantile Dacryocystitis with Nasolacrimal Duct Cysts (An American Ophthalmological Society Thesis)

    PubMed Central

    Lueder, Gregg T.

    2012-01-01

    Purpose: To investigate whether neonatal dacryocystoceles and dacryocystitis are associated with nasolacrimal duct cysts, and to report the outcomes of treatment of these disorders. Methods: This was a retrospective medical record review of two groups of infants with nasolacrimal duct (NLD) obstruction. The first group had dacryocystoceles with or without dacryocystitis. The second group had NLD obstruction with symptoms severe enough to require early NLD probing. All of the patients underwent NLD probing and nasal endoscopy. When present, NLD cysts were removed. Results: In the first group, 33 infants had dacryocystoceles. Acute dacryocystitis was present in 16 patients, 12 had noninfected dacryocystoceles that did not resolve, and 5 had dacryocystoceles that resolved but severe symptoms persisted. All of the patients had NLD cysts that were surgically removed. The symptoms resolved after surgery in 31 patients (94%). In the second group, 27 infants less than 6 months old without dacryocystoceles underwent early NLD probing and endoscopy due to severity of symptoms. Twelve (44%) of these patients had NLD cysts. The symptoms resolved in 11 (92%) of 12 patients following NLD probing and cyst removal. Conclusions: Neonatal dacryocystoceles are almost always associated with NLD cysts. The success rate of NLD probing and endoscopic cyst removal in these patients is excellent. Nasolacrimal duct cysts also are present in many young infants with severe symptoms of NLD obstruction. Nasal endoscopy is an important adjunct to the management of these infants. PMID:23818736

  15. Nasolacrimal duct obstruction: Does it really increase the risk of amblyopia in children?

    PubMed

    Ramkumar, V Akila; Agarkar, Sumita; Mukherjee, Bipasha

    2016-07-01

    To report the prevalence of amblyopia risk factors in children with congenital nasolacrimal duct obstruction. A retrospective review of records of children with the diagnosis of congenital nasolacrimal duct obstruction (NLDO), who underwent probing from January 2009 to October 2011, was done. All of them underwent a complete ophthalmic evaluation including cycloplegic refraction and strabismus evaluation before probing. A total of 142 children were included in this study. The mean age at presentation was 22.38 months (sample standard deviation (SSD) - 15.88). Amblyopia risk factors were defined according to two sets of guidelines: The American Association for Pediatric Ophthalmology and Strabismus (AAPOS) referral criteria guidelines and the new AAPOS Vision Screening Committee guidelines. Twenty-eight (20%) children were found to have some form of amblyopia risk factor based on the referral criteria prescribed by AAPOS. However, on applying modified guidelines described by Donahue et al., to analyze the same cohort, 21 children were found to have amblyogenic risk factors. Of these 28 children, 13 had significant astigmatism (>1.50 D), 8 children had hypermetropia (>3.50 D), and six children had anisometropia (>1.50 D). One child had significant cataract (media opacity >1 mm). None of the children in this series had either myopia or strabismus. Prevalence of amblyopia risk factor was found to be 20% in our study based on the older guidelines; however, it reduces to 14.78% by applying the modified guidelines. Despite this reduction, importance of a comprehensive ophthalmic examination including cycloplegic refraction in all children presenting with NLDO cannot be overstated. A close follow-up of these children is also essential to prevent the development of amblyopia.

  16. Change in quality of life of patients undergoing silicone stent intubation for nasolacrimal duct stenosis combined with dry eye syndrome.

    PubMed

    Oh, Jong Rok; Chang, Jee Ho; Yoon, Jin Sook; Jang, Sun Young

    2015-11-01

    To investigate the effect of silicone stent intubation (SI) on the quality of life of patients diagnosed with nasolacrimal duct stenosis and dry eye syndrome. This study is a prospective, interventional case series. Consecutive 30 patients diagnosed with nasolacrimal duct stenosis and reflex tearing due to dry eye syndrome were included. Eligible subjects underwent SI and were asked to complete the Glasgow Benefit Inventory (GBI) questionnaire. Surgical outcomes and GBI scores were investigated 6 months postoperatively. The surgical success rate determined by the patients' subjective symptoms was 76.7% (23/30). Mean total GBI score was +17.19 (95% CI 8.34 to 26.03). The general subscale score was +20.36 (95% CI 10.19 to 30.54), the social support scale score was +21.54 (95% CI 11.37 to 31.71) and the physical health score was -0.56 (95% CI -8.92 to 7.80). SI could be an effective treatment option for reflex tearing in patients diagnosed with dry eye syndrome and nasolacrimal duct stenosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Use of adjunctive mitomycin C in external dacryocystorhinostomy surgery compared with surgery alone in patients with nasolacrimal duct obstruction: A prospective, double-masked, randomized, controlled trial.

    PubMed

    Ari, Seyhmus; Gun, Ramazan; Surmeli, Serdar; Atay, Ahmet Engin; Caca, Ihsan

    2009-08-01

    The most common cause for the failure of external dacryocystorhinostomy (DCR) surgery is the formation of granulation tissue at the osteotomy site or common canaliculus. The aims of this study were to assess the efficacy of intraoperative adjunctive mitomycin C (MMC) treatment in external DCR surgery and to compare this procedure with the standard DCR procedure alone in the long term (1 year). In this prospective, double-masked, randomized, controlled trial, patients with primary acquired nasolacrimal duct obstruction were randomized (using a random number table) into 2 groups based on surgical procedure. In the MMC group, intraoperative adjunctive MMC 0.2 mg/mL was applied to the osteotomy site for 30 minutes. The control group underwent standard DCR procedure only. The results of the DCR surgeries were assessed using objective findings (eg, cessation of excessive tearing via nasolacrimal duct irrigation and the improvement in height of tear meniscus) and subjective symptoms (asking patients to describe the degree of tearing improvement). Both the patients and the researchers who were assessing the study outcomes were masked to treatment group. One hundred eyes of 100 Turkish patients were assessed and equally randomized to the MMC (27 women, 23 men; mean [SD] age, 47.0 [7.6] years) and control (26 women, 24 men; mean age, 46.6 [8.8] years) groups. The follow-up period was not significantly different between the MMC and the control groups (13.1 [1.1] vs 13.2 [1.4] months). Significantly more eyes in the MMC group than the control group remained symptom-free throughout the 1-year follow-up period (45/50 [90%] vs 33/50 [66%]; P=0.005). Significantly more patients in the control group than the MMC group had an improvement in symptoms at the 1-year follow-up (8/50 [16%] vs 2/50 [4%] eyes; P=0.005). Based on the patency of the drainage system, the success rate was significantly greater in the MMC group than the control group (48/50 [96%] vs 42/50 [84%]; P=0.005). Based

  18. Use of adjunctive mitomycin C in external dacryocystorhinostomy surgery compared with surgery alone in patients with nasolacrimal duct obstruction: A prospective, double-masked, randomized, controlled trial

    PubMed Central

    Ari, Şeyhmus; Gun, Ramazan; Surmeli, Serdar; Atay, Ahmet Engin; Çaca, Îhsan

    2009-01-01

    Background: The most common cause for the failure of external dacryocystorhinostomy (DCR) surgery is the formation of granulation tissue at the osteotomy site or common canaliculus. Objectives: The aims of this study were to assess the efficacy of intraoperative adjunctive mitomycin C (MMC) treatment in external DCR surgery and to compare this procedure with the standard DCR procedure alone in the long term (1 year). Methods: In this prospective, double-masked, randomized, controlled trial, patients with primary acquired nasolacrimal duct obstruction were randomized (using a random number table) into 2 groups based on surgical procedure. In the MMC group, intraoperative adjunctive MMC 0.2 mg/mL was applied to the osteotomy site for 30 minutes. The control group underwent standard DCR procedure only. The results of the DCR surgeries were assessed using objective findings (eg, cessation of excessive tearing via nasolacrimal duct irrigation and the improvement in height of tear meniscus) and subjective symptoms (asking patients to describe the degree of tearing improvement). Both the patients and the researchers who were assessing the study outcomes were masked to treatment group. Results: One hundred eyes of 100 Turkish patients were assessed and equally randomized to the MMC (27 women, 23 men; mean [SD] age, 47.0 [7.6] years) and control (26 women, 24 men; mean age, 46.6 [8.8] years) groups. The follow-up period was not significantly different between the MMC and the control groups (13.1 [1.1] vs 13.2 [1.4] months). Significantly more eyes in the MMC group than the control group remained symptom-free throughout the 1-year follow-up period (45/50 [90%] vs 33/50 [66%]; P=0.005). Significantly more patients in the control group than the MMC group had an improvement in symptoms at the 1-year follow-up (8/50 [16%] vs 2/50 [4%] eyes; P=0.005). Based on the patency of the drainage system, the success rate was significantly greater in the MMC group than the control group

  19. Morphometric Measurements of Bony Nasolacrimal Canal in Children.

    PubMed

    Ela, Araz Server; Cigdem, Kalaycik Ertugay; Karagoz, Yesim; Yigit, Ozgur; Longur, Ecem Sevim

    2018-05-01

    Morphology and dimensions of the bony nasolacrimal canal duct (BNLD) as a key factor in the development of primary acquired nasolacrimal duct obstruction. We aimed to obtain detailed morphometric analysis of BNLD in children without nasolacrimal duct pathology by using computed tomography and provide standard measurements by means of age which could be utilized in planning management or in invasive interventions. Picture Archiving Communication Systems database of our hospital's radiology department was searched for this retrospective study. Subjects were under 18 years of age who had undergone a paranasal, maxillofacial, or temporal bone high-resolution computed tomography scan in last 2 years with various indications. Those with fractures including facial bones and/or nasolacrimal canal or history of nasolacrimal duct pathology were excluded from the study. We measured the diameter, angle, and surface area of BNLD. A total number of 136 subjects (86 boys, 50 girls) were included in the study. The average age was 7.3 ± 5.1 years. We documented statistically significantly positive correlation between all measured diameters and ages (P < 0.001), whereas there was a negative association between mean angle and age (P < 0.001). Mean angle is defined as the angle between BNLD and nasal floor. The surface area of BNLD was found to be significantly increasing depending on age (P < 0.001). However, we could not find any significant association between gender and measured parameters (P > 0.050). Our study demonstrated that development of BNLD continues during childhood, regardless of gender.

  20. Outcomes in children with nasolacrimal duct obstruction: Significance of persistent symptoms while stents are in place.

    PubMed

    Espinoza, Gabriela M; Lueder, Gregg T

    2007-04-01

    To evaluate the correlation between persistent symptoms while stents are in place and final outcome in children with nasolacrimal duct obstruction (NLDO). A retrospective observational case series, with medical record review that included indications for surgery, surgical procedure, presence of symptoms while stents were in place, and final outcome after stent removal. Twenty-eight children with NLDO had nasolacrimal duct stents placed in 42 eyes. Twenty-one of the 42 eyes (50%) had minimal or no signs or symptoms of NLDO while stents were in place, and 18 of 21 (86%) were symptom-free after stent removal. Twenty-one of the 42 eyes (50%) remained symptomatic while stents were in place. Eleven of these 21 eyes (52%) had good outcomes after stent removal. Ten (48%) of these patients had persistent symptoms after stent removal requiring further treatment. The prognosis for a good outcome is excellent if symptoms of NLDO resolve while stents are in place. The prognosis is poorer if symptoms of NLDO persist, but more than half of such patients still have good outcomes. Careful counseling of parents regarding these outcomes should be performed before considering additional interventions.

  1. Videoreflective dacryomeniscometry in normal adults and in patients with functional or primary acquired nasolacrimal duct obstruction.

    PubMed

    Francis, Ian C; Chan, Derek G; Papalkar, Daya; Papas, Eric B; Stapleton, Fiona

    2005-03-01

    Videoreflective dacryomeniscometry (VRD) for evaluation of marginal tear film has not been performed in patients with watery eye or in a controlled study. We used VRD to evaluate the height of the central marginal lower lid tear film in normal adults and compared it with two watery-eye groups and a postoperative dacryocystorhinostomy (DCR) group. Case-controlled interventional case series. We evaluated with VRD 20 subjects with normal lacrimal drainage function, 21 patients with primary acquired nasolacrimal duct obstruction (PANDO), 28 patients with functional nasolacrimal duct obstruction (FNLDO), and a postoperative group of 14 patients derived from the previous two pathologic groups. Comparison between the four groups was performed to determine statistically significant differences between tear film height. PANDO and FNLDO groups were shown to have significantly greater median tear meniscus heights ([TMH] PANDO: 620 microm, interquartile range [IQR] 453 microm; FNLDO: 731 microm, IQR 529 microm) than normal subjects (296 microm, IQR 214 microm; P < .001) and postoperative PANDO patients (265 microm, IQR 159 microm). There was no significant difference in TMH between PANDO and FNLDO groups preoperatively (P = .275). There was a reduction in median TMH postoperatively of 355 microm (P = .008) in PANDO and 360 microm (P = .068) in FNLDO. PANDO and FNLDO patients have similar preoperative TMH. In both these groups, TMH is significantly greater than in normal control subjects. Lacrimal drainage surgery substantially reduces TMH as measured using VRD in PANDO.

  2. Nasolacrimal obstruction caused by root abscess of the upper canine in a cat.

    PubMed

    Anthony, James M G; Sandmeyer, Lynne S; Laycock, Amanda R

    2010-03-01

    A 10-year-old, castrated male domestic short hair cat was presented to the Small Animal Clinic at the Western College of Veterinary Medicine with a presenting complaint of chronic, ocular discharge from the left eye. Ocular examination confirmed epiphora and mucopurulent discharge but there were no apparent reasons for the ocular discharge, and nasolacrimal obstruction was suspected. The cat had swelling of the left side of the face, severe periodontal disease and a fractured upper left canine tooth with pulpal exposure. Dacryocystorhinography revealed narrowing of the nasolacrimal duct above the root of the fractured upper left canine and dental radiographs showed a severe periapical lucency at the apex of the upper left canine tooth. The fractured canine tooth was removed. Subsequently, the ocular discharge and facial swelling resolved. After 2 years, the epiphora has never reoccurred. This is a noteworthy case because a suspected root abscess resulted in extralumenal compression of the nasolacrimal duct, which shows the importance of a thorough oral examination when nasolacrimal obstruction is evident.

  3. Blocked Tear Duct

    MedlinePlus

    ... of the nose (lacrimal sac). From there tears travel down a duct (the nasolacrimal duct) draining into your nose. Once in the nose, tears are reabsorbed. A blockage can occur at any point in the tear drainage system, from the puncta ...

  4. Dacryocystitis following a nasolacrimal duct obstruction caused by an ectopic intranasal tooth in a dog.

    PubMed

    Voelter-Ratson, Katrin; Hagen, Regine; Grundmann, Stefan; Spiess, Bernhard Martin

    2015-09-01

    To describe a nasolacrimal duct (NLD) obstruction secondary to an ectopic tooth in a 5-year-old male Border collie. The dog was presented with a 1-month history of mucopurulent discharge from the left eye (OS) preceded by a lifelong history of epiphora OS. Treatment with neomycin/polymyxin B/dexamethasone ophthalmic solution had not improved the clinical signs, and the NLD was not patent when irrigated by the referring veterinarian. A complete ophthalmologic examination was performed followed by dacryocystorhinography and computed tomography (CT). The ophthalmologic examination revealed marked mucopurulent discharge, mild conjunctivitis, slightly elevated STT measurements, and a negative Jones test OS. Both nasolacrimal puncta OS could be cannulated without resistance for approximately 1.5 cm. Upon irrigation, copious amounts of mucopurulent discharge were exited through the corresponding punctum, while no fluid could be detected at the nares. Dacryocystorhinography was performed. Radiographs revealed an ectopic left canine tooth within the left nasal cavity. A cystic dilation of the NLD was observed proximal to the ectopic tooth. Computed tomography was performed to determine the exact position of the tooth and possible involvement of adjacent structures; CT confirmed the previous imaging findings. Treatment with systemic antibiotics, NSAIDs, and ofloxacin ophthalmic solution led to resolution of the clinical signs within several days. Surgery was declined by the owner. This is the first case report describing a blocked NLD due to an ectopic tooth in a dog. Ectopic teeth should be included as a differential diagnosis in cases of dacryocystitis and chronic epiphora in dogs. © 2014 American College of Veterinary Ophthalmologists.

  5. Transitional cell neoplasm of the nasolacrimal duct associated with human papillomavirus type 11.

    PubMed

    Vickers, Jennifer L; Matherne, Ryan J; Allison, Ashley W; Wilkerson, Michael G; Tyring, Stephen K; Bartlett, Brenda L; Rady, Peter L; Kelly, Brent C

    2010-07-01

    Tumors of the lacrimal sac are rare but noteworthy because of their significant potential to become malignant or life-threatening if treatment is delayed. Dermatologists may be the first to encounter such neoplasms. We report a case of a 53-year-old Caucasian woman who presented with a seven-year history of an asymptomatic, subcutaneous nodule near her right medial canthus. Histology of the lesion revealed transitional epithelium in a papillary growth pattern with numerous goblet cells, scattered mitoses and focal full-thickness atypia. The patient was diagnosed with transitional cell neoplasm (inverted papilloma-type) of the nasolacrimal duct. PCR evaluation identified HPV type 11 in the lesion. Our report is one of a growing number of case reports and series detecting HPV DNA in these tumors which further supports HPV as an etiologic agent in epithelial lacrimal sac tumors. We believe that dermatopathologists need to be aware of this entity, as dermatologists may be the first to encounter these neoplasms. The association of HPV with this tumor does not prove causality.

  6. Endocanalicular diode laser dacryocystorhinostomy for nasolacrimal duct obstruction: short-term results of a new minimally invasive surgical technique.

    PubMed

    Özçimen, Muammer; Uysal, Ismail Onder; Eryılmaz, Mehmet Akif; Kal, Ali

    2010-11-01

    To evaluate the results, complications, effectiveness, and operative results of the endocanalicular laser dacryocystorhinostomy (ECL DCR) in the distal obstructions of the lacrimal drainage system. Sixty eyes of 57 patients who had a diagnosis of distal obstruction of the lacrimal drainage system were evaluated retrospectively in this study. All patients underwent ECL DCR by diode laser between October 2008 and July 2009. Forty-nine patients (86%) were females, 8 patients (14%) were males, and age distribution was between 3 and 84 years old (median, 40 y). The canaliculi were intubated by a silicone tube. The patency of the nasolacrimal system was controlled by lacrimal lavage, loss of epiphora, and endoscopic evaluation of the endonasal rhinostomy site with routine follow-up scheduled at first day and 1-week, 1-month, and 3-month postoperative intervals. After the 60 ECL DCRs, 10 patients underwent revision ECL DCR because of the persistent epiphora. The patency of the nasolacrimal duct or the decrease of the symptoms was assigned as success. There were no symptoms at all in 83.3% of the patients. The ECL DCR in the treatment of the distal obstructions of the lacrimal drainage system was easily tolerated by the patients, cosmetically preferred because there was no incision and scar formation with high success rates, and a minimally invasive alternative technique.

  7. Endoscopic-modified medial maxillectomy and its limitation for a solitary fibrous tumor of the lacrimal sac and nasolacrimal duct.

    PubMed

    Moriyama, Munehito; Kodama, Satoru; Hirano, Takashi; Suzuki, Masashi

    2017-06-01

    Solitary fibrous tumor (SFT) is an uncommon neoplasm that usually arises from the pleura. Recently, SFTs have been reported in the head and neck region located in subsites such as the orbit. SFTs of the lacrimal sac are extremely rare, with only six cases reported in the English literature. We describe a SFT arising from the right lacrimal sac and extending along the nasolacrimal duct into the nasal cavity. Although, the tumor could not be removed by endoscopic-modified medial maxillectomy (EMMM) alone, combined approach with EMMM and a small external incision achieved the complete removal of the tumor. The patient has remained disease-free 24 months after surgery. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Efficacy of probing for children with congenital nasolacrimal duct obstruction: a retrospective study using fluorescein dye disappearance test and lacrimal sac echography.

    PubMed

    Steindler, Piero; Mantovani, Enrico; Incorvaia, Carlo; Parmeggiani, Francesco

    2009-06-01

    To evaluate B-scan echography for the assessment of lacrimal sac (LS) in pediatric epiphora secondary to congenital nasolacrimal duct obstruction (CNLDO), and to verify its predictive role in functional efficacy of nasolacrimal duct probing. Thirty-nine eyes of 23 consecutive children, treated with a single probing for persistent CNLDO-related epiphora, were retrospectively studied. These cases were investigated both collectively and considering two sub-groups: group A (ten patients [20 eyes] 13 months. Fluorescein dye disappearance test at 10 minutes (FDDT-10) and ultrasound examination of LS were performed before and after probing. An echographic LS scoring system (grade 0 = no LS enlargement; grade 1 = slight longitudinal LS enlargement; grade 2 = longitudinal and slight transverse LS enlargement; grade 3 = marked longitudinal and transverse LS enlargement) was introduced as a predictor of probing efficacy, estimating FDDT-10 modification between pre- and post-operative checks. Echographic LS evaluation was easily practicable without sedation. In the total cluster and in both age sub-groups, post-probing FDDT-10 decreased with respect to pre-probing value (p < 0.001). Post-probing LS score improved with respect to pre-probing check within the total cluster and group A (p < 0.05). Strong correlation between pre-probing LS alteration and functional probing failure was present in each studied cluster (all p values <0.0001). Within group B, a greater gain of post-probing FDDT-10 was more frequent in patients with a better pre-probing LS score, as well as in younger children (both p values <0.0001). In children with CNLDO-related epiphora, B-scan echography of the LS can represent a reliable and useful examination for a better understanding of the functional prognosis after probing treatment.

  9. A survey of management of congenital nasolacrimal duct obstruction by pediatric primary health care providers in Spain.

    PubMed

    Galindo-Ferreiro, Alicia; Palencia-Ercilla, Teresa; Ferreira, Livia Mendoza; Galvez-Ruiz, Alberto; Zornoff, Denise C M; Khandekar, Rajiv; Schellini, Silvana A

    2017-06-26

    To survey the management of congenital nasolacrimal duct obstruction (CNLDO) by pediatric primary health care providers in Spain. This was a descriptive study using a web-based questionnaire to evaluate the perceptions of the members of the Pediatric Primary Care Society in Castilla-León, Spain (APAPCYL), regarding management of CNLDO. The questionnaire contained 14 direct questions and was sent by e-mail to all the pediatricians. All the responses were analyzed by the frequency of occurrence and percentages. Ninety physicians responded to the questionnaire. Massage 2 or 3 times a day was the initial treatment advised by 60.47% of pediatricians. Nearly half of the pediatricians recommended continuing massage until symptoms resolved. Fewer than 50% of children required referral to an ophthalmologist. Reasons for an ophthalmic consult included persistence of symptoms among 87.21% of pediatricians and parental/guardian request among 10.5% of pediatricians. According to 45.6% of pediatricians, their knowledge about CNLDO is limited, and 92.2% would like to receive further training on CNLDO. Massage was the main initial treatment for managing CNLDO among pediatricians. The outcomes of this survey indicated that massage fails in fewer than 50% of patients and an ophthalmic referral is required for these cases.

  10. Reliability of fluorescein dye disappearance test in assessment of adults with nasolacrimal duct obstruction.

    PubMed

    Kashkouli, Mohsen Bahmani; Mirzajani, Hoora; Jamshidian-Tehrani, Mansooreh; Pakdel, Farzad; Nojomi, Marzieh; Aghaei, Gholam-Hossein

    2013-01-01

    To evaluate the role of fluorescein dye disappearance test (FDDT) in assessment of adults with primary acquired nasolacrimal duct obstruction (PANDO) and its correlation with age and severity of epiphora. In a prospective, cross-sectional comparative study, FDDT at 2 (2-FDDT), 5 (5-FDDT), and 10 (10-FDDT) minutes were performed in 58 eyes of 58 patients with PANDO (case) and 58 eyes of 58 subjects without epiphora (control) between 2008 and 2010. Exclusion criteria were any disease, trauma, or medications that might have an effect on tear drainage system. Patients with functional or incomplete obstruction and upper lacrimal drainage system obstruction were excluded in the case group. FDDT and severity of epiphora were graded. Case and control groups were matched. 2-FDDT showed a sensitivity of 82.8%, specificity of 91.4%, positive predictive value of 90.6%, and negative predictive value of 84.1%. Sensitivity and negative predictive value decreased to 71.1% and 78.6% in 5-FDDT. 5-FDDT specificity and positive predictive value, however, increased to 94.8% and 93.5%, respectively. There was no statistically significant correlation between severity of epiphora and age with FDDT. FDDT is a simple, reliable, and highly specific test in assessment of adults with PANDO.

  11. Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction.

    PubMed

    Mor, Joel M; Guo, Yongwei; Koch, Konrad R; Heindl, Ludwig M

    2017-10-13

    Today's gold standard in the treatment of infrasaccal primary acquired nasolacrimal duct obstruction (PANDO) is external dacryocystorhinostomy (DCR), a relatively invasive procedure that can be performed after failure of recanalizing treatments. However, with progress in the field of diode laser technology, new approaches have emerged. Laser-assisted transcanalicular DCR with subsequent bicanalicular silicon intubation is a new option showing great promise as a viable minimally invasive procedure. Under permanent endoscopic visual control from the nasal cavity, a diode laser fiber is inserted into the lacrimal sac and laser energy is applied to create a bony ostium between the lacrimal sac and the nasal cavity. Since no skin incision needs to be made, advantages of this method comprise the sparing of the skin as well as the medial palpebral structures and the physiological palpebral-canalicular pump mechanism. The duration of surgery as well as reconvalescence is generally shorter than with external DCR. Complications include silicon tube prolapse, mild swelling and, rarely, canalicular infection and thermal injury. One-year functional success rates, defined as complete resolution of symptoms and ostium patency, are high, yet still range behind those of external DCR. However, secondary external DCR after failure of laser-assisted DCR can be performed without difficulty. Thus, laser-assisted transcanalicular DCR is a valid option that should be considered as a second-step procedure after failure of recanalization procedures and before external DCR.

  12. Intubation of the ostium and nasolacrimal duct with a single self-linking silicone stent in external dacryocystorhinostomy.

    PubMed

    Hui, Jennifer I; Shriver, Erin M; Tse, David T

    2011-01-01

    To describe a stent placement method that eliminates stent prolapse in external dacryocystorhinostomy. A retrospective, institutional review board- approved case series of patients undergoing external dacryocystorhinostomy with an alternative stenting method. Following anastomosis of the posterior flaps, one arm of a Crawford silicone stent is passed through each canaliculus. Both arms are then passed through the nasolacrimal duct and retrieved in the inferior meatus. The 2 distal arms are redirected in the nose; one arm is looped around the proximal portions within the lacrimal sac and tied to the second arm. The stent is self-linked around the inferior turbinate. Nine patients underwent external dacryocystorhinostomy with alternative stenting. None experienced postoperative stent prolapse. At last follow-up (average, 38 months; range, 5-102 months), 8 patients reported resolution of tearing and exhibited normal dye clearance. On compression of the lacrimal sac, none of these 8 patients exhibited reflux of stagnant tears or dye through the canaliculi. This alternative method improves stent retention by using the inferior turbinate as a stopper to eliminate stent prolapse. The self-linking nature obviates the need and expense of additional biomedical devices.

  13. Microbiology of primary acquired nasolacrimal duct obstruction: simple epiphora, acute dacryocystitis, and chronic dacryocystitis

    PubMed Central

    Pornpanich, Kanograt; Luemsamran, Panitee; Leelaporn, Amornrut; Santisuk, Jiraporn; Tesavibul, Nattaporn; Lertsuwanroj, Buntitar; Vangveeravong, Sumalee

    2016-01-01

    Purpose The aim of this study was to determine the microbiology of primary acquired nasolacrimal duct obstruction (PANDO) and its antimicrobial susceptibilities. Methods Ninety-three patients (100 eyes) diagnosed with PANDO, categorized as acute, chronic dacryocystitis, or simple epiphora, were prospectively enrolled. Lacrimal sac contents were cultured for aerobic and anaerobic bacteria and fungi. Cultured organisms were identified, and antimicrobial susceptibility testing was performed for aerobic bacteria. Results Seventy-nine of the 100 samples were culture positive. One hundred twenty-seven organisms were isolated, and 29 different species were identified. Most microorganisms were Gram-positive bacteria (45 samples or 57.0% of all positive culture samples), whereas Gram-negative bacteria, anaerobic bacteria, and fungi were found in 39 (49.4%), 24 (30.4%), and four samples (5.1%), respectively. The most frequently isolated group was coagulase-negative staphylococci (27.8%), followed by nonspore-forming Gram-positive rods (anaerobe) (17.7%) and Pseudomonas aeruginosa (15.2%). Of the 100 samples, five, 45, and 50 samples were obtained from patients with acute dacryocystitis, chronic dacryocystitis, and simple epiphora, respectively. Subgroup analysis showed that Gram-negative organisms were isolated more frequently from the chronic dacryocystitis subgroup than from the simple epiphora subgroup (P=0.012). Antimicrobial susceptibility testing demonstrated that ciprofloxacin was the most effective drug against all Gram-positive and Gram-negative organisms. Conclusion Patients with PANDO, with or without clinical signs of lacrimal infection, were culture positive. Gram-negative organisms were frequently isolated, which were different from previous studies. Ciprofloxacin was the most effective agent against all Gram-positive and Gram-negative organisms. PMID:26955261

  14. Changes in cytokines in tears after endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction.

    PubMed

    Lee, J K; Kim, T H

    2014-05-01

    We attempted to compare the cytokine composition of tears between primary acquired nasolacrimal duct (NLD) obstruction and normal controls. We investigated the changes in cytokines in tears after endoscopic endonasal dacryocystorhinostomy (DCR). Eighteen patients underwent endonasal DCR, with seven patients undergoing bilateral DCR, resulting in twenty-five DCRs in total. Eleven contralateral un-operated eyes were used as normal controls. Silicone stents were removed 3 months after surgery. Tear samples were collected from all eyes before surgery, and at 1 month, 2 months, 3 months, and 4 months after surgery. The level of interleukin (IL)-1β, IL-2, IL-6, IL-10, transforming growth factor (TGF)-β2, fibroblast growth factor (FGF)-2, and vascular endothelial growth factor (VEGF) in the tears was measured. The concentrations of IL-2, IL-6, IL-10, VEGF, and FGF-2 were significantly higher in eyes with NLD obstruction than controls before surgery (P=0.006, 0.018, 0.002, 0.048, and 0.039, respectively). Most inflammatory cytokines (IL-1β, IL-2, IL-6, VEGF, and FGF-2) were higher in the tears of the DCR group compared with the controls during the postoperative follow-up, but then rapidly decreased to the level of the controls after removal of the silicone stent. The recurred eyes showed a higher level of TGF-β2 and FGF-2 in tears compared with the eyes that showed good surgical results (P<0.005 and <0.005, respectively). The tear levels of inflammatory cytokines were higher in eyes with NLD obstruction than controls. The changes in cytokine level during the postoperative period showed the importance of cytokine analysis in understanding wound healing after DCR.

  15. Endoscopic endonasal dacryocystorhinostomy with ostial stent intubation following nasolacrimal duct stent incarceration.

    PubMed

    Wang, Xiaopeng; Bian, Yang; Yan, Wentao; Daniel, Pelaez; Tu, Yunhai; Wu, Wencan

    2015-01-01

    To study the feasibility of endoscopic endonasal dacryocystorhinostomy (EE-DCR) with novel lacrimal ostial stent (LOS) intubation for patients with chronic dacryocystitis with incarceration of a previously implanted nasolacrimal duct stent (NDS). According to surgical procedure, 166 patients (167 eyes) were divided into two groups: EE-DCR with LOS intubation was performed on 126 patients (127 eyes) in the EE-DCR group; while external dacryocystorhinostomy (E-DCR) with silicone tube intubation was performed on 40 patients (40 eyes) in the E-DCR group. The LOS or silicone tube was retained for 3-6 months. All patients were followed up for 12-36 months. Success rate of tear drainage reconstruction (TDR) and complications were retrospectively compared. Excluding patients with early detachment of the LOS or the silicone tube, or with incomplete follow-up period, 117 patients (117 eyes) in the EE-DCR group and 36 patients (36 eyes) in the E-DCR group were included. The mean surgical time was 45.8 ± 11.5 min in the EE-DCR group and 68.1 ± 23.8 min in the E-DCR group (p < 0.001). Intraoperatively, the lacrimal sac was observed to become very small and its walls were thin, hyperemic and fragile, firmly attaching to the NDS by fibrous bands in all eyes. Upon final review, success rate of TDR was 83.8% (98/117) in the EE-DCR group, while 58.3% (21/36) in the E-DCR group (p < 0.01). Failure of TDR due to ostial closure by excessive fibrosis occurred in 14 out of 19 patients in the EE-DCR group, significantly less than the 11 out of 15 patients with failed TDR in the E-DCR group (χ(2 )= 6.959, p < 0.01). No significant difference existed in failures due to granuloma occluding the ostium or common canaliculus obstruction. EE-DCR with LOS intubation may be an effective procedure to manage the special subgroup of patients with chronic dacryocystitis with incarcerations of a previously implanted NDS.

  16. Nasolacrimal duct obstruction following radioactive iodine 131 therapy in differentiated thyroid cancers: review of 19 cases.

    PubMed

    Al-Qahtani, Khalid Hussain; Al Asiri, Mushabbab; Tunio, Mutahir A; Aljohani, Naji J; Bayoumi, Yasser; Munir, Iqbal; AlAyoubi, Ayman

    2014-01-01

    Radioactive iodine 131 ((131)I) therapy has long been used in the treatment of differentiated thyroid cancers (DTC). While salivary and lacrimal glandular complications secondary to (131)I therapy are well documented, there is little in the literature addressing nasolacrimal duct obstruction (NLDO). We aimed to evaluate the frequency of (131)I therapy-acquired NLDO, its correlation to (131)I therapy doses, and the surgical treatment outcome of this rare side effect. From 2000-2012, a retrospective review of 864 among 1,192 patients with confirmed DTC who were treated with (131)I therapy was performed to examine the frequency of NLDO, its causative factors, as well as imaging, surgical intervention, and outcomes. Nineteen (2.2%) patients were identified with NLDO. The mean age was 51.9±10.5 years (range: 39-72 years). Fifteen (78.9%) were female and four were male (21.1%). The mean individual (131)I doses were 311.1±169.3 millicurie (mCi) (range: 150-600 mCi). The mean duration between the date of (131)I therapy and the occurrence of NLDO was 11.6±4.1 months (range: 6.5-20). Fourteen (73.7%) patients had bilateral epiphora. Computed tomography dacryography allowed for the detection of all NLDO. Eighteen (94.7%) patients underwent dacryocystorhinostomy. Complete recovery was obtained in 14 (73.7%) patients. Age >45 years and (131)I therapy doses >150 mCi were significantly correlated with NLDO (P=0.02 and P=0.03, respectively). NLDO is an underestimated complication of (131)I therapy in DTC patients. Clinicians should be aware of this rare complication for prompt intervention.

  17. Comparison of endoscopic and external dacryocystorhinostomy for treatment of primary acquired nasolacrimal duct obstruction

    PubMed Central

    Su, Pei-Yuan

    2018-01-01

    PURPOSE: The purpose of this study is to compare the success rates of endoscopic endonasal dacryocystorhinostomy (EN-DCR) and external DCR (EX-DCR) for the treatment of primary acquired nasolacrimal duct obstruction (PANLDO). DESIGN: This was a retrospective, comparative, nonrandomized clinical study. METHODS: Reviewed medical records of PANLDO underwent DCR at Far-Eastern Memorial Hospital from May 2011 to June 2017. Data regarding the lacrimal passage system, comorbidities, surgical outcomes, and postoperative complications were analyzed. Anatomical success was defined as patency confirmed by intranasal endoscopic inspection of the ostium and successful lacrimal irrigation; functional success was defined as complete resolution of epiphora and positive fluorescein dye disappearance test, which were assessed at postoperative 6th months. RESULTS: One hundred and seventy patients (37 males, 133 females, mean age 57 years) underwent 178 DCR surgeries for PANLDO. The overall anatomical success rate was 94.4% (93.5% in EN-DCR vs. 95.8% in EX-DCR, P = 0.511) and functional success rate was 90.4% (90.7% in EN-DCR and 90.1% in EX-DCR, P = 0.909). Surgical outcomes were comparable between two groups. Complication rate was low in both groups, including 11 cases of early canalicular stent dislodge (7 in EN-DCR, 4 in EX-DCR), one case of postoperative nasal bleeding in EN-DCR, and two skin wound dehiscence and three cutaneous keloid formation in EX-DCR. None of these cases were concluded into surgical failure at the final visit. The time to symptoms relief was statistical significantly shorter in EN-DCR group (1.7 vs. 3.7 weeks in EX-DCR, P < 0.001). CONCLUSIONS: Success rate of DCR for PANLDO in our study was high, and complication rate was low for both endoscopic and external approaches. There was no statistically significant difference between them. EN-DCR provided higher satisfaction due to quicker recovery and lack of external incision. Endoscopic DCR should be considered

  18. The natural process of congenital nasolacrimal duct obstruction and effect of lacrimal sac massage.

    PubMed

    Karti, Omer; Karahan, Eyyup; Acan, Durgul; Kusbeci, Tuncay

    2016-12-01

    This study aimed to examine the rate of symptomatic improvement of congenital nasolacrimal duct obstruction (CNLDO) in infants treated with conservative management within the first year of age. Other purpose of the study is to emphasize the relationship between spontaneous resolution time and effective lacrimal sac massage. Thirty-one infants were diagnosed to have CNLDO by an ophthalmologist prior to 3 months of age. In this study, 36 eyes of 31 patients were included with CNLDO. The patients were divided into two groups. Group 1 (28 eyes of 24 patients) was consisted of the patients who were applied effective lacrimal sac massage regularly during the follow-up period, and patients whose parents did not apply a regular lacrimal passage regularly were accepted as group 2 (8 eyes of 7 patients). Thirty-three eyes of 31 patients (18 rights and 15 left) successfully resolved with only conservative management (91.6 %). In these thirty-three eyes, one eye (3 %) resolved between 0 and 3 months, fourteen eyes (42.5 %) resolved between 4 and 6 months, eleven eyes (33.3 %) resolved between 7 and 9 months, and seven eyes (21.2 %) resolved between 10 and 12 months. CNLDO was resolved in 27 (96.2 %) of 28 eyes in group 1, and in group 2, six eyes (77.7 %) had resolvement. This difference was statistically significant (p = 0.001). The mean age of resolution was 6.8 ± 1.88 months in group 1, 10.3 ± 1.5 months in group 2 (p < 0.001). In light of our study, we believe that conservative management of CNLDO is highly successful. Our study provided a possible objective explanation for the efficacy of lacrimal sac massage. Emphasizing the importance of the massage to parents and describing in detail can reduce the risk of unnecessary surgical interventions.

  19. Development of the nasolacrimal apparatus in the Mongolian gerbil (Meriones unguiculatus), with notes on network topology and function.

    PubMed

    Rehorek, Susan J; Cunningham, Jayna; Bruening, Amanda E; Johnson, Jessica L; Bhatnagar, Kunwar P; Smith, Timothy D; Hillenius, Willem J

    2015-09-01

    The nasolacrimal apparatus (NLA) is a multicomponent functional system comprised of multiple orbital glands (up to four larger multicellular exocrine structures), a nasal chemosensory structure (vomeronasal organ: VNO), and a connecting duct (nasolacrimal duct: NLD). Although this system has been described in all tetrapod vertebrate lineages, albeit not always with all three main components present, considerably less is known about its ontogeny. The Mongolian gerbil (Meriones unguiculatus) is a common lab rodent in which the individual components of the adult NLA have been well studied, but as yet nothing is known about the ontogeny of the NLA. In this study, serial sections of 15 fetal and three adult Mongolian gerbil heads show that the development of the NLA falls into three fetal stages: inception (origin of all features), elongation (lengthening of all features), and expansion (widening of all features). No postnatal or juvenile specimens were observed in this study, but considerable growth evidently occurs before the final adult condition is reached. The development of the orbital glands and the VNO in the Mongolian gerbil is largely consistent with those in other mammals, despite a slight nomenclatural conundrum for the anterior orbital glands. However, the Mongolian gerbil NLD follows a more circuitous route than in other tetrapods, due mainly to the convoluted arrangement of the narial cartilages, the development of a pair of enlarged incisors as well as an enlarged infraorbital foramen. The impact of these associated features on the ontogeny and phylogeny of the NLA could be examined through the approach of network science. This approach allows for the incorporation of adaptations to specific lifestyles as potential explanations for the variation observed in the NLA across different tetrapod clades. © 2015 Wiley Periodicals, Inc.

  20. Biofilm Quantification on Nasolacrimal Silastic Stents After Dacryocystorhinostomy.

    PubMed

    Murphy, Jae; Ali, Mohammed Javed; Psaltis, Alkis James

    2015-01-01

    Biofilms are now recognized as potential factors in the pathogenesis of chronic inflammatory and infective diseases. The aim of this study was to examine the presence of biofilms and quantify their biomass on silastic nasolacrimal duct stents inserted after dacryocystorhinostomy (DCR). A prospective study was performed on a series of patients undergoing DCR with O'Donoghue stent insertion. After removal, the stents were subjected to biofilm analysis using standard protocols of confocal laser scanning microscopy (CLSM) and scanning electron microscopy. These stents were compared against negative controls and positive in vitro ones established using Staphylococcus aureus strain ATCC 25923. Biofilm quantification was performed using the COMSTAT2 software and the total biofilm biomass was calculated. A total of nine consecutive patient samples were included in this prospective study. None of the patients had any evidence of postoperative infection. All the stents demonstrated evidence of biofilm formation using both imaging modalities. The presence of various different sized organisms within a common exopolysaccharide matrix on CLSM suggested the existence of polymicrobial communities. The mean biomass of patient samples was 0.9385 μm³/μm² (range: 0.3901-1.9511 μm³/μm²). This is the first study to report the quantification of biomass on lacrimal stents. The presence of biofilms on lacrimal stents after DCR is a common finding but this need not necessarily translate to postoperative clinical infection.

  1. Use of the Crawford tube for symptomatic epiphora without nasolacrimal obstruction.

    PubMed

    Tong, Nyu-Xia; Zhao, Ying-Ying; Jin, Xiu-Ming

    2016-01-01

    To evaluate the effectiveness of the Crawford tube in treating symptomatic epiphora without nasolacrimal obstruction. A protocol was adopted for the management of symptomatic epiphora without nasolacrimal obstruction. Patients who suffered symptomatic epiphora without nasolacrimal obstruction in both eyes were included in the study. One eye was treated with Crawford tube intubation and the other eye was treated with medication therapy. Degree of watering, patient satisfaction, and symptomatic improvement were carefully evaluated by one of the authors at the end of the follow-up period, after Crawford tube removal, to ascertain functional results. Thirty-seven adult patients (37 eyes) underwent Crawford tube intubation for functional epiphora. The mean follow-up time after removal of the tube was 14.8±4.8mo. The procedure was an overall success in 28 eyes (75.7%), with symptoms improving significantly. Two eyes (5.4%) were relieved of indoor epiphora, two (5.4%) had minimal epiphora outdoors, but only with wind or cold, and five (13.5%) continued to experience tearing both indoors and outdoors. Thirty of the patients (81%) expressed satisfaction with the procedure. Crawford tube insertion is an effective, safe, simple, and relatively noninvasive treatment strategy for functional lacrimal system obstruction.

  2. Surgical treatment of dacryocystitis caused by cystic dilatation of the nasolacrimal system in three dogs.

    PubMed

    van der Woerdt, A; Wilkie, D A; Gilger, B C; Smeak, D D; Kerpsack, S J

    1997-08-15

    A 4-year-old castrated male Golden Retriever was referred for evaluation of intermittent purulent discharge from the right eye of 4-months' duration. A radiolucent area in the maxillary bone was detected on examination of skull radiographs. Dacryocystorhinography revealed pooling of contrast material in the radiolucent area. A rhinotomy was performed, and a large opening between the cystic structure of the nasolacrimal system and the nasal cavity was created. Epiphora resolved after surgery and had not recurred by 9 months after surgery. Two other dogs had cystic structures of the nasolacrimal system and were treated surgically to allow drainage into the nasal cavity.

  3. THE INCIDENCE OF SYMPTOMATIC ACQUIRED LACRIMAL OUTFLOW OBSTRUCTION AMONG RESIDENTS OF OLMSTED COUNTY, MINNESOTA, 1976–2000 (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS)

    PubMed Central

    J., John; Woog

    2007-01-01

    Purpose To define the incidence, clinical characteristics, and outcomes following treatment of symptomatic acquired lacrimal outflow obstruction (SALOO) in Olmsted County, Minnesota, from 1976 to 2000, and to test the hypothesis that the incidence of this disorder increased over this interval. Methods In this retrospective, population-based study, the Rochester Epidemiology Project was used to identify patients above the age of 5 years with SALOO. Patient medical records were reviewed, and the incidence and localization of lacrimal obstruction were determined. Results Five-hundred eighty-seven patients with SALOO were identified, with an average annual incidence rate of 30.47 per 100,000. Nasolacrimal duct obstruction was most common, with an incidence of 20.24 per 100,000. The increase in incidence from 1976–1979 to 1996–2000 was statistically significant (P=.01). Among 397 patients with nasolacrimal duct obstruction, 107 (27%) were male and 290 (73%) female, with a mean age of 59.5 ± 22 years. SALOO and nasolacrimal duct obstruction incidence increased with age. Glaucoma, dry eye, cataract, diabetes mellitus, systemic malignancy, cigarette smoking, and hypertension were noted in 5.5%, 8.7%, 37.5%, 10.9%, 18.5%, 26.4%, and 41.1% of patients, respectively. One hundred eleven patients underwent dacryocystorhinostomy, with a success rate of 94.1%. Conclusions SALOO incidence increased during the study interval, although a possible plateau effect was noted during the last 5 years of the study period. The majority of patients were female above the age of 66 years. The latter finding, in conjunction with US demographic trends, suggests that the frequency of SALOO may continue to increase in the future. External dacryocystorhinostomy appeared to be effective in the management of nasolacrimal duct obstruction. PMID:18427633

  4. Nasolacrimal drainage system cyst in an adult.

    PubMed

    Yamasoba, T; Sugimura, H

    1996-01-01

    A cyst of the nasolacrimal drainage system (NLDS) is rare in an adult. We report a case in a 29-year-old man of a mucous retention cyst of the NLDS, which appeared 2 years after the patient developed dacryocystitis coincident with an aggravation of chronic sinusitis. The lesion was successfully managed by removing the bony wall of the NLDS at the interface with the ethmoid and nasal cavity, as well as the membranous closure of the ostium of the common canaliculus. We speculate that the cyst development might have been initiated by inflammatory change such as mucosal adhesion in the NLDS resulting from the spread of secondary infection from the sinonasal tract.

  5. Large Eddy Simulation of Ducted Propulsors in Crashbac

    NASA Astrophysics Data System (ADS)

    Jang, Hyunchul; Mahesh, Krishnan

    2008-11-01

    Flow around a ducted marine propulsor is computed using the large eddy simulation methodology under crashback conditions. Crashback is an operating condition where a propulsor rotates in the reverse direction while the vessel moves in the forward direction. It is characterized by massive flow separation and highly unsteady propeller loads, which affect both blade life and maneuverability. The simulations are performed on unstructured grids using the algorithm developed by Mahesh at al. (2004, J. Comput. Phys 197). The flow is computed at the advance ratio J=-0.7 and Reynolds number Re=480,000 based on the propeller diameter. Average and RMS values of the unsteady loads such as thrust, torque, and side force on the blades and duct are compared to experiment. It is seen that even though effects of the duct on thrust and torque are not large enough, those on the side force are significant. The rms of side forces is much higher in the presence of the duct. Pressure distributions on blade surfaces and duct surface are examined and used to explain this effect. This work was supported by the United States Office of Naval Research under ONR Grant N00014-05-1-0003.

  6. Scanning Electron Microscopic Features of Nasolacrimal Silastic Stents Retained for Prolong Durations Following Dacryocystorhinostomy.

    PubMed

    Ali, Mohammad Javed; Baig, Farhana; Lakshman, Mekala; Naik, Milind N

    2016-01-01

    The aims of this study were to examine the scanning electron microscopic features of silastic nasolacrimal duct stents retained for long durations following a dacryocystorhinostomy. A prospective interventional study was performed on stents retrieved from patients who were lost to follow up after a dacryocystorhinostomy with Crawford stent insertion. Long duration was defined as stents retrieved at a minimum of 1 year following a dacryocystorhinostomy. None of the patients had any evidence of postoperative infection. After removal, the stent segments were subjected to biofilm and physical deposit analysis using standard protocols of scanning electron microscopy. These stent segments were compared against sterile stents which acted as controls. A total of 7 stents were studied. Five were consecutive patient samples, and 2 were sterile stents. All the 5 stents were retrieved from patients who were lost to follow up for a minimum of 12 months following surgery. The mean duration of intubation at retrieval was 21 months. All the stents demonstrated evidence of biofilm formation and physical deposits. However, as the duration of retention increased, the deposits and biofilms were noted to be progressively denser, multilayered and extensive. Certain areas demonstrated thick biofilm integration with the deposits. Polymicrobial communities were noted within the exopolysaccharide matrix. This is the first study to exclusively report on scanning electron microscopic features of lacrimal stents retained for long durations. Further studies on physical elements within the deposits and protein analysis would provide more insights into stent-tissue interactions.

  7. Endoscopic Modified Medial Maxillectomy for Resection of an Inverted Papilloma Originating from the Entire Circumference of the Maxillary Sinus

    PubMed Central

    Wada, Kota; Ishigaki, Takashi; Ida, Yutaro; Yamada, Yuki; Hosono, Sachiko; Edamatsu, Hideo

    2015-01-01

    For treatment of a sinonasal inverted papilloma (IP), it is essential to have a definite diagnosis, to identify its origin by computed tomography (CT) and magnetic resonance imaging (MRI), and to select the appropriate surgical approach based on the staging system proposed by Krouse. Recently, a new surgical approach named endoscopic modified medial maxillectomy (EMMM) was proposed. This approach can preserve the inferior turbinate and nasolacrimal duct. We successfully treated sinonasal IP with EMMM in a 71-year-old female patient. In this patient, the sinonasal IP originated from the entire circumference of the maxillary sinus. EMMM is not a difficult procedure and provides good visibility of the operative field. Lacrimation and empty nose syndrome do not occur postoperatively as the nasolacrimal duct and inferior turbinate are preserved. EMMM is considered to be a very favorable approach for treatment of sinonasal IP. PMID:26146581

  8. Endoscopic modified medial maxillectomy for treatment of inverted papilloma originating from the maxillary sinus.

    PubMed

    Erbek, Selim S; Koycu, Alper; Buyuklu, Fuat

    2015-05-01

    Endoscopic approaches have become an alternative to external approaches in the treatment of sinonasal inverted papillomas (IPs) in recent years. The aim of this study was to analyze the outcomes of endoscopic modified medial maxillectomy preserving the nasolacrimal duct and the inferior turbinate in selected IP cases. Medical charts of patients diagnosed with IP originating from the maxillary sinus between July 2008 and August 2013 were reviewed. Eight patients who had undergone endoscopic modified medial maxillectomy were included in the study. Attachment of IP was located on the medial wall of the maxillary sinus in all cases. The nasolacrimal duct was preserved in all of the patients. The inferior turbinate was completely preserved in 5 patients, and the anterior part of the inferior turbinate was preserved in 3 patients. The mean follow-up period of the patients was 30.8 months (12-60  mo). None of the patients had recurrence or major complications. The postoperative complaints were minor hemorrhagic discharge and crusting for the first few weeks. Endoscopic modified medial maxillectomy preserving the nasolacrimal duct and the inferior turbinate provides good surgical and functional outcomes in selected IP cases.

  9. 22. DETAIL INTERIOR VIEW OF OFFICE, SHOWING ORIGINAL SASH WINDOWS ...

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

    22. DETAIL INTERIOR VIEW OF OFFICE, SHOWING ORIGINAL SASH WINDOWS AND DUCT WORK (OTHER OFFICE INTERIORS ARE GREATLY ALTERED FROM THE ORIGINAL) - Oakland Army Base, Transit Shed, East of Dunkirk Street & South of Burma Road, Oakland, Alameda County, CA

  10. Acute dacryocystitis associated with epstein-barr virus infection.

    PubMed

    Ghauri, Abdul-Jabbar; Keane, Pearse A; Scotcher, Stephen M; Clarke, Jayne L; Madge, Simon N

    2011-10-01

    Acute dacryocystitis is a rare complication of infectious mononucleosis with only three previous reports in the English literature. We present two further children with acute dacryocystitis and clinical and laboratory features of Epstein-Barr Virus related infectious mononucleosis. Both were treated with systemic antibiotics and one child additionally required surgical drainage of a lacrimal sac abscess. Both children made a complete recovery without any lacrimal symptoms. Acute dacryocystitis is uncommon in children without a history of congenital nasolacrimal duct obstruction, and an underlying systemic condition such as infectious mononucleosis should be suspected. In such patients, dacryocystitis can be expected to resolve without symptoms of nasolacrimal duct obstruction and dacryocystorhinostomy is seldom required.

  11. Modified transnasal endoscopic medial maxillectomy through prelacrimal duct approach.

    PubMed

    Suzuki, Motohiko; Nakamura, Yoshihisa; Yokota, Makoto; Ozaki, Shinya; Murakami, Shingo

    2017-10-01

    We previously reported a modified endoscopic medial maxillectomy (modified transnasal endoscopic medial maxillectomy through prelacrimal duct approach [MTEMMPDA]) to resect inverted papilloma (IP), for which the inferior turbinate (IT) and nasolacrimal duct (ND) can be preserved. MTEMMPDA is a safe and effective method to obtain wide, straight access to the maxillary sinus (MS). However, there are few reported cases of patients who underwent MTEMMPDA, and even fewer of patients who underwent partial osteotomy of the apertura piriformis and the anterior wall of the MS. In this study, we analyzed the outcomes of 51 patients who underwent MTEMMPDA. Retrospective review. All patients who underwent MTEMMPDA at our hospital between January 2004 and December 2015 were included in this study. Fifty-one patients with sinonasal IP in the MS underwent MTEMMPDA. Recurrence was seen in the MS of one patient (follow-up of 2-138 months). The IT remained unchanged in all 51 patients without atrophy. We have not observed epiphora, eye discharge, dry nose, or persistent crusting after this surgery. Although seven patients had numbness around the upper lip after surgery, this had disappeared by 1 year after surgery. Additional partial osteotomy of the apertura piriformis and the anterior wall of the MS were done in eight patients. Deformation of the external nose was not seen. This approach appears to be a safe and effective method to resect IP in the MS, even if there is additional partial osteotomy of the apertura piriformis and the anterior wall of the MS. 4. Laryngoscope, 127:2205-2209, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  12. 11. VIEW OF A HEATING DUCT SITUATED SOUTHWEST OF THE ...

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

    11. VIEW OF A HEATING DUCT SITUATED SOUTHWEST OF THE FAN HOUSE, ALONG THE MINE ROAD. THE BURNED RUINS OF THE MINE OFFICE ARE LOCATED ON THE FAR SIDE OF THE HEATING DUCT, TO THE NORTHWEST. - Tower Hill No. 2 Mine, Approximately 0.47 mile Southwest of intersection of Stone Church Road & Township Route 561, Hibbs, Fayette County, PA

  13. Observations of Strong Surface Radar Ducts over the Persian Gulf.

    NASA Astrophysics Data System (ADS)

    Brooks, Ian M.; Goroch, Andreas K.; Rogers, David P.

    1999-09-01

    Ducting of microwave radiation is a common phenomenon over the oceans. The height and strength of the duct are controlling factors for radar propagation and must be determined accurately to assess propagation ranges. A surface evaporation duct commonly forms due to the large gradient in specific humidity just above the sea surface; a deeper surface-based or elevated duct frequently is associated with the sudden change in temperature and humidity across the boundary layer inversion.In April 1996 the U.K. Meteorological Office C-130 Hercules research aircraft took part in the U.S. Navy Ship Antisubmarine Warfare Readiness/Effectiveness Measuring exercise (SHAREM-115) in the Persian Gulf by providing meteorological support and making measurements for the study of electromagnetic and electro-optical propagation. The boundary layer structure over the Gulf is influenced strongly by the surrounding desert landmass. Warm dry air flows from the desert over the cooler waters of the Gulf. Heat loss to the surface results in the formation of a stable internal boundary layer. The layer evolves continuously along wind, eventually forming a new marine atmospheric boundary layer. The stable stratification suppresses vertical mixing, trapping moisture within the layer and leading to an increase in refractive index and the formation of a strong boundary layer duct. A surface evaporation duct coexists with the boundary layer duct.In this paper the authors present aircraft- and ship-based observations of both the surface evaporation and boundary layer ducts. A series of sawtooth aircraft profiles map the boundary layer structure and provide spatially distributed estimates of the duct depth. The boundary layer duct is found to have considerable spatial variability in both depth and strength, and to evolve along wind over distances significant to naval operations (100 km). The depth of the evaporation duct is derived from a bulk parameterization based on Monin-Obukhov similarity theory

  14. IET exhaust gas duct, system layout, plan, and section. shows ...

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

    IET exhaust gas duct, system layout, plan, and section. shows mounting brackets, concrete braces, divided portion of duct, other details. Ralph M. Parsons 902-5-ANP-712-S 429. Date: May 1954. Approved by INEEL Classification Office for public release. INEEL index code no. 035-0712-60-693-106980 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  15. Successes rate of endoscopic dacryocystorhinostomy at KMC.

    PubMed

    Shrestha, S; Kafle, P K; Pokhrel, S; Maharjan, M; Toran, K C

    2010-01-01

    Nasolacrimal duct obstruction is a common problem which can be corrected by dacryocystorhinostomy (DCR). The gold standard treatment for this is DCR operation through an external approach. Development of endoscopic sinus surgery and endoscopic DCR performed through intranasal route is a major recent development in this field. The aim of this study is to find out the success rate of endoscopic dacryocystorhinostomy without silicon stent intubation within the period of six month following surgery. A prospective study was done on 26 patients with obstruction of the nasolacrimal duct referred from eye out-patient department to ENT OPD during one year period from 2008 to 2009. All the cases had undergone endoscopic DCR operation which was regularly followed up for a period of six months. Postoperative patency of ostium was checked by sac syringing and endoscopic visualisation of ostium in the nasal cavity. The success of surgery was categorised as: complete cure, partial cure and no improvement depending upon symptomatic relief and clinical examination such as sac syringing and endoscopic examination following surgery. In six months' follow-up, 22 (84.5%) out of 26 patients had achieved the complete cure and 4 patients (15.5%) continued to have persistent epiphora. Endoscopic DCR is a beneficial procedure for nasolacrimal duct obstruction with no external scar on face and less bleeding. The success rate is as good as external DCR.

  16. Biofilms and Physical Deposits on Nasolacrimal Silastic Stents Following Dacryocystorhinostomy: Is There a Difference Between Ocular and Nasal Segments?

    PubMed

    Ali, Mohammad Javed; Baig, Farhana; Lakshman, Mekala; Naik, Milind N

    2015-01-01

    The aims of this study were to examine the presence of biofilms and physical deposits on ocular and nasal segments of silastic nasolacrimal duct stents inserted after dacryocystorhinostomy and to document any differences. A prospective interventional study was performed on a series of patients undergoing dacryocystorhinostomy with Crawford stent insertion. All the patient samples were retrieved 4 weeks after an endoscopic dacryocystorhinostomy. None of the patients had any evidence of postoperative infection. The ocular and nasal segments were separated during retrieval. After removal, the stent segments were subjected to biofilm and physical deposit analysis using standard protocols of scanning electron microscopy. These stent segments were compared against sterile stents which acted as controls. A total of 11 stents were studied. Nine were consecutive patient samples and 2 were sterile stents. The ocular and nasal segments of all the stents demonstrated evidence of biofilm formation and physical deposits. However, the deposits and biofilms were thicker and extensive in the ocular segment, although more focal in nature. In contrast, the nasal segments showed thinner biofilms and sparser deposits but were more diffuse in nature. The presence of different-sized organisms within the exopolysaccharide matrix and in between the deposits suggests the existence of polymicrobial communities. This is the first study to report the differences between ocular and nasal segments of lacrimal stents. These differences could propel further studies on stent biomechanics and their interactions with ocular and nasal tissues, following a dacryocystorhinostomy.

  17. Ducted turbine theory with right angled ducts

    NASA Astrophysics Data System (ADS)

    McLaren-Gow, S.; Jamieson, P.; Graham, J. M. R.

    2014-06-01

    This paper describes the use of an inviscid approach to model a ducted turbine - also known as a diffuser augmented turbine - and a comparison of results with a particular one-dimensional theory. The aim of the investigation was to gain a better understanding of the relationship between a real duct and the ideal diffuser, which is a concept that is developed in the theory. A range of right angled ducts, which have a rim for a 90° exit angle, were modelled. As a result, the performance of right angled ducts has been characterised in inviscid flow. It was concluded that right angled ducts cannot match the performance of their associated ideal diffuser and that the optimum rotor loading for these turbines varies with the duct dimensions.

  18. Advanced Duct Sealing Testing

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

    Sherman, Max H.; Walker, Iain S.

    Duct leakage has been identified as a major source of energy loss in residential buildings. Most duct leakage occurs at the connections to registers, plenums or branches in the duct system. At each of these connections a method of sealing the duct system is required. Typical sealing methods include tapes or mastics applied around the joints in the system. Field examinations of duct systems have typically shown that these seals tend to fail over extended periods of time. The Lawrence Berkeley National Laboratory has been testing sealant durability for several years. Typical duct tape (i.e. fabric backed tapes with naturalmore » rubber adhesives) was found to fail more rapidly than all other duct sealants. This report summarizes the results of duct sealant durability testing of five UL 181B-FX listed duct tapes (three cloth tapes, a foil tape and an Oriented Polypropylene (OPP) tape). One of the cloth tapes was specifically developed in collaboration with a tape manufacturer to perform better in our durability testing. The first test involved the aging of common ''core-to-collar joints'' of flexible duct to sheet metal collars, and sheet metal ''collar-to-plenum joints'' pressurized with 200 F (93 C) air. The second test consisted of baking duct tape specimens in a constant 212 F (100 C) oven following the UL 181B-FX ''Temperature Test'' requirements. Additional tests were also performed on only two tapes using sheet metal collar-to-plenum joints. Since an unsealed flexible duct joint can have a variable leakage depending on the positioning of the flexible duct core, the durability of the flexible duct joints could not be based on the 10% of unsealed leakage criteria. Nevertheless, the leakage of the sealed specimens prior to testing could be considered as a basis for a failure criteria. Visual inspection was also documented throughout the tests. The flexible duct core-to-collar joints were inspected monthly, while the sheet metal collar-to-plenum joints were

  19. Bile duct hamartomas (von Mayenburg complexes) mimicking liver metastases from bile duct cancer: MRC findings

    PubMed Central

    Nagano, Yasuhiko; Matsuo, Kenichi; Gorai, Katsuya; Sugimori, Kazuya; Kunisaki, Chikara; Ike, Hideyuki; Tanaka, Katsuaki; Imada, Toshio; Shimada, Hiroshi

    2006-01-01

    We present a case of a 72-year-old man with a common bile duct cancer, who was initially believed to have multiple liver metastases based on computed tomography findings, and in whom magnetic resonance cholangiography (MRC) revealed a diagnosis of bile duct hamartomas. At exploration for pancreaticoduodenectomy, liver palpation revealed disseminated nodules at the surface of the liver. These nodules showed gray-white nodular lesions of about 0.5 cm in diameter scattered on the surface of both liver lobes, which were looked like multiple liver metastases from bile duct cancer. Frozen section of the liver biopsy disclosed multiple bile ducts with slightly dilated lumens embedded in the collagenous stroma characteristics of multiple bile duct hamartomas (BDHs). Only two reports have described the MRC features of bile duct hamartomas. Of all imaging procedures, MRC provides the most relevant features for the imaging diagnosis of bile duct hamartomas. PMID:16534895

  20. Finite element based stability-constrained weight minimization of sandwich composite ducts for airship applications

    NASA Astrophysics Data System (ADS)

    Khode, Urmi B.

    High Altitude Long Endurance (HALE) airships are platform of interest due to their persistent observation and persistent communication capabilities. A novel HALE airship design configuration incorporates a composite sandwich propulsive hull duct between the front and the back of the hull for significant drag reduction via blown wake effects. The sandwich composite shell duct is subjected to hull pressure on its outer walls and flow suction on its inner walls which result in in-plane wall compressive stress, which may cause duct buckling. An approach based upon finite element stability analysis combined with a ply layup and foam thickness determination weight minimization search algorithm is utilized. Its goal is to achieve an optimized solution for the configuration of the sandwich composite as a solution to a constrained minimum weight design problem, for which the shell duct remains stable with a prescribed margin of safety under prescribed loading. The stability analysis methodology is first verified by comparing published analytical results for a number of simple cylindrical shell configurations with FEM counterpart solutions obtained using the commercially available code ABAQUS. Results show that the approach is effective in identifying minimum weight composite duct configurations for a number of representative combinations of duct geometry, composite material and foam properties, and propulsive duct applied pressure loading.

  1. Large-Eddy Simulation of Crashback in a Ducted Propulsor

    NASA Astrophysics Data System (ADS)

    Jang, Hyunchul; Mahesh, Krishnan

    2011-11-01

    Crashback is an operating condition to quickly stop a propelled vehicle, where the propeller is rotated in the reverse direction to yield negative thrust. The crashback condition is dominated by the interaction of free stream flow with strong reverse flow. Crashback causes highly unsteady loads and flow separation on blade surface. This study uses Large-Eddy Simulation to predict the highly unsteady flow field in crashback for a ducted propulsor. Thrust mostly arises from the blade surface, but most of side-force is generated from the duct surface. Both mean and RMS of pressure are much higher on inner surface of duct, especially near blade tips. This implies that side-force on the ducted propulsor is caused by the blade-duct interaction. Strong tip leakage flow is observed behind the suction side at the tip gap. The physical source of the tip leakage flow is seen to be the large pressure difference between pressure and suction sides. The conditional average during high amplitude event shows that the tip leakage flow and pressure difference are significantly higher. This work is supported by the United States Office of Naval Research under ONR Grant N00014-05-1-0003.

  2. Pediatric endocanalicular diode laser dacryocystorhinostomy: results of a minimally invasive surgical technique.

    PubMed

    Uysal, Ismail Onder; Ozçimen, Muammer; Yener, Halil Ibrahim; Kal, Ali

    2011-09-01

    The purpose of this study was to evaluate the effectiveness of endocanalicular diode laser dacryocystorhinostomy (DCR), which is a minimally invasive surgical technique, in pediatric patients with congenital nasolacrimal duct obstruction (NLDO). A retrospective study was carried out on patients treated between October 2008 and August 2009 for nasolacrimal duct obstruction with an endocanalicular diode laser procedure. Patients diagnosed as having nasolacrimal duct obstruction were included in this study and an endocanalicular diode laser procedure was performed. The main outcome measures were patients' previous treatments, clinical presentation, operative and postoperative complications, postoperative follow-up and resolution of epiphora. Eighteen children (10 girls, 8 boys) with a mean age of 6.11 ± 2.08 years (range, 4-10) underwent 20 endocanalicular laser DCR operations for congenital NLDO. In all eyes (100%), there was a history of epiphora and chronic dacryocystitis; two (10%) presented with acute dacryocystitis. Previous procedures included probing and irrigation of all eyes (100%) and silicone tube intubation in nine eyes (45%). None of the patients underwent any previous DCR operations. During a mean postoperative follow-up period of 20.50 ± 3.24 months (range, 14-24 months), the anatomical success rate (patency of ostium on nasal endoscopy) was 100%, and the clinical success rate (resolution of epiphora) was 85%. Endocanalicular diode laser DCR is an effective treatment modality for pediatric patients with congenital NLDO that compares favorably with the reported success rates of external and endoscopic endonasal DCR. Moreover, it has an added advantage of shorter operative time, less morbidity and avoidance of overnight admission.

  3. Duct Joining System

    DOEpatents

    Proctor, John P.

    2001-02-27

    A duct joining system for providing an air-tight seal and mechanical connection for ducts and fittings is disclosed. The duct joining system includes a flexible gasket affixed to a male end of a duct or fitting. The flexible gasket is affixed at an angle relative to normal of the male end of the duct. The female end of the other duct includes a raised bead in which the flexible gasket is seated when the ducts are properly joined. The angled flexible gasket seated in the raised bead forms an air-tight seal as well as fastens or locks the male end to the female end. Alternatively, when a flexible duct is used, a band clamp with a raised bead is clamped over the female end of the flexible duct and over the male end of a fitting to provide an air tight seal and fastened connection.

  4. Duct joining system

    DOEpatents

    Proctor, John P.; deKieffer, Robert C.

    2001-01-01

    A duct joining system for providing an air-tight seal and mechanical connection for ducts and fittings is disclosed. The duct joining system includes a flexible gasket affixed to a male end of a duct or fitting. The flexible gasket is affixed at an angle relative to normal of the male end of the duct. The female end of the other duct includes a raised bead in which the flexible gasket is seated when the ducts are properly joined. The angled flexible gasket seated in the raised bead forms an air-tight seal as well as fastens or locks the male end to the female end. Alternatively, when a flexible duct is used, a band clamp with a raised bead is clamped over the female end of the flexible duct and over the male end of a fitting to provide an air tight seal and fastened connection.

  5. Turbofan aft duct suppressor study

    NASA Technical Reports Server (NTRS)

    Syed, A. A.; Motsinger, R. E.; Fiske, G. H.; Joshi, M. C.; Kraft, R. E.

    1983-01-01

    Suppressions due to acoustic treatment in the annular exhaust duct of a model fan were theoretically predicted and compared with measured suppressions. The predictions are based on the modal analysis of sound propagation in a straight annular flow duct with segmented treatment. Modal distributions of the fan noise source (fan-stator interaction only) were measured using in-duct modal probes. The flow profiles were also measured in the vicinity of the modal probes. The acoustic impedance of the single degree of freedom treatment was measured in the presence of grazing flow. The measured values of mode distribution of the fan noise source, the flow velocity profile and the acoustic impedance of the treatment in the duct were used as input to the prediction program. The predicted suppressions, under the assumption of uniform flow in the duct, compared well with the suppressions measured in the duct for all test conditions. The interaction modes generated by the rotor-stator interaction spanned a cut-off ratio range from nearly 1 to 7.

  6. Lensing duct

    DOEpatents

    Beach, R.J.; Benett, W.J.

    1994-04-26

    A lensing duct to condense (intensify) light using a combination of front surface lensing and reflective waveguiding is described. The duct tapers down from a wide input side to a narrow output side, with the input side being lens-shaped and coated with an antireflective coating for more efficient transmission into the duct. The four side surfaces are uncoated, preventing light from escaping by total internal reflection as it travels along the duct (reflective waveguiding). The duct has various applications for intensifying light, such as in the coupling of diode array pump light to solid state lasing materials, and can be fabricated from inexpensive glass and plastic. 3 figures.

  7. Management of maxillary sinus inverted papilloma via endoscopic partial medial maxillectomy with an inferior turbinate reversing approach.

    PubMed

    Wang, Feng; Yang, Yang; Wang, Shenqing; Chen, Haihong; Wang, Dehui; Wang, Qinying

    2017-12-01

    The aim of this study is to evaluate the efficacy of endoscopic treatment for maxillary inverted papilloma (IP) through partial medial maxillectomy with an inferior turbinate reversing approach. A retrospective analysis of patients treated in our institution for maxillary sinus IP between July 2011 and August 2015 was performed. Demographics, operative technique, characteristics of tumors, complications, postoperative follow-up, and recurrence were evaluated. Twenty-two patients were enrolled in the study. All tumor attachments were identified intraoperatively. Adequate visualization was obtained following our approach. All inferior turbinate and nasolacrimal ducts were preserved. The median follow-up time was 41 months. One recurrence occurred at the follow-up time of 27 months. Postoperative hemorrhage and numbness at the ipsilateral frontal teeth were reported in two and one patients, respectively. Endoscopic surgery through partial medial maxillectomy using an inferior turbinate reversing approach provides full access to the maxillary sinus and preserves the inferior turbinate and nasolacrimal duct.

  8. LES of a ducted propeller with rotor and stator in crashback

    NASA Astrophysics Data System (ADS)

    Jang, Hyunchul; Mahesh, Krishnan

    2012-11-01

    A sliding interface method is developed for large eddy simulation (LES) of flow past ducted propellers with both rotor and stator. The method is developed for arbitrarily shaped unstructured elements on massively parallel computing platforms. Novel algorithms for searching sliding elements, interpolation at the sliding interface, and data structures for message passing are developed. We perform LES of flow past a ducted propeller with stator blades in the crashback mode of operation, where a marine vessel is quickly decelerated by rotating the propeller in reverse. The unsteady loads predicted by LES are in good agreement with experiments. A highly unsteady vortex ring is observed outside the duct. High pressure fluctuations are observed near the blade tips, which significantly contribute to the side-force. This work is supported by the United States Office of Naval Research.

  9. PMR Graphite Engine Duct Development

    NASA Technical Reports Server (NTRS)

    Stotler, C. L.; Yokel, S. A.

    1989-01-01

    The objective was to demonstrate the cost and weight advantages that could be obtained by utilizing the graphite/PMR15 material system to replace titanium in selected turbofan engine applications. The first component to be selected as a basis for evaluation was the outer bypass duct of the General Electric F404 engine. The operating environment of this duct was defined and then an extensive mechanical and physical property test program was conducted using material made by processing techniques which were also established by this program. Based on these properties, design concepts to fabricate a composite version of the duct were established and two complete ducts fabricated. One of these ducts was proof pressure tested and then run successfully on a factory test engine for over 1900 hours. The second duct was static tested to 210 percent design limit load without failure. An improved design was then developed which utilized integral composite end flanges. A complete duct was fabricated and successfully proof pressure tested. The net results of this effort showed that a composite version of the outer duct would be 14 percent lighter and 30 percent less expensive that the titanium duct. The other type of structure chosen for investigation was the F404 fan stator assembly, including the fan stator vanes. It was concluded that it was feasible to utilize composite materials for this type structure but that the requirements imposed by replacing an existing metal design resulted in an inefficient composite design. It was concluded that if composites were to be effectively used in this type structure, the design must be tailored for composite application from the outset.

  10. Bile Duct Exploration

    MedlinePlus

    ... Patients & Visitors Health Library Institutes & Departments Home / Health Library / Diagnostics & Testing / Bile Duct Exploration Advertising Policy Bile Duct Exploration Common bile duct exploration is ...

  11. 14 CFR 29.1103 - Induction systems ducts and air duct systems.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Induction systems ducts and air duct systems. 29.1103 Section 29.1103 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Induction System § 29.1103 Induction systems ducts and air duct...

  12. 14 CFR 25.1103 - Induction system ducts and air duct systems.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Induction system ducts and air duct systems. 25.1103 Section 25.1103 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY AIRPLANES Powerplant Induction System § 25.1103 Induction system ducts and air duct...

  13. Hollow lensing duct

    DOEpatents

    Beach, Raymond J.; Honea, Eric C.; Bibeau, Camille; Mitchell, Scott; Lang, John; Maderas, Dennis; Speth, Joel; Payne, Stephen A.

    2000-01-01

    A hollow lensing duct to condense (intensify) light using a combination of focusing using a spherical or cylindrical lens followed by reflective waveguiding. The hollow duct tapers down from a wide input side to a narrow output side, with the input side consisting of a lens that may be coated with an antireflective coating for more efficient transmission into the duct. The inside surfaces of the hollow lens duct are appropriately coated to be reflective, preventing light from escaping by reflection as it travels along the duct (reflective waveguiding). The hollow duct has various applications for intensifying light, such as in the coupling of diode array pump light to solid state lasing materials.

  14. FET. Exhaust duct and stack. Plan, elevation, foundation, details. Ralph ...

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

    FET. Exhaust duct and stack. Plan, elevation, foundation, details. Ralph M. Parsons 1480-10 ANP/GE-5-716-S-3. Date: February 1959. Approved by INEEL Classification Office for public release. INEEL index code no. 036-0716-00-693-107474 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  15. Therapeutic Breast Massage in Lactation for the Management of Engorgement, Plugged Ducts, and Mastitis.

    PubMed

    Witt, Ann M; Bolman, Maya; Kredit, Sheila; Vanic, Anne

    2016-02-01

    Many women in developed countries do not meet their breastfeeding goals and wean early because of breast pain. This study aimed to describe clinical response to therapeutic breast massage in lactation (TBML) in the management of engorgement, plugged ducts, and mastitis. Breastfeeding women presenting with engorgement, plugged ducts, or mastitis who received TBML as part of their treatment were enrolled (n = 42). Data collected at the initial visit included demographic, history, and exam data pre-TBML and post-TBML. Email surveys sent 2 days, 2 weeks, and 12 weeks following the initial visit assessed pain and breastfeeding complications. A nested case control of engorged mothers (n = 73) was separately enrolled to compare engorgement severity. Reasons for the visit included engorgement (36%), plugged ducts (67%), and mastitis (29%). Cases, compared to controls, were significantly more likely to have severe engorgement (47% vs 7%, P < .001). Initial mean breast pain level among those receiving TBML was 6.4 out of 10. Following TBML, there was significant improvement in both breast (6.4 vs 2.8, P < .001) and nipple pain (4.6 vs 2.8, P = .013). All women reported immediate improvement in their pain level. At the 12-week survey, 65% found the massage treatment very helpful. The majority of the women with a new episode of mastitis or plugged duct during the study follow-up found the techniques learned during the office visit very helpful for home management of these episodes. In office, TBML is helpful for the reduction of acute breast pain associated with milk stasis. Mothers find TBML helpful both immediately in-office and for home management of future episodes. © The Author(s) 2015.

  16. [Rare bile duct anatomy variant - Right bile duct intraparenchymal junction into the left bile duct].

    PubMed

    Gál, Adrián Róbert; Kalmár-Nagy, Károly; Fincsur, András; Horváth, Örs Péter; Vereczkei, András

    2018-03-01

    The authors present a case of a 67-year-old male patient, who previously had been diagnosed with a malignant liver tumor localized in segment II. He underwent bisegmentectomy (II and III) and partial IV segmentectomy. After the primary surgery jaundice developed, the level of bilirubin increased and after several imaging modalities reoperation was indicated. During the surgery a rare bile duct anatomy variant was found. The right hepatic duct joined the left duct in the parenchyma of the left lobe, and was ligated at the resection. As the liver hilum was not explored, the absence of the right duct was not discovered. Reconstruction of the biliary system was accomplished by a Roux-en-Y loop.

  17. Mammary Duct Ectasia

    MedlinePlus

    ... tenderness or inflammation of the clogged duct (periductal mastitis). Mammary duct ectasia most often occurs in women ... that's turned inward (inverted) A bacterial infection called mastitis also may develop in the affected milk duct, ...

  18. Pancreatic-duct-lavage cytology in candidates for surgical resection of branch-duct intraductal papillary mucinous neoplasm of the pancreas: should the International Consensus Guidelines be revised?

    PubMed

    Sai, Jin Kan; Suyama, Masafumi; Kubokawa, Yoshihiro; Watanabe, Sumio; Maehara, Tadayuki

    2009-03-01

    The International Consensus Guidelines are helpful for the management of branch-duct intraductal papillary mucinous neoplasms (IPMNs), because they allow us to exclude malignancy. However, it is not possible to predict malignancy with certainty, and further preoperative differentiation between benign and malignant IPMNs is required to avoid the false-positive results. To examine the usefulness of pancreatic-duct-lavage cytology by using an originally designed double-lumen catheter for discriminating benign and malignant IPMNs of the branch-duct type in candidates for surgical resection based on the International Consensus Guidelines. Pancreatic-duct-lavage cytology was investigated in 24 patients with branch-duct IPMNs who underwent surgical resection based on the International Consensus Guidelines, namely, they either had intramural nodules or the ectatic branch duct was >30 mm in diameter. Single-center retrospective study. Academic medical center. The sensitivity and specificity of pancreatic-duct-lavage cytology for discriminating benign from malignant IPMNs. More than 30 mL of pancreatic-duct-lavage fluid was obtained from each patient, and there were no patients with noninformative results. The sensitivity, specificity, positive predictive value, and negative predictive value of the cytologic diagnosis were 78%, 93%, 88%, and 88%, respectively. Single-center and small number of patients. Pancreatic-duct-lavage cytology can improve differentiation between benign and malignant IPMNs of the branch-duct type in candidates for surgical resection based on the International Consensus Guidelines.

  19. Duct closure

    DOEpatents

    Vowell, Kennison L.

    1987-01-01

    A closure for an inclined duct having an open upper end and defining downwardly extending passageway. The closure includes a cap for sealing engagement with the open upper end of the duct. Associated with the cap are an array of vertically aligned plug members, each of which has a cross-sectional area substantially conforming to the cross-sectional area of the passageway at least adjacent the upper end of the passageway. The plug members are interconnected in a manner to provide for free movement only in the plane in which the duct is inclined. The uppermost plug member is attached to the cap means and the cap means is in turn connected to a hoist means which is located directly over the open end of the duct.

  20. HVAC; Heating, Ventilation, Air Conditioning - Aerosol Duct Sealant

    DTIC Science & Technology

    2016-09-01

    material was applied. Annual energy and cost savings were predicted based on a typical weather year for each site. The installation of the duct...Balance reports; Visible dust streaks on duct work, ceilings near supply diffusers, or electrical boxes; Comfort complaints Specific Leakage...energy consumption , depending on the HVAC system type and the location of the ducts that were sealed. The cost effectiveness of the technology is

  1. Graft versus host disease: what should the oculoplastic surgeon know?

    PubMed

    Tung, Cynthia I

    2017-09-01

    To provide a concise review of the oculoplastic manifestations of ocular graft versus host disease (GVHD), and to discuss their management. Ocular GVHD occurs as a common immune-mediated complication of hematopoietic stem cell transplantation that presents as a Stevens-Johnson-like syndrome in the acute phase or a Sjögren-like syndrome in the chronic phase. Cicatricial conjunctivitis may be underreported in ocular GVHD. The spectrum of oculoplastic manifestations includes GVHD of the skin, cicatricial entropion, nasolacrimal duct obstruction, and lacrimal gland dysfunction. Surgical treatment is indicated for patients with significant corneal complications from entropion. Surgical approach to repair of nasolacrimal duct obstruction is presented in this review, including modified approaches for treating patients at risk for keratitis sicca. Management of the ocular graft versus host patient may require a multidisciplinary approach involving collaboration from the oculoplastic surgeon, the corneal specialist, and the stem cell transplant physician. Oculoplastic manifestations of ocular GVHD typically present as cicatricial changes in the eyelid and lacrimal system. Careful oculoplastic and corneal evaluation are necessary when considering surgical management for the ocular GVHD patient.

  2. Scissors Duct

    NASA Image and Video Library

    2007-06-26

    Stennis Space Center engineers are preparing to conduct water tests on an updated version of the scissors duct component of the J-2X engine. Measuring about 2 feet long and about 8 inches in diameter, the duct on the J-2X predecessor, the J-2, connected its fuel turbo pumps to the flight vehicle's upper stage run tanks. According to NASA's J-2X project manager at SSC, Gary Benton, the water tests should establish the limits of the duct's ability to withstand vibration.

  3. Liver and Bile Duct Cancer—Health Professional Version

    Cancer.gov

    Liver cancer includes two major types: hepatocellular carcinoma (HCC) and intrahepatic bile duct cancer, also known as cholangiocarcinoma. Find evidence-based information on liver and bile duct cancer treatment, causes and prevention, screening, research, genomics and statistics.

  4. User's Manual for DuctE3D: A Program for 3D Euler Unsteady Aerodynamic and Aeroelastic Analysis of Ducted Fans

    NASA Technical Reports Server (NTRS)

    Srivastava, R.; Reddy, T. S. R.

    1997-01-01

    The program DuctE3D is used for steady or unsteady aerodynamic and aeroelastic analysis of ducted fans. This guide describes the input data required and the output files generated, in using DuctE3D. The analysis solves three dimensional unsteady, compressible Euler equations to obtain the aerodynamic forces. A normal mode structural analysis is used to obtain the aeroelastic equations, which are solved using either the time domain or the frequency domain solution method. Sample input and output files are included in this guide for steady aerodynamic analysis and aeroelastic analysis of an isolated fan row.

  5. Ducting Conditions for Electromagnetic Wave Propagation in Tropical Disturbances from GPS Dropsonde Data

    DTIC Science & Technology

    2013-12-01

    depression, tropical storm , hurricane, extratropical cyclone, subtropical depression, subtropical storm , a low of no category, tropical wave, disturbance or...surface-based ducts, and elevated ducts. We further separate the duct occurrence based on the location relative to their respective storms . Based...on the number of soundings in different types of tropical disturbances, we chose to further analyze duct conditions in hurricanes and tropical storms

  6. Developing flow in S-shaped ducts. 2: Circular cross-section duct

    NASA Technical Reports Server (NTRS)

    Taylor, A. M. K. P.; Whitelaw, J. H.; Yianneskis, M.

    1984-01-01

    Laser-Doppler velocimetry measured the laminar and turbulent streamwise flow in a S-duct. The wall pressure distribution and one component of cross-stream velocity were also obtained for the turbulent flow case. Boundary layers near the duct inlet were about 25 percent of the hydraulic diameter in the laminar flow and varied around the periphery of the pipe between 10 percent and 20 percent in turbulent flow. Pressure-driven secondary flows develop in the first half of the S-duct and are attenuated and reversed in the second half. For both Reynolds numbers there is a region near the outer wall of the second half of the duct where the sign of the radial vorticity results in an enforcement of the secondary flow which was established in the first half of the S-duct. The core flow migrates, for both Reynolds numbers, to the outside wall of the first half and lies towards the inside wall of the second half of the S-duct at the outlet. The thinner inlet boundary layers in the turbulent flow give rise to weaker secondary motion.

  7. Turbofan aft duct suppressor study program listing and user's guide

    NASA Technical Reports Server (NTRS)

    Joshi, M. C.; Kraft, R. E.

    1983-01-01

    A description of the structure of the Annular Flow Duct Program (AFDP) for the calculation of acoustic suppression due to treatment in a finite length annular duct carrying sheared flow is presented. Although most appropriate for engine exhaust ducts, this program can be used to study sound propagation in any duct that maintains annular geometry over a considerable length of the duct. The program is based on the modal analysis of sound propagation in ducts with axial segments of different wall impedances. For specified duct geometry, wall impedance, flow and acoustic conditions in the duct (including mode amplitude distribution of the source) and duct termination reflection characteristics, the program calculates the suppression due to the treatment in the duct. The presence of forward and backward traveling modes in the duct due to the reflection and redistribution of modes at segment interfaces and duct end terminations are taken into account in the calculations. The effects of thin wall boundary layers (with a linear or mean flow velocity profile) on the acoustic propagation are also included in the program. A functional description of the major subroutines is included and a sample run is provided with an explanation of the output.

  8. Using the phacoemulsification crescent knife in dacryocystorhinostomy.

    PubMed

    Fong, K S; Koh, A H; Choo, C T

    1998-04-01

    Dacryocystorhinostomy is an effective treatment for nasolacrimal duct obstruction. Most techniques employ a conventional blade or knife in making the incision of the nasal mucosa and lacrimal sac. The authors describe the use of a phacoemulsification crescent knife for this purpose. This technique can be effective and at the same time safer and easier to perform.

  9. Epiphora associated with dacryops in a dog.

    PubMed

    Grahn, B H; Mason, R A

    1995-01-01

    A six-month-old basset hound was presented with unilateral right epiphora and medial canthal and maxillary bone swelling. Skull radiographs and dacryocystorhinography revealed a nasal cyst, right nasolacrimal duct dilatation, and obstruction. Laboratory examination of the cyst confirmed the diagnosis of dacryops, a cyst of lacrimal gland origin. The cyst was treated successfully with surgical drainage and curettage.

  10. Office-based Management of Recurrent Respiratory Papilloma.

    PubMed

    Motz, Kevin M; Hillel, Alexander T

    2016-06-01

    This review will highlight the indications and benefits of office-based therapy for recurrent respiratory papillomatosis (RRP) and discuss the utilization of photo-dynamic lasers and adjuvant medical therapy in office-based settings. Office-based management of RRP allows for more timely interventions, is preferred by the majority of patients, and negates the risk of general anesthesia. Current literature argues for the utilization of KTP laser over CO 2 laser for office-based treatment of RRP. Medical therapies for RRP are limited, but agents such as bevacizumab are promising and have been shown to reduce disease burden. Medical therapies that can induce disease remission are still needed. Office-based procedures save time and healthcare expenses compared to like procedures in the operating room. However, the increased frequency for office-based procedures predicts similar overall healthcare costs for office-based and OR laser excision of RRP. Office-based management of RRP is a feasible and well-tolerated strategy in appropriately selected patients with adequate local anesthesia.

  11. Lightweight Valve Closes Duct Quickly

    NASA Technical Reports Server (NTRS)

    Fournier, Walter L.; Burgy, N. Frank

    1991-01-01

    Expanding balloon serves as lightweight emergency valve to close wide duct. Uninflated balloon stored in housing of duct. Pad resting on burst diaphragm protects balloon from hot gases in duct. Once control system triggers valve, balloon inflates rapidly to block duct. Weighs much less than does conventional butterfly, hot-gas, or poppet valve capable of closing duct of equal diameter.

  12. Management of functional epiphora in patients with an anatomically patent dacryocystorhinostomy.

    PubMed

    Shams, Pari N; Chen, Philip G; Wormald, Peter J; Sloan, Brian; Wilcsek, Geoff; McNab, Alan; Selva, Dinesh

    2014-09-01

    Approximately 5% to 10% of patients continue to experience persistent epiphora following an anatomically successful dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction or stenosis. To investigate the management and success rate of so-called "functional failure" of DCR for nasolacrimal duct obstruction by experienced lacrimal surgeons. Multicenter retrospective case series including 5 Australian and New Zealand centers. Participants included 61 patients (71% women [n = 46]; mean age, 66 years) with functional epiphora after 65 DCRs (69% transnasal) who were recruited over a mean of 7.6 years. Inclusion criteria included confirmed preoperative diagnosis of nasolacrimal duct obstruction or stenosis, age greater than 18 years, recurrent or persistent epiphora after DCR, an anatomically successful DCR, and follow-up longer than 6 months. Exclusion criteria included evidence of lacrimal hypersecretion, eyelid malposition, and punctal or canalicular abnormalities. The number, type, timing, and success of all clinical interventions performed for the management of functional epiphora after DCR. Epiphora recurred a mean of 8.9 months after primary DCR; 89% of the cases (n = 58) had evidence of a patent ostium and 100% were patent on lacrimal irrigation. Intubation with a lacrimal stent was performed in 82% of the cases at the time of surgery, and all stents were removed a mean of 8 weeks postoperatively. Epiphora was reported immediately following DCR in 32% (n = 21) of the cases and within 6 weeks after removal of the stent in 31% (n = 20); late recurrence (>12 months after DCR) developed in 37% (n = 24) of the cases. In a total of 15% of the cases, participants declined any treatment following DCR. The remainder underwent a mean of 1.3 interventions (range, 1-3) during a mean of 23 to 41 months after primary DCR, following which 72% (n = 47) of the cases had a successful outcome; 12% (n = 8) failed to achieve improvement, and the patients declined further

  13. Silver zeolite antimicrobial activity in aluminium heating, ventilation and air conditioning system ducts.

    PubMed

    Rizzetto, R; Mansi, A; Panatto, D; Rizzitelli, E; Tinteri, C; Sasso, T; Gasparini, R; Crovari, P

    2008-03-01

    Air pollution in confined environments is a serious health problem, in that most people spend long periods indoors (in homes, offices, classrooms etc.). Some people (children, the elderly, heart disease patients, asthmatic or allergic subjects) are at greater risk because of their conditions of frailty. The growing use of air-conditioning systems in many public and private buildings aggravates this health risk, especially when these systems are not correctly installed or regularly serviced. The aim of our study was to verify the capacity of Ag+ ions to stop the growth of bacteria and moulds inside the ducts of Heating, Ventilation and Air Conditioning system ducts (HVAC) systems when these ducts were lined with active Ag+ ions zeolite-coated panels. A Y-shaped HVAC model with two branches was used; one branch was made of traditional galvanized iron, as was the whole system, while the other was lined with active Ag+ zeolite-coated polyurethane panels. During the test, samples of dust present inside both ducts were collected and seeded in liquid and solid media to detect bacteria and moulds. The presence of bacteria was also sought in the air emerging from the outlets of both ducts. Tests made on samples of particulate collected from the two different ducts revealed a lower total bacterial load in the samples collected from the Ag+ zeolite-coated duct than in the samples from the traditional Zn galvanized duct. In addition, the values of bacterial load found in the air emerging from the Ag+ ions zeolite-lined duct were 5 times lower than those found in the air from the traditional galvanized iron duct. The utilization of Ag+ zeolite-coated panels in air-conditioning systems could improve the quality of the emerging air in comparison with traditional installations in galvanized iron. This innovation could prove particularly advantageous in the event of accidents during the installation of air-conditioning systems or of contaminated aerosols coming from outside.

  14. Patent vitellointestinal duct

    PubMed Central

    Agrawal, Sanwar; Memon, Ameen

    2010-01-01

    During the 3rd week of intrauterine life there is a communication between the intraembryonic gut and the yolk sac. As the development proceeds this communication narrows into a tube known as the vitellointestinal duct (VID). With the establishment of placental nutrition this duct usually becomes obliterated by the end of the 7th week of intrauterine life. In about 2% of humans this duct persists and gives rise to a group of anomalies of which Meckel's diverticulum is the commonest and complete patency of the duct is the rarest.1 We report a case of a 4-month-old infant who presented with umbilical polyp, discharge from the umbilicus, significant dehydration and failure to thrive because of complete patency of the VID PMID:22778111

  15. Choleperitoneum due to intrahepatic bile duct rupture - case report.

    PubMed

    Simion, L; Straja, Dn; Prunoiu, Vm; Alecu, M; Brătucu, E

    2014-01-01

    Non-traumatic perforations of the bile ducts are unfrequently encountered entities, all the more when they affect the intrahepatic bile ducts, exteriorizing their biliary content in the great peritoneal cavity. Reporting such a case has determined the authors to perform a careful overview of the cases present in the literature. An observation that can be made based on these is that the obstruction of the main bile duct due to lithiasis determines, by pressure increase, the dilation of the bile system branches, all on the background of an unknown malformation of the intrahepatic bile ducts. Celsius.

  16. [Clinicopathologic features of drug-induced vanishing bile duct syndrome].

    PubMed

    Ye, L H; Wang, C K; Zhang, H C; Liu, Z Q; Zheng, H W

    2017-04-20

    Vanishing bile duct syndrome (VBDS) manifests as progressive destruction and disappearance of the intrahepatic bile duct caused by various factors and cholestasis. VBDS associated with drug-induced liver injury (D-VBDS) is an important etiology of VBDS, and immune disorder or immune imbalance may be the main pathogenesis. According to its clinical symptoms, serological markers, and course of the disease, D-VBDS is classified into major form and minor form, and its clinical features are based on various pathomorphological findings. Its prognosis is associated various factors including regeneration of bile duct cells, number of bile duct injuries, level and range of bile duct injury, bile duct proliferation, and compensatory shunt of bile duct branches. This disease has various clinical outcomes; most patients have good prognosis after drug withdrawal, and some patients may experience cholestatic cirrhosis, liver failure, and even death. Due to the clinical manifestation and biochemical changes are similar to the primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), it need to identify by clinical physician.

  17. Performance prediction of a ducted rocket combustor

    NASA Astrophysics Data System (ADS)

    Stowe, Robert

    2001-07-01

    The ducted rocket is a supersonic flight propulsion system that takes the exhaust from a solid fuel gas generator, mixes it with air, and burns it to produce thrust. To develop such systems, the use of numerical models based on Computational Fluid Dynamics (CFD) is increasingly popular, but their application to reacting flow requires specific attention and validation. Through a careful examination of the governing equations and experimental measurements, a CFD-based method was developed to predict the performance of a ducted rocket combustor. It uses an equilibrium-chemistry Probability Density Function (PDF) combustion model, with a gaseous and a separate stream of 75 nm diameter carbon spheres to represent the fuel. After extensive validation with water tunnel and direct-connect combustion experiments over a wide range of geometries and test conditions, this CFD-based method was able to predict, within a good degree of accuracy, the combustion efficiency of a ducted rocket combustor.

  18. Duct-to-duct biliary reconstruction after radical resection of Bismuth IIIa hilar cholangiocarcinoma.

    PubMed

    Wu, Wen-Guang; Gu, Jun; Dong, Ping; Lu, Jian-Hua; Li, Mao-Lan; Wu, Xiang-Song; Yang, Jia-Hua; Zhang, Lin; Ding, Qi-Chen; Weng, Hao; Ding, Qian; Liu, Ying-Bin

    2013-04-21

    At present, radical resection remains the only effective treatment for patients with hilar cholangiocarcinoma. The surgical approach for R0 resection of hilar cholangiocarcinoma is complex and diverse, but for the biliary reconstruction after resection, almost all surgeons use Roux-en-Y hepaticojejunostomy. A viable alternative to Roux-en-Y reconstruction after radical resection of hilar cholangiocarcinoma has not yet been proposed. We report a case of performing duct-to-duct biliary reconstruction after radical resection of Bismuth IIIa hilar cholangiocarcinoma. End-to-end anastomosis between the left hepatic duct and the distal common bile duct was used for the biliary reconstruction, and a single-layer continuous suture was performed along the bile duct using 5-0 prolene. The patient was discharged favorably without biliary fistula 2 wk later. Evidence for tumor recurrence was not found after an 18 mo follow-up. Performing bile duct end-to-end anastomosis in hilar cholangiocarcinoma can simplify the complex digestive tract reconstruction process.

  19. Radiopaque biodegradable stent for duct-to-duct biliary reconstruction in pigs.

    PubMed

    Tanimoto, Yoshisato; Tashiro, Hirotaka; Mikuriya, Yoshihiro; Kuroda, Shintaro; Hashimoto, Masakazu; Kobayashi, Tsuyoshi; Taniura, Tokunori; Ohdan, Hideki

    2016-06-01

    Biliary stricture is a common cause of morbidity after liver transplantation. We previously developed a duct-to-duct biliary anastomosis technique using a biodegradable stent tube and confirmed the feasibility and safety of biliary stent use. However, the duration and mechanism of biliary stent absorption in the common bile duct remain unclear. Radiopaque biodegradable biliary stents were created using a copolymer of L-lactide and ε-caprolactone (70: 30) and coated with barium sulfate. Stents were surgically implanted in the common bile duct of 11 pigs. Liver function tests and computed tomography (CT) scans were performed postoperatively, and autopsies were conducted 6 months after biliary stent implantation. After the surgery, all 11 pigs had normal liver function and survived without any significant complications such as biliary leakage. A CT scan at 2 months post-procedure showed that the biliary stents were located in the hilum of the liver. The stents were not visible by CT scan at the 6-month follow-up examination. The surgical implantation of radiopaque biodegradable biliary stents in biliary surgery represents a new option for duct-to-duct biliary reconstruction. This technique appears to be feasible and safe and is not associated with any significant biliary complications. The advantage of coated biliary stent use is that it may be visualized using abdominal radiography such as CT.

  20. CFD-Based Design of Turbopump Inlet Duct for Reduced Dynamic Loads

    NASA Technical Reports Server (NTRS)

    Rothermel, Jeffry; Dorney, Suzanne M.; Dorney, Daniel J.

    2003-01-01

    Numerical simulations have been completed for a variety of designs for a 90 deg elbow duct. The objective is to identify a design that minimizes the dynamic load entering a LOX turbopump located at the elbow exit. Designs simulated to date indicate that simpler duct geometries result in lower losses. Benchmark simulations have verified that the compressible flow codes used in this study are applicable to these incompressible flow simulations.

  1. Reciprocity principle in duct acoustics

    NASA Technical Reports Server (NTRS)

    Cho, Y.-C.

    1979-01-01

    Various reciprocity relations in duct acoustics have been derived on the basis of the spatial reciprocity principle implied in Green's functions for linear waves. The derivation includes the reciprocity relations between mode conversion coefficients for reflection and transmission in nonuniform ducts, and the relation between the radiation of a mode from an arbitrarily terminated duct and the absorption of an externally incident plane wave by the duct. Such relations are well defined as long as the systems remain linear, regardless of acoustic properties of duct nonuniformities which cause the mode conversions.

  2. Bile Duct Cancer

    MedlinePlus

    ... the liver get rid of toxins and wastes. Bile duct cancer is rare. It can happen in the parts ... Itchy skin Fever Abdominal pain Tests to diagnose bile duct cancer may include a physical exam, imaging tests of ...

  3. Reference values of MRI measurements of the common bile duct and pancreatic duct in children.

    PubMed

    Gwal, Kriti; Bedoya, Maria A; Patel, Neal; Rambhatla, Siri J; Darge, Kassa; Sreedharan, Ram R; Anupindi, Sudha A

    2015-07-01

    Magnetic resonance imaging/cholangiopancreatography (MRI/MRCP) is now an essential imaging modality for the evaluation of biliary and pancreatic pathology in children, but there are no data depicting the normal diameters of the common bile duct (CBD) and pancreatic duct. Recognition of abnormal duct size is important and the increasing use of MRCP necessitates normal MRI measurements. To present normal MRI measurements for the common bile duct and pancreatic duct in children. In this retrospective study we searched all children ages birth to 10 years in our MR urography (MRU) database from 2006 until 2013. We excluded children with a history of hepatobiliary or pancreatic surgery. We stratified 204 children into five age groups and retrospectively measured the CBD and the pancreatic duct on 2-D axial and 3-D coronal T2-weighted sequences. We performed statistical analysis, using logistic and linear regressions to detect the age association of the visibility and size of the duct measurements. We used non-parametric tests to detect gender and imaging plane differences. Our study included 204 children, 106 (52%) boys and 98 (48%) girls, with a median age of 33 months (range 0-119 months). The children were distributed into five age groups. The common bile duct was visible in all children in all age groups. The pancreatic duct was significantly less visible in the youngest children, group 1 (54/67, 80.5%; P = 0.003) than in the oldest children, group 5 (22/22, 100%). In group 2 the pancreatic duct was seen in 19/21 (90.4%), in group 3 52/55 (94.5%), and in group 4 39/39 (100%). All duct measurements increased with age (P < 0.001; r-value > 0.423), and the incremental differences between ages were significant. The measurement variations between the axial and coronal planes were statistically significant (P < 0.001); however these differences were fractions of millimeters. For example, in group 1 the mean coronal measurement of the CBD was 2.1 mm and

  4. Bile duct stricture

    MedlinePlus

    ... duct, the tube that moves bile from the liver to the small intestine. Bile is a substance that helps with digestion. ... causes of this condition include: Cancer of the bile duct, liver or pancreas Damage and scarring due to a ...

  5. Investigation of the tone-burst tube for duct lining attenuation measurement

    NASA Technical Reports Server (NTRS)

    Soffel, A. R.; Morrow, P. F.

    1972-01-01

    The tone burst technique makes practical the laboratory evaluation of potential inlet and discharge duct treatments. Tone burst apparatus requires only simple machined parts and standard components. Small, simply made, lining samples are quickly and easily installed in the system. Two small electromagnetric loudspeaker drivers produce peak sound pressure level of over 166 db in the 3-square-inch sample duct. Air pump available in most laboratories can produce air flows of over plus and minus Mach 0.3 in the sample duct. The technique uses short shaped pulses of sound propagated down a progressive wave tube containing the sample duct. The peak pressure level output of the treated duct is compared with the peak pressure level output of a substituted reference duct. The difference between the levels is the attenuation or insertion loss of the treated duct. Evaluations of resonant absorber linings by the tone burst technique check attenuation values predicted by empirical formulas based on full scale ducts.

  6. Sealing ducts to save energy

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

    Siuru, B.

    1996-07-01

    Large amounts of energy are wasted when heat leaks through ductwork located in uninsulated spaces. The Electric Power Research INstitute recently did a study that accurately measured these losses, then substantially reduced them by sealing the leaky ductwork. Six homes in the Pacific Northwest with significant duct leakage to the outside were selected for the study. The homes had electric resistance or heat pump, forced-air heating systems with a major portion of the supply and return ductwork in crawl spaces, attics, garages, etc. Measurements of duct leakage and heating system efficiency were done on all the homes before starting themore » duct sealing. Retrofitting included finding holes, gaps, cracks and disconnected joints in supply and return ducts as well as in plenums. When necessary, plenums were cut open for repairs. Leaks were sealed with Latex mastic and fiberglass tape. Outside ducts were covered or wrapped with insulation. Unducted returns were sealed with duct board. In some cases, leakage was corrected by merely reconnecting ducts and boots.« less

  7. Albumin expression distinguishes bile duct adenomas from metastatic adenocarcinoma.

    PubMed

    Moy, Andrea P; Arora, Kshitij; Deshpande, Vikram

    2016-09-01

    Bile duct adenomas may be difficult to distinguish from metastatic carcinomas, particularly well-differentiated pancreatic ductal adenocarcinoma. Prior studies have evaluated the utility of various immunohistochemical markers, although these markers are notable for low sensitivity and/or specificity. The aim of this study was to investigate the utility of albumin and BRAFV600E expression in distinguishing between metastatic pancreatic adenocarcinoma and bile duct adenoma. We studied 26 bile duct adenomas, three bile duct hamartomas, and 158 pancreatic ductal adenocarcinomas. Branched-chain in-situ hybridization (bISH) for albumin was performed; bISH is based on the branched DNA technology, wherein signal amplification is achieved via a series of sequential steps. Additionally, BRAFV600E immunohistochemistry (IHC) was performed on a subset of cases. Twenty-three of 25 (92%) bile duct adenomas were positive for albumin; 18 (72%) showed diffuse staining, and five showed focal staining (20%), including two challenging examples. Two bile duct hamartomas also stained positively. All pancreatic adenocarcinomas were negative for albumin. Seven of 16 (44%) bile duct adenomas and five of 106 (5%) pancreatic ductal adenocarcinomas were positive for BRAFV600E by IHC. The sensitivity and specificity of expression of albumin, as detected by bISH, for distinguishing bile duct adenomas from metastatic pancreatic adenocarcinomas were 92% and 100%, respectively; the sensitivity and specificity of BRAFV600E IHC for distinguishing bile duct adenomas from metastatic pancreatic adenocarcinomas were 43.8% and 95.3%, respectively. Diagnostically challenging examples of bile duct adenoma may be distinguished from metastatic pancreatic adenocarcinoma by the use of albumin bISH. © 2016 John Wiley & Sons Ltd.

  8. Ducted fuel injection

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

    Mueller, Charles J.

    Various technologies presented herein relate to enhancing mixing inside a combustion chamber to form one or more locally premixed mixtures comprising fuel and charge-gas with low peak fuel to charge-gas ratios to enable minimal, or no, generation of soot and other undesired emissions during ignition and subsequent combustion of the locally premixed mixtures. To enable sufficient mixing of the fuel and charge-gas, a jet of fuel can be directed to pass through a bore of a duct causing charge-gas to be drawn into the bore creating turbulence to mix the fuel and the drawn charge-gas. The duct can be locatedmore » proximate to an opening in a tip of a fuel injector. The duct can comprise of one or more holes along its length to enable charge-gas to be drawn into the bore, and further, the duct can cool the fuel and/or charge-gas prior to combustion.« less

  9. Bile duct anastomotic stricture after pediatric living donor liver transplantation.

    PubMed

    Chok, Kenneth S H; Chan, See Ching; Chan, Kwong Leung; Sharr, William W; Tam, Paul K H; Fan, Sheung Tat; Lo, Chung Mau

    2012-07-01

    Hepaticojejunostomy is a well-accepted method, whereas duct-to-duct anastomosis is gaining popularity for bile duct reconstruction in pediatric living donor liver transplantation (LDLT). Biliary complications, especially biliary anastomotic stricture (BAS), are not clearly defined. The aim of the present study is to determine the rate of BAS and its associated risk factors. The study included 78 pediatric patients (<18 years old) who underwent LDLT during the period from end of September 1993 to end of November 2010. The diagnosis of BAS was based on clinical, biochemical, histologic, and radiologic results. All patients received left-side grafts. Thirteen patients (16.7%) developed BAS after LDLT. Among them, 3 patients (23.1%) had duct-to-duct anastomosis during LDLT. The median follow-up period for the BAS group and the non-BAS group was 57.8 and 79.5 months, respectively (P = .683). Ten of the patients with BAS required percutaneous transhepatic biliary drainage with or without dilatation for treating the stricture. Multivariable analysis showed that hepatic artery thrombosis and duct-to-duct anastomosis were 2 risk factors associated with BAS. In pediatric LDLT, hepaticojejunostomy is the preferred method for bile duct reconstruction, but more large-scale research needs to be done to reconfirm this result. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Optimizing Electrospray Interfaces Using Slowly Diverging Conical Duct (ConDuct) Electrodes

    PubMed Central

    Krutchinsky, Andrew N.; Padovan, Júlio C.; Cohen, Herbert; Chait, Brian T.

    2015-01-01

    We demonstrate that the efficiency of ion transmission from atmosphere to vacuum through stainless steel electrodes that contain slowly divergent conical duct (ConDuct) channels can be close to 100%. Here, we explore the properties of 2.5 cm long electrodes with angles of divergence of 0°, 1°, 2°, 3°, 5°, 8°, 13°, and 21°, respectively. The ion transmission efficiency was observed to jump from 10–20% for the 0° (straight) channels to 90–95% for channels with an angle of divergence as small as 1°. Furthermore, the 2–3° ConDuct electrodes produced extraordinarily low divergence ion beams that propagated in a laser-like fashion over long distances in vacuum. To take advantage of these newly discovered properties, we constructed a novel atmosphere-to-vacuum ion interface utilizing a 2° ConDuct as an inlet electrode and compared its ion transmission efficiency with that of the interface used in the commercial (Thermo) Velos Orbitrap and Q Exactive mass spectrometers. We observed that the ConDuct interface transmitted up to 17 times more ions than the commercial reference interface and also yielded improved signal-to-noise mass spectra of peptides. We infer from these results that the performance of many current atmosphere-tovacuum interfaces utilizing metal capillaries can be substantially improved by replacing them with 1° or 2° metal ConDuct electrodes, which should preserve the convenience of supplying ion desolvation energy by heating the electrode while greatly increasing the efficiency of ion transmission into the mass spectrometer. PMID:25667060

  11. Optimizing Electrospray Interfaces Using Slowly Diverging Conical Duct (ConDuct) Electrodes

    NASA Astrophysics Data System (ADS)

    Krutchinsky, Andrew N.; Padovan, Júlio C.; Cohen, Herbert; Chait, Brian T.

    2015-04-01

    We demonstrate that the efficiency of ion transmission from atmosphere to vacuum through stainless steel electrodes that contain slowly divergent conical duct (ConDuct) channels can be close to 100%. Here, we explore the properties of 2.5-cm-long electrodes with angles of divergence of 0°, 1°, 2°, 3°, 5°, 8°, 13°, and 21°, respectively. The ion transmission efficiency was observed to jump from 10-20% for the 0° (straight) channels to 90-95% for channels with an angle of divergence as small as 1°. Furthermore, the 2-3° ConDuct electrodes produced extraordinarily low divergence ion beams that propagated in a laser-like fashion over long distances in vacuum. To take advantage of these newly discovered properties, we constructed a novel atmosphere-to-vacuum ion interface utilizing a 2° ConDuct as an inlet electrode and compared its ion transmission efficiency with that of the interface used in the commercial (Thermo Fisher Scientific, San Jose, CA, USA) Velos Orbitrap and Q Exactive mass spectrometers. We observed that the ConDuct interface transmitted up to 17 times more ions than the commercial reference interface and also yielded improved signal-to-noise mass spectra of peptides. We infer from these results that the performance of many current atmosphere-to-vacuum interfaces utilizing metal capillaries can be substantially improved by replacing them with 1° or 2° metal ConDuct electrodes, which should preserve the convenience of supplying ion desolvation energy by heating the electrode while greatly increasing the efficiency of ion transmission into the mass spectrometer.

  12. CFD-based Design of LOX Pump Inlet Duct for Reduced Dynamic Loads

    NASA Technical Reports Server (NTRS)

    Rothermel, Jeffry; Dorney, Daniel J.; Dorney, Suzanne M.

    2003-01-01

    Numerical simulations have been completed for a variety of designs for a 90 deg elbow duct. The objective is to identify a design that minimizes the dynamic load entering a LOX turbopump located at the elbow exit. Designs simulated to date indicate that simpler duct geometries result in lower losses. Benchmark simulations have verified that the compressible flow code used in this study is applicable to these incompressible flow simulations.

  13. Heat Transfer in Conical Corner and Short Superelliptical Transition Ducts

    NASA Technical Reports Server (NTRS)

    Poinsatte, Philip; Thurman, Douglas; Hippensteele, Steven

    2008-01-01

    Local surface heat transfer measurements were experimentally mapped using a transient liquid-crystal heat-transfer technique on the surface of two circular-to-rectangular transition ducts. One has a transition cross section defined by conical corners (Duct 1) and the other by an elliptical equation with changing coefficients (Duct 2). Duct 1 has a length-to-diameter ratio of 0.75 and an exit plane aspect ratio of 1.5. Duct 2 has a length-to-diameter ratio of 1.0 and an exit plane aspect ratio of 2.9. Test results are reported for various inlet-diameter-based Reynolds numbers ranging from 0.45 106 to 2.39 106 and two freestream turbulence intensities of about 1 percent, which is typical of wind tunnels, and up to 16 percent, which may be more typical of real engine conditions.

  14. Salivary duct carcinoma treated with cetuximab-based targeted therapy: A case report.

    PubMed

    Kawahara, Kenta; Hiraki, Akimitsu; Yoshida, Ryoji; Arita, Hidetaka; Matsuoka, Yuichiro; Yamashita, Toshio; Koga, Kan-Ichi; Nagata, Masashi; Hirosue, Akiyuki; Fukuma, Daiki; Nakayama, Hideki

    2017-06-01

    Salivary duct carcinoma is a highly aggressive disease with a poor prognosis. Surgical resection is currently the only curative treatment, as there is no effective systemic therapy for this malignancy. Recently, trastuzumab has been shown to exhibit therapeutic efficacy in the treatment of salivary duct carcinoma; similarly, molecularly targeted agents, such as cetuximab, are expected to be useful for salivary duct carcinoma treatment. We herein describe the case of a 56-year-old man diagnosed with salivary duct carcinoma in the left submandibular region, with ipsilateral multiple metastases to the neck lymph nodes. Radical resection of the tumor and submandibular gland with neck dissection were performed. One month after radical surgery, computed tomography (CT) scans indicated metastasis in the lower lobe of the left lung. CT-guided transthoracic fine-needle aspiration biopsy revealed a single metastasis and lung metastasectomy was immediately performed. The tumor cells of the primary lesion and those of the lung metastasis were immunohistochemically positive for epidermal growth factor receptor. One month later, multiple right lung metastases appeared, and the patient was treated with cisplatin/5-fluorouracil (5-FU) chemotherapy plus cetuximab, achieving a complete radiographic response. However, multiple lung metastases developed during adjuvant weekly cetuximab monotherapy. Subsequently, treatment with S-1 and weekly cetuximab was initiated, and the multiple lung metastases have been maintained as stable disease for 5 months. To the best of our knowledge, this is the first report of cetuximab use for the treatment of salivary duct carcinoma. Although cisplatin/5-FU chemotherapy plus cetuximab was efficacious in treating the lung metastasis, cetuximab monotherapy was insufficient for controlling tumor growth.

  15. Simple resection of the lesion bile duct branch for treatment of regional hepatic bile duct stones

    PubMed Central

    Enliang, Li; Rongshou, Wu; Shidai, Shi; Jingling, Zhang; Qian, Feng; Wenjun, Liao; Linquan, Wu

    2017-01-01

    Abstract To evaluate the effectiveness and safety of simple resections of bile duct branch lesions for the treatment of regional hepatic bile duct stones. A retrospective analysis of the clinical data from patients in our hospital from November 2008 to November 2015, who only underwent a simple resection of the lesion bile duct branch. The patients’ clinical characteristics, surgical features, postoperative complications, stone clear rate, residual stone rate, and recurrence stone rate were analyzed. This study of 32 patients included 13 males and 19 females with intrahepatic bile duct stones confined to the right hepatic bile duct branch. The intraoperative blood loss, operation time, and postoperative hospital stay were 478.0 ± 86.5, 210.7 ± 6.6, and 10.8 ± 3.5, respectively. Postoperative complications occurred in 6 patients (18.8%), all of whom recovered with conservative management. There were no deaths during hospitalization. The intraoperative stone clearance rate was 95.8%. Three patients had a recurrence of stones at a mean of 22 months of follow-up (range, 4–36 months). Simple resection of bile duct branch lesions is safe and feasible for patients who have regional hepatic bile duct stones limited to the right hepatic bile duct branches. PMID:28682899

  16. Eversion Bile Duct Anastomosis: A Safe Alternative for Bile Duct Size Discrepancy in Deceased Donor Liver Transplantation.

    PubMed

    Leal-Leyte, Pilar; McKenna, Greg J; Ruiz, Richard M; Anthony, Tiffany L; Saracino, Giovanna; Giuliano, Testa; Klintmalm, Goran B; Kim, Peter Tw

    2018-04-10

    Introduction Bile duct size discrepancy in liver transplantation may increase the risk of biliary complications. The aim of this study was to evaluate the safety and outcomes of the eversion bile duct anastomosis technique in deceased donor liver transplantation (DDLT) with duct to duct anastomosis. Methods A total of 210 patients who received a DDLT with duct to duct anastomosis from 2012 to 2017 were divided into two groups: those who had eversion bile duct anastomosis (N=70) and standard bile duct anastomosis (N=140). Biliary complications rates were compared between the two groups. Results There was no difference in the cumulative incidence of biliary strictures (P=0.20) and leaks (P=0.17) between the two groups. The biliary complication rate in the eversion group was 14.3% and 11.4% in the standard anastomosis group. All the biliary complications in the eversion group were managed with endoscopic stenting. A severe size mismatch (≥3:1 ratio) was associated with a significantly higher incidence of biliary strictures (44.4%) compared to 2:1 ratio (8.2%), (P=0.002). Conclusion The use of the eversion technique is a safe alternative for bile duct discrepancy in deceased donor liver transplantation; however, severe bile duct size mismatch may be a risk factor for biliary strictures with such technique. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.

  17. Bilateral congenital lacrimal fistulas in an adult as part of ectrodactyly-ectodermal dysplasia-clefting syndrome: A rare anomaly.

    PubMed

    Ghosh, Debangshu; Saha, Somnath; Basu, Sumit Kumar

    2015-10-01

    Ectrodactyly-ectodermal dysplasia and clefting syndrome or "Lobster claw" deformity is a rare congenital anomaly that affects tissues of ectodermal and mesodermal origin. Nasolacrimal duct (NLD) obstruction with or without atresia of lacrimal passage is a common finding of such a syndrome. The authors report here even a rarer presentation of the syndrome which manifested as bilateral NLD obstruction and lacrimal fistula along with cleft lip and palate, syndactyly affecting all four limbs, mild mental retardation, otitis media, and sinusitis. Lacrimal duct obstruction and fistula were managed successfully with endoscopic dacryocystorhinostomy (DCR) which is a good alternative to lacrimal probing or open DCR in such a case.

  18. Carcinosarcoma of the Extrahepatic Bile Duct Presenting with Stone-like Radiological Findings.

    PubMed

    Kumei, Shinsuke; Onishi, Yutaka; Ogura, Takeshi; Kusumoto, Chosei; Matsuno, Yasuko; Nishigami, Takashi; Maeda, Mitsuo; Harada, Masaru

    2015-01-01

    A 73-year-old woman was referred to our hospital due to epigastralgia and jaundice. The radiological findings showed a stone-like tumor in the extrahepatic bile duct. The patient was initially thought to have adenocarcinoma of the bile duct based on the findings of a pathological examination of the bile duct biopsy specimen and underwent pancreaticoduodenectomy; the final diagnosis of the lesion was so-called carcinosarcoma of the extrahepatic bile duct. She died of liver metastasis six months after the surgery. This case suggests that surgical resection is not adequate for achieving a radical cure, and the optimal treatment for extrahepatic bile duct carcinosarcoma should be established immediately.

  19. Photoneutron radiation field of ducts in barrier of 15 MV medical electron accelerators

    NASA Astrophysics Data System (ADS)

    Deng, Lei; Zhou, Ning; Chen, Yi-shui; Tu, Yu

    2017-11-01

    Shielding body of the high-energy medical electron accelerators is always penetrated by ducts, which would influence the shielding capability of local barrier. In order to quantitatively analyze the duct's impact on shielding of the photoneutron from 15 MV accelerators, the ambient dose equivalent rate and energy spectrum at the center of a typical duct and the external mouth of duct were calculated based on MCNP program for the first time. The results demonstrate that leakage neutrons at the external mouth of duct are mainly thermal neutron, and its dose rate is decreased with the increase of the intersection angle between duct and wall as well as the reduction of duct diameter. When a duct in a diameter no more than 30 cm penetrates the wall unidirectionally and the inclined Angle (θ) is 60°, neutron dose rate at the external mouth of duct could meet the requirements of protection. At last, according to the calculation results, some suggestions are proposed for the shielding design of ducts in walls.

  20. Flow in curved ducts of varying cross-section

    NASA Astrophysics Data System (ADS)

    Sotiropoulos, F.; Patel, V. C.

    1992-07-01

    Two numerical methods for solving the incompressible Navier-Stokes equations are compared with each other by applying them to calculate laminar and turbulent flows through curved ducts of regular cross-section. Detailed comparisons, between the computed solutions and experimental data, are carried out in order to validate the two methods and to identify their relative merits and disadvantages. Based on the conclusions of this comparative study a numerical method is developed for simulating viscous flows through curved ducts of varying cross-sections. The proposed method is capable of simulating the near-wall turbulence using fine computational meshes across the sublayer in conjunction with a two-layer k-epsilon model. Numerical solutions are obtained for: (1) a straight transition duct geometry, and (2) a hydroturbine draft-tube configuration at model scale Reynolds number for various inlet swirl intensities. The report also provides a detailed literature survey that summarizes all the experimental and computational work in the area of duct flows.

  1. Office-based surgery: embracing patient safety strategies.

    PubMed

    Shapiro, Fred E; Punwani, Nathan; Urman, Richard D

    2013-01-01

    Office-based surgery continues to grow as more procedures are being performed in the outpatient setting. With this exponential growth, there is an increasing emphasis on safe and effective patient care. Current research shows both gaps in safety and opportunities for improvement. Practice managers, clinicians, and other personnel should be cognizant that office procedures are coming under intense regulatory scrutiny. Effective strategies to maintain quality and patient safety include the use of checklists, obtaining office accreditation, encouraging board-certification and proper credentialing of proceduralists, and appropriate patient and procedure selection. There is increasing regulation of ambulatory surgery on state and national levels that will likely affect the financial and care quality aspects of office-based practice. Socioeconomic and political forces will continue to shape the future of office-based surgery.

  2. Validation of a spectrophotometer-based method for estimating daily sperm production and deferent duct transit.

    PubMed

    Froman, D P; Rhoads, D D

    2012-10-01

    The objectives of the present work were 3-fold. First, a new method for estimating daily sperm production was validated. This method, in turn, was used to evaluate testis output as well as deferent duct throughput. Next, this analytical approach was evaluated in 2 experiments. The first experiment compared left and right reproductive tracts within roosters. The second experiment compared reproductive tract throughput in roosters from low and high sperm mobility lines. Standard curves were constructed from which unknown concentrations of sperm cells and sperm nuclei could be predicted from observed absorbance. In each case, the independent variable was based upon hemacytometer counts, and absorbance was a linear function of concentration. Reproductive tracts were excised, semen recovered from each duct, and the extragonadal sperm reserve determined by multiplying volume by sperm cell concentration. Testicular sperm nuclei were procured by homogenization of a whole testis, overlaying a 20-mL volume of homogenate upon 15% (wt/vol) Accudenz (Accurate Chemical and Scientific Corporation, Westbury, NY), and then washing nuclei by centrifugation through the Accudenz layer. Daily sperm production was determined by dividing the predicted number of sperm nuclei within the homogenate by 4.5 d (i.e., the time sperm with elongated nuclei spend within the testis). Sperm transit through the deferent duct was estimated by dividing the extragonadal reserve by daily sperm production. Neither the efficiency of sperm production (sperm per gram of testicular parenchyma per day) nor deferent duct transit differed between left and right reproductive tracts (P > 0.05). Whereas efficiency of sperm production did not differ (P > 0.05) between low and high sperm mobility lines, deferent duct transit differed between lines (P < 0.001). On average, this process required 2.2 and 1.0 d for low and high lines, respectively. In summary, we developed and then tested a method for quantifying male

  3. 91. VIEW OF OBSOLETE AIRCONDITIONING DUCTS LOCATED IN NORTHWEST CORNER ...

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

    91. VIEW OF OBSOLETE AIR-CONDITIONING DUCTS LOCATED IN NORTHWEST CORNER OF ROOM, ABOVE SLC-3E AUTOPILOT EQUIPMENT. DIGITAL COUNTDOWN AND HOLD CLOCKS ON WALL LEFT OF DUCTS - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  4. Double-duct liquid metal magnetohydrodynamic engine

    DOEpatents

    Haaland, Carsten M.

    1995-01-01

    An internal combustion, liquid metal (LM) magnetohydrodynamic (MHD) engine and an alternating current (AC) magnetohydrodynamic generator, are used in combination to provide useful AC electric energy output. The engine design has-four pistons and a double duct configuration, with each duct containing sodium potassium liquid metal confined between free pistons located at either end of the duct. The liquid metal is forced to flow back and forth in the duct by the movement of the pistons, which are alternatively driven by an internal combustion process. In the MHD generator, the two LM-MHD ducts pass in close proximity through a Hartmann duct with output transformer. AC power is produced by operating the engine with the liquid metal in the two generator ducts always flowing in counter directions. The amount of liquid metal maintained in the ducts may be varied. This provides a variable stroke length for the pistons. The engine/generator provides variable AC power at variable frequencies that correspond to the power demands of the vehicular propulsion. Also the engine should maintain nearly constant efficiency throughout the range of power usage. Automobiles and trucks could be powered by the invention, with no transmission or power converter devices being required.

  5. Double-duct liquid metal magnetohydrodynamic engine

    DOEpatents

    Haaland, Carsten M.

    1997-01-01

    An internal combustion, liquid metal (LM) magnetohydrodynamic (MHD) engine and an alternating current (AC) magnetohydrodynamic generator, are used in combination to provide useful AC electric energy output. The engine design has four pistons and a double duct configuration, with each duct containing sodium potassium liquid metal confined between free pistons located at either end of the duct. The liquid metal is forced to flow back and forth in the duct by the movement of the pistons, which are alternatively driven by an internal combustion process. In the MHD generator, the two LM-MHD ducts pass in close proximity through a Hartmann duct with output transformer. AC power is produced by operating the engine with the liquid metal in the two generator ducts always flowing in counter directions. The amount of liquid metal maintained in the ducts may be varied. This provides a variable stroke length for the pistons. The engine/generator provides variable AC power at variable frequencies that correspond to the power demands of the vehicular propulsion. Also the engine should maintain nearly constant efficiency throughout the range of power usage. Automobiles and trucks could be powered by the invention, with no transmission or power converter devices being required.

  6. Perceived office environments and occupational physical activity in office-based workers.

    PubMed

    Sawyer, A; Smith, L; Ucci, M; Jones, R; Marmot, A; Fisher, A

    2017-06-01

    Individuals in office-based occupations have low levels of physical activity but there is little research into the socio-ecological correlates of workplace activity. To identify factors contributing to office-based workers' perceptions of the office environment and explore cross-sectional relationships between these factors and occupational physical activity. Participants in the Active Buildings study reported perceptions of their office environment using the Movement at Work Survey. A principal component analysis (PCA) was conducted on survey items. A sub-sample wore the ActivPAL3TM accelerometer for ≥3 workdays to measure occupational step count, standing, sitting and sit-to-stand transitions. Linear regression analyses assessed relationships between environmental perceptions and activity. There were 433 participants, with accelerometer data available for 115 participants across 11 organ izations. The PCA revealed four factors: (i) perceived distance to office destinations, (ii) perceived office aesthetics and comfort, (iii) perceived office social environment and (iv) perceived management discouragement of unscheduled breaks. Younger participants perceived office destinations as being closer to their desk. Younger and female participants perceived more positive office social environments; there were no other socio-demographic differences. Within the sub-sample with accelerometer data, perceived discouragement of breaks by management was related to occupational step count/hour (B = -64.5; 95% CI -109.7 to -19.2). No other environmental perceptions were related to activity or sitting. Perceived managerial discouragement of breaks could be related to meaningful decreases in occupational step count. Future research should aim to elucidate the role of the workplace socio-cultural environment in occupational walking, with a focus on the role of management. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All

  7. McArthur removes AAA clamps and ducts inside the CHeCS Rack during Expedition 12

    NASA Image and Video Library

    2005-12-09

    ISS012-E-10817 (9 December 2005) --- Astronaut William S. (Bill) McArthur Jr., Expedition 12 commander and NASA space station science officer, opens the back panel of the Crew Health Care System (CHeCS) rack and removes the Avionics Air Assembly (AAA) air ducts during in-flight maintenance (IFM) in the Destiny laboratory of the International Space Station.

  8. Heat Transfer in a Superelliptic Transition Duct

    NASA Technical Reports Server (NTRS)

    Poinsatte, Philip; Thurman, Douglas; Hippensteele, Steven

    2008-01-01

    Local heat transfer measurements were experimentally mapped using a transient liquid-crystal heat transfer technique on the surface of a circular-to-rectangular transition duct. The transition duct had a length-to-diameter ratio of 1.5 and an exit-plane aspect ratio of 3. The crosssectional geometry was defined by the equation of a superellipse. The cross-sectional area was the same at the inlet and exit but varied up to 15 percent higher through the transition. The duct was preheated to a uniform temperature (nominally 64 C) before allowing room temperature air to be suddenly drawn through it. As the surface cooled, the resulting isothermal contours on the duct surface were revealed using a surface coating of thermochromic liquid crystals that display distinctive colors at particular temperatures. A video record was made of the surface temperature and time data for all points on the duct surfaces during each test. Using this surface temperature-time data together with the temperature of the air flowing through the model and the initial temperature of the model wall, the heat transfer coefficient was calculated by employing the classic one-dimensional, semi-infinite wall heat transfer conduction model. Test results are reported for inlet diameter-based Reynolds numbers ranging from 0.4x106 to 2.4x106 and two grid-generated freestream turbulence intensities of about 1 percent, which is typical of wind tunnels, and up to 16 percent, which may be more typical of real engine conditions.

  9. Office-based anesthesia for the urologist.

    PubMed

    Galway, Ursula; Borkowski, Raymond

    2013-11-01

    This article describes office-based surgery and office-based anesthesia (OBA), including the safe setup of OBA and safety concerns regarding OBA. Also discussed are the preoperative selection and workup of a patient undergoing OBA, anesthetic options, the prevention and treatment of postoperative nausea, vomiting, and pain, and planning for safe discharge. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. HAARP-Induced Ionospheric Ducts

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

    Milikh, Gennady; Vartanyan, Aram

    2011-01-04

    It is well known that strong electron heating by a powerful HF-facility can lead to the formation of electron and ion density perturbations that stretch along the magnetic field line. Those density perturbations can serve as ducts for ELF waves, both of natural and artificial origin. This paper presents observations of the plasma density perturbations caused by the HF-heating of the ionosphere by the HAARP facility. The low orbit satellite DEMETER was used as a diagnostic tool to measure the electron and ion temperature and density along the satellite orbit overflying close to the magnetic zenith of the HF-heater. Thosemore » observations will be then checked against the theoretical model of duct formation due to HF-heating of the ionosphere. The model is based on the modified SAMI2 code, and is validated by comparison with well documented experiments.« less

  11. Reimbursement for office-based gynecologic procedures.

    PubMed

    Pritzker, Jordan

    2013-12-01

    Reimbursement for office-based gynecologic procedures varies with the contractual obligations that the physician has with the payers involved with the care of the particular patient. The payers may be patients without health insurance coverage (self-pay) or patients with third-party health insurance coverage, such as an employer-based commercial insurance carrier or a government program (eg, Medicare [federal] or Medicaid [state based]). This article discusses the reimbursement for office-based gynecologic procedures by third-party payers. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Duct having oscillatory side wall

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

    Sprouse, Kenneth M.

    A pump system includes a particulate consolidator pump that has a pump outlet. A duct is coupled to the pump outlet. The duct has a wall that is coupled with an oscillator. The oscillator is operable to oscillate the wall at a controlled frequency. The controlled frequency is selected with respect to breaking static bridging of particulate in the duct due, at least in part, to consolidation of the particulate from a downstream check valve.

  13. A case of annular pancreas with Wirsung's duct encircling the duodenum: embryological hypothesis based on cholangiopancreatographic and immunohistochemical findings.

    PubMed

    Fukai, Manami; Kamisawa, Terumi; Horiguchi, Shin-Ichirou; Hishima, Tsunekazu; Kuruma, Sawako; Chiba, Kazuro; Koizumi, Satomi; Tabata, Taku; Nagao, Sayaka; Kikuyama, Masataka; Honda, Goro; Kurata, Masanao

    2017-06-01

    We present a resected case of annular pancreas in which Wirsung's duct encircled the duodenum and continued directly to the main pancreatic duct in the body and tail. Furthermore, Wirsung's duct coursed along the right side of the lower bile duct near the major duodenal papilla. Histologically, the islets of Langerhans in the annular pancreas were irregular in shape and were characterized by a striking abundance of pancreatic polypeptide (PP)-positive cells. The PP-rich area that encircled the duodenum was fused with the PP-poor area in the head of the pancreas. The following embryological hypothesis is proposed. The tip of the ventral pancreatic anlage adhered to the duodenal wall and stretched to form a ring during clockwise rotation. The rotation was incomplete, and the pancreatic duct did not cross over the lower bile duct. Since there was adequate ventral anlage in the lower part of the head of the pancreas, fusion between the ducts of the ventral and dorsal anlagen did not occur. The tip of the ventral anlage overgrew and adhered to the dorsal anlage, and the annular duct fused with the main duct of the dorsal anlage.

  14. Using the surface panel method to predict the steady performance of ducted propellers

    NASA Astrophysics Data System (ADS)

    Cai, Hao-Peng; Su, Yu-Min; Li, Xin; Shen, Hai-Long

    2009-12-01

    A new numerical method was developed for predicting the steady hydrodynamic performance of ducted propellers. A potential based surface panel method was applied both to the duct and the propeller, and the interaction between them was solved by an induced velocity potential iterative method. Compared with the induced velocity iterative method, the method presented can save programming and calculating time. Numerical results for a JD simplified ducted propeller series showed that the method presented is effective for predicting the steady hydrodynamic performance of ducted propellers.

  15. Neonatal prolapsed patent vitellointestinal duct.

    PubMed

    Patel, Ramnik V; Kumar, Hemant; Sinha, C K; Patricolo, Mario

    2013-07-10

    A case of a prolapsed patent vitellointestinal duct (PVID) in a 10-day-old neonate who presented with vomiting and poor weight gain with partial intestinal obstruction and a flower like pink, prolapsing lesion at his umbilicus has been reported. A limited contrast study through the tubular structure confirmed it to be a PVID. He underwent transumbilical exploration and resection and anastomosis uneventfully. Persistence of the vitellointestinal duct as a whole or part of it leads to a wide variety of anomalies-Meckel's diverticulum is the commonest lesion and a PVID is the rarest. Umbilical cord clamping flush with the abdominal wall may convert a Meckel's diverticulum prolapsing in the base of umbilical ring into a PVID. Careful assessment should be made for associated anomalies. Transumbilical exploration gives the best cosmetic and functional results.

  16. [Late stage stenoses of bile ducts after iatrogenic bile duct injuries following cholecystectomy].

    PubMed

    Bektas, H; Winny, M; Schrem, H; Becker, T; Klempnauer, J

    2007-12-01

    Iatrogenic bile duct injuries represent a severe complication after cholecystectomy. For the attending physician therapy and management of these injuries are a challenge. Inadequate and delayed treatment can lead to stenoses at a late stage, which can necessitate further surgical intervention. In a study data of 74 patients, who were treated in our clinic for bile duct injuries following cholecystectomy, were analysed retrospectively. A total of 8 patients with late stage bile duct strictures following iatrogenic bile duct injury including the subsequent therapy could be identified. The data of these patients were analysed in respect of cause and strategies to prevent late stage stenoses. In 62 patients the bile duct injury occurred following laparoscopic and in 12 patients following open cholecystectomy. In 16 patients the injury was combined with a vascular lesion. The interval between primary intervention and definitive therapy was 11 days in 53 patients and 1-15 years in 21 patients. In 8 patients the reason for the re-operation after a long interval (1-15 years) was a late stage stenosis. A hepatico-jejunostomy was performed subsequently and during follow-up 5 / 8 patients were symptom-free; 7 patients were re-operated due to a stenosed primary biliodigestive anastomosis and 3 patients each due to atrophy of the right liver lobe and recurrent cholangitis. One patient complained of recurrent cholangitis and a further patient of symptoms due to adhesions. If treated inadequately bile duct injuries occurring during cholecystectomy can in the long-term lead to considerable problems such as recurrent cholangitis, late stage stenoses and even to secondary biliary cirrhosis. Therefore, a complex inter-disciplinary therapeutic concept aiming at timely treatment is necessary.

  17. Complicated bile duct stones

    PubMed Central

    Roy, Ashwin; Martin, Derrick

    2013-01-01

    Common bile duct stones (CBDSs) are solid deposits that can either form within the gallbladder or migrate to the common bile duct (CBD), or form de novo in the biliary tree. In the USA around 15% of the population have gallstones and of these, 3% present with symptoms annually. Because of this, there have been major advancements in the management of gallstones and related conditions. Management is based on the patient's risk profile; young and healthy patients are likely to be recommended for surgery and elderly patients with comorbidities are usually recommended for endoscopic procedures. Imaging of gallstones has advanced in the last 30 years with endoscopic retrograde cholangiopancreatography evolving from a diagnostic to a therapeutic procedure in removing CBDSs. We present a complicated case of a patient with a CBDS and periampullary diverticulum and discuss the techniques used to diagnose and remove the stone from the biliary system. PMID:23946532

  18. A Plug-and-Play Duct System Evaluation

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

    Beach, Robert; Dickson, Bruce; Grisolia, Anthony

    This report describes an air distribution system composed of a series of uniformly-sized ducts that terminate in rooms throughout the home and return to a central manifold, similar in fashion to a “home-run” cross-linked polyethylene plumbing system. With a well-designed manifold, each duct receives an equal static pressure potential for airflow from the air handling unit, and the number of needed ducts for each room are simply attached to fittings located on the manifold; in this sense, the system is plug-and-play (PnP). As indicated, all ducts in the PnP system are identical in size and small enough to fit inmore » the ceiling and wall cavities of a house (i.e., less than 3.5-in. outer diameter). These ducts are also more appropriately sized for the lower airflow requirements of modern, energy-efficient homes; therefore, the velocity of the air moving through the duct is between that of conventional duct systems (approximately 700 ft/min) and high-velocity systems (more than 1,500 ft/min) on the market today. The PnP duct system uses semi-rigid plastic pipes, which have a smooth inner wall and are straightforward to install correctly, resulting in a system that has minimal air leakage. However, plastic ducts are currently not accepted by code for use in residential buildings; therefore, the project team considered other duct materials for the system that are currently accepted by code, such as small-diameter, wirehelix, flexible ductwork.« less

  19. A Plug-and-Play Duct System Evaluation

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

    Beach, R.; Dickson, B.; Grisolia, A.

    2017-07-01

    This report describes an air distribution system composed of a series of uniformly-sized ducts that terminate in rooms throughout the home and return to a central manifold, similar in fashion to a “home-run” cross-linked polyethylene plumbing system. With a well-designed manifold, each duct receives an equal static pressure potential for airflow from the air handling unit, and the number of needed ducts for each room are simply attached to fittings located on the manifold; in this sense, the system is plug-and-play (PnP). As indicated, all ducts in the PnP system are identical in size and small enough to fit inmore » the ceiling and wall cavities of a house (i.e., less than 3.5-in. outer diameter). These ducts are also more appropriately sized for the lower airflow requirements of modern, energy-efficient homes; therefore, the velocity of the air moving through the duct is between that of conventional duct systems (approximately 700 ft/min) and high-velocity systems (more than 1,500 ft/min) on the market today. The PnP duct system uses semi-rigid plastic pipes, which have a smooth inner wall and are straightforward to install correctly, resulting in a system that has minimal air leakage. However, plastic ducts are currently not accepted by code for use in residential buildings; therefore, the project team considered other duct materials for the system that are currently accepted by code, such as small-diameter, wirehelix, flexible ductwork.« less

  20. Intraductal Transanastomotic Stenting in Duct-to-Duct Biliary Reconstruction after Living-Donor Liver Transplantation: A Randomized Trial.

    PubMed

    Santosh Kumar, K Y; Mathew, Johns Shaji; Balakrishnan, Dinesh; Bharathan, Viju Kumar; Thankamony Amma, Binoj Sivasankara Pillai; Gopalakrishnan, Unnikrishnan; Narayana Menon, Ramachandran; Dhar, Puneet; Vayoth, Sudheer Othiyil; Sudhindran, Surendran

    2017-12-01

    Biliary complications continue to be the "Achilles heel" of living-donor liver transplantation (LDLT). The use of biliary stents in LDLT to reduce biliary complications is a controversial issue. We performed a randomized trial to study the impact of intraductal biliary stents on postoperative biliary complications after LDLT. Of the 94 LDLTs that were performed during a period of 16 months, ABO-incompatible transplants, left lobe grafts, 3 or more bile ducts on the graft, and those requiring bilioenteric drainage were excluded. Eligible patients were randomized to either a study arm (intraductal stent, n = 31) or a control arm (no stent, n = 33) by block randomization. Stratification was done, based on the number of ducts on the graft requiring anastomosis, into single (n = 20) or 2 ducts (n = 44). Ureteric stents of 3F to 5F placed across the biliary anastomosis and exiting into the duodenum for later endoscopic removal at 3 months were used. The primary end point was postoperative bile leak. Bile leak occurred in 15 of 64 (23.4%), the incidence was higher in the stented group compared with the control group (35.5% vs 12.1%; p = 0.03). Multiplicity of bile ducts and stenting were identified as risk factors for bile leak on multivariate analysis (p = 0.031 and p = 0.032). During a median follow-up of 2 years, biliary stricture developed in 9 patients (14.1%). Postoperative bile leak is a significant risk factor for the development of biliary stricture (p = 0.003). Intraductal transanastomotic biliary stenting and multiplicity of graft ducts were identified as independent risk factors for the development of postoperative biliary complications. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Lightweight Forms for Epoxy/Aramid Ducts

    NASA Technical Reports Server (NTRS)

    Mix, E. W.; Anderson, A. N.; Bedford, Donald L., Sr.

    1986-01-01

    Aluminum mandrels easy to remove. Lightweight aluminum mandrel for shaping epoxy/aramid ducts simplifies and speeds production. In new process, glass-reinforced epoxy/aramid cloth wrapped on aluminum mandrel. Stainless-steel flanges and other hardware fitted on duct and held by simple tooling. Entire assembly placed in oven to cure epoxy. After curing, assembly placed in alkaline bath dissolves aluminum mandrel in about 4 hours. Epoxy/aramid shell ready for use as duct. Aluminum mandrel used to make ducts of various inside diameters up to 6 in. Standard aluminum forms used. Conventional tube-bending equipment produces requisite curves in mandrels.

  2. Noise radiation directivity from a wind-tunnel inlet with inlet vanes and duct wall linings

    NASA Technical Reports Server (NTRS)

    Soderman, P. T.; Phillips, J. D.

    1986-01-01

    The acoustic radiation patterns from a 1/15th scale model of the Ames 80- by 120-Ft Wind Tunnel test section and inlet have been measured with a noise source installed in the test section. Data were acquired without airflow in the duct. Sound-absorbent inlet vanes oriented parallel to each other, or splayed with a variable incidence relative to the duct long axis, were evaluated along with duct wall linings. Results show that splayed vans tend to spread the sound to greater angles than those measured with the open inlet. Parallel vanes narrowed the high-frequency radiation pattern. Duct wall linings had a strong effect on acoustic directivity by attenuating wall reflections. Vane insertion loss was measured. Directivity results are compared with existing data from square ducts. Two prediction methods for duct radiation directivity are described: one is an empirical method based on the test data, and the other is a analytical method based on ray acoustics.

  3. Tear-Duct Obstruction and Surgery

    MedlinePlus

    ... Staying Safe Videos for Educators Search English Español Tear-Duct Obstruction and Surgery KidsHealth / For Parents / Tear- ... year old with little or no treatment. About Tear Ducts Our eyes are continually exposed to dust, ...

  4. Observed characteristics of atmospheric ducts over the South China Sea in autumn

    NASA Astrophysics Data System (ADS)

    Cheng, Yinhe; Zhou, Shengqi; Wang, Dongxiao; Lu, Yuanzheng; Huang, Ke; Yao, Jinglong; You, Xiaobao

    2016-05-01

    The observed characteristics of lower atmospheric ducts over the South China Sea (SCS) were analyzed based on Global Position Systerm (GPS) radiosonde data collected four times daily during autumn open cruises from 2006 to 2012. Duct occurrence, thickness, and strength over the SCS were about 40%, 150-m thick, and 8 M units, respectively, which were larger than during the summer monsoon period. Most ducts occurred at heights <1 500 m and these ducts easily trap electromagnetic wave clusters with wavelengths <2 m. Diurnal variation of the SCS ducts appeared evident. They occurred more often at midnight at higher altitudes (about 1 100 m), with a thickest layer of about 145 m and less frequently during the evening at lower altitudes (about 800 m), with a thinnest layer of about 125 m. Moreover, ducts during the daytime at a mean height of about 900 m, with the greatest strength of about 10 M units. Furthermore, all duct variables observed over the SCS in autumn decreased from north to south. These findings are useful not only in the design of radar and communication systems, but also for evaluating possible effects of anomalous propagation on meteorological radar and military applications.

  5. Electromagnetic propagation in PEC and absorbing curved S-ducts

    NASA Technical Reports Server (NTRS)

    Baumeister, Kenneth J.

    1988-01-01

    A finite-element Galerkin formulation has been developed to study transverse magnetic (TM) wave propagation in 2-D S-curved ducts with both perfectly conducting and absorbing walls. The reflection and transmission at the entrances and the exits of the curved ducts are determined by coupling the finite-element solutions in the curved ducts to the eigenfunctions of an infinite, uniform, perfectly conducting duct. Example solutions are presented for a double mitred and S-ducts of various lengths. The length of the S-duct is found to significantly effect the reflective characteristics of the duct. Also, the effect of curvature on an absorbing duct is illustrated.

  6. Neonatal prolapsed patent vitellointestinal duct

    PubMed Central

    Patel, Ramnik V; Kumar, Hemant; Sinha, C K; Patricolo, Mario

    2013-01-01

    A case of a prolapsed patent vitellointestinal duct (PVID) in a 10-day-old neonate who presented with vomiting and poor weight gain with partial intestinal obstruction and a flower like pink, prolapsing lesion at his umbilicus has been reported. A limited contrast study through the tubular structure confirmed it to be a PVID. He underwent transumbilical exploration and resection and anastomosis uneventfully. Persistence of the vitellointestinal duct as a whole or part of it leads to a wide variety of anomalies–Meckel's diverticulum is the commonest lesion and a PVID is the rarest. Umbilical cord clamping flush with the abdominal wall may convert a Meckel's diverticulum prolapsing in the base of umbilical ring into a PVID. Careful assessment should be made for associated anomalies. Transumbilical exploration gives the best cosmetic and functional results. PMID:23845681

  7. IFCPT S-Duct Grid-Adapted FUN3D Computations for the Third Propulsion Aerodynamics Works

    NASA Technical Reports Server (NTRS)

    Davis, Zach S.; Park, M. A.

    2017-01-01

    Contributions of the unstructured Reynolds-averaged Navier-Stokes code, FUN3D, to the 3rd AIAA Propulsion Aerodynamics Workshop are described for the diffusing IFCPT S-Duct. Using workshop-supplied grids, results for the baseline S-Duct, baseline S-Duct with Aerodynamic Interface Plane (AIP) rake hardware, and baseline S-Duct with flow control devices are compared with experimental data and results computed with output-based, off-body grid adaptation in FUN3D. Due to the absence of influential geometry components, total pressure recovery is overpredicted on the baseline S-Duct and S-Duct with flow control vanes when compared to experimental values. An estimate for the exact value of total pressure recovery is derived for these cases given an infinitely refined mesh. When results from output-based mesh adaptation are compared with those computed on workshop-supplied grids, a considerable improvement in predicting total pressure recovery is observed. By including more representative geometry, output-based mesh adaptation compares very favorably with experimental data in terms of predicting the total pressure recovery cost-function; whereas, results computed using the workshop-supplied grids are underpredicted.

  8. Measure Guideline: Summary of Interior Ducts in New Construction, Including an Efficient, Affordable Method to Install Fur-Down Interior Ducts

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

    Beal, D.; McIlvaine , J.; Fonorow, K.

    2011-11-01

    This document illustrates guidelines for the efficient installation of interior duct systems in new housing, including the fur-up chase method, the fur-down chase method, and interior ducts positioned in sealed attics or sealed crawl spaces. This document illustrates guidelines for the efficient installation of interior duct systems in new housing. Interior ducts result from bringing the duct work inside a home's thermal and air barrier. Architects, designers, builders, and new home buyers should thoroughly investigate any opportunity for energy savings that is as easy to implement during construction, such as the opportunity to construct interior duct work. In addition tomore » enhanced energy efficiency, interior ductwork results in other important advantages, such as improved indoor air quality, increased system durability and increased homeowner comfort. While the advantages of well-designed and constructed interior duct systems are recognized, the implementation of this approach has not gained a significant market acceptance. This guideline describes a variety of methods to create interior ducts including the fur-up chase method, the fur-down chase method, and interior ducts positioned in sealed attics or sealed crawl spaces. As communication of the intent of an interior duct system, and collaboration on its construction are paramount to success, this guideline details the critical design, planning, construction, inspection, and verification steps that must be taken. Involved in this process are individuals from the design team; sales/marketing team; and mechanical, insulation, plumbing, electrical, framing, drywall and solar contractors.« less

  9. Convolution seal for transition duct in turbine system

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

    Flanagan, James Scott; LeBegue, Jeffrey Scott; McMahan, Kevin Weston

    2015-05-26

    A turbine system is disclosed. In one embodiment, the turbine system includes a transition duct. The transition duct includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct further includes an interface feature for interfacing with an adjacent transition duct. The turbine system further includes a convolution seal contacting the interface feature to provide a seal between the interface feature andmore » the adjacent transition duct.« less

  10. Radiative interactions in laminar duct flows

    NASA Technical Reports Server (NTRS)

    Trivedi, P. A.; Tiwari, S. N.

    1990-01-01

    Analyses and numerical procedures are presented for infrared radiative energy transfer in gases when other modes of energy transfer occur simultaneously. Two types of geometries are considered, a parallel plate duct and a circular duct. Fully developed laminar incompressible flows of absorbing-emitting species in black surfaced ducts are considered under the conditions of uniform wall heat flux. The participating species considered are OH, CO, CO2, and H2O. Nongray as well as gray formulations are developed for both geometries. Appropriate limiting solutions of the governing equations are obtained and conduction-radiation interaction parameters are evaluated. Tien and Lowder's wide band model correlation was used in nongray formulation. Numerical procedures are presented to solve the integro-differential equations for both geometries. The range of physical variables considered are 300 to 2000 K for temperature, 0.1 to 100.0 atm for pressure, and 0.1 to 100 cm spacings between plates/radius of the tube. An extensive parametric study based on nongray formulation is presented. Results obtained for different flow conditions indicate that the radiative interactions can be quite significant in fully developed incompressible flows.

  11. Financial Aspects of Bile Duct Injuries.

    PubMed

    Palaz Alı, Ozgkıour; Ibis, Abdil Cem; Gurtekin, Basak

    2017-11-04

    BACKGROUND Major bile duct injury is the most worrisome complication of cholecystectomy. There is no detailed data about the incidence or treatment-related costs of bile duct injuries in Turkey. We aimed to determine prevalence and therapeutic costs of patients with major biliary duct injuries managed in our department, and further estimate a projection of these parameters at the national level. MATERIAL AND METHODS All patients admitted due to bile duct injury during cholecystectomy from 2011 to 2014 were included. Healthcare costs were calculated by summing of their all treatment-related costs in Istanbul Medical Faculty. We collected 2014-2015 data on number of patients diagnosed with cholecystitis in Turkey, the number of cholecystectomies, and the number of the interventions performed following these initial surgeries, which were obtained from the Turkish Social Security Institution. RESULTS Forty-nine patients were enrolled and bilioenteric diversion was performed in 39 patients: 20.4% of patients had Bismuth II, 38.8% had Bismuth III, and 40.8% had Bismuth IV biliary stricture. Comparison of stricture types with total costs, days of hospitalization, and outpatient clinic costs revealed significant differences. Mean total cost of corrective surgeries was 9199 TRY. We estimated that 1.5% to 2.4% of patients who underwent cholecystectomy in Turkey have bile duct injury (including 0.3% with major bile duct injury). CONCLUSIONS New preventive strategies should be used to avoid bile duct injuries, which have a huge financial impact on the national economy.

  12. Duct Leakage Repeatability Testing

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

    Walker, Iain; Sherman, Max

    2014-08-01

    The purpose of this report is to evaluate the repeatability of the three most significant measurement techniques for duct leakage using data from the literature and recently obtained field data. We will also briefly discuss the first two factors. The main question to be answered by this study is to determine if differences in the repeatability of these tests methods is sufficient to indicate that any of these methods is so poor that it should be excluded from consideration as an allowed procedure in codes and standards. The three duct leak measurement methods assessed in this report are the twomore » duct pressurization methods that are commonly used by many practitioners and the DeltaQ technique. These are methods B, C and A, respectively of the ASTM E1554 standard. Although it would be useful to evaluate other duct leak test methods, this study focused on those test methods that are commonly used and are required in various test standards, such as BPI (2010), RESNET (2014), ASHRAE 62.2 (2013), California Title 24 (CEC 2012), DOE Weatherization and many other energy efficiency programs.« less

  13. Articulated transition duct in turbomachine

    DOEpatents

    Flanagan, James Scott; McMahan, Kevin Weston; LeBegue, Jeffrey Scott; Pentecost, Ronnie Ray

    2014-04-29

    Turbine systems are provided. A turbine system includes a transition duct comprising an inlet, an outlet, and a duct passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The duct passage includes an upstream portion and a downstream portion. The upstream portion extends from the inlet between an inlet end and an aft end. The downstream portion extends from the outlet between an outlet end and a head end. The turbine system further includes a joint coupling the aft end of the upstream portion and the head end of the downstream portion together. The joint is configured to allow movement of the upstream portion and the downstream portion relative to each other about or along at least one axis.

  14. Vitellointestinal Duct Anomalies in Infancy.

    PubMed

    Kadian, Yogender Singh; Verma, Anjali; Rattan, Kamal Nain; Kajal, Pardeep

    2016-01-01

    Vitellointestinal duct (VID) or omphalomesenteric duct anomalies are secondary to the persistence of the embryonic vitelline duct, which normally obliterates by weeks 5-9 of intrauterine life. This is a retrospective analysis of a total of 16 patients of symptomatic remnants of vitellointestinal duct from period of Jan 2009 to May 2013. Male to female ratio (M:F) was 4.3:1 and mean age of presentation was 2 months and their mode of presentation was: patent VID in 9 (56.25%) patients, umbilical cyst in 2(12.25%), umbilical granuloma in 2 (12.25%), and Meckel diverticulum as content of hernia sac in obstructed umbilical hernia in 1 (6.25%) patient. Two patients with umbilical fistula had severe electrolyte disturbance and died without surgical intervention. Persistent VID may have varied presentations in infancy. High output umbilical fistula and excessive bowel prolapse demand urgent surgical intervention to avoid morbidity and mortality.

  15. Intensification and refraction of acoustical signals in partially choked converging ducts

    NASA Technical Reports Server (NTRS)

    Nayfeh, A. H.

    1980-01-01

    A computer code based on the wave-envelope technique is used to perform detailed numerical calculations for the intensification and refraction of sound in converging hard walled and lined circular ducts carrying high mean Mach number flows. The results show that converging ducts produce substantial refractions toward the duct center for waves propagating against near choked flows. As expected, the magnitude of the refraction decreases as the real part of the admittance increases. The pressure wave pattern is that of interference among the different modes, and hence the variation of the magnitude of pressure refraction with frequency is not monotonic.

  16. Large Eddy Simulation of Ducted Propulsors in Crashback

    NASA Astrophysics Data System (ADS)

    Jang, Hyunchul; Mahesh, Krishnan

    2009-11-01

    Flow around a ducted marine propulsor is computed using the large eddy simulation methodology under crashback conditions. Crashback is an operating condition where a propulsor rotates in the reverse direction while the vessel moves in the forward direction. It is characterized by massive flow separation and highly unsteady propeller loads, which affect both blade life and maneuverability. The simulations are performed on unstructured grids using the discrete kinetic energy conserving algorithm developed by Mahesh at al. (2004, J. Comput. Phys 197). Numerical challenges posed by sharp blade edges and small blade tip clearances are discussed. The flow is computed at the advance ratio J=-0.7 and Reynolds number Re=480,000 based on the propeller diameter. Average and RMS values of the unsteady loads such as thrust, torque, and side force on the blades and duct are compared to experiment, and the effect of the duct on crashback is discussed.

  17. Fan/Ram Duct Program

    DTIC Science & Technology

    1973-10-01

    turbofan engine shutoff scheme, the ram duct flow conditions, and the Ian duct shutoff vane area transi- tion schedule. This loss will be...airflow. The performance of the turbofan is neglected until the main engine burner is ignited. At that time it is assumed that the turbo - fan...B. Transient Operation . . .. TRANSIENT TRANSITION TEST CASES A. Turbofan to Ramjet B. Ramjet to Turbo fan CONCLUSIONS AND RECOMMENDATIONS

  18. The Development of the Ducted Fan Noise Propagation and Radiation Code CDUCT-LaRC

    NASA Technical Reports Server (NTRS)

    Nark, Douglas M.; Farassat, F.; Pope, D. Stuart; Vatsa, Veer

    2003-01-01

    The development of the ducted fan noise propagation and radiation code CDUCT-LaRC at NASA Langley Research Center is described. This code calculates the propagation and radiation of given acoustic modes ahead of the fan face or aft of the exhaust guide vanes in the inlet or exhaust ducts, respectively. This paper gives a description of the modules comprising CDUCT-LaRC. The grid generation module provides automatic creation of numerical grids for complex (non-axisymmetric) geometries that include single or multiple pylons. Files for performing automatic inviscid mean flow calculations are also generated within this module. The duct propagation is based on the parabolic approximation theory of R. P. Dougherty. This theory allows the handling of complex internal geometries and the ability to study the effect of non-uniform (i.e. circumferentially and axially segmented) liners. Finally, the duct radiation module is based on the Ffowcs Williams-Hawkings (FW-H) equation with a penetrable data surface. Refraction of sound through the shear layer between the external flow and bypass duct flow is included. Results for benchmark annular ducts, as well as other geometries with pylons, are presented and compared with available analytical data.

  19. Sound radiation from a flanged inclined duct.

    PubMed

    McAlpine, Alan; Daymond-King, Alex P; Kempton, Andrew J

    2012-12-01

    A simple method to calculate sound radiation from a flanged inclined duct is presented. An inclined annular duct is terminated by a rigid vertical plane. The duct termination is representative of a scarfed exit. The concept of a scarfed duct has been examined in turbofan aero-engines as a means to, potentially, shield a portion of the radiated sound from being transmitted directly to the ground. The sound field inside the annular duct is expressed in terms of spinning modes. Exterior to the duct, the radiated sound field owing to each mode can be expressed in terms of its directivity pattern, which is found by evaluating an appropriate form of Rayleigh's integral. The asymmetry is shown to affect the amplitude of the principal lobe of the directivity pattern, and to alter the proportion of the sound power radiated up or down. The methodology detailed in this article provides a simple engineering approach to investigate the sound radiation for a three-dimensional problem.

  20. In-Situ Observation of Undisturbed Surface Layer Scaler Profiles for Characterizing Evaporative Duct Properties

    DTIC Science & Technology

    2016-06-01

    lowest tens of meters of the MASL from a small Rigid Hull Inflatable Boat (RHIB), or a small work boat, equipped with a tethered profiling system and...ducting Research (CASPER) project. It is capable of making repeated measurements of the lowest tens of meters of the MASL from a small Rigid Hull ...Naval Postgraduate School ONR Office of Naval Research PJ Paulus-Jeske RHIB rigid- hulled inflatable boat R/V research vessel SST sea

  1. The acoustics of ducted propellers

    NASA Astrophysics Data System (ADS)

    Ali, Sherif F.

    The return of the propeller to the long haul commercial service may be rapidly approaching in the form of advanced "prop fans". It is believed that the advanced turboprop will considerably reduce the operational cost. However, such aircraft will come into general use only if their noise levels meet the standards of community acceptability currently applied to existing aircraft. In this work a time-marching boundary-element technique is developed, and used to study the acoustics of ducted propeller. The numerical technique is developed in this work eliminated the inherent instability suffered by conventional approaches. The methodology is validated against other numerical and analytical results. The results show excellent agreement with the analytical solution and show no indication of unstable behavior. For the ducted propeller problem, the propeller is modeled by a rotating source-sink pairs, and the duct is modeled by rigid annular body of elliptical cross-section. Using the model and the developed technique, the effect of different parameters on the acoustic field is predicted and analyzed. This includes the effect of duct length, propeller axial location, and source Mach number. The results of this study show that installing a short duct around the propeller can reduce the noise that reaches an observer on a side line.

  2. Propagation and radiation of sound from flanged circular ducts with circumferentially varying wall admittances. I Semi-infinite ducts. II - Finite ducts with sources

    NASA Technical Reports Server (NTRS)

    Fuller, C. R.

    1984-01-01

    Sound propagation in infinite, semiinfinite, and finite circular ducts with circumferentially varying wall admittances is investigated analytically. The infinite case is considered, and an example demonstrates the effects of wall-admittance distribution on dispersion characteristics and mode shapes. An exact solution is obtained for the semiinfinite case, a circular duct with a flanged opening: sidelobe suppression and circumferential-mode energy scattering leading to radiated-field asymmetry are found. A finite duct system with specified hard-walled pressure sources is examined in detail, evaluating reflection coefficients, transmission losses, and radiated-field directivity. Graphs and diagrams are provided, and the implications of the results obtained for the design of aircraft-turbofan inlet liners are discussed.

  3. Duct modes damping through an adjustable electroacoustic liner under grazing incidence

    NASA Astrophysics Data System (ADS)

    Boulandet, R.; Lissek, H.; Karkar, S.; Collet, M.; Matten, G.; Ouisse, M.; Versaevel, M.

    2018-07-01

    This paper deals with active sound attenuation in lined ducts with flow and its application to duct modes damping in aircraft engine nacelles. It presents an active lining concept based on an arrangement of electroacoustic absorbers flush mounted in the duct wall. Such feedback-controlled loudspeaker membranes are used to achieve locally reacting impedances with adjustable resistance and reactance. A broadband impedance model is formulated from the loudspeaker parameters and a design procedure is proposed to achieve specified acoustic resistances and reactances. The performance is studied for multimodal excitation by simulation using the finite element method and the results are compared to measurements made in a flow duct facility. This electroacoustic liner has an attenuation potential comparable to that of a conventional passive liner, but also offers greater flexibility to achieve the target acoustic impedance in the low frequencies. In addition, it is adaptive in real time to track variable engine speeds. It is shown with the liner prototype that the duct modes can be attenuated over a bandwidth of two octaves around the resonance frequency of the loudspeakers.

  4. Compact Buried Ducts in a Hot-Humid Climate House

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

    Mallay, Dave

    2016-01-07

    "9A system of compact, buried ducts provides a high-performance and cost-effective solution for delivering conditioned air throughout the building. This report outlines research activities that are expected to facilitate adoption of compact buried duct systems by builders. The results of this research would be scalable to many new house designs in most climates and markets, leading to wider industry acceptance and building code and energy program approval. The primary research question with buried ducts is potential condensation at the outer jacket of the duct insulation in humid climates during the cooling season. Current best practices for buried ducts rely onmore » encapsulating the insulated ducts with closed-cell spray polyurethane foam insulation to control condensation and improve air sealing. The encapsulated buried duct concept has been analyzed and shown to be effective in hot-humid climates. The purpose of this project is to develop an alternative buried duct system that performs effectively as ducts in conditioned space - durable, energy efficient, and cost-effective - in a hot-humid climate (IECC warm-humid climate zone 3A) with three goals that distinguish this project: 1) Evaluation of design criteria for buried ducts that use common materials and do not rely on encapsulation using spray foam or disrupt traditional work sequences; 2) Establishing design criteria for compact ducts and incorporate those with the buried duct criteria to further reduce energy losses and control installed costs; 3) Developing HVAC design guidance for performing accurate heating and cooling load calculations for compact buried ducts.« less

  5. Vitellointestinal Duct Anomalies in Infancy

    PubMed Central

    Kadian, Yogender Singh; Verma, Anjali; Rattan, Kamal Nain; Kajal, Pardeep

    2016-01-01

    Background: Vitellointestinal duct (VID) or omphalomesenteric duct anomalies are secondary to the persistence of the embryonic vitelline duct, which normally obliterates by weeks 5–9 of intrauterine life. Methods: This is a retrospective analysis of a total of 16 patients of symptomatic remnants of vitellointestinal duct from period of Jan 2009 to May 2013. Results: Male to female ratio (M:F) was 4.3:1 and mean age of presentation was 2 months and their mode of presentation was: patent VID in 9 (56.25%) patients, umbilical cyst in 2(12.25%), umbilical granuloma in 2 (12.25%), and Meckel diverticulum as content of hernia sac in obstructed umbilical hernia in 1 (6.25%) patient. Two patients with umbilical fistula had severe electrolyte disturbance and died without surgical intervention. Conclusion: Persistent VID may have varied presentations in infancy. High output umbilical fistula and excessive bowel prolapse demand urgent surgical intervention to avoid morbidity and mortality. PMID:27433448

  6. Bile duct adenoma and von Meyenburg complex-like duct arising in hepatitis and cirrhosis: pathogenesis and histological characteristics.

    PubMed

    Aishima, Shinichi; Tanaka, Yuki; Kubo, Yuichiro; Shirabe, Ken; Maehara, Yoshihiko; Oda, Yoshinao

    2014-11-01

    Morphologic features and neoplastic potentials of bile duct adenoma (BDA) and von Meyenburg complex (VMC)-like duct arising in chronic liver disease were unknown. Thirty-five BDAs and 12 VMC-like duct lesions were observed in 39 cases with chronic liver disease. BDAs were divided into the EMA-cytoplasmic type (n = 14) and EMA-luminal type (n = 21). EMA-cytoplasmic BDA composed of a proliferation of cuboidal to low-columnar cells forming an open lumen with NCAM(+)/MUC6(-), resembling an interlobular bile duct. EMA-luminal BDA showed uniform cuboidal cells with narrow lumen, and NCAM(++)/MUC6(++), resembling a ductular reaction. VMC-like duct showed positive MUC1 expression and negative MUC6. The expression of S100P, glucose transporter-1 (GLUT-1) and insulin-like growth factor II mRNA-binding protein 3 (IMP-3) were not detected in three lesions. p16 expression was higher than those of the ductular reaction, and the Ki67 and p53 indexes were very low (<1.0%). Large-sized EMA-luminal BDA shows sclerotic stroma. We classified small nodular lesions of ductal or ductular cells in chronic hepatitis and cirrhosis into the following groups: BDA, interlobular bile duct type; BDA, ductular/peribiliary gland type; and VMC-like duct. They may be reactive proliferation rather than neoplastic lesions. © 2014 Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd.

  7. Monitoring of Grouting Compactness in a Post-Tensioning Tendon Duct Using Piezoceramic Transducers

    PubMed Central

    Jiang, Tianyong; Kong, Qingzhao; Wang, Wenxi; Huo, Linsheng; Song, Gangbing

    2016-01-01

    A post-tensioning tendon duct filled with grout can effectively prevent corrosion of the reinforcement, maintain bonding behavior between the reinforcement and concrete, and enhance the load bearing capacity of concrete structures. In practice, grouting of the post-tensioning tendon ducts always causes quality problems, which may reduce structural integrity and service life, and even cause accidents. However, monitoring of the grouting compactness is still a challenge due to the invisibility of the grout in the duct during the grouting process. This paper presents a stress wave-based active sensing approach using piezoceramic transducers to monitor the grouting compactness in real time. A segment of a commercial tendon duct was used as research object in this study. One lead zirconate titanate (PZT) piezoceramic transducer with marble protection, called a smart aggregate (SA), was bonded on the tendon and installed in the tendon duct. Two PZT patch sensors were mounted on the top outside surface of the duct, and one PZT patch sensor was bonded on the bottom outside surface of the tendon duct. In the active sensing approach, the SA was used as an actuator to generate a stress wave and the PZT sensors were utilized to detect the wave response. Cement or grout in the duct functions as a wave conduit, which can propagate the stress wave. If the cement or grout is not fully filled in the tendon duct, the top PZT sensors cannot receive much stress wave energy. The experimental procedures simulated four stages during the grout pouring process, which includes empty status, half grouting, 90% grouting, and full grouting of the duct. Experimental results show that the bottom PZT sensor can detect the signal when the grout level increases towards 50%, when a conduit between the SA and PZT sensor is formed. The top PZT sensors cannot receive any signal until the grout process is completely finished. The wavelet packet-based energy analysis was adopted in this research to

  8. Office-based surgery: advantages, disadvantages, and the nurse's role.

    PubMed

    Anello, S

    2000-01-01

    Office-based surgery is a growing trend in surgical services offered to many patients, however, it is not without risk. In knowing the facts about office-based surgery, nurses will be able to assist our patients in the most appropriate decisions regarding their surgical care. This article will present the indications, advantages, and limitations of office-based surgery, as well as the nurse's role in this environment.

  9. Cystic Duct Closure by Sealing With Bipolar Electrocoagulation

    PubMed Central

    Damgaard, B.; Jorgensen, L. N.; Larsen, S. S.; Kristiansen, V. B.

    2010-01-01

    Background: Cystic duct leakage after cholecystectomy is not uncommon and is a potentially serious complication. The aim of this study was to assess a bipolar sealing system (LigaSure®) for closure of the cystic duct. Methods: The records from consecutive laparoscopic cholecystectomies performed in 2 hospitals with closure of the cystic duct with LigaSure after informed consent were recorded and complications and morbidity registered. The records were compared with those of patients undergoing laparoscopic cholecystectomy with closure of the cystic duct with clips during the same period. Results: During the study period, 218 laparoscopic cholecystectomies were performed; 102 of these were performed with the LigaSure. One patient was excluded due to violation of the protocol. We experienced no cases of cystic duct leakage, but in one patient, bile leakage from the gallbladder bed was observed probably due to a small aberrant duct. Conclusion: The LigaSure system was safe and effective for closure and division of the cystic duct in laparoscopic cholecystectomy. PMID:20412641

  10. Acoustic propagation in curved ducts with extended reacting wall treatment

    NASA Technical Reports Server (NTRS)

    Baumeister, Kenneth J.

    1989-01-01

    A finite-element Galerkin formulation was employed to study the attenuation of acoustic waves propagating in two-dimensional S-curved ducts with absorbing walls without a mean flow. The reflection and transmission at the entrance and the exit of a curved duct were determined by coupling the finite-element solutions in the curved duct to the eigenfunctions of an infinite, uniform, hard wall duct. In the frequency range where the duct height and acoustic wave length are nearly equal, the effects of duct length, curvature (duct offset) and absorber thickness were examined. For a given offset in the curved duct, the length of the S-duct was found to significantly affect both the absorptive and reflective characteristics of the duct. A means of reducing the number of elements in the absorber region was also presented. In addition, for a curved duct, power attenuation contours were examined to determine conditions for maximum acoustic power absorption. Again, wall curvature was found to significantly effect the optimization process.

  11. Transition duct assembly with modified trailing edge in turbine system

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

    McMahan, Kevin Weston; Schott, Carl Gerard; Ingram, Clint Luigie

    2016-10-04

    Transition duct assemblies for turbine systems and turbomachines are provided. In one embodiment, a transition duct assembly includes a plurality of transition ducts disposed in a generally annular array and comprising a first transition duct and a second transition duct. Each of the plurality of transition ducts includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of each transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct assembly further includes anmore » aerodynamic structure defined by the passages of the first transition duct and the second transition duct. The aerodynamic structure includes a pressure side, a suction side, and a trailing edge, the trailing edge having a modified aerodynamic contour.« less

  12. Office-based procedures for diagnosis and treatment of esophageal pathology.

    PubMed

    Wellenstein, David J; Schutte, Henrieke W; Marres, Henri A M; Honings, Jimmie; Belafsky, Peter C; Postma, Gregory N; Takes, Robert P; van den Broek, Guido B

    2017-09-01

    Diagnostic and therapeutic office-based procedures under topical anesthesia are emerging in the daily practice of laryngologists and head and neck surgeons. Since the introduction of the transnasal esophagoscope, office-based procedures for the esophagus are increasingly performed. We conducted a systematic review of literature on office-based procedures under topical anesthesia for the esophagus. Transnasal esophagoscopy is an extensively investigated office-based procedure. This procedure shows better patient tolerability and equivalent accuracy compared to conventional transoral esophagoscopy, as well as time and cost savings. Secondary tracheoesophageal puncture, esophageal dilatation, esophageal sphincter injection, and foreign body removal are less investigated, but show promising results. With the introduction of the transnasal esophagoscope, an increasing number of diagnostic and therapeutic office-based procedures for the esophagus are possible, with multiple advantages. Further investigation must prove the clinical feasibility and effectiveness of the therapeutic office-based procedures. © 2017 Wiley Periodicals, Inc.

  13. Cholestasis‐induced adaptive remodeling of interlobular bile ducts

    PubMed Central

    Damle‐Vartak, Amruta; Richter, Beate; Dirsch, Olaf; Dahmen, Uta; Hammad, Seddik

    2016-01-01

    Cholestasis is a common complication in liver diseases that triggers a proliferative response of the biliary tree. Bile duct ligation (BDL) is a frequently used model of cholestasis in rodents. To determine which changes occur in the three‐dimensional (3D) architecture of the interlobular bile duct during cholestasis, we used 3D confocal imaging, surface reconstructions, and automated image quantification covering a period up to 28 days after BDL. We show a highly reproducible sequence of interlobular duct remodeling, where cholangiocyte proliferation initially causes corrugation of the luminal duct surface, leading to an approximately five‐fold increase in surface area. This is analogous to the function of villi in the intestine or sulci in the brain, where an expansion of area is achieved within a restricted volume. The increase in surface area is further enhanced by duct branching, branch elongation, and loop formation through self‐joining, whereby an initially relatively sparse mesh surrounding the portal vein becomes five‐fold denser through elongation, corrugation, and ramification. The number of connections between the bile duct and the lobular bile canalicular network by the canals of Hering decreases proportionally to the increase in bile duct length, suggesting that no novel connections are established. The diameter of the interlobular bile duct remains constant after BDL, a response that is qualitatively distinct from that of large bile ducts, which tend to enlarge their diameters. Therefore, volume enhancement is only due to net elongation of the ducts. Because curvature and tortuosity of the bile duct are unaltered, this enlargement of the biliary tree is caused by branching and not by convolution. Conclusion: BDL causes adaptive remodeling that aims at optimizing the intraluminal surface area by way of corrugation and branching. (Hepatology 2016;63:951–964) PMID:26610202

  14. The consequence of premature silicone stent loss after external dacryocystorhinostomy.

    PubMed

    Vicinanzo, Matthew G; McGwin, Gerald; Boyle, Michael; Long, John A

    2008-07-01

    To investigate the clinical affects of premature silicone stent loss after external dacryocystorhinostomy (DCR). Retrospective chart review. Two hundred thirty-three consecutive external dacryocystorhinostomies. Demographic information was recorded, including length to follow-up, age, gender, number of days until stent removal, and success of surgery. All patients who extruded their silicone stent prematurely were identified. All were primary DCRs (i.e., all reoperations were excluded). All patients had had documented nasolacrimal duct obstruction before surgery, with or without current or prior dacryocystitis. Failure of DCR surgery was accepted as symptomatic epiphora with notable nasolacrimal duct blockage and/or infection at long term follow-up. Of the 233 DCRs, 42 stents extruded or had to be removed before the planned 2-month period. The overall success rate of the surgery was 94.9%, with a 90.5% success for those who had early extrusion and 95.8% for those who did not (P = 0.24). Moreover, of the 4 people who had a failed surgery (of 42 early extrusions), none had a recurrent infection or pain, and only 1 opted to have a revision of the surgery. Patient age, gender, or timing of the extrusion was not found to affect surgical success significantly. Our experience and this study suggest that concerns over early stent extrusion or removal may not be wholly warranted. Moreover, our review of the literature shows no evidence-based recommendations that longer stent retention or reintubation after early extrusion results in a higher success rate. Although other surgeries (e.g., canalicular laceration, congenital epiphora) may benefit from intervention or reinsertion after early extrusion, we cannot extrapolate such a practice for the DCR.

  15. Surgical treatment of chronic pancreatitis with pancreatic main duct dilatation: Long term results after head resection and duct drainage

    PubMed Central

    Schwarz, A.; Beger, H. G.

    2005-01-01

    Tissue and duct hypertension is considered as a major factor in the etiology of pain in patients with chronic pancreatitis (CP). Duct dilatation is a consequence of duct obstruction due to scars or duct stones. Nevertheless, the procedure of choice, drainage or resection, is still under discussion. We present long-term results of patients operated with duodenum-preserving pancreatic head resection (DPPHR) combined with a Partington-Rochelle duct drainage in cases of chronic pancreatitis with multiple stenosis and dilatation of the side ducts. Methods and patients. From April 1982 to September 2001, in 55 out of 538 patients with chronic pancreatitis, a DPPHR with additionally Partington-Rochelle duct drainage was performed (44 male, 11 female, mean age 45.8 years). Ninety-two percent of the patients suffered from alcoholic pancreatitis. Medical respective pain treatment for chronic pancreatitis was in median 64.5 months prior to surgery. The indications for surgery were in 87% pain, 59% of the patients had an inflammatory mass in the head of the pancreas, 36% a common bile duct stenosis and 5% a severe stenosis of the duodenum. The endocrine function (OGGT) was impaired in 79% of the patients preoperatively. Results. Hospital mortality was 0%, postoperative complications occurred in 11 patients. Follow-up: All except 2 patients were followed up in the outpatient clinic with the mean follow-up time of 69.7 months (8–105 months), the late mortality was 9%. Sixty-eight percent of the patients were completely free of pain, 29% had occasional pain, 3% suffered from a further attack of pancreatitis. Body weight increased in 79%, 58% were professionally rehabilitated. Late postoperative endocrine function was unchanged in 85% (improved in 5%, deteriorated in 10%). Conclusion. The pain control in patients with multiple duct stenosis after duodenum-preserving pancreatic head resection with duct drainage leads to long-standing absence of pain and low recurrence rate of

  16. Pseudotumor of the distal common bile duct at endoscopic retrograde cholangiopancreatography

    PubMed Central

    Tan, Justin H.; Coakley, Fergus V; Wang, Zhen J.; Poder, Liina; Webb, Emily; Yeh, Benjamin M.

    2010-01-01

    Background Prior studies have described a pseudocalculus appearance in the distal common bile duct as a normal variant at cholangiography. The objective of this study is to describe the occurrence of pseudotumor in the distal common bile duct at endoscopic retrograde cholangiopancreatography (ERCP). Methods Nine patients who underwent ERCP between May 2004 and July 2008 were identified as having a transient eccentric mural-based filling defect in the distal common bile duct. A single reader systematically reviewed all studies and recorded the imaging findings. Results The mean diameter of the filling defect was 9 mm (range, 5 to 11). Eight patients had resolution of the filling defect during the same ERCP or on a subsequent ERCP, and in 2 of these patients the inferior border of the filling defect was not well visualized. The other patient underwent surgical resection of a presumed tumor with no evidence of malignancy on surgical pathology. Conclusion An eccentric mural-based filling defect in the distal common bile duct can be artifactual in nature and may reflect transient contraction of the sphincter of Oddi. Recognition of this pseudotumor may help avoid unnecessary surgery. PMID:21724120

  17. Design and performance of duct acoustic treatment

    NASA Technical Reports Server (NTRS)

    Motsinger, R. E.; Kraft, R. E.

    1991-01-01

    The procedure for designing acoustic treatment panels used to line the walls of aircraft engine ducts and for estimating the resulting suppression of turbofan engine duct noise is discussed. This procedure is intended to be used for estimating noise suppression of existing designs or for designing new acoustic treatment panels and duct configurations to achieve desired suppression levels.

  18. MRI ductography of contrast agent distribution and leakage in normal mouse mammary ducts and ducts with in situ cancer.

    PubMed

    Markiewicz, Erica; Fan, Xiaobing; Mustafi, Devkumar; Zamora, Marta; Conzen, Suzanne D; Karczmar, Gregory S

    2017-07-01

    High resolution 3D MRI was used to study contrast agent distribution and leakage in normal mouse mammary glands and glands containing in situ cancer after intra-ductal injection. Five female FVB/N mice (~19weeks old) with no detectable mammary cancer and eight C3(1) SV40 Tag virgin female mice (~15weeks old) with extensive in situ cancer were studied. A 34G, 45° tip Hamilton needle with a 25μL Hamilton syringe was inserted into the tip of the nipple and approximately 15μL of a Gadodiamide was injected slowly over 1min into the nipple and throughout the duct on one side of the inguinal gland. Following injection, the mouse was placed in a 9.4T MRI scanner, and a series of high resolution 3D T1-weighted images was acquired with a temporal resolution of 9.1min to follow contrast agent leakage from the ducts. The first image was acquired at about 12min after injection. Ductal enhancement regions detected in images acquired between 12 and 21min after contrast agent injection was five times smaller in SV40 mouse mammary ducts (p<0.001) than in non-cancerous FVB/N mouse mammary ducts, perhaps due to rapid washout of contrast agent from the SV40 ducts. The contrast agent washout rate measured between 12min and 90min after injection was ~20% faster (p<0.004) in SV40 mammary ducts than in FVB/N mammary ducts. These results may be due to higher permeability of the SV40 ducts, likely due to the presence of in situ cancers. Therefore, increased permeability of ducts may indicate early stage breast cancers. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Generator stator core vent duct spacer posts

    DOEpatents

    Griffith, John Wesley; Tong, Wei

    2003-06-24

    Generator stator cores are constructed by stacking many layers of magnetic laminations. Ventilation ducts may be inserted between these layers by inserting spacers into the core stack. The ventilation ducts allow for the passage of cooling gas through the core during operation. The spacers or spacer posts are positioned between groups of the magnetic laminations to define the ventilation ducts. The spacer posts are secured with longitudinal axes thereof substantially parallel to the core axis. With this structure, core tightness can be assured while maximizing ventilation duct cross section for gas flow and minimizing magnetic loss in the spacers.

  20. [Stenon or Stensen duct. How sholud we call the secretory duct of the parotid gland? Brief biography of its discoverer].

    PubMed

    Morais Pérez, D

    2004-01-01

    The duct of the parotid gland had been indiscriminately named Stenon's duct or Stensen's duct. In order to establish its origin we carried out a biographic search and a brief revision of the life of the great anatomist, geologist, palaeontologist, bishop and finally Saint Nicolaus Stensen.

  1. Transition duct with divided upstream and downstream portions

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

    McMahan, Kevin Weston; LeBegue, Jeffrey Scott; Maldonado, Jaime Javier

    2015-07-14

    Turbine systems are provided. In one embodiment, a turbine system includes a transition duct comprising an inlet, an outlet, and a duct passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The duct passage includes an upstream portion extending from the inlet and a downstream portion extending from the outlet. The turbine system further includes a rib extending from an outer surface of the duct passage, the rib dividing themore » upstream portion and the downstream portion.« less

  2. A study of the compressible flow through a diffusing S-duct

    NASA Technical Reports Server (NTRS)

    Wellborn, Steven R.; Okiishi, Theodore H.; Reichert, Bruce A.

    1993-01-01

    Benchmark aerodynamic data are presented for compressible flow through a representative S-duct configuration. A numerical prediction of the S-duct flow field, obtained from a subsonic parabolized Navier-Stokes algorithm, is also shown. The experimental and numerical results are compared. Measurements of the three-dimensional velocity field, total pressures, and static pressures were obtained at five cross-sectional planes. Aerodynamic data were gathered with calibrated pneumatic probes. Surface static pressure and surface flow visualization data were also acquired. All reported tests were conducted with an inlet centerline Mach number of 0.6. The Reynolds number, based on the inlet centerline velocity and duct inlet diameter, was 2.6 x 10(exp 6). Thin inlet turbulent boundary layers existed. The collected data should be beneficial to aircraft inlet designers and the measurements are suitable for the validation of computational codes. The results show that a region of streamwise flow separation occurred within the duct. Details about the separated flow region, including mechanisms which drive this complicated flow phenomenon, are discussed. Results also indicate that the duct curvature induces strong pressure driven secondary flows. The cross flows evolve into counter-rotating vortices. These vortices convect low momentum fluid of the boundary layer toward the center of the duct, degrading both the uniformity and magnitude of the total pressure profile.

  3. Analysis of the velocity distribution in different types of ventilation system ducts

    NASA Astrophysics Data System (ADS)

    Peszyński, Kazimierz; Olszewski, Lukasz; Smyk, Emil; Perczyński, Daniel

    2018-06-01

    The paper presents the results obtained during the preliminary studies of circular and rectangular ducts before testing the properties elements (elbows, tees, etc.)of rectangular with rounded corners ducts. The fundamental problem of the studies was to determine the flow rate in the ventilation duct. Due to the size of the channel it was decided to determine the flow rate based on the integration of flow velocity over the considered cross-section. This method requires knowledge of the velocity distribution in the cross section. Approximation of the measured actual profile by the classic and modified Prandtl power-law velocity profile was analysed.

  4. Flow control in a diffusing S-Duct

    NASA Technical Reports Server (NTRS)

    Vakili, A. D.; Wu, J. M.; Liver, P.; Bhat, M. K.

    1985-01-01

    Accurate measurements have been made of secondary flow in a 1.51 area ratio diffusing 30 deg - 30 deg S-Duct with circulair cross section. Turbulent flow was entering the duct at Mach number of 0.6, the boundary layer thickness at the duct entrance was ten percent of the duct inlet diameter. Through measurements made, local flow velocity vector as well as static and total pressures mapping of the flow at several stations were obtained. Strong secondary flow was measured in the first bend which continued into the second bend with new vorticity produced in there in the opposite direction. Surface oil flow visualization and wall pressures indicated a region of separated flow starting at theta approximately equal to 22 deg on the inside of the first bend up to theta approximately equal to 44 deg on the outside of the second bend. The flow separated in 'cyclone' form and never reattached in the duct. As a result of the secondary flow and the flow separation, significant total pressure distortion was observed at the exit of the duct. Using flow control devices the separation was eliminated while the exit distortion was improved.

  5. [Endoscopic manometry in the common bile duct].

    PubMed

    Brandstätter, G; Kratochvil, P; Stupnicki, T; Zenker, G; Justich, E; Resch, M

    1982-09-17

    Reproducible results were obtained by endoscopic transpapillary pressure measurements with the help of a constantly perfused catheter. Manometric measurements were performed in 51 patients without any premedication. 14 patients with a normal biliary system were compared with 17 patients after cholecystectomy, 14 patients with stones in the common bile duct and 6 patients after papillotomy. Although there were significant differences in the diameter of the common bile duct in the four groups, only the papillotomized patients demonstrated a distinct change of the pressure in the bile duct. In these patients almost no pressure gradient existed between the biliary ducts and the duodenum. On the other hand, there was an increase in intraluminal pressure in the 2 patients with papillary stenosis. Endoscopic manometric measurements in the common bile duct are indicated to obtain reliable data on stenosis of the papilla duodeni, insufficient papillotomy or recurrent stenosis.

  6. Preventive saline irrigation of the bile duct after the endoscopic removal of common bile duct stones.

    PubMed

    Jang, Sang Eon; Ahn, Dong-Won; Lee, Sang Hyub; Lee, Ban Seok; Jeong, Ji Bong; Hwang, Jin-Hyeok; Ryu, Ji Kon; Kim, Yong-Tae; Lee, Kyoung Ho; Kim, Young Hoon

    2013-08-01

    Small stone fragments after an endoscopic stone extraction for choledocholithiasis may act as the nidus for recurrent choledocholithiasis. Therefore, efforts to eliminate the nidus might reduce the recurrence of choledocholithiasis and cholangitis related to choledocholithiasis. The purpose of this study was to determine whether an additional preventive saline irrigation of the bile duct after the endoscopic removal of common bile duct stones would decrease residual stones and the recurrence of cholangitis. A retrospective analysis was performed for the consecutively collected data about the patients who underwent the complete endoscopic treatment for common bile duct stone. Among 99 patients, 45 patients underwent saline irrigation. Residual stones were detected in 18 patients (18.2 %). The incidences of residual stones were 8.9 % (4 of 45 patients) in the irrigation group and 25.9 % (14 of 54 patients) in the non-irrigation group (P = 0.037). In multivariate analysis, preventive saline irrigation was found to be the only significant factor for the decrease of residual stones (HR = 0.258, P = 0.039). When analyzing the occurrence of recurrent cholangitis and the procedure related to complications, there were no significant differences according to the performance of preventive saline irrigation of the bile duct. Preventive saline irrigation could reduce the residual common bile duct stones without complications.

  7. Traumatic resin ducts as indicators of bark beetle outbreaks

    Treesearch

    R. Justin DeRose; Matthew F. Bekker; James N. Long

    2017-01-01

    The formation of traumatic resin ducts (TRDs) represents an important induced defense in woody plants that enhances oleoresin production and flow in response to environmental perturbations. In some genera (Pinus), resin ducts are copious and conspicuous; however, in others (Picea), resin ducts are relatively rare. The occurrence and strength of resin ducts, in...

  8. Coupled parametric design of flow control and duct shape

    NASA Technical Reports Server (NTRS)

    Florea, Razvan (Inventor); Bertuccioli, Luca (Inventor)

    2009-01-01

    A method for designing gas turbine engine components using a coupled parametric analysis of part geometry and flow control is disclosed. Included are the steps of parametrically defining the geometry of the duct wall shape, parametrically defining one or more flow control actuators in the duct wall, measuring a plurality of performance parameters or metrics (e.g., flow characteristics) of the duct and comparing the results of the measurement with desired or target parameters, and selecting the optimal duct geometry and flow control for at least a portion of the duct, the selection process including evaluating the plurality of performance metrics in a pareto analysis. The use of this method in the design of inter-turbine transition ducts, serpentine ducts, inlets, diffusers, and similar components provides a design which reduces pressure losses and flow profile distortions.

  9. Characterization of the secondary flow in hexagonal ducts

    NASA Astrophysics Data System (ADS)

    Marin, O.; Vinuesa, R.; Obabko, A. V.; Schlatter, P.

    2016-12-01

    In this work we report the results of DNSs and LESs of the turbulent flow through hexagonal ducts at friction Reynolds numbers based on centerplane wall shear and duct half-height Reτ,c ≃ 180, 360, and 550. The evolution of the Fanning friction factor f with Re is in very good agreement with experimental measurements. A significant disagreement between the DNS and previous RANS simulations was found in the prediction of the in-plane velocity, and is explained through the inability of the RANS model to properly reproduce the secondary flow present in the hexagon. The kinetic energy of the secondary flow integrated over the cross-sectional area yz decreases with Re in the hexagon, whereas it remains constant with Re in square ducts at comparable Reynolds numbers. Close connection between the values of Reynolds stress u w ¯ on the horizontal wall close to the corner and the interaction of bursting events between the horizontal and inclined walls is found. This interaction leads to the formation of the secondary flow, and is less frequent in the hexagon as Re increases due to the 120∘ aperture of its vertex, whereas in the square duct the 90∘ corner leads to the same level of interaction with increasing Re. Analysis of turbulence statistics at the centerplane and the azimuthal variance of the mean flow and the fluctuations shows a close connection between hexagonal ducts and pipe flows, since the hexagon exhibits near-axisymmetric conditions up to a distance of around 0.15DH measured from its center. Spanwise distributions of wall-shear stress show that in square ducts the 90∘ corner sets the location of a high-speed streak at a distance zv+≃50 from it, whereas in hexagons the 120∘ aperture leads to a shorter distance of zv+≃38 . At these locations the root mean square of the wall-shear stresses exhibits an inflection point, which further shows the connections between the near-wall structures and the large-scale motions in the outer flow.

  10. On turbulent friction in straight ducts with complex cross-section: the wall law and the hydraulic diameter

    NASA Astrophysics Data System (ADS)

    Pirozzoli, Sergio

    2018-07-01

    We develop predictive formulas for friction resistance in ducts with complex cross-sectional shape based on the use of the log law and neglect of wall shear stress nonuniformities. The traditional hydraulic diameter naturally emerges from the analysis as the controlling length scale for common duct shapes as triangles and regular polygons. The analysis also suggests that a new effective diameter should be used in more general cases, yielding corrections of a few percent to friction estimates based on the traditional hydraulic diameter. Fair but consistent predictive improvement is shown for duct geometries of practical relevance, including rectangular and annular ducts, and circular rod bundles.

  11. Breast carcinoma with a predominant duct-replacing component and chondroid matrix production.

    PubMed

    Tajima, Shogo; Koda, Kenji

    2016-12-01

    Breast carcinomas that produce chondroid matrix are extremely rare. If the carcinoma is invasive, it is classified as a matrix-producing carcinoma (MPC). Herein, we present a case of a breast carcinoma, which showed duct-replacing growth with chondroid matrix production. A 63-year-old woman underwent fine needle aspiration cytology for suspected malignancy, based on radiological findings. Cellular components showed sufficient atypia to allow a diagnosis of malignancy. A partial mastectomy was performed, and no mass-forming lesion was apparent in the surgically resected specimen. Histopathological examination showed that the carcinoma produced chondroid matrix and grew replacing ducts, which were associated with a small amount of an obvious invasive component without matrix production. Some parts of the duct-replacing component might take the form of expansile invasion due to the absence of residual duct-lining myoepithelial cells; it is difficult to decide whether the duct-replacing component is invasive or not. However, regarding a few tumor nests, they would be recognized as MPC-like intraductal components because of the focal presence of myoepithelial cells around them. Hence, this carcinoma could not be definitely diagnosed as a MPC, even though we believe they are closely related. This is the first reported case of a breast carcinoma displaying duct-replacing growth with chondroid matrix production.

  12. Ventilation duct with concurrent acoustic feed-forward and decentralised structural feedback active control

    NASA Astrophysics Data System (ADS)

    Rohlfing, J.; Gardonio, P.

    2014-02-01

    This paper presents theoretical and experimental work on concurrent active noise and vibration control for a ventilation duct. The active noise control system is used to reduce the air-borne noise radiated via the duct outlet whereas the active vibration control system is used to both reduce the structure-borne noise radiated by the duct wall and to minimise the structural feed-through effect that reduces the effectiveness of the active noise control system. An elemental model based on structural mobility functions and acoustic impedance functions has been developed to investigate the principal effects and limitations of feed-forward active noise control and decentralised velocity feedback vibration control. The principal simulation results have been contrasted and validated with measurements taken on a laboratory duct set-up, equipped with an active noise control system and a decentralised vibration control system. Both simulations and experimental results show that the air-borne noise radiated from the duct outlet can be significantly attenuated using the feed-forward active noise control. In the presence of structure-borne noise the performance of the active noise control system is impaired by a structure-borne feed-through effect. Also the sound radiation from the duct wall is increased. In this case, if the active noise control is combined with a concurrent active vibration control system, the sound radiation by the duct outlet is further reduced and the sound radiation from the duct wall at low frequencies reduces noticeably.

  13. Meta-analysis of Duct-to-duct versus Roux-en-Y biliary reconstruction following liver transplantation for primary sclerosing cholangitis.

    PubMed

    Pandanaboyana, Sanjay; Bell, Richard; Bartlett, Adam J; McCall, John; Hidalgo, Ernest

    2015-04-01

    This meta-analysis aimed to compare outcomes following bile duct reconstruction in patients with primary sclerosing cholangitis (PSC) undergoing liver transplantation depending on whether duct-to-duct or Roux-en-Y anastomosis was utilized. An electronic search was performed of the MEDLINE, EMBASE, PubMed databases using both subject headings (MeSH) and truncated word searches. Pooled risk ratios and mean difference were calculated using the fixed-effects and random-effects models for meta-analysis. Ten studies including 910 patients met the inclusion criteria. There was no difference in the overall incidence of biliary strictures between the two groups [odds ratio (OR) 1.06 (0.68, 1.66); (P = 0.80)]. The anastomotic stricture rate was similar, [OR 1.18 (0.56, 2.50); (P = 0.67)]. Ascending cholangitis was higher in the Roux-en-Y group [OR 2.91 (1.17, 7.23); (P = 0.02)]. Anastomotic bile leak rates, graft survival, PSC recurrence and number of patients diagnosed with cholangiocarcinoma following transplantation were comparable between both groups. Duct-to-duct and Roux-en-Y reconstruction had comparable outcomes. Both techniques are associated with similar incidence of biliary stricture. The bilioenteric reconstruction was associated with a higher risk of cholangitis. The incidence of de novo cholangiocarcinoma was similar in both groups. Duct-to-duct reconstruction should be considered when feasible in patients with PSC. © 2015 Steunstichting ESOT.

  14. Patients’ Reasons for Choosing Office-based Buprenorphine: Preference for Patient-Centered Care

    PubMed Central

    Korthuis, P. Todd; Gregg, Jessica; Rogers, Wendy E.; McCarty, Dennis; Nicolaidis, Christina; Boverman, Joshua

    2010-01-01

    Objectives To explore HIV-infected patients’ attitudes about buprenorphine treatment in office-based and opioid treatment program (OTP) settings. Methods We conducted in-depth qualitative interviews with 29 patients with co-existing HIV infection and opioid dependence seeking buprenorphine maintenance therapy in office-based and OTP settings. We used thematic analysis of transcribed audiorecorded interviews to identify themes. Results Patients voiced a strong preference for office-based treatment. Four themes emerged to explain this preference. First, patients perceived the greater convenience of office-based treatment as improving their ability to address HIV and other healthcare issues. Second, they perceived a strong patient-focused orientation in patient-provider relationships underpinning their preference for office-based care. This was manifest as increased trust, listening, empathy, and respect from office-based staff and providers. Third, they perceived shared power and responsibility in office-based settings. Finally, patients viewed office-based treatment as a more supportive environment for sobriety and relapse prevention. This was partly due to strong therapeutic alliances with office-based staff and providers who prioritized a harm reduction approach, but also due to the perception that the office-based settings were “safer” for sobriety, compared with increased opportunities for purchasing and using illicit opiates in OTP settings. Conclusions HIV-infected patients with opioid dependence preferred office-based buprenorphine because they perceived it as offering a more patient-centered approach to care compared with OTP referral. Office-based buprenorphine may facilitate engagement in care for patients with co-existing opioid dependence and HIV infection. PMID:21170143

  15. Lesions of the segmental and lobar hepatic ducts.

    PubMed Central

    Longmire, W P; Tompkins, R K

    1975-01-01

    Despite reports to the contrary, unobstructed drainage of 50% of an otherwise normal liver through either the right or left uninfected hepatic duct is adequate to restore normal liver function, even if the obstructed lobe remains in place. An undrained liver lobe, if present, may require no further treatment. As long as it is completely obstructed and uninfected, it will undergo a progressive asymptomatic atrophy. Cholangitis invariably develops behind a partial lobar ductal obstruction, producing jaundice, pruritis, and fever. Unless unobstructed, uninfected biliary flow can be achieved through a segmental or lobar duct, it is better that the duct be completely obstructed and the affected liver parenchyma allowed to atrophy, provided there is normal biliary flow from the residual 50% of liver. This concept is important in the management of injured anomalous segmental or lobar hepatic duct and in the palliative treatment of bile duct carcinoma. Localized intrahepatic infections communicating with abnormal biliary ducts will require hepatic resection of the infected parenchyma and ducts for cure. The abnormality may be saccular dilatation of the intrahepatic ductal system with abscess formation or intrahepatic abscess associated with stenosis of the ductal system from trauma to the duct, to the duct and liver, or to retained intrahepatic stones. Diffusely situated intrahepatic abscesses secondary to ductal abnormalities can be treated with systemic antibiotics, local drainage of a dmoninant abscess, and efforts to improve biliary drainage. Images Fig. 4. Fig. 5. Fig. 6. Fig. 8. Fig. 9. Fig. 10. Figs. 11A and B Figs. 12A and B. Fig. 13. Fig. 14. Fig. 15. Fig. 16. Fig. 17. PMID:1180585

  16. Decline of the performance of a portable axial-flow fan due to the friction and duct bending loss of a connected flexible duct.

    PubMed

    Ojima, Jun

    2017-03-28

    In a job site, a portable fan is often used to ventilate a confined space. When a portable fan is applied to such a space, the actual ventilation flow rate must be accurately estimated in advance because the safety level of contaminant and oxygen concentrations in the space will determine the ventilation requirements. When a portable fan is used with a flexible duct, the actual flow rate of the fan decreases due to the friction and duct bending loss of the duct. Intending to show the decline of a fan performance, the author conducted laboratory experiments and reported the quantitative effect of the friction and duct bending loss of a flexible duct to the flow rate of a portable fan. Four commercial portable fans of different specifications were procured for the experiments, and the decline of the performance of each portable fan due to the friction loss etc. of a connected flexible duct was investigated by measuring actual flow rate. The flow rate showed an obvious decrease from the rated flow rate when a flexible duct was connected. Connection of a straight polyester flexible duct and a straight aluminum flexible duct reduced the flow rates to 81.2 - 52.9% and less than 50%, respectively. The flow rate decreased with an increase of the bend angle of the flexible duct. It is recommended that flow rate check of a portable fan should be diligently carried out in every job site.

  17. [Iatrogenic bile duct injuries during the process of laparoscopic cholecystectomy].

    PubMed

    Qian, G; Wu, M; Zhang, Y

    1995-11-01

    Twelve patients with iatrogenic bile duct injuries occurred during laparoscopic cholecystectomy (LC) were treated from June 1992 to May 1994. All the patients underwent re-operation and were cured. The causes and characteristics of the injuries were: (1) perforation of the common hepatic or common bile duct caused by dissecting hook (3 cases); (2) necrosis and perforation of the common hepatic duct due to diathermic injury (1 case); (3) clamping of the common hepatic duct by Ti clip (1 case); (4) secondary high bile duct stricture following a failed end-to-end anastomosis or hepatico-cholangio-jejunostomy of the amputated common hepatic duct (5 cases); (5) delayed high bile duct stricture (2 cases). It is emphasized that the severity of bile duct injuries by LC be should not overlooked, and more experience in this field be accumulated to avoid this serious complication.

  18. Heterogeneity Between Ducts of the Same Nuclear Grade Involved by Duct Carcinoma In Situ (DCIS) of the Breast

    PubMed Central

    Miller, Naomi A.; Chapman, Judith-Anne W.; Qian, Jin; Christens-Barry, William A.; Fu, Yuejiao; Yuan, Yan; Lickley, H. Lavina A.; Axelrod, David E.

    2010-01-01

    Purpose Nuclear grade of breast DCIS is considered during patient management decision-making although it may have only a modest prognostic association with therapeutic outcome. We hypothesized that visual inspection may miss substantive differences in nuclei classified as having the same nuclear grade. To test this hypothesis, we measured subvisual nuclear features by quantitative image cytometry for nuclei with the same grade, and tested for statistical differences in these features. Experimental design and statistical analysis Thirty-nine nuclear digital image features of about 100 nuclei were measured in digital images of H&E stained slides of 81 breast biopsy specimens. One field with at least 5 ducts was evaluated for each patient. We compared features of nuclei with the same grade in multiple ducts of the same patient with ANOVA (or Welch test), and compared features of nuclei with the same grade in two ducts of different patients using 2-sided t-tests (P ≤ 0.05). Also, we compared image features for nuclei in patients with single grade to those with the same grade in patients with multiple grades using t-tests. Results Statistically significant differences were detected in nuclear features between ducts with the same nuclear grade, both in different ducts of the same patient, and between ducts in different patients with DCIS of more than one grade. Conclusion Nuclei in ducts visually described as having the same nuclear grade had significantly different subvisual digital image features. These subvisual differences may be considered additional manifestations of heterogeneity over and above differences that can be observed microscopically. This heterogeneity may explain the inconsistency of nuclear grading as a prognostic factor. PMID:20981137

  19. Subsonic Flows through S-Ducts with Flow Control

    NASA Astrophysics Data System (ADS)

    Chen, Yi

    An inlet duct of an aircraft connects the air intake mounted on the fuselage to the engine within the aircraft body. The ideal outflow quality of the duct is steady, uniform and of high total pressure. Recently compact S-shaped inlet ducts are drawing more attention in the design of UAVs with short propulsion system. Compact ducts usually involve strong streamwise adverse pressure gradient and transverse secondary flow, leading to large-scale harmful vortical structures in the outflow. To improve the outflow quality modern flow control techniques have to be applied. Before designing successful flow control methods a solid understanding of the baseline flow field with the duct is crucial. In this work the fundamental mechanism of how the three dimensional flow topology evolves when the relevant parameters such as the duct geometry and boundary layer thickness are varied, is studied carefully. Two distinct secondary-flow patterns are identified. For the first time the sensitivity of the flow topology to the inflow boundary layer thickness in long ducts is clearly addressed. The interaction between the transverse motion induced by the transverse pressure gradient and the streamwise separation is revealed as the crucial reason for the various flow patterns existing in short ducts. A non-symmetric flow pattern is identified for the first time in both experiments and simulations in short ducts in which the intensity of the streamwise separation and the transverse invasion are in the same order of magnitude. A theory of energy accumulation and solution bifurcation is used to give a reasonable explanation for this non-symmetry. After gaining the knowledge of where and how the harmful vortical structures are generated several flow control techniques are tested to achieve a better outflow quality. The analysis of the flow control cases also provides a deeper insight into the behavior of the three-dimensional flow within the ducts. The conventional separation control method

  20. Predicting vibrational failure of flexible ducting

    NASA Technical Reports Server (NTRS)

    Henry, R. H.

    1971-01-01

    Technique applies to liquid or gas transfer through flexible ducting and proves valuable in high velocity fluid flow cases. Fluid mechanism responsible for free bellows vibrational excitation also causes flexible hose oscillation. Static pressure stress influences flexible ducting fatigue life and is considered separately.

  1. Parotid salivary duct stenosis following caudal maxillectomy.

    PubMed

    Mestrinho, Lisa A; Faísca, Pedro B; Niza, Maria M R E

    2014-01-01

    Parotid salivary duct dilation was diagnosed in a 9-year-old male dog. The dog had undergone caudal maxillectomy on the ipsilateral side 2-years prior to presentation. Treatment consisted of parotid salivary duct excision and superficial parotidectomy that lead to the resolution of clinical signs. Transient facial neuropraxia was observed immediately after surgery and resolved spontaneously after 2-weeks. Parotid salivary duct dilation should be considered as a chronic postoperative complication following caudal maxillectomy.

  2. Synchronous double primary cancers of the extrahepatic bile duct: A case report and literature review.

    PubMed

    Nishi, Takeshi; Sato, Yoshitoshi; Hanaoka, Takuya; Takahashi, Takuya; Miura, Hiroshi; Takubo, Kenji

    2018-01-01

    Double cancers of the biliary tract system are rare. Most of these cancers are synchronous double cancers of the gall bladder and bile duct, associated with pancreaticobiliary maljunction (PBM). Synchronous double cancers of the extrahepatic bile duct without PBM are especially rare, and only 4 cases have been reported. A 78-year-old woman was admitted to our hospital for examination of hyperbilirubinemia and liver dysfunction. Contrast-enhanced abdominal computed tomography, Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography revealed 2 stenotic regions in the common bile duct: at its junction with the cystic duct and in the distal bile duct. No findings suggested PBM, such as a markedly long common channel. The diagnosis based on endoscopic brush cytology from both stricture portions was adenocarcinoma. The patient had a pylorus-preserving pancreaticoduodenectomy with regional lymph node resection. Macroscopically, there were 2 stenotic regions at the cystic duct junction and in the distal bile duct. Microscopically, the tumor at the junction of the cystic duct was a well-to-moderately differentiated adenocarcinoma. On the other hand, the tumor of the distal bile duct was a poorly differentiated adenocarcinoma. There was no evidence of communication between these 2 cancers. Double cancers of the extrahepatic bile duct without PBM are very rare. Therefore, an accurate diagnosis prior to surgery is necessary. Furthermore, this rare condition seems to be associated with a poor prognosis. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Flow duct for nuclear reactors

    DOEpatents

    Straalsund, Jerry L.

    1978-01-01

    Improved liquid sodium flow ducts for nuclear reactors are described wherein the improvement comprises varying the wall thickness of each of the walls of a polygonal tubular duct structure so that each of the walls is of reduced cross-section along the longitudinal center line and of a greater cross-section along wall junctions with the other walls to form the polygonal tubular configuration.

  4. Morphological study of human sweat ducts for the investigation of THz-wave interaction (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Kawase, Kodo; Tripathi, Saroj R.

    2016-03-01

    Recently, some studies reported that the sweat ducts act as a low-Q-factor helical antenna due to their helical structure, and resonate in the terahertz frequency range according to their structural parameters. According to the antenna theory, when the duct works as a helical antenna, the dimension of the helix plays a key role to determine the frequency of resonance. Therefore, the accurate determination of structural parameters of sweat duct is crucially important to obtain the reliable frequency of resonance and modes of operations. Therefore, here we performed the optical coherence tomography (OCT) of human subjects on their palm and foot to investigate the density, distribution and morphological features of sweat ducts. Moreover, we measured the dielectric properties of stratum corneum using terahertz time domain spectroscopy and based upon this information, we determined the frequency of resonance. We recruited 32 subjects for the measurement and the average duct diameter was 95±11μm. Based upon this information on diameter of duct and THz dielectric properties of stratum corneum (ɛ=5.1±1.3), we have calculated the frequency of resonance of sweat duct. Finally, we determined that the center frequency of resonance was 442±76 GHz. We believe that these findings will facilitate further investigation of the THz-skin interaction and provide guidelines for safety levels with respect to human exposure. We will also report on the EEG measurement while being shined by micro watt order THz waves.

  5. Bile duct epithelial tight junctions and barrier function

    PubMed Central

    Rao, R.K.; Samak, G.

    2013-01-01

    Bile ducts play a crucial role in the formation and secretion of bile as well as excretion of circulating xenobiotic substances. In addition to its secretory and excretory functions, bile duct epithelium plays an important role in the formation of a barrier to the diffusion of toxic substances from bile into the hepatic interstitial tissue. Disruption of barrier function and toxic injury to liver cells appear to be involved in the pathogenesis of a variety of liver diseases such as primary sclerosing cholangitis, primary biliary cirrhosis and cholangiocarcinoma. Although the investigations into understanding the structure and regulation of tight junctions in gut, renal and endothelial tissues have expanded rapidly, very little is known about the structure and regulation of tight junctions in the bile duct epithelium. In this article we summarize the current understanding of physiology and pathophysiology of bile duct epithelium, the structure and regulation of tight junctions in canaliculi and bile duct epithelia and different mechanisms involved in the regulation of disruption and protection of bile duct epithelial tight junctions. This article will make a case for the need of future investigations toward our understanding of molecular organization and regulation of canalicular and bile duct epithelial tight junctions. PMID:24665411

  6. Analyses of radiation impedances of finite cylindrical ducts

    NASA Astrophysics Data System (ADS)

    Shao, W.; Mechefske, C. K.

    2005-08-01

    To aid in understanding the characteristics of acoustic radiation from finite cylindrical ducts with infinite flanges, mathematical expressions of generalized radiation impedances at the open ends have been developed. Newton's method is used to find the complex wavenumbers of radial modes for the absorption boundary condition. The self-radiation impedances and mutual impedances for some acoustic modes are calculated for the ducts with rigid and absorption walls. The results show that the acoustical conditions of the duct walls have a significant influence on the radiation impedance. The acoustical interaction between the two open ends of the ducts cannot be neglected, especially for plane waves. To increase the wall admittance will reduce this interference effect. This study creates the possibility for simulating the sound field inside finite ducts in future work.

  7. 14 CFR 141.25 - Business office and operations base.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Business office and operations base. 141.25... operations base. (a) Each holder of a pilot school or a provisional pilot school certificate must maintain a... or the operations base, each certificate holder must notify the FAA Flight Standards District Office...

  8. 14 CFR 141.25 - Business office and operations base.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Business office and operations base. 141.25... operations base. (a) Each holder of a pilot school or a provisional pilot school certificate must maintain a... or the operations base, each certificate holder must notify the FAA Flight Standards District Office...

  9. 14 CFR 141.25 - Business office and operations base.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Business office and operations base. 141.25... operations base. (a) Each holder of a pilot school or a provisional pilot school certificate must maintain a... or the operations base, each certificate holder must notify the FAA Flight Standards District Office...

  10. 14 CFR 141.25 - Business office and operations base.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Business office and operations base. 141.25... operations base. (a) Each holder of a pilot school or a provisional pilot school certificate must maintain a... or the operations base, each certificate holder must notify the FAA Flight Standards District Office...

  11. Turbofan Duct Propagation Model

    NASA Technical Reports Server (NTRS)

    Lan, Justin H.; Posey, Joe W. (Technical Monitor)

    2001-01-01

    The CDUCT code utilizes a parabolic approximation to the convected Helmholtz equation in order to efficiently model acoustic propagation in acoustically treated, complex shaped ducts. The parabolic approximation solves one-way wave propagation with a marching method which neglects backwards reflected waves. The derivation of the parabolic approximation is presented. Several code validation cases are given. An acoustic lining design process for an example aft fan duct is discussed. It is noted that the method can efficiently model realistic three-dimension effects, acoustic lining, and flow within the computational capabilities of a typical computer workstation.

  12. Rotating Rake Turbofan Duct Mode Measurement System

    NASA Technical Reports Server (NTRS)

    Sutliff, Daniel L.

    2005-01-01

    An experimental measurement system was developed and implemented by the NASA Glenn Research Center in the 1990s to measure turbofan duct acoustic modes. The system is a continuously rotating radial microphone rake that is inserted into the duct. This Rotating Rake provides a complete map of the acoustic duct modes present in a ducted fan and has been used on a variety of test articles: from a low-speed, concept test rig, to a full-scale production turbofan engine. The Rotating Rake has been critical in developing and evaluating a number of noise reduction concepts as well as providing experimental databases for verification of several aero-acoustic codes. More detailed derivation of the unique Rotating Rake equations are presented in the appendix.

  13. Changing patterns of traumatic bile duct injuries: a review of forty years experience

    PubMed Central

    Huang, Zhi-Qiang; Huang, Xiao-Qiang

    2002-01-01

    AIM: To summarize the experiences of treating bile duct injuries in 40 years of clinical practice. MATHODS: Based on the experience of more than 40 years of clinical work, 122 cases including a series of 61 bile duct injuries of the Southwest Hospital, Chongqing, and 42 cases (1989-1997) and 19 cases (1998-2001) of the General Hospital of PLA, Beijing, were reviewed with special reference to the pattern of injury. A series of cases of the liver and the biliary tract injuries following interventional therapy for hepatic tumors, most often hemangioma of the liver, were collected. Chinese medical literature from 1995 to 1999 dealing with 2742 traumatic bile duct strictures were reviewed. RESULTS: There was a changing pattern of the bile duct injury. Although most of the cases of bile duct injuries resulted from open cholecystectomy. Other types of trauma such as laparoscopic cholecystectomy (LC) and hepatic surgery were increased in recent years. Moreover, serious hepato-biliary injuries following HAE using sclerotic agents such as sodium morrhuate and absolute ethanol for the treatment of hepatic hemangiomas were encountered in recent years. Experiences in how to avoid bile duct injury and to treat traumatic biliary strictures were presented. CONCLUSION: Traumatic bile duct stricture is one of the serious complications of hepato-biliary surgery, its prevalence seemed to be increased in recent years. The pattern of bile duct injury was also changed and has become more complicated. Interventional therapy with sclerosing agents may cause serious hepatobiliary complications and should be avoided. PMID:11833062

  14. Frequency of resonance of human sweat duct in different modes of operation

    NASA Astrophysics Data System (ADS)

    Tripathi, Saroj R.; Takahashi, Shogo; Kinumura, Kento; Kawase, Kodo

    2018-02-01

    Recently, some studies have demonstrated that the sweat ducts present in the skin play a significant role in terahertz (THz) wave interaction with human beings. It was reported that the sweat ducts act as a low-Q-factor helical antenna due to their helical structure, and resonate in the sub-terahertz frequency range according to their structural parameters, such as helix diameter and helix length. According to the antenna theory, a helical antenna resonates in two different modes of operation known as normal mode and axial mode and the dimension of the helix plays a key role to determine the frequency of resonance. Therefore, here we performed the optical coherence tomography (OCT) of number of human subjects on their palm and foot to investigate the density, distribution and morphological features of sweat ducts. Moreover, we calculated the dielectric properties of human skin using terahertz time domain spectroscopy. Based on the structural parameters of human sweat ducts and its THz dielectric properties of surrounding medium, we computed the frequency of resonance of sweat duct in different modes of operation and we found that these ducts resonate in subterahertz frequency region. We believe that these findings will facilitate further investigation of the THz-skin interaction and provide guidelines for safety levels with respect to human exposure to electromagnetic waves at these frequencies.

  15. A population-based case-control study of cancer of the bile ducts and gallbladder in Quebec, Canada.

    PubMed

    Ghadirian, P; Simard, A; Baillargeon, J

    1993-01-01

    In a population-based case-control study of pancreatic cancer in Greater Montreal between 1984 and 1988, a total of 24 patients with cancer of the bile ducts and 33 patients suffering from cancer of the gallbladder were compared to 239 population-based controls. This study was part of the SEARCH program of the International Agency for Research on Cancer. In cases of cancer of the bile ducts, smoking nonfiltered cigarettes produced a relative risk of 2.82 and a 95% confidence interval of 1.01-7.86 after adjustment for age, sex, other smoking habits, alcohol consumption, schooling, and respondent status. Laxative intake was associated with a risk of 2.87 (1.00-8.22). Coffee drinkers were collectively at lower risk than non-drinkers: OR = 0.26 (0.07-0.95). In patients with cancer of the gallbladder, constipation was related to a risk of 3.19 (1.02-9.95) after adjustment for the same factors. In cases with previous gallbladder problems, the risk was found to be significant [OR = 7.96 (2.03-31.2)], 8 times greater in cases than in controls.

  16. Common Bile Duct Stricture After Laparoscopic Cholecystectomy: Case Report

    PubMed

    Zoričić, Ivan; Soldo, Ivo; Simović, Ivan; Sever, Marko; Bakula, Branko; Grbavac, Martin; Marušić, Marinko; Soldo, Anamaria

    2017-03-01

    Despite progress in laparoscopic surgery and increasing surgical experience, the incidence of bile duct injury during laparoscopic cholecystectomy fails to fall below 0.3%-0.6% and it is still higher than those recorded in the era of open cholecystectomy. Bile duct injuries belong to the most serious complications of abdominal surgery in general and often end up with liver transplantation as the only hope for cure. We present a case of a 78-year-old jaundiced male patient who sustained common hepatic duct injury during laparoscopic cholecystectomy eight months earlier. Exploratory laparotomy, ERCP and MRCP revealed a metal clip placed just below hepatic duct confluence and causing stricture of bile duct with dilatation of bile ducts proximal to the level of stenosis (Strasberg classification type E3 injury). Repair of the injury was performed by creating termino-lateral hepaticojejunostomy between the right and left hepatic ducts and retrocolic Roux en-Y jejunal limb. By presenting this case, we wish to emphasize the importance of timely conversion and execution of intraoperative cholangiography in all cases when identification of the structures of Calot’s triangle is not clear enough. Successful treatment of bile duct injury is only possible with joint approach of radiologist, gastroenterologist and experienced hepatobiliary surgeon.

  17. Long duct nacelle aerodynamic development for DC-10 derivatives

    NASA Technical Reports Server (NTRS)

    Patel, S. P.; Donelson, J. E.

    1980-01-01

    The results are presented of a wind tunnel test utilizing a 4.7-percent-scale semispan model of the DC-10 in the Calspan 8-foot transonic wind tunnel. The effect of a revised long-duct nacelle shape on the channel velocities, the incremental drag relative to the baseline long-duct nacelle, and channel velocities for the baseline long-duct nacelle were determined and compared with data obtained at Ames. The baseline and the revised long-duct nacelles are representative of a CF6-50 mixed-flow configuration and were evaluated on a model of a proposed DC-10 stretched-fuselage configuration. The results showed that the revised long-duct nacelle has an appreciable effect on the inboard channel velocities, resulting in an increased channel Mach number. However, the pressure recovery on the nacelle afterbody was about the same for both nacelles. The lift curves for both long-duct nacelle configurations were the same. The channel pressures measured at Calspan were in good agreement with those measured at Ames for the baseline long-duct nacelle. The incremental drag for the revised nacelle was measured as two to four counts (three counts is approximately equal to one percent of the airplane drag) higher than that of the baseline long-duct nacelle.

  18. Parametric study of electromagnetic waves propagating in absorbing curved S ducts

    NASA Technical Reports Server (NTRS)

    Baumeister, Kenneth J.

    1989-01-01

    A finite-element Galerkin formulation has been developed to study attenuation of transverse magnetic (TM) waves propagating in two-dimensional S-curved ducts with absorbing walls. In the frequency range where the duct diameter and electromagnetic wave length are nearly equal, the effect of duct length, curvature (duct offset), and absorber wall thickness was examined. For a given offset in the curved duct, the length of the S-duct was found to significantly affect both the absorptive and reflective characteristics of the duct. For a straight and a curved duct with perfect electric conductor terminations, power attenuation contours were examined to determine electromagnetic wall properties associated with maximum input signal absorption. Offset of the S-duct was found to significantly affect the value of the wall permittivity associated with the optimal attenuation of the incident electromagnetic wave.

  19. Leaf seal for transition duct in turbine system

    DOEpatents

    Flanagan, James Scott; LeBegue, Jeffrey Scott; McMahan, Kevin Weston; Dillard, Daniel Jackson; Pentecost, Ronnie Ray

    2013-06-11

    A turbine system is disclosed. In one embodiment, the turbine system includes a transition duct. The transition duct includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct further includes an interface member for interfacing with a turbine section. The turbine system further includes a leaf seal contacting the interface member to provide a seal between the interface member and the turbine section.

  20. Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®)—Health Professional Version

    Cancer.gov

    Bile duct cancer (also called cholangiocarcinoma) can occur in the bile ducts in the liver (intrahepatic) or outside the liver (perihilar or distal extrahepatic). Learn about the types of bile duct cancer, risk factors, clinical features, staging, and treatment for bile duct cancer in this expert-reviewed summary.

  1. The testicular sperm ducts and genital kidney of male Ambystoma maculatum (Amphibia, Urodela, Ambystomatidae).

    PubMed

    Siegel, Dustin S; Aldridge, Robert D; Rheubert, Justin L; Gribbins, Kevin M; Sever, David M; Trauth, Stanley E

    2013-03-01

    The ducts associated with sperm transport from the testicular lobules to the Wolffian ducts in Ambystoma maculatum were examined with transmission electron microscopy. Based on the ultrastructure and historical precedence, new terminology for this network of ducts is proposed that better represents primary hypotheses of homology. Furthermore, the terminology proposed better characterizes the distinct regions of the sperm transport ducts in salamanders based on anatomy and should, therefore, lead to more accurate comparisons in the future. While developing the above ontology, we also tested the hypothesis that nephrons from the genital kidney are modified from those of the pelvic kidney due to the fact that the former nephrons function in sperm transport. Our ultrastructural analysis of the genital kidney supports this hypothesis, as the basal plasma membrane of distinct functional regions of the nephron (proximal convoluted tubule, distal convoluted tubule, and collecting tubule) appear less folded (indicating decreased surface area and reduced reabsorption efficiency) and the proximal convoluted tubule possesses ciliated epithelial cells along its entire length. Furthermore, visible luminal filtrate is absent from the nephrons of the genital kidney throughout their entire length. Thus, it appears that the nephrons of the genital kidney have reduced reabsorptive capacity and ciliated cells of the proximal convoluted tubule may increase the movement of immature sperm through the sperm transport ducts or aid in the mixing of seminal fluids within the ducts. Copyright © 2012 Wiley Periodicals, Inc.

  2. Prototype of smart office system using based security system

    NASA Astrophysics Data System (ADS)

    Prasetyo, T. F.; Zaliluddin, D.; Iqbal, M.

    2018-05-01

    Creating a new technology in the modern era gives a positive impact on business and industry. Internet of Things (IoT) as a new communication technology is very useful in realizing smart systems such as: smart home, smart office, smart parking and smart city. This study presents a prototype of the smart office system which was designed as a security system based on IoT. Smart office system development method used waterfall model. IoT-based smart office system used platform (project builder) cayenne so that. The data can be accessed and controlled through internet network from long distance. Smart office system used arduino mega 2560 microcontroller as a controller component. In this study, Smart office system is able to detect threats of dangerous objects made from metals, earthquakes, fires, intruders or theft and perform security monitoring outside the building by using raspberry pi cameras on autonomous robots in real time to the security guard.

  3. Measure Guideline: Buried and/or Encapsulated Ducts

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

    Shapiro, C.; Zoeller, W.; Mantha, P.

    2013-08-01

    Buried and/or encapsulated ducts (BEDs) are a class of advanced, energy-efficiency strategies intended to address the significant ductwork thermal losses associated with ducts installed in unconditioned attics. BEDs are ducts installed in unconditioned attics that are covered in loose-fill insulation and/or encapsulated in closed cell polyurethane spray foam insulation. This Measure Guideline covers the technical aspects of BEDs as well as the advantages, disadvantages, and risks of BEDs compared to other alternative strategies. This guideline also provides detailed guidance on installation of BEDs strategies in new and existing homes through step-by-step installation procedures. Some of the procedures presented here, however,more » require specialized equipment or expertise. In addition, some alterations to duct systems may require a specialized license.« less

  4. Characterization of the secondary flow in hexagonal ducts

    DOE PAGES

    Marin, O.; Vinuesa, R.; Obabko, A. V.; ...

    2016-12-06

    In this work we report the results of DNSs and LESs of the turbulent flow through hexagonal ducts at friction Reynolds numbers based on centerplane wall shear and duct half-height Re τ,c ≃ 180, 360, and 550. The evolution of the Fanning friction factor f with Re is in very good agreement with experimental measurements. A significant disagreement between the DNS and previous RANS simulations was found in the prediction of the in-plane velocity, and is explained through the inability of the RANS model to properly reproduce the secondary flow present in the hexagon. The kinetic energy of the secondarymore » flow integrated over the cross-sectional area < K > yz decreases with Re in the hexagon, whereas it remains constant with Re in square ducts at comparable Reynolds numbers. Close connection between the values of Reynolds stress uw¯ on the horizontal wall close to the corner and the interaction of bursting events between the horizontal and inclined walls is found. This interaction leads to the formation of the secondary flow, and is less frequent in the hexagon as Re increases due to the 120° aperture of its vertex, whereas in the square duct the 90° corner leads to the same level of interaction with increasing Re. Analysis of turbulence statistics at the centerplane and the azimuthal variance of the mean flow and the fluctuations shows a close connection between hexagonal ducts and pipe flows, since the hexagon exhibits near-axisymmetric conditions up to a distance of around 0.15 DH measured from its center. Spanwise distributions of wall-shear stress show that in square ducts the 90° corner sets the location of a high-speed streak at a distance z + v≃50 from it, whereas in hexagons the 120° aperture leads to a shorter distance of z + v≃38. Finally, at these locations the root mean square of the wall-shear stresses exhibits an inflection point, which further shows the connections between the near-wall structures and the large-scale motions in the

  5. Case-controlled clinical and histopathological study of conjunctivochalasis.

    PubMed

    Francis, I C; Chan, D G; Kim, P; Wilcsek, G; Filipic, M; Yong, J; Coroneo, M T

    2005-03-01

    Conjunctivochalasis, a secondary cause of the watery eye, is frequently seen in the older age group as an elevation of the bulbar conjunctiva lying along the lateral or central lower lid margin. A prospective, interventional, case-controlled clinical and histopathological study was conducted. The relevant features of 18 patients (29 eyes) who had their conjunctivochalasis resected as part of the surgical management of their watery eye syndrome were examined. In the control group, tissue was obtained from an age matched series of 24 normal subjects undergoing routine cataract surgery. 24 controls (24 specimens) and 18 patients (29 specimens) had conjunctival strip biopsies, taken from the usual lid margin level bulbar conjunctiva in line with the inferior limbus (controls), and the clinically apparent conjunctivochalasis (patients). These were submitted for histological study. 23 of 24 control sections demonstrated normal conjunctival variation. Four of 29 patient specimens demonstrated a chronic non-granulomatous conjunctivitis, while three eyes of the patient group (two patients) demonstrated features of elastosis. Of the four patients who had the inflammatory infiltrates, three had functional nasolacrimal duct obstructions (FNLDOs) and one had a primary acquired nasolacrimal duct obstruction (PANDO). Of the two patients who had elastosis, one had an FNLDO and the other had normal lacrimal drainage and was Jones 1 positive. Six of 18 patients--that is, seven of 29 specimens of conjunctivochalasis demonstrated signs of elastosis or of chronic non-granulomatous inflammation. Clinically, patients had a spectrum of aetiologies of their watery eye syndrome.

  6. "TuNa-saving" endoscopic medial maxillectomy: a surgical technique for maxillary inverted papilloma.

    PubMed

    Pagella, Fabio; Pusateri, Alessandro; Matti, Elina; Avato, Irene; Zaccari, Dario; Emanuelli, Enzo; Volo, Tiziana; Cazzador, Diego; Citraro, Leonardo; Ricci, Giampiero; Tomacelli, Giovanni Leo

    2017-07-01

    The maxillary sinus is the most common site of sinonasal inverted papilloma. Endoscopic sinus surgery, in particular endoscopic medial maxillectomy, is currently the gold standard for treatment of maxillary sinus papilloma. Although a common technique, complications such as stenosis of the lacrimal pathway and consequent development of epiphora are still possible. To avoid these problems, we propose a modification of this surgical technique that preserves the head of the inferior turbinate and the nasolacrimal duct. A retrospective analysis was performed on patients treated for maxillary inverted papilloma in three tertiary medical centres between 2006 and 2014. Pedicle-oriented endoscopic surgery principles were applied and, in select cases where the tumour pedicle was located on the anterior wall, a modified endoscopic medial maxillectomy was carried out as described in this paper. From 2006 to 2014 a total of 84 patients were treated. A standard endoscopic medial maxillectomy was performed in 55 patients (65.4%), while the remaining 29 (34.6%) had a modified technique performed. Three recurrences (3/84; 3.6%) were observed after a minimum follow-up of 24 months. A new surgical approach for select cases of maxillary sinus inverted papilloma is proposed in this paper. In this technique, the endoscopic medial maxillectomy was performed while preserving the head of the inferior turbinate and the nasolacrimal duct ("TuNa-saving"). This technique allowed for good visualization of the maxillary sinus, good oncological control and a reduction in the rate of complications.

  7. Ultrasound imaging of the mouse pancreatic duct using lipid microbubbles

    NASA Astrophysics Data System (ADS)

    Banerjee, B.; McKeown, K. R.; Skovan, B.; Ogram, E.; Ingram, P.; Ignatenko, N.; Paine-Murrieta, G.; Witte, R.; Matsunaga, T. O.

    2012-03-01

    Research requiring the murine pancreatic duct to be imaged is often challenging due to the difficulty in selectively cannulating the pancreatic duct. We have successfully catheterized the pancreatic duct through the common bile duct in severe combined immune deficient (SCID) mice and imaged the pancreatic duct with gas filled lipid microbubbles that increase ultrasound imaging sensitivity due to exquisite scattering at the gas/liquid interface. A SCID mouse was euthanized by CO2, a midline abdominal incision made, the common bile duct cut at its midpoint, a 2 cm, 32 gauge tip catheter was inserted about 1 mm into the duct and tied with suture. The duodenum and pancreas were excised, removed in toto, embedded in agar and an infusion pump was used to instill normal saline or lipid-coated microbubbles (10 million / ml) into the duct. B-mode images before and after infusion of the duct with microbubbles imaged the entire pancreatic duct (~ 1 cm) with high contrast. The microbubbles were cavitated by high mechanical index (HMI) ultrasound for imaging to be repeated. Our technique of catheterization and using lipid microbubbles as a contrast agent may provide an effective, affordable technique of imaging the murine pancreatic duct; cavitation with HMI ultrasound would enable repeated imaging to be performed and clustering of targeted microbubbles to receptors on ductal cells would allow pathology to be localized accurately. This research was supported by the Experimental Mouse Shared Service of the AZ Cancer Center (Grant Number P30CA023074, NIH/NCI and the GI SPORE (NIH/NCI P50 CA95060).

  8. Ultra structural changes occurring in duct ectasia and periductal mastitis and their significance in etiopathogenesis.

    PubMed

    Ramalingam, Kirithiga; Vuthaluru, Seenu; Srivastava, Anurag; Dinda, Amit Kumar; Dhar, Anita

    2017-01-01

    Duct ectasia (DE) and periductal mastitis (PDM) are the most common benign breast conditions seen in women. The etiopathogenesis of these entities is still not clear and most of the theories regarding the causation are based on the histological features as seen on light microscopy. The ultramicroscopic features associated with these conditions that may give more insight to the etiopathogenesis are unknown. To study the ultrastructural changes occurring in mammary duct cones in patients with DE and PDM using Transmission Electron Microscopic (TEM). Major ducts removed by radical duct excision from 21 patients with final histopathological diagnosis of DE and PDM were subjected to TEM study with 2 normal duct samples as controls. The TEM features of DE were denudation of the epithelial cells with focal loss of microvilli, widening of the inter-epithelial junctions with focal disruption of the T bars, periductal collagenisation without inflammation, and features suggestive of Epithelial Mesenchymal Transition (EMT). PDM features are intact epithelial lining with proliferative epithelium and periductal collagenisation with inflammation. Based on the TEM findings, we suggest that DE and PDM are two different entities. EMT a novel finding observed in DE in this study.

  9. Effects of cholestasis on learning and locomotor activity in bile duct ligated rats.

    PubMed

    Hosseini, Nasrin; Alaei, Hojjatallah; Nasehi, Mohammad; Radahmadi, Maryam; Mohammad Reza, Zarrindast

    2014-01-01

    Cognitive functions are impaired in patients with liver disease. Bile duct ligation causes cholestasis that impairs liver function. This study investigated the impact of cholestasis progression on the acquisition and retention times in the passive avoidance test and on the locomotor activity of rats. Cholestasis was induced in male Wistar rats by ligating the main bile duct. Locomotor activity, learning and memory were assessed by the passive avoidance learning test at day 7, day 14, and day 21 post-bile duct ligation. The serum levels of bilirubin, alanine aminotransferase, and alkaline phosphatase were measured. The results showed that acquisition time and locomotor activity were not affected at day 7 and day 14, but they were significantly (P < 0.05) impaired at day 21 post-bile duct ligation compared with the results for the control group. Additionally, memory was significantly impaired on day 7 (P < 0.01), day 14, and day 21 (P < 0.001) compared with the control groups. The levels of total bilirubin, direct bilirubin, indirect bilirubin, alanine aminotransferase, and alkaline phosphatase were significantly higher at day 7, day 14, and day 21 post-bile duct ligation compared with the levels in the sham group. Based on these findings, both liver and memory function were affected in the early stage of cholestasis (7 days after bile duct ligation), while learning and locomotor activity were impaired at 21 days after bile duct ligation following the progression of cholestasis.

  10. MHD work related to a self-cooled Pb-17Li blanket with poloidal-radial-toroidal ducts

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

    Reimann, J.; Barleon, L.; Buehler, L.

    1994-12-31

    For self cooled liquid metal blankets MHD pressure drop and velocity distributions are considered as critical issues. This paper summarizes MHD work performed for a DEMO-relevant Pb-17Li blanket which uses essential characteristics of a previous ANL design: The coolant flows downwards in the rear poloidal ducts, turns by 180{degrees} at the blanket bottom and is distributed from the ascending poloidal ducts into short radial channels which feed the toroidal First Wall coolant ducts (aligned with the main magnetic field direction). The flow through the subsequent radial channels is collected again in poloidal channels and the coolant leaves the blanket segmentmore » at the top. The blanket design is based on the use of flow channel inserts (FCIs) (which means electrically thin conducting walls for MHD) for all ducts except for the toroidal FW coolant channels. MHD related issues were defined and estimations of corresponding pressure drops were performed. Previous experimental work included a proof of principle of FCIs and a detailed experiment with a single {open_quotes}poloidal{sm_bullet}toroidal{sm_bullet}poloidal{close_quotes} duct (cooperation with ANL). In parallel, a numerical code based on the Core Flow Approximation (CFA) was developed to predict pressure drop and velocity distributions for arbitrary single duct geometries.« less

  11. Convolution seal for transition duct in turbine system

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

    Flanagan, James Scott; LeBegue, Jeffrey Scott; McMahan, Kevin Weston

    2015-03-10

    A turbine system is disclosed. In one embodiment, the turbine system includes a transition duct. The transition duct includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct further includes an interface member for interfacing with a turbine section. The turbine system further includes a convolution seal contacting the interface member to provide a seal between the interface member and themore » turbine section.« less

  12. Acoustic radiation from lined, unflanged ducts: Acoustic source distribution program

    NASA Technical Reports Server (NTRS)

    Beckemeyer, R. J.; Sawdy, D. T.

    1971-01-01

    An acoustic radiation analysis was developed to predict the far-field characteristics of fan noise radiated from an acoustically lined unflanged duct. This analysis is comprised of three modular digital computer programs which together provide a capability of accounting for the impedance mismatch at the duct exit plane. Admissible duct configurations include circular or annular, with or without an extended centerbody. This variation in duct configurations provides a capability of modeling inlet and fan duct noise radiation. The computer programs are described in detail.

  13. [Bile duct lesions in laparoscopic cholecystectomy].

    PubMed

    Siewert, J R; Ungeheuer, A; Feussner, H

    1994-09-01

    Laparoscopic cholecystectomy is both resulting in a slightly higher incidence of biliary lesions and a change of prevalence of the type of lesions. Damage to the biliary system occurs in 4 different types: The most severe case is the lesion with a structural defect of the hepatic or common bile duct with (IVa) or without (IVb) vascular injury. Tangential lesions without structural loss of the duct should be denominated as type III (IIIa with additional lesion to the vessels, type IIIb without). Type II comprehends late strictures without obvious intraoperative trauma to the duct. Type I includes immediate biliary fistulae of usually good prognosis. The increasing prevalence of structural defects of the bile ducts appears to be a peculiarity of laparoscopic cholecystectomy necessitating highly demanding operative repair. In the majority of cases, hepatico-jejunostomy or even intraparenchymatous anastomoses are required. Adaptation of well proven principles of open surgery is the best prevention of biliary lesions in laparoscopic cholecystectomy as well as the readiness to convert early to the open procedure.

  14. Measure Guideline: Buried and/or Encapsulated Ducts

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

    Shapiro, C.; Zoeller, W.; Mantha, P.

    2013-08-01

    Buried and/or encapsulated ducts (BEDs) are a class of advanced, energy-efficiency strategies intended to address the significant ductwork thermal losses associated with ducts installed in unconditioned attics. BEDs are ducts installed in unconditioned attics that are covered in loose-fill insulation and/or encapsulated in closed cell polyurethane spray foam insulation. This Measure Guideline covers the technical aspects of BEDs as well as the advantages, disadvantages, and risks of BEDs compared to other alternative strategies. This guideline also provides detailed guidance on installation of BEDs strategies in new and existing homes through step-by-step installation procedures. This Building America Measure Guideline synthesizes previouslymore » published research on BEDs and provides practical information to builders, contractors, homeowners, policy analysts, building professions, and building scientists. Some of the procedures presented here, however, require specialized equipment or expertise. In addition, some alterations to duct systems may require a specialized license. Persons implementing duct system improvements should not go beyond their expertise or qualifications. This guideline provides valuable information for a building industry that has struggled to address ductwork thermal losses in new and existing homes. As building codes strengthen requirements for duct air sealing and insulation, flexibility is needed to address energy efficiency goals. While ductwork in conditioned spaces has been promoted as the panacea for addressing ductwork thermal losses, BEDs installations approach - and sometimes exceed - the performance of ductwork in conditioned spaces.« less

  15. Acoustic energy in ducts - Further observations

    NASA Technical Reports Server (NTRS)

    Eversman, W.

    1979-01-01

    The transmission of acoustic energy in uniform ducts carrying uniform flow is investigated with the purpose of clarifying two points of interest. The two commonly used definitions of acoustic 'energy' flux are shown to be related by a Legendre transformation of the Lagrangian density exactly as in deriving the Hamiltonian density in mechanics. In the acoustic case the total energy density and the Hamiltonian density are not the same which accounts for two different 'energy' fluxes. When the duct has acoustically absorptive walls neither of the two flux expressions gives correct results. A reevaluation of the basis of derivation of the energy density and energy flux provides forms which yield consistent results for soft walled ducts.

  16. Characterization of flow in a scroll duct

    NASA Technical Reports Server (NTRS)

    Begg, E. K.; Bennett, J. C.

    1985-01-01

    A quantitative, flow visualization study was made of a partially elliptic cross section, inward curving duct (scroll duct), with an axial outflow through a vaneless annular cutlet. The working fluid was water, with a Re(d) of 40,000 at the inlet to the scroll duct, this Reynolds number being representative of the conditions in an actual gas turbine scroll. Both still and high speed moving pictures of fluorescein dye injected into the flow and illuminated by an argon ion laser were used to document the flow. Strong secondary flow, similar to the secondary flow in a pipe bend, was found in the bottom half of the scroll within the first 180 degs of turning. The pressure field set up by the turning duct was strong enough to affect the inlet flow condition. At 90 degs downstream, the large scale secondary flow was found to be oscillatory in nature. The exit flow was nonuniform in the annular exit. By 270 degs downstream, the flow appeared unorganized with no distinctive secondary flow pattern. Large scale structures from the upstream core region appeared by 90 degs and continued through the duct to reenter at the inlet section.

  17. Pipe crawler development for duct elbow removal

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

    Zollinger, W.T.; Treanor, R.C.

    1992-01-01

    This paper describes the development of equipment for removing an elbow in a 36 inch diameter ventilation line by cutting from the inside. Radiation levels, high air flow and physical constraints preclude any manual rework of the ventilation system. A remotely operated pipe crawler was developed. Testing has been performed in a full-scale mockup which models the ventilation duct configuration with the exception of radiation levels. The results gathered from the testing are discussed, and illustrate the strengths and weaknesses of the crawler and plasma arc torch system. To date, the equipment has successfully completed the tasks of maneuvering throughmore » the duct geometry, performing the two required cuts, and backing out of the duct mockup. The elbow successfully fell away from the main duct, showing that the line would be clear of obstructions.« less

  18. Pipe crawler development for duct elbow removal

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

    Zollinger, W.T.; Treanor, R.C.

    1992-11-01

    This paper describes the development of equipment for removing an elbow in a 36 inch diameter ventilation line by cutting from the inside. Radiation levels, high air flow and physical constraints preclude any manual rework of the ventilation system. A remotely operated pipe crawler was developed. Testing has been performed in a full-scale mockup which models the ventilation duct configuration with the exception of radiation levels. The results gathered from the testing are discussed, and illustrate the strengths and weaknesses of the crawler and plasma arc torch system. To date, the equipment has successfully completed the tasks of maneuvering throughmore » the duct geometry, performing the two required cuts, and backing out of the duct mockup. The elbow successfully fell away from the main duct, showing that the line would be clear of obstructions.« less

  19. Acoustic Power Transmission Through a Ducted Fan

    NASA Technical Reports Server (NTRS)

    Envia, Ed

    2016-01-01

    For high-speed ducted fans, when the rotor flowfield is shock-free, the main contribution to the inlet radiated acoustic power comes from the portion of the rotor stator interaction sound field that is transmitted upstream through the rotor. As such, inclusion of the acoustic transmission is an essential ingredient in the prediction of the fan inlet noise when the fan tip relative speed is subsonic. This paper describes a linearized Euler based approach to computing the acoustic transmission of fan tones through the rotor. The approach is embodied in a code called LINFLUX was applied to a candidate subsonic fan called the Advanced Ducted Propulsor (ADP). The results from this study suggest that it is possible to make such prediction with sufficient fidelity to provide an indication of the acoustic transmission trends with the fan tip speed.

  20. [Bile duct lesions repaired with peritoneal tube grafts].

    PubMed

    Lorenzana-Bautista, Ileana; Flores-Plascencia, Aníbal; Barrios-Pineda, Francisco Javier; Alderete-Vázquez, Georgia; Sánchez-Valdivieso, Enrique Alejandro

    2013-01-01

    A significant number of people suffer iatrogenic bile duct injury during laparoscopic cholescystectomy. Biliary-digestive bypass may be complicated by stenosis and biliary sepsis, affecting both quality of life and life expectancy. To avoid bypass synthetic grafts have been used, which are expensive. Evaluating autologous implantation of peritoneus as alternative of bile duct repair. Under general anesthesia, ten New Zealand adult rabbits were operated, common bile duct approached and sectioned underneath the cystic duct followed by a liver biopsy. An autologous graft was built of peritoneum and graft-bile duct proximal and distal end-to-end anastomosis done. Animals were followed-up by weekly bilirrubin and transferases. Rabbits were scheduled euthanized and a liver biopsy done for histological examinations. Autologous graft was easy to create and all rabbits survived. They did not develop jaundice or alterations in their normal habits. At necropsy, autologous grafts were removed and no signs of occlusion were noticed. Moderate short-term liver damage was observed but long-term damage was negligible. Bileoma and pyogenic liver abscess were observed in two animals, respectively. Our results favourably match well-known procedures used for bile duct repair, especially in cases of severe injury (Bismuth-Strasberg E1-3): it seems less complicated than biliary-digestive bypass, not as expensive as synthetic grafts, and much easier to build than human amnion graft. Interposing an autologous graft of peritoneum is an easy-to-create surgical procedure and circumferential bile duct injuries were adequately repaired.

  1. Borescope Device Takes Impressions In Ducts

    NASA Technical Reports Server (NTRS)

    Walter, Richard F.; Turner, Laura J.

    1990-01-01

    Maneuverable device built around borescope equipped to make impression molds of welded joints in interior surfaces of ducts. Molds then examined to determine degress of mismatch in welds. Inserted in duct, and color-coded handles on ends of cables used to articulate head to maneuver around corners. Use of device fairly easy and requires little training.

  2. A non-local computational boundary condition for duct acoustics

    NASA Technical Reports Server (NTRS)

    Zorumski, William E.; Watson, Willie R.; Hodge, Steve L.

    1994-01-01

    A non-local boundary condition is formulated for acoustic waves in ducts without flow. The ducts are two dimensional with constant area, but with variable impedance wall lining. Extension of the formulation to three dimensional and variable area ducts is straightforward in principle, but requires significantly more computation. The boundary condition simulates a nonreflecting wave field in an infinite duct. It is implemented by a constant matrix operator which is applied at the boundary of the computational domain. An efficient computational solution scheme is developed which allows calculations for high frequencies and long duct lengths. This computational solution utilizes the boundary condition to limit the computational space while preserving the radiation boundary condition. The boundary condition is tested for several sources. It is demonstrated that the boundary condition can be applied close to the sound sources, rendering the computational domain small. Computational solutions with the new non-local boundary condition are shown to be consistent with the known solutions for nonreflecting wavefields in an infinite uniform duct.

  3. The punctal apposition syndrome: a new surgical approach.

    PubMed

    Francis, I C; Wan, M K

    2002-11-01

    To assess the punctal apposition syndrome (PAS) and its response to lateral canthal tendon (LCT) repair. In this retrospective, interventional case series, five patients (seven symptomatic eyes) with PAS were managed. Lateral canthal tendon repair was performed in all seven eyes. The main outcome measure was correction of watery eye symptomatology. All five patients achieved symptomatic resolution. Conjunctivochalasis and functional nasolacrimal duct obstruction were associated with the PAS. This new surgical approach to the PAS, using a LCT repair, was successful in all patients. Two patients (three eyes) required conjunctivochalasis excision.

  4. Generalized osteosclerosis in a cat.

    PubMed

    Hanel, Rita M; Graham, John P; Levy, Julie K; Buergelt, Claus D; Creamer, Jeff

    2004-01-01

    A 12-year-old, neutered male, domestic long-hair cat was evaluated for a 6-month history of inspiratory stertor and epiphora. In computed tomography of the skull and pelvis, and radiographs of the thorax, right femur and stifle there was generalized osteosclerosis, with obliteration of the nasal turbinates and nasolacrimal duct obstruction. The cat also had a large fibrosarcoma involving the right pelvic limb. Osteosclerosis is a rare disorder that is poorly understood but has been described in several species. Various manifestations, potential causes, and radiologic findings of osteosclerosis are discussed.

  5. On Computations of Duct Acoustics with Near Cut-Off Frequency

    NASA Technical Reports Server (NTRS)

    Dong, Thomas Z.; Povinelli, Louis A.

    1997-01-01

    The cut-off is a unique feature associated with duct acoustics due to the presence of duct walls. A study of this cut-off effect on the computations of duct acoustics is performed in the present work. The results show that the computation of duct acoustic modes near cut-off requires higher numerical resolutions than others to avoid being numerically cut off. Duct acoustic problems in Category 2 are solved by the DRP finite difference scheme with the selective artificial damping method and results are presented and compared to reference solutions.

  6. Bile duct injury during cholecystectomy.

    PubMed

    Kapoor, V K

    2015-08-01

    Laparoscopic cholecystectomy (LC) is the treatment of choice for gallstones, but is associated with increased risk of bile duct injury (BDI bile duct injury). If the BDI is detected during LC can be addressed immediately, if available hepatobiliary surgeon, but the easiest and safest procedure for the general surgeon is placing drains into subhepatic region and the transfer of acute BDI to controlled external biliary fistula (external Biliary fistula EBF). Most BDI is diagnosed when the postoperative period, when there is biliary leak. Therapy is a percutaneous catheter drainage and endoscopic stenting in the bile duct; early repair is not recommended. Repair in the form hepatico-jejunostomy (HJ) should be performed hepatobiliary surgeon at intervals of 46 weeks after it closes EBF. BDI is a frequent cause medico-legal actions and a substantial burden on health care costs. Most BDI can be avoided by adherence to the principles of safe cholecystectomy.

  7. DUCT RETROFIT STRATEGY TO COMPLEMENT A MODULATING FURNACE.

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

    ANDREWS,J.W.

    2002-10-02

    Some recent work (Walker 2001, Andrews 2002) has indicated that installing a modulating furnace in a conventional duct system may, in many cases, result in a significant degradation in thermal distribution efficiency. The fundamental mechanism was pointed out nearly two decades ago (Andrews and Krajewski 1985). The problem occurs in duct systems that are less-than-perfectly insulated (e.g., R-4 duct wrap) and are located outside the conditioned space. It stems from the fact that when the airflow rate is reduced, as it will be when the modulating furnace reduces its heat output rate, the supply air will have a longer residencemore » time in the ducts and will therefore lose a greater percentage of its heat by conduction than it did at the higher airflow rate. The impact of duct leakage, on the other hand, is not expected to change very much under furnace modulation. The pressures in the duct system will be reduced when the airflow rate is reduced, thus reducing the leakage per unit time. This is balanced by the fact that the operating time will increase in order to meet the same heating load as with the conventional furnace operating at higher output and airflow rates. The balance would be exact if the exponent in the pressure vs. airflow equation were the same as that in the pressure vs. duct leakage equation. Since the pressure-airflow exponent is usually {approx}0.5 and the pressure-leakage exponent is usually {approx}0.6, the leakage loss as a fraction of the load should be slightly lower for the modulating furnace. The difference, however, is expected to be small, determined as it is by a function with an exponent equal to the difference between the above two exponents, or {approx}0.1. The negative impact of increased thermal conduction losses from the duct system may be partially offset by improved efficiency of the modulating furnace itself. Also, the modulating furnace will cycle on and off less often than a single-capacity model, and this may add a small

  8. Inlets, ducts, and nozzles

    NASA Technical Reports Server (NTRS)

    Abbott, John M.; Anderson, Bernhard H.; Rice, Edward J.

    1990-01-01

    The internal fluid mechanics research program in inlets, ducts, and nozzles consists of a balanced effort between the development of computational tools (both parabolized Navier-Stokes and full Navier-Stokes) and the conduct of experimental research. The experiments are designed to better understand the fluid flow physics, to develop new or improved flow models, and to provide benchmark quality data sets for validation of the computational methods. The inlet, duct, and nozzle research program is described according to three major classifications of flow phenomena: (1) highly 3-D flow fields; (2) shock-boundary-layer interactions; and (3) shear layer control. Specific examples of current and future elements of the research program are described for each of these phenomenon. In particular, the highly 3-D flow field phenomenon is highlighted by describing the computational and experimental research program in transition ducts having a round-to-rectangular area variation. In the case of shock-boundary-layer interactions, the specific details of research for normal shock-boundary-layer interactions are described. For shear layer control, research in vortex generators and the use of aerodynamic excitation for enhancement of the jet mixing process are described.

  9. Bile duct obstruction

    MedlinePlus

    ... Tumors that have spread to the biliary system Liver and bile duct worms (flukes) The risk factors include: History of ... Increased bilirubin level Increased alkaline phosphatase level Increased liver enzymes The ... CT scan Endoscopic retrograde cholangiopancreatography ( ...

  10. [Syncrhonous carcinosarcoma of the extrahepatic bile duct and gallbladder.

    PubMed

    Páramo, Ana Alberca; Valverde, David Padilla; Campos, Pedro Villarejo; Santos, Esther Pilar Garcia; Puche, Jose Luis Bertelli; Guerrero, Paloma Núńez; Delgado, Margarita; Fernindez, Jesus Martin

    2016-03-01

    Carcinosarcoma is a malignant neoplasm characterized for intermingled epithelial and mesenchymal components. A preoperative suspected diagnosis will allow a radical therapy avoiding a very bad prognosis. We report on a male patient who was operated in our Service with diagnosis of synchronous carcinosarcoma of gallbladder and extrahepatic bile duct and a review of the Medical Literature. A gallblader carcinosarcoma showing extension into common bile duct is very rare, a carcinosarcoma of the bile duct is exceptional, and a synchronous carcinosarcoma ofthe bile duct and gallbladder has not been reported previously.

  11. Anomalous pancreatico-biliary ductal union with cystic dilatation of the bile duct.

    PubMed

    Richer, J P; Faure, J P; Morichau-Beauchant, M; Dugue, T; Maillot, N; Kamina, P; Carretier, M

    1998-01-01

    We report, in an adult, an asymptomatic association between cystic dilation of the bile duct (type IV A in Todani's classification) and anomalous pancreatico-biliary ductal union (APBD) with stones in a long common channel. In APBD, the connection between the common bile duct and the main pancreatic duct is located outside the duodenal wall andis therefore not under the influence of the sphincter of Boyden. An abnormally long common channel is in excess of 15 mm. Two types of convergence anomalies are defined according to whether the bile duct opens into the main pancreatic duct (BP) or the main pancreatic duct into the bile duct (PB). In APBD, there is probably a reverse pressure gradient between the bile and pancreatic ducts, with regurgitation of pancreatic juice into the bile duct, repeated attacks of cholangitis, stenosis and cystic dilatation. A long common channel is associated with a higher incidence of carcinoma of the gall bladder of the bile duct.

  12. Fluid flow in a spiral microfluidic duct

    NASA Astrophysics Data System (ADS)

    Harding, Brendan; Stokes, Yvonne

    2018-04-01

    We consider the steady, pressure driven flow of a viscous fluid through a microfluidic device having the geometry of a planar spiral duct with a slowly varying curvature and height smaller than width. For this problem, it is convenient to express the Navier-Stokes equations in terms of a non-orthogonal coordinate system. Then, after applying appropriate scalings, the leading order equations admit a relatively simple solution in the central region of the duct cross section. First-order corrections with respect to the duct curvature and aspect ratio parameters are also obtained for this region. Additional correction terms are needed to ensure that no slip and no penetration conditions are satisfied on the side walls. Our solutions allow for a top wall shape that varies with respect to the radial coordinate which allows us to study the flow in a variety of cross-sectional shapes, including trapezoidal-shaped ducts that have been studied experimentally. At leading order, the flow is found to depend on the local height and slope of the top wall within the central region. The solutions are compared with numerical approximations of a classical Dean flow and are found to be in good agreement for a small duct aspect ratio and a slowly varying and small curvature. We conclude that the slowly varying curvature typical of spiral microfluidic devices has a negligible impact on the flow in the sense that locally the flow does not differ significantly from the classical Dean flow through a duct having the same curvature.

  13. Intraductal papillary neoplasm originating from an anomalous bile duct.

    PubMed

    Maki, Harufumi; Aoki, Taku; Ishizawa, Takeaki; Tanaka, Mariko; Sakatani, Takashi; Beck, Yoshifumi; Hasegawa, Kiyoshi; Sakamoto, Yoshihiro; Kokudo, Norihiro

    2017-04-01

    An 82-year-old woman who had been suffering from repeated obstructive jaundice for 7 years was referred to our hospital. Although endoscopic aspiration of the mucin in the common bile duct had been temporally effective, origin of the mucin production had not been detectable. The patient thus had been forced to be on long-term follow-up without curative resection. Endoscopic retrograde cholangioscopy on admission revealed massive mucin in the common bile duct. In addition, an anomalous bile duct located proximal to the gallbladder was identified. Since the lumen of the anomalous duct was irregular and the rest of biliary tree was completely free of suspicious lesions, the anomalous duct was judged to be the primary site. Surgical resection of the segment 4 and 5 of the liver combined with the extrahepatic biliary tract was performed. Pathological diagnosis was compatible to intraductal papillary neoplasm with high-grade intraepithelial dysplasia of the anomalous bile duct. The patient has been free from the disease for 6.5 years after resection. This is the first case of intraductal papillary neoplasm derived from an anomalous bile duct, which was resected after long-term conservative treatment. The present case suggested the slow growing character of natural history of the neoplasm.

  14. Generation of Higher Order Modes in a Rectangular Duct

    NASA Technical Reports Server (NTRS)

    Gerhold, Carl H.; Cabell, Randolph H.; Brown, Donald E.

    2004-01-01

    Advanced noise control methodologies to reduce sound emission from aircraft engines take advantage of the modal structure of the noise in the duct. This noise is caused by the interaction of rotor wakes with downstream obstructions such as exit guide vanes. Mode synthesis has been accomplished in circular ducts and current active noise control work has made use of this capability to cancel fan noise. The goal of the current effort is to examine the fundamental process of higher order mode propagation through an acoustically treated, curved duct. The duct cross-section is rectangular to permit greater flexibility in representation of a range of duct curvatures. The work presented is the development of a feedforward control system to generate a user-specified modal pattern in the duct. The multiple-error, filtered-x LMS algorithm is used to determine the magnitude and phase of signal input to the loudspeakers to produce a desired modal pattern at a set of error microphones. Implementation issues, including loudspeaker placement and error microphone placement, are discussed. Preliminary results from a 9-3/8 inch by 21 inch duct, using 12 loudspeakers and 24 microphones, are presented. These results demonstrate the ability of the control system to generate a user-specified mode while suppressing undesired modes.

  15. Office-Based Procedures for the Diagnosis and Treatment of Laryngeal Pathology.

    PubMed

    Wellenstein, David J; Schutte, Henrieke W; Takes, Robert P; Honings, Jimmie; Marres, Henri A M; Burns, James A; van den Broek, Guido B

    2017-09-18

    Since the development of distal chip endoscopes with a working channel, diagnostic and therapeutic possibilities in the outpatient clinic in the management of laryngeal pathology have increased. Which of these office-based procedures are currently available, and their clinical indications and possible advantages, remains unclear. Review of literature on office-based procedures in laryngology and head and neck oncology. Flexible endoscopic biopsy (FEB), vocal cord injection, and laser surgery are well-established office-based procedures that can be performed under topical anesthesia. These procedures demonstrate good patient tolerability and multiple advantages. Office-based procedures under topical anesthesia are currently an established method in the management of laryngeal pathology. These procedures offer medical and economic advantages compared with operating room-performed procedures. Furthermore, office-based procedures enhance the speed and timing of the diagnostic and therapeutic process. Copyright © 2017 The Voice Foundation. All rights reserved.

  16. Resident Front Office Experience: A Systems-Based Practice Activity

    PubMed Central

    Sutkin, Gary; Aronoff, Christine K.

    2008-01-01

    Purpose: We set out to create and evaluate a systems-based practice experience designed to introduce residents to front office responsibilities and stimulate suggestions for front office improvements. Methods: On two occasions in 2002 and 2006, each resident in the Obstetrics and Gynecology Department was trained by a front office staff member for one day. The residents completed pre- and post-experience surveys, answered open-ended questions about their experience, and volunteered suggestions for improving the front office staff, and were evaluated by their precepting staff member. Results: All but two of 23 particpating residents participated enthusiastically. These residents perceived experiencing the staff as vital to the success of the practice, reported an increased sense of appreciation for the training of staff personnel, and were evaluated favorably. Conclusion: This program gave our residents an appreciation for the training and responsibilities of pivotal office staff and an opportunity to suggest improvements. This program also satisfied ACGME resident education requirements regarding systems-based practice. PMID:20165536

  17. Post-Tensioning Duct Air Pressure Testing Effects on Web Cracking

    DOT National Transportation Integrated Search

    2015-01-01

    Nevada Department of Transportation (NDOT) post-tensioned concrete bridges have experienced web cracking near the post-tensioning ducts during the construction process. The ducts were air pressure tested to ensure the duct can successfully be grouted...

  18. Ultra structural changes occurring in duct ectasia and periductal mastitis and their significance in etiopathogenesis

    PubMed Central

    Ramalingam, Kirithiga; Vuthaluru, Seenu; Srivastava, Anurag; Dinda, Amit Kumar; Dhar, Anita

    2017-01-01

    Introduction Duct ectasia (DE) and periductal mastitis (PDM) are the most common benign breast conditions seen in women. The etiopathogenesis of these entities is still not clear and most of the theories regarding the causation are based on the histological features as seen on light microscopy. The ultramicroscopic features associated with these conditions that may give more insight to the etiopathogenesis are unknown. Aim To study the ultrastructural changes occurring in mammary duct cones in patients with DE and PDM using Transmission Electron Microscopic (TEM). Method Major ducts removed by radical duct excision from 21 patients with final histopathological diagnosis of DE and PDM were subjected to TEM study with 2 normal duct samples as controls. Results The TEM features of DE were denudation of the epithelial cells with focal loss of microvilli, widening of the inter-epithelial junctions with focal disruption of the T bars, periductal collagenisation without inflammation, and features suggestive of Epithelial Mesenchymal Transition (EMT). PDM features are intact epithelial lining with proliferative epithelium and periductal collagenisation with inflammation. Conclusions Based on the TEM findings, we suggest that DE and PDM are two different entities. EMT a novel finding observed in DE in this study. PMID:28273122

  19. Energy efficient engine: Turbine transition duct model technology report

    NASA Technical Reports Server (NTRS)

    Leach, K.; Thurlin, R.

    1982-01-01

    The Low-Pressure Turbine Transition Duct Model Technology Program was directed toward substantiating the aerodynamic definition of a turbine transition duct for the Energy Efficient Engine. This effort was successful in demonstrating an aerodynamically viable compact duct geometry and the performance benefits associated with a low camber low-pressure turbine inlet guide vane. The transition duct design for the flight propulsion system was tested and the pressure loss goal of 0.7 percent was verified. Also, strut fairing pressure distributions, as well as wall pressure coefficients, were in close agreement with analytical predictions. Duct modifications for the integrated core/low spool were also evaluated. The total pressure loss was 1.59 percent. Although the increase in exit area in this design produced higher wall loadings, reflecting a more aggressive aerodynamic design, pressure profiles showed no evidence of flow separation. Overall, the results acquired have provided pertinent design and diagnostic information for the design of a turbine transition duct for both the flight propulsion system and the integrated core/low spool.

  20. Analytical screening of low emissions, high performance duct burners for supersonic cruise aircraft engines

    NASA Technical Reports Server (NTRS)

    Lohmann, R. A.; Riecke, G. T.

    1977-01-01

    An analytical screening study was conducted to identify duct burner concepts capable of providing low emissions and high performance in advanced supersonic engines. Duct burner configurations ranging from current augmenter technology to advanced concepts such as premix-prevaporized burners were defined. Aerothermal and mechanical design studies provided the basis for screening these configurations using the criteria of emissions, performance, engine compatibility, cost, weight and relative risk. Technology levels derived from recently defined experimental low emissions main burners are required to achieve both low emissions and high performance goals. A configuration based on the Vorbix (Vortex burning and mixing) combustor concept was analytically determined to meet the performance goals and is consistent with the fan duct envelope of a variable cycle engine. The duct burner configuration has a moderate risk level compatible with the schedule of anticipated experimental programs.

  1. Police officer response to the injured officer: a survey-based analysis of medical care decisions.

    PubMed

    Sztajnkrycer, Matthew D; Callaway, David W; Baez, Amado Alejandro

    2007-01-01

    No widely accepted, specialized medical training exists for police officers confronted with medical emergencies while under conditions of active threat. The purpose of this study was to assess medical decision-making capabilities of law enforcement personnel under these circumstances. Web-based surveys were administered to all sworn officers within the county jurisdiction. Thirty-eight key actions were predetermined for nine injured officer scenarios, with each correct action worth one point. Descriptive statistics and t-tests were used to analyze results. Ninety-seven officers (65.1% response rate) responded to the survey. The majority of officers (68.0%) were trained to the first-responder level. Overall mean score for the scenarios was 15.5 +/- 3.6 (range 7-25). A higher level of medical training (EMT-B/P versus first responder) was associated with a higher mean score (16.6 +/- 3.4, p = 0.05 vs. 15.0 +/- 3.6, p = 0.05). Tactical unit assignment was associated with a lower score compared with non-assigned officers (13.5 +/- 2.9 vs. 16.0 +/- 3.6, p = 0.0085). No difference was noted based upon previous military experience. Ninety-two percent of respondents expressed interest in a law enforcement-oriented advanced first-aid course. Tactical medical decision-making capability, as assessed through the nine scenarios, was sub-optimal. In this post 9/11 era, development of law enforcement-specific medical training appears appropriate.

  2. Liver and Bile Duct Cancer—Patient Version

    Cancer.gov

    Liver cancer includes hepatocellular carcinoma and bile duct cancer (cholangiocarcinoma). Risk factors for HCC include chronic infection with hepatitis B or C and cirrhosis of the liver. Start here to find information on liver and bile duct cancer treatment, causes and prevention, screening, research, and statistics.

  3. Investigation of the sound generation mechanisms for in-duct orifice plates.

    PubMed

    Tao, Fuyang; Joseph, Phillip; Zhang, Xin; Stalnov, Oksana; Siercke, Matthias; Scheel, Henning

    2017-08-01

    Sound generation due to an orifice plate in a hard-walled flow duct which is commonly used in air distribution systems (ADS) and flow meters is investigated. The aim is to provide an understanding of this noise generation mechanism based on measurements of the source pressure distribution over the orifice plate. A simple model based on Curle's acoustic analogy is described that relates the broadband in-duct sound field to the surface pressure cross spectrum on both sides of the orifice plate. This work describes careful measurements of the surface pressure cross spectrum over the orifice plate from which the surface pressure distribution and correlation length is deduced. This information is then used to predict the radiated in-duct sound field. Agreement within 3 dB between the predicted and directly measured sound fields is obtained, providing direct confirmation that the surface pressure fluctuations acting over the orifice plates are the main noise sources. Based on the developed model, the contributions to the sound field from different radial locations of the orifice plate are calculated. The surface pressure is shown to follow a U 3.9 velocity scaling law and the area over which the surface sources are correlated follows a U 1.8 velocity scaling law.

  4. Office-based ultrasound screening for abdominal aortic aneurysm

    PubMed Central

    Blois, Beau

    2012-01-01

    Abstract Objective To assess the efficacy of an office-based, family physician–administered ultrasound examination to screen for abdominal aortic aneurysm (AAA). Design A prospective observational study. Consecutive patients were approached by nonphysician staff. Setting Rural family physician offices in Grand Forks and Revelstoke, BC. Participants The Canadian Society for Vascular Surgery screening recommendations for AAA were used to help select patients who were at risk of AAA. All men 65 years of age or older were included. Women 65 years of age or older were included if they were current smokers or had diabetes, hypertension, a history of coronary artery disease, or a family history of AAA. Main outcome measures A focused “quick screen,” which measured the maximal diameter of the abdominal aorta using point-of-care ultrasound technology, was performed in the office by a resident physician trained in emergency ultrasonography. Each patient was then booked for a criterion standard scan (ie, a conventional abdominal ultrasound scan performed by a technician and interpreted by a radiologist). The maximal abdominal aortic diameter measured by ultrasound in the office was compared with that measured by the criterion standard method. The time to screen each patient was recorded. Results Forty-five patients were included in data analysis; 62% of participants were men. The mean age was 73 years. The mean pairwise difference between the office-based ultrasound scan and the criterion standard scan was not statistically significant. The mean absolute difference between the 2 scans was 0.20 cm (95% CI 0.15 to 0.25 cm). Correlation between the scans was 0.81. The office-based ultrasound scan had both a sensitivity and a specificity of 100%. The mean time to screen each patient was 212 seconds (95% CI 194 to 230 seconds). Conclusion Abdominal aortic aneurysm screening can be safely performed in the office by family physicians who are trained to use point

  5. Office-based ultrasound screening for abdominal aortic aneurysm.

    PubMed

    Blois, Beau

    2012-03-01

    To assess the efficacy of an office-based, family physician–administered ultrasound examination to screen for abdominal aortic aneurysm (AAA). A prospective observational study. Consecutive patients were approached by nonphysician staff. Rural family physician offices in Grand Forks and Revelstoke, BC. The Canadian Society for Vascular Surgery screening recommendations for AAA were used to help select patients who were at risk of AAA. All men 65 years of age or older were included. Women 65 years of age or older were included if they were current smokers or had diabetes, hypertension, a history of coronary artery disease, or a family history of AAA. A focused “quick screen”, which measured the maximal diameter of the abdominal aorta using point-of-care ultrasound technology, was performed in the office by a resident physician trained in emergency ultrasonography. Each patient was then booked for a criterion standard scan (i.e., a conventional abdominal ultrasound scan performed by a technician and interpreted by a radiologist). The maximal abdominal aortic diameter measured by ultrasound in the office was compared with that measured by the criterion standard method. The time to screen each patient was recorded. Forty-five patients were included in data analysis; 62% of participants were men. The mean age was 73 years. The mean pairwise difference between the office-based ultrasound scan and the criterion standard scan was not statistically significant. The mean absolute difference between the 2 scans was 0.20 cm (95% CI 0.15 to 0.25 cm). Correlation between the scans was 0.81. The office-based ultrasound scan had both a sensitivity and a specificity of 100%. The mean time to screen each patient was 212 seconds (95% CI 194 to 230 seconds). Abdominal aortic aneurysm screening can be safely performed in the office by family physicians who are trained to use point-of- care ultrasound technology. The screening test can be completed within the time constraints of a

  6. 54. DETAIL OF AIRCONDITIONING EXHAUST DUCTS ON NORTH FACE OF ...

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

    54. DETAIL OF AIR-CONDITIONING EXHAUST DUCTS ON NORTH FACE OF ERECT UMBILICAL MAST - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  7. Acoustic imaging of a duct spinning mode by the use of an in-duct circular microphone array.

    PubMed

    Wei, Qingkai; Huang, Xun; Peers, Edward

    2013-06-01

    An imaging method of acoustic spinning modes propagating within a circular duct simply with surface pressure information is introduced in this paper. The proposed method is developed in a theoretical way and is demonstrated by a numerical simulation case. Nowadays, the measurements within a duct have to be conducted using in-duct microphone array, which is unable to provide information of complete acoustic solutions across the test section. The proposed method can estimate immeasurable information by forming a so-called observer. The fundamental idea behind the testing method was originally developed in control theory for ordinary differential equations. Spinning mode propagation, however, is formulated in partial differential equations. A finite difference technique is used to reduce the associated partial differential equations to a classical form in control. The observer method can thereafter be applied straightforwardly. The algorithm is recursive and, thus, could be operated in real-time. A numerical simulation for a straight circular duct is conducted. The acoustic solutions on the test section can be reconstructed with good agreement to analytical solutions. The results suggest the potential and applications of the proposed method.

  8. Choledochoscopic Holmium Laser Lithotripsy for Difficult Bile Duct Stones.

    PubMed

    Lv, Shangdong; Fang, Zheping; Wang, Aidong; Yang, Jian; Zhang, Wenlong

    2017-01-01

    The aim of this study was to evaluate the feasibility and efficacy of choledochoscopic holmium laser lithotripsy as a means of removing resistant extrahepatic and intrahepatic bile duct stones. Clinical data on 28 patients who had undergone choledochoscopic holmium laser lithotripsy were analyzed. Complete stone clearance was obtained in 24 patients; small numbers of residual stones in the left or right hepatic duct were found in 4 patients. No severe complications such as hemobilia and bile duct injuries occurred. Choledochoscopic holmium laser lithotripsy is a simple, safe, and effective treatment method for patients with resistant bile duct stones.

  9. Flexible metallic seal for transition duct in turbine system

    DOEpatents

    Flanagan, James Scott; LeBegue, Jeffrey Scott; McMahan, Kevin Weston; Dillard, Daniel Jackson; Pentecost, Ronnie Ray

    2014-04-22

    A turbine system is disclosed. In one embodiment, the turbine system includes a transition duct. The transition duct includes an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The transition duct further includes an interface member for interfacing with a turbine section. The turbine system further includes a flexible metallic seal contacting the interface member to provide a seal between the interface member and the turbine section.

  10. Bile Duct Cancer (Cholangiocarcinoma)

    MedlinePlus

    ... and pediatric oncologists, oncology nurses, physician assistants, social workers, and patient advocates. Cancer.Net Guide Bile Duct Cancer (Cholangiocarcinoma) ... Team Additional Resources View All Pages f ...

  11. Turbulence and secondary motions in square duct flow

    NASA Astrophysics Data System (ADS)

    Pirozzoli, Sergio; Modesti, Davide; Orlandi, Paolo; Grasso, Francesco

    2017-11-01

    We study turbulent flows in pressure-driven ducts with square cross-section through DNS up to Reτ 1050 . Numerical simulations are carried out over extremely long integration times to get adequate convergence of the flow statistics, and specifically high-fidelity representation of the secondary motions which arise. The intensity of the latter is found to be in the order of 1-2% of the bulk velocity, and unaffected by Reynolds number variations. The smallness of the mean convection terms in the streamwise vorticity equation points to a simple characterization of the secondary flows, which in the asymptotic high-Re regime are found to be approximated with good accuracy by eigenfunctions of the Laplace operator. Despite their effect of redistributing the wall shear stress along the duct perimeter, we find that secondary motions do not have large influence on the mean velocity field, which can be characterized with good accuracy as that resulting from the concurrent effect of four independent flat walls, each controlling a quarter of the flow domain. As a consequence, we find that parametrizations based on the hydraulic diameter concept, and modifications thereof, are successful in predicting the duct friction coefficient. This research was carried out using resources from PRACE EU Grants.

  12. Methods for the calculation of axial wave numbers in lined ducts with mean flow

    NASA Technical Reports Server (NTRS)

    Eversman, W.

    1981-01-01

    A survey is made of the methods available for the calculation of axial wave numbers in lined ducts. Rectangular and circular ducts with both uniform and non-uniform flow are considered as are ducts with peripherally varying liners. A historical perspective is provided by a discussion of the classical methods for computing attenuation when no mean flow is present. When flow is present these techniques become either impractical or impossible. A number of direct eigenvalue determination schemes which have been used when flow is present are discussed. Methods described are extensions of the classical no-flow technique, perturbation methods based on the no-flow technique, direct integration methods for solution of the eigenvalue equation, an integration-iteration method based on the governing differential equation for acoustic transmission, Galerkin methods, finite difference methods, and finite element methods.

  13. Results and comparison of Hall and DW duct experiments

    NASA Technical Reports Server (NTRS)

    Smith, J. M.; Morgan, J. L.

    1982-01-01

    Experimental data from recent tests of a 45 deg diagonal wall duct are presented and compared with the results of a similar Hall duct. It is shown that while the peak power density of the two devices is approximately equal that the diagonal wall duct produces greater total power output due to its ability to better utilize the available magnetic field.

  14. Office-based endoscopic revision using a microdebrider for failed endoscopic dacryocystorhinostomy.

    PubMed

    Park, Jongyeop; Kim, Hochang

    2016-12-01

    This article is to introduce office-based endoscopic revision surgery using a microdebrider for failed endoscopic dacryocystorhinostomy (EN-DCR). The authors conducted retrospective, non-comparative, interventional case series analysis of 27 eyes of 24 patients, treated by office-based revision EN-DCR using a microdebrider. After local anesthesia, anatomical failures (cicatrization, granuloma, synechia) after primary EN-DCR were treated with a microdebrider (Osseoduo 120, Bien-Air Surgery, Le Noirmont, Switzerland) in an office setting, and a bicanalicular silicone tube was placed. Anatomical improvement and functional relief of epiphora were evaluated at 6-months after revision. The causes of failed EN-DCR were rhinostomy site cicatrization (17/27, 63.0 %), granulomatous obstruction (7/27, 25.9 %) and synechial formation (3/27, 11.1 %). The anatomical success rate was 100 %, and 85.2 % cases achieved complete relief of epiphora. The surgery did not exceed 10 min in any case and no complications were observed. Office-based revision EN-DCR using a microdebrider provided prompt management of post-DCR epiphora. The portable nature and all-round ability of the microdebrider allowed office-based surgery, which offered advantage to work with the surgeon's own well-trained office staff. Office-based revision EN-DCR can be both time- and money-saving, and might be regarded the treatment of choice for failed EN-DCR.

  15. Thrust control system design of ducted rockets

    NASA Astrophysics Data System (ADS)

    Chang, Juntao; Li, Bin; Bao, Wen; Niu, Wenyu; Yu, Daren

    2011-07-01

    The investigation of the thrust control system is aroused by the need for propulsion system of ducted rockets. Firstly the dynamic mathematical models of gas flow regulating system, pneumatic servo system and ducted rocket engine were established and analyzed. Then, to conquer the discussed problems of thrust control, the idea of information fusion was proposed to construct a new feedback variable. With this fused feedback variable, the thrust control system was designed. According to the simulation results, the introduction of the new fused feedback variable is valid in eliminating the contradiction between rapid response and stability for the thrust control system of ducted rockets.

  16. Ducting arrangement for cooling a gas turbine structure

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

    Lee, Ching-Pang; Morrison, Jay A.

    2015-07-21

    A ducting arrangement (10) for a can annular gas turbine engine, including: a duct (12, 14) disposed between a combustor (16) and a first row of turbine blades and defining a hot gas path (30) therein, the duct (12, 14) having raised geometric features (54) incorporated into an outer surface (80); and a flow sleeve (72) defining a cooling flow path (84) between an inner surface (78) of the flow sleeve (72) and the duct outer surface (80). After a cooling fluid (86) traverses a relatively upstream raised geometric feature (90), the inner surface (78) of the flow sleeve (72)more » is effective to direct the cooling fluid (86) toward a landing (94) separating the relatively upstream raised geometric feature (90) from a relatively downstream raised geometric feature (94).« less

  17. Propagation Of Sound In Curved Ducts

    NASA Technical Reports Server (NTRS)

    Rostafinski, Wojciech

    1992-01-01

    Monograph presents concise, comprehensive summary of knowledge of propagation of acoustic waves in ducts and pipes including bends. Pulls together information from Lord Rayleigh's book Theory Of Sound, published in 1878, and from 33 papers scattered throughout various scientific journals published between 1945 and 1989. Monograph useful to scientists and engineers interested in such diverse topics as musical instruments, air-conditioning ducts, and jet engines. Material not available in current texts.

  18. Kinetic Energy Recovery from the Chimney Flue Gases Using Ducted Turbine System

    NASA Astrophysics Data System (ADS)

    Mann, Harjeet S.; Singh, Pradeep K.

    2017-03-01

    An innovative idea of extracting kinetic energy from man-made wind resources using ducted turbine system for on-site power generation is introduced in this paper. A horizontal axis ducted turbine is attached to the top of the chimney to harness the kinetic energy of flue gases for producing electricity. The turbine system is positioned beyond the chimney outlet, to avoid any negative impact on the chimney performance. The convergent-divergent duct causes increase in the flue gas velocity and hence enhances the performance of the turbine. It also acts as a safety cover to the energy recovery system. The results from the CFD based simulation analysis indicate that significant power 34 kW can be harnessed from the chimney exhaust. The effect of airfoils NACA4412 and NACA4416 and the diffuser angle on the power extraction by the energy recovery system using a 6-bladed ducted turbine has been studied with the CFD simulation. It is observed that the average flue gas velocity in the duct section at the throat is approximately twice that of the inlet velocity, whereas maximum velocity achieved is 2.6 times the inlet velocity. The simulated results show that about power may be extracted from the chimney flue gases of 660 MW power plant. The system can be retrofitted to existing chimneys of thermal power plants, refineries and other industries.

  19. 76. DETAIL OF AIRCONDITIONING DUCT BETWEEN PORTABLE PAYLOAD AIRCONDITIONING SYSTEM ...

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

    76. DETAIL OF AIR-CONDITIONING DUCT BETWEEN PORTABLE PAYLOAD AIR-CONDITIONING SYSTEM AND LSB (BLDG. 770) - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  20. Endoscopic stenting in bile duct cancer increases liver volume.

    PubMed

    Lee, Chang Hun; Kim, Seong Hun; Kim, In Hee; Kim, Sang Wook; Lee, Soo Teik; Kim, Dae Ghon; Yang, Jae Do; Yu, Hee Chul; Cho, Baik Hwan; Lee, Seung Ok

    2014-09-01

    Objective evaluation tools for assessing the effectiveness of stenting in palliative treatment of malignant biliary obstruction are not satisfactory. Effects of biliary stenting on liver volume change have never been studied. We aimed to use volumetry to analyze liver volume changes after endoscopic stenting in bile duct cancer according to the location and number of stents. Retrospective review. University hospital. Patients with a diagnosis of hilar or distal bile duct cancer and who underwent biliary metal stenting. ERCP with self-expandable metal stent placement. Liver volume change after biliary stenting and its comparison according to the location (hilar vs distal common bile duct) and number (hilar bilateral vs hilar unilateral). There were 60 patients; 31 were treated for hilar bile duct cancer (13 for bilateral stent and 18 for unilateral stent) and 29 for distal bile duct cancer. Overall mean follow-up duration was 11.7 ± 4.9 weeks. Liver volume increased 17.4 ± 24.1%. The rate of liver growth was rapid during the early period from 4 to 8 weeks. Stenting in hilar bile duct cancer tended to increase liver volume more than distal biliary stents (22.5% vs 11.9%, P = .091). In hilar bile duct cancer, unilateral and bilateral stents showed similar liver volume increases (20.1% and 25.8%, respectively; P = .512). Single center, retrospective. Biliary stenting markedly increased liver volume in both hilar and distal bile duct cancer. Our data suggest that liver volume assessment could be a useful tool for evaluating stent efficacy. Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  1. Reconstruction of Bile Duct Injury and Defect with the Round Ligament.

    PubMed

    Dokmak, Safi; Aussilhou, Béatrice; Ragot, Emilia; Tantardini, Camille; Cauchy, François; Ponsot, Philippe; Belghiti, Jacques; Sauvanet, Alain; Soubrane, Olivier

    2017-09-01

    Lateral injury of the bile duct can occur after cholecystectomy, bile duct dissection, or exploration. If direct repair is not possible, conversion to bilioenteric anastomosis can be needed with the risk of long-term bile duct infections and associated complications. We developed a new surgical technique which consist of reconstructing the bile duct with the round ligament. The vascularized round ligament is completely mobilized until its origin and used for lateral reconstruction of the bile duct to cover the defect. T tube was inserted and removed after few months. Patency of the bile duct was assessed by cholangiography, the liver function test and magnetic resonance imaging (MRI). Two patients aged 33 and 59 years old underwent lateral reconstruction of the bile duct for defects secondary to choledocotomy for stone extraction or during dissection for Mirizzi syndrome. The defects measured 2 and 3 cm and occupied half of the bile duct circumference. The postoperative course was marked by low output biliary fistula resolved spontaneously. In one patient, the T tube was removed at 3 months after surgery and MRI at 9 months showed strictly normal aspect of the bile duct with normal liver function test. The second patient is going very well 2 months after surgery and the T tube is closed. Lateral reconstruction of the bile duct can be safely achieved with the vascularized round ligament. We will extend our indications to tubular reconstruction.

  2. Anatomic variations in intrahepatic bile ducts in a north Indian population.

    PubMed

    Sharma, Vijay; Saraswat, Vivek Anand; Baijal, Sanjay Saran; Choudhuri, Gourdas

    2008-07-01

    In the present study, we described the anatomical variations in the branching patterns of intrahepatic bile ducts (IHD) and determined the frequency of each variation in north Indian patients. There are no data from India. The study group consisted of 253 consecutive patients (131 women) undergoing endoscopic retrograde cholangiograms for different indications. Anatomical variations in IHD were classified according to the branching pattern of the right anterior segmental duct (RASD) and the right posterior segmental duct (RPSD), presence or absence of first-order branch of left hepatic duct (LHD) and of an accessory hepatic duct. Anatomy of the IHD was typical in 52.9% of cases (n = 134), showing triple confluence in 11.46% (n = 29), anomalous drainage of the RPSD into the LHD in 18.2% (n = 46), anomalous drainage of the RPSD into the common hepatic duct (CHD) in 7.1% (n = 18), drainage of the right hepatic duct (RHD) into the cystic duct 0.4% (n = 1), presence of an accessory duct leading to the CHD or RHD in 4.7% (n = 12), individual drainage of the LHD into the RHD or CHD in 2.4% (n = 6), and unclassified or complex variations in 2.7% (n = 7). None had anomalous drainage of RPSD into the cystic duct. The branching pattern of IHD was atypical in 47% patients. The two most common variations were drainage of the RPSD into the LHD (18.2%) and triple confluence of the RASD, RPSD, and LHD (11.5%).

  3. Iatrogenic bile duct strictures: a review of 22 cases.

    PubMed

    Ersumo, Tessema

    2003-10-01

    The incidence of iatrogenic bile duct strictures in Ethiopia appears to be increasing. Of 27 patients that sustained bile duct injuries at open cholecystectomy, admitted during May 1996 to December 2002, 22 cases of bile duct strictures are presented to evaluate outcome of treatment. The mean age was 40 years, 15 females. Twenty-one were referrals. The usual presenting features were biliary peritonitis and jaundice. The average time lapse between the original surgery and admission to hospital was eight months. About 73% had Bismuth grade III-IV strictures and all patients underwent Roux-en-Y hepatico-jejunostomy. Postoperatively, biliary-cutaneous fistula, recurrent ascending cholangitis and wound infection were observed frequently. The overall mortality rate was 13.6%. Bile duct injuries and strictures occur in young productive age groups. Prevention of the occurrence of bile duct injury and its progression to a devastating stricture reduces morbidity and mortality.

  4. Patent vitellointestinal duct as paraumblical abcess: A rare presentation

    PubMed Central

    Rekhi, Harnam Singh; Mittal, Sushil; Singh, Gurtej; Rekhi, Balwinder Kaur; Dugg, Pankaj

    2015-01-01

    Introduction Umbilical and paraumblical abscess can occur in children with presenting complaint of discharge from umbilical region. However, patent vitello intestinal duct presenting as paraumblical abscess is rare phenomenon. Presentation of case One year old male child presented with complain of discharge from umbilical region since birth. Incision & drainage done twice thinking it to be paraumblical abscess. Discussion Vitellointestinal duct as abscess is rare presentation but it should be considered as a differential diagnosis of discharging umbilicus as management of abscess and patent duct are different. Conclusion Patent vitellointestinal duct can present as paraumbilical abscess, and it should be kept in differential diagnosis specifically in children. PMID:26301682

  5. Method and apparatus for duct sealing using a clog-resistant insertable injector

    DOEpatents

    Wang, Duo; Modera, Mark P.

    2010-12-14

    A method for forming a duct access region through one side of a previously installed air duct, wherein the air duct has an air flow with an air flow direction by inserting an aerosol injector into a previously installed air duct through the access region. The aerosol injector includes a liquid tube having a liquid tube orifice for ejecting a liquid to be atomized; and a propellant cap. The method is accomplished by aligning the aerosol injector with the direction of air flow in the duct; activating an air flow within the duct; and spraying a sealant through the aerosol injector to seal the duct in the direction of the air flow.

  6. Are Ducted Mini-Splits Worth It?

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

    Winkler, Jonathan M; Maguire, Jeffrey B; Metzger, Cheryn E.

    Ducted mini-split heat pumps are gaining popularity in some regions of the country due to their energy-efficient specifications and their ability to be hidden from sight. Although product and install costs are typically higher than the ductless mini-split heat pumps, this technology is well worth the premium for some homeowners who do not like to see an indoor unit in their living area. Due to the interest in this technology by local utilities and homeowners, the Bonneville Power Administration (BPA) has funded the Pacific Northwest National Laboratory (PNNL) and the National Renewable Energy Laboratory (NREL) to develop capabilities within themore » Building Energy Optimization (BEopt) tool to model ducted mini-split heat pumps. After the fundamental capabilities were added, energy-use results could be compared to other technologies that were already in BEopt, such as zonal electric resistance heat, central air source heat pumps, and ductless mini-split heat pumps. Each of these technologies was then compared using five prototype configurations in three different BPA heating zones to determine how the ducted mini-split technology would perform under different scenarios. The result of this project was a set of EnergyPlus models representing the various prototype configurations in each climate zone. Overall, the ducted mini-split heat pumps saved about 33-60% compared to zonal electric resistance heat (with window AC systems modeled in the summer). The results also showed that the ducted mini-split systems used about 4% more energy than the ductless mini-split systems, which saved about 37-64% compared to electric zonal heat (depending on the prototype and climate).« less

  7. Detonation duct gas generator demonstration program

    NASA Technical Reports Server (NTRS)

    Wortman, Andrew; Brinlee, Gayl A.; Othmer, Peter; Whelan, Michael A.

    1991-01-01

    The feasibility of the generation of detonation waves moving periodically across high speed channel flow is experimentally demonstrated. Such waves are essential to the concept of compressing requirements and increasing the engine pressure compressor with the objective of reducing conventional compressor requirements and increasing the engine thermodynamic efficiency through isochoric energy addition. By generating transient transverse waves, rather than standing waves, shock wave losses are reduced by an order of magnitude. The ultimate objective is to use such detonation ducts downstream of a low pressure gas turbine compressor to produce a high overall pressure ratio thermodynamic cycle. A 4 foot long, 1 inch x 12 inch cross-section, detonation duct was operated in a blow-down mode using compressed air reservoirs. Liquid or vapor propane was injected through injectors or solenoid valves located in the plenum or the duct itself. Detonation waves were generated when the mixture was ignited by a row of spark plugs in the duct wall. Problems with fuel injection and mixing limited the air speeds to about Mach 0.5, frequencies to below 10 Hz, and measured pressure ratios of about 5 to 6. The feasibility of the gas dynamic compression was demonstrated and the critical problem areas were identified.

  8. Mean velocity and turbulence measurements in a 90 deg curved duct with thin inlet boundary layer

    NASA Technical Reports Server (NTRS)

    Crawford, R. A.; Peters, C. E.; Steinhoff, J.; Hornkohl, J. O.; Nourinejad, J.; Ramachandran, K.

    1985-01-01

    The experimental database established by this investigation of the flow in a large rectangular turning duct is of benchmark quality. The experimental Reynolds numbers, Deans numbers and boundary layer characteristics are significantly different from previous benchmark curved-duct experimental parameters. This investigation extends the experimental database to higher Reynolds number and thinner entrance boundary layers. The 5% to 10% thick boundary layers, based on duct half-width, results in a large region of near-potential flow in the duct core surrounded by developing boundary layers with large crossflows. The turbulent entrance boundary layer case at R sub ed = 328,000 provides an incompressible flowfield which approaches real turbine blade cascade characteristics. The results of this investigation provide a challenging benchmark database for computational fluid dynamics code development.

  9. Flow Through a Rectangular-to-Semiannular Diffusing Transition Duct

    NASA Technical Reports Server (NTRS)

    Foster, Jeff; Wendt, Bruce J.; Reichert, Bruce A.; Okiishi, Theodore H.

    1997-01-01

    Rectangular-to-semiannular diffusing transition ducts are critical inlet components on supersonic airplanes having bifucated engine inlets. This paper documents measured details of the flow through a rectangular-to-semiannular transition duct having an expansion area ratio of 1.53. Three-dimensional velocity vectors and total pressures at the exit plane of the diffuser are presented. Surface oil-flow visualization and surface static pressure data are shown. The tests were conducted with an inlet Mach number of 0.786 and a Reynolds number based on the inlet centerline velocity and exit diameter of 3.2 x 10(exp 6). The measured data are compared with previously published computational results. The ability of vortex generators to reduce circumferential total pressure distortion is demonstrated.

  10. Ducted fan inlet/exit and rotor tip flow improvements for vertical lift systems

    NASA Astrophysics Data System (ADS)

    Akturk, Ali

    The current research utilized experimental and computational techniques in 5" and 22" diameter ducted fan test systems that have been custom designed and manufactured. Qualitative investigation of flow around the ducted fan was also performed using smoke flow visualizations. Quantitative measurements consisted of 2D and 3D velocity measurements using planar and Stereoscopic Particle Image Velocimetry (PIV and SPIV), high resolution total pressure measurements using Kiel total pressure probes and real time six-component force and torque measurements. The computational techniques used in this thesis included a recently developed radial equilibrium based rotor model(REBRM) and a three dimensional Reynolds-Averaged Navier Stokes (RANS) based CFD model. A radial equilibrium based rotor model (REBRM) developed by the author was effectively integrated into a three-dimensional RANS based computational system. The PIV measurements and computational flow predictions using (REBRM) near the fan inlet plane were in a good agreement at hover and forward flight conditions. The aerodynamic modifications resulting from the fan inlet flow distortions in forward flight regime were clearly captured in 2D PIV results. High resolution total pressure measurements at the downstream of the fan rotor showed that tip leakage, rotor hub separation, and passage flow related total pressure losses were dominant in hover condition. However, the losses were dramatically increased in forward flight because of inlet lip separation and distortion. A novel ducted fan inlet flow conditioning concept named "Double Ducted Fan" (DDF) was developed. The (DDF) concept has a potential to significantly improve the performance and controllability of VTOL UAVs and many other ducted fan based vertical lift systems. The new concept that will significantly reduce the inlet lip separation related performance penalties used a secondary stationary duct system to control "inlet lip separation" occurring especially at

  11. T-tube drainage versus primary closure after laparoscopic common bile duct exploration.

    PubMed

    Gurusamy, Kurinchi Selvan; Koti, Rahul; Davidson, Brian R

    2013-06-21

    T-tube drainage may prevent bile leak from the biliary tract following bile duct exploration and it offers post-operative access to the bile ducts for visualisation and exploration. Use of T-tube drainage after laparoscopic common bile duct (CBD) exploration is controversial. To assess the benefits and harms of T-tube drainage versus primary closure after laparoscopic common bile duct exploration. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until April 2013. We included all randomised clinical trials comparing T-tube drainage versus primary closure after laparoscopic common bile duct exploration. Two of four authors independently identified the studies for inclusion and extracted data. We analysed the data with both the fixed-effect and the random-effects model meta-analyses using Review Manager (RevMan) Analysis. For each outcome we calculated the risk ratio (RR), rate ratio (RaR), or mean difference (MD) with 95% confidence intervals (CI) based on intention-to-treat analysis. We included three trials randomising 295 participants: 147 to T-tube drainage versus 148 to primary closure. All trials had a high risk of bias. No one died during the follow-up period. There was no significant difference in the proportion of patients with serious morbidity (17/147 (weighted percentage 11.3%) in the T-tube drainage versus 9/148 (6.1%) in the primary closure group; RR 1.86; 95% CI 0.87 to 3.96; three trials), and no significant difference was found in the serious morbidity rates (weighted serious morbidity rate = 97 events per 1000 patients) in participants randomised to T-tube drainage versus serious morbidity rate = 61 events per 1000 patients in the primary closure group; RR 1.59; 95% CI 0.66 to 3.83; three trials). Quality of life was not reported in any of the trials. The operating time was significantly longer in the T-tube drainage group compared with the primary

  12. T-tube drainage versus primary closure after open common bile duct exploration.

    PubMed

    Gurusamy, Kurinchi Selvan; Koti, Rahul; Davidson, Brian R

    2013-06-21

    Between 5% and 11% of people undergoing cholecystectomy have common bile duct stones. Stones may be removed at the time of cholecystectomy by opening and clearing the common bile duct. The optimal technique is unclear. The aim is to assess the benefits and harms of T-tube drainage versus primary closure without biliary stent after open common bile duct exploration for common bile duct stones. We searched the Cochrane Hepato-Biliary Group Controlled Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until April 2013. We included all randomised clinical trials comparing T-tube drainage versus primary closure after open common bile duct exploration. Two of four authors independently identified the studies for inclusion and extracted data. We analysed the data with both the fixed-effect and the random-effects model using Review Manager (RevMan) analyses. For each outcome we calculated the risk ratio (RR), rate ratio (RaR), or mean difference (MD) with 95% confidence interval (CI) based on intention-to-treat analysis. We included six trials randomising 359 participants, 178 to T-tube drainage and 181 to primary closure. All trials were at high risk of bias. There was no significant difference in mortality between the two groups (4/178 (weighted percentage 1.2%) in the T-tube group versus 1/181 (0.6%) in the primary closure group; RR 2.25; 95% CI 0.55 to 9.25; six trials). There was no significant difference in the serious morbidity rate between the two groups (24/136 (weighted serious morbidity rate, 145 events per 1000 patients) in the T-tube group versus 9/136 (weighted serious morbidity rate, 66 events per 1000 patients) in the primary closure group; RaR 2.19; 95% CI 0.98 to 4.91; four trials). Quality of life and return to work were not reported in any of the trials. The operating time was significantly longer in the T-tube drainage group compared with the primary

  13. Acoustic-Liner Admittance in a Duct

    NASA Technical Reports Server (NTRS)

    Watson, W. R.

    1986-01-01

    Method calculates admittance from easily obtainable values. New method for calculating acoustic-liner admittance in rectangular duct with grazing flow based on finite-element discretization of acoustic field and reposing of unknown admittance value as linear eigenvalue problem on admittance value. Problem solved by Gaussian elimination. Unlike existing methods, present method extendable to mean flows with two-dimensional boundary layers as well. In presence of shear, results of method compared well with results of Runge-Kutta integration technique.

  14. Observationally constrained modeling of sound in curved ocean internal waves: examination of deep ducting and surface ducting at short range.

    PubMed

    Duda, Timothy F; Lin, Ying-Tsong; Reeder, D Benjamin

    2011-09-01

    A study of 400 Hz sound focusing and ducting effects in a packet of curved nonlinear internal waves in shallow water is presented. Sound propagation roughly along the crests of the waves is simulated with a three-dimensional parabolic equation computational code, and the results are compared to measured propagation along fixed 3 and 6 km source/receiver paths. The measurements were made on the shelf of the South China Sea northeast of Tung-Sha Island. Construction of the time-varying three-dimensional sound-speed fields used in the modeling simulations was guided by environmental data collected concurrently with the acoustic data. Computed three-dimensional propagation results compare well with field observations. The simulations allow identification of time-dependent sound forward scattering and ducting processes within the curved internal gravity waves. Strong acoustic intensity enhancement was observed during passage of high-amplitude nonlinear waves over the source/receiver paths, and is replicated in the model. The waves were typical of the region (35 m vertical displacement). Two types of ducting are found in the model, which occur asynchronously. One type is three-dimensional modal trapping in deep ducts within the wave crests (shallow thermocline zones). The second type is surface ducting within the wave troughs (deep thermocline zones). © 2011 Acoustical Society of America

  15. Müllerian duct cyst: diagnosis with MR imaging.

    PubMed

    Thurnher, S; Hricak, H; Tanagho, E A

    1988-07-01

    The value of magnetic resonance (MR) imaging in diagnosing clinically suspected müllerian duct cysts was assessed in six patients. MR imaging correctly demonstrated the abnormality to be intraprostatic, consistent with the diagnosis of müllerian duct cysts in four patients, and allowed the diagnosis to be excluded in the other two. The demonstration of prostatic zonal anatomy, the ability to obtain direct images in all three orthogonal planes, and a large field of view make MR imaging valuable in the study of suspected müllerian duct cysts.

  16. Transition duct with late injection in turbine system

    DOEpatents

    LeBegue, Jeffrey Scott; Pentecost, Ronnie Ray; Flanagan, James Scott; Kim, Won -Wook; McMahan, Kevin Weston

    2015-09-15

    A system for supplying an injection fluid to a combustor is disclosed. The system includes a transition duct comprising an inlet, an outlet, and a passage extending between the inlet and the outlet and defining a longitudinal axis, a radial axis, and a tangential axis. The outlet of the transition duct is offset from the inlet along the longitudinal axis and the tangential axis. The passage defines a combustion chamber. The system further includes a tube providing fluid communication for the injection fluid to flow through the transition duct and into the combustion chamber.

  17. Regeneratively cooled transition duct with transversely buffered impingement nozzles

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

    Morrison, Jay A; Lee, Ching-Pang; Crawford, Michael E

    2015-04-21

    A cooling arrangement (56) having: a duct (30) configured to receive hot gases (16) from a combustor; and a flow sleeve (50) surrounding the duct and defining a cooling plenum (52) there between, wherein the flow sleeve is configured to form impingement cooling jets (70) emanating from dimples (82) in the flow sleeve effective to predominately cool the duct in an impingement cooling zone (60), and wherein the flow sleeve defines a convection cooling zone (64) effective to cool the duct solely via a cross-flow (76), the cross-flow comprising cooling fluid (72) exhausting from the impingement cooling zone. In themore » impingement cooling zone an undimpled portion (84) of the flow sleeve tapers away from the duct as the undimpled portion nears the convection cooling zone. The flow sleeve is configured to effect a greater velocity of the cross-flow in the convection cooling zone than in the impingement cooling zone.« less

  18. Membrane covered duct lining for high-frequency noise attenuation: prediction using a Chebyshev collocation method.

    PubMed

    Huang, Lixi

    2008-11-01

    A spectral method of Chebyshev collocation with domain decomposition is introduced for linear interaction between sound and structure in a duct lined with flexible walls backed by cavities with or without a porous material. The spectral convergence is validated by a one-dimensional problem with a closed-form analytical solution, and is then extended to the two-dimensional configuration and compared favorably against a previous method based on the Fourier-Galerkin procedure and a finite element modeling. The nonlocal, exact Dirichlet-to-Neumann boundary condition is embedded in the domain decomposition scheme without imposing extra computational burden. The scheme is applied to the problem of high-frequency sound absorption by duct lining, which is normally ineffective when the wavelength is comparable with or shorter than the duct height. When a tensioned membrane covers the lining, however, it scatters the incident plane wave into higher-order modes, which then penetrate the duct lining more easily and get dissipated. For the frequency range of f=0.3-3 studied here, f=0.5 being the first cut-on frequency of the central duct, the membrane cover is found to offer an additional 0.9 dB attenuation per unit axial distance equal to half of the duct height.

  19. Coherent flow structures and heat transfer in a duct with electromagnetic forcing

    NASA Astrophysics Data System (ADS)

    Himo, Rawad; Habchi, Charbel

    2018-04-01

    Coherent vortices are generated electromagnetically in a square duct flow. The vortices are induced by a Lorentz force applied in a small section near the entrance of the duct. The flow structure complexity increases with the electromagnetic forcing since the primary vortices propagating along the duct detach to generate secondary smaller streamwise vortices and hairpin-like structures. The Reynolds number based on the mean flow velocity and hydraulic diameter is 500, and five cases were studied by varying the electromagnetic forcing. Even though this Reynolds number is relatively low, a periodic sequence of hairpin-like structure flow was observed for the high forcing cases. This mechanism enhances the mixing process between the different flow regions resulting in an increase in the thermal performances which reaches 66% relative to the duct flow without forcing. In addition to the flow complexity, lower forcing cases remained steady, unlike high Lorentz forces that induced periodic instabilities with a Strouhal number around 0.59 for the transient eddies. The effect of the flow structure on the heat transfer is analyzed qualitatively and quantitatively using numerical simulations based on the finite volume method. Moreover, proper orthogonal decomposition (POD) analysis was performed on the flow structures to evaluate the most energetic modes contributing in the flow. It is found from the POD analysis that the primary streamwise vortices and hairpin legs are the flow structures that are the most contributing to the heat transfer process.

  20. A hybrid method for determination of the acoustic impedance of an unflanged cylindrical duct for multimode wave

    NASA Astrophysics Data System (ADS)

    Snakowska, Anna; Jurkiewicz, Jerzy; Gorazd, Łukasz

    2017-05-01

    The paper presents derivation of the impedance matrix based on the rigorous solution of the wave equation obtained by the Wiener-Hopf technique for a semi-infinite unflanged cylindrical duct. The impedance matrix allows, in turn, calculate the acoustic impedance along the duct and, as a special case, the radiation impedance. The analysis is carried out for a multimode incident wave accounting for modes coupling on the duct outlet not only qualitatively but also quantitatively for a selected source operating inside. The quantitative evaluation of the acoustic impedance requires setting of modes amplitudes which has been obtained applying the mode decomposition method to the far-field pressure radiation measurements and theoretical formulae for single mode directivity characteristics for an unflanged duct. Calculation of the acoustic impedance for a non-uniform distribution of the sound pressure and the sound velocity on a duct cross section requires determination of the acoustic power transmitted along/radiated from a duct. In the paper, the impedance matrix, the power, and the acoustic impedance were derived as functions of Helmholtz number and distance from the outlet.

  1. Recruiting physicians for office-based research.

    PubMed

    Levinson, W; Dull, V T; Roter, D L; Chaumeton, N; Frankel, R M

    1998-06-01

    Research conducted in community outpatient offices can provide insight into the common experiences of patients and physicians. However, recruiting physicians to participate in office-based research is challenging and few descriptions of methods that have been used to successfully recruit random samples of physicians are available. This article describes recruitment strategies utilized in a project that achieved high rates of participation from community-based primary care physicians and surgeons. Recruitment methods included the use of advisory boards to identify potential barriers to participation, use of respected members of the medical community as recruiters, and obtaining endorsements from physician organizations and prominent members of the medical community. Overall, 81% of physicians contacted from a sample frame agreed to participate in the project. Participating physicians most frequently reported that they participated because the project could provide them with feedback about their interviewing style. The recruitment methods described here can be generalized to other types of investigations.

  2. Positive predictive value of cholescintigraphy in common bile duct obstruction

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

    Lecklitner, M.L.; Austin, A.R.; Benedetto, A.R.

    1986-09-01

    Technetium-99m DISIDA imaging was employed in 400 patients to differentiate obstruction of the common bile duct from medical and other surgical causes of hyperbilirubinemia. Sequential anterior images demonstrated variable degrees of liver uptake, yet there was no evidence of intrabiliary or extrabiliary radioactivity for at least 4 hr after injection in 25 patients. Twenty-three patients were surgically documented to have complete obstruction of the common bile duct. One patient had hepatitis, and another had sickle cell crisis without bile duct obstruction. The remaining patients had either partial or no obstruction of the common bile duct. We conclude that the presencemore » of liver uptake without evident biliary excretion by 4 hr on cholescintigraphy is highly sensitive and predictive of total obstruction of the common bile duct.« less

  3. Carcinoids of the common bile duct: a case report and literature review

    PubMed Central

    Ross, Alison C.; Hurley, James B.; Hay, W. Bruce; Rusnak, Conrad H.; Petrunia, Denis M.

    1999-01-01

    Carcinoids of the extrahepatic bile ducts and particularly the common bile duct are extremely rare. A 65-year-old woman presented with obstructive jaundice. Laboratory and imaging studies gave results that were consistent with an obstructing lesion in the common bile duct. In this case, a stent was inserted initially to decompress the bile ducts. Subsequently a laparotomy and pancreaticoduodenectomy were performed and a tissue diagnosis of carcinoid of the common bile duct was made. The patient was well with no evidence of recurrence 17 months postoperatively. The authors believe this is the 19th reported case of an extrahepatic bile duct carcinoid. PMID:10071590

  4. Collecting Duct Intercalated Cell Function and Regulation

    PubMed Central

    Roy, Ankita; Al-bataineh, Mohammad M.

    2015-01-01

    Intercalated cells are kidney tubule epithelial cells with important roles in the regulation of acid-base homeostasis. However, in recent years the understanding of the function of the intercalated cell has become greatly enhanced and has shaped a new model for how the distal segments of the kidney tubule integrate salt and water reabsorption, potassium homeostasis, and acid-base status. These cells appear in the late distal convoluted tubule or in the connecting segment, depending on the species. They are most abundant in the collecting duct, where they can be detected all the way from the cortex to the initial part of the inner medulla. Intercalated cells are interspersed among the more numerous segment-specific principal cells. There are three types of intercalated cells, each having distinct structures and expressing different ensembles of transport proteins that translate into very different functions in the processing of the urine. This review includes recent findings on how intercalated cells regulate their intracellular milieu and contribute to acid-base regulation and sodium, chloride, and potassium homeostasis, thus highlighting their potential role as targets for the treatment of hypertension. Their novel regulation by paracrine signals in the collecting duct is also discussed. Finally, this article addresses their role as part of the innate immune system of the kidney tubule. PMID:25632105

  5. The statistical evaluation of duct tape end match as physical evidence

    NASA Astrophysics Data System (ADS)

    Chan, Ka Lok

    Duct tapes are often submitted to crime laboratories as evidence associated with abductions, homicides, or construction of explosive devices. As a result, trace evidence examiners are often asked to analyze and compare commercial duct tapes so that they can establish possible evidentiary links. Duct tape end matches are believed to be the strongest association between exemplar and question samples because they are considered as evidence with unique individual characteristics. While end match analysis and comparison have long been undertaken by trace evidence examiners, there is a significant lack of scientific research for associating two or more segments of duct tapes. This study is designed to obtain statistical inferences on the uniqueness of duct tape tears. Three experiments were devised to compile the basis for a statistical assessment of the probability of duct tape end matches along with a proposed error rate. In one experiment, we conducted the equivalent of 10,000 end match examinations with an error rate of 0%. In the second experiment, we performed 2,704 end match examinations having 0% error rate. In the third experiment, using duct tape by an Elmendorf Tear tester, we conducted 576 end match examinations with an error rate of 0% and having all samples correctly associated. The results of this study indicate that end matches are distinguishable among a single roll of duct tape and between two different rolls of duct tape having very similar surface features and weave pattern.

  6. Trypsin level in gallbladder bile and ductitis and width of the cystic duct.

    PubMed

    Vracko, J; Wiechel, K L

    2000-01-01

    The change from laparotomy to laparoscopy for cholecystectomy has raised the question of how to manage concomitant bile duct stones. The present-day interest--and controversy--has focused on a transcystic approach reported to be feasible in 66-96% of cases, but without explaining the necessary prerequisite: the widening of the cystic duct. The cystic duct, wide mainly in patients with bile duct stones, has been reported to be highly variable: from strictured to very wide. The present study aims at comparing the trypsin level in the gallbladder bile and the cystic duct morphology and width in patients with and without bile duct stones. A prospective series of 63 gallstone patients, 30 with and 33 without bile duct stones (controls), underwent cholecystectomy and bile duct clearance. The study includes the trypsin level in the gallbladder bile, the width and morphology of the cystic duct, and the size of the gallstones. The patients with bile duct stones had, in contrast to the controls, higher trypsin levels in the gallbladder bile (P < 0.001) and wider cystic ducts (P < 0.001) with more pronounced signs of chronic ductitis. The obtained results strongly suggest that the increased trypsin level, a sign of reflux of pancreatic juice, caused changes in the cystic duct that facilitate gallstone migration, which also ought to render a transcystic stone extraction feasible.

  7. Agenesis of the gallbladder with hypoplastic cystic duct diagnosed at laparoscopy.

    PubMed

    Kwon, A-Hon; Yanagimoto, Hiroaki; Matsui, Yoichi; Imamura, Atsushi

    2006-08-01

    An 86-year-old man was admitted to our department with complaints of intermittent upper abdominal pain. Ultrasonography of the abdomen showed dilated extrahepatic bile ducts containing stones; however, the gallbladder was not clearly identified. Magnetic resonance cholangiopancreatography showed dilated extrahepatic ducts and choledocholithiasis without gallbladder visualization. The stone extraction was performed with endoscopic sphincterotomy. Three-dimensional images using spiral-computed tomography after intravenous-infusion cholangiography clearly demonstrated an obstruction of the cystic duct. The patient was scheduled for laparoscopic cholecystectomy. At laparoscopy, the gallbladder fossa was not identified on the undersurface of the liver. Despite a thorough examination of the intrahepatic (left-sided within the lesser omentum), retroperitoneal, retrohepatic (within the falciform ligament), retroduodenal, and retropancreatic areas using laparoscopic ultrasonography, the gallbladder was not found. After careful dissection of the hepatoduodenal ligament, the dilated extrahepatic bile duct and a 1-cm length of hypoplastic cystic duct were found. Gallbladder agenesis is usually accompanied by the lack of the cystic duct. The present case is the third report of gallbladder agenesis with a patent or hypoplastic cystic duct.

  8. Analysis of pain and satisfaction with office-based hysteroscopic sterilization.

    PubMed

    Levie, Mark; Weiss, Gil; Kaiser, Bente; Daif, Jennifer; Chudnoff, Scott G

    2010-09-01

    To assess pain and patient satisfaction with office-based hysteroscopic sterilization. This prospective, observational study was designed to assess patient pain perception and satisfaction with office-based hysteroscopic sterilization using the Essure device (Conceptus, Mountain View, CA). Faculty practice office at an inner-city urban medical center. Women seeking hysteroscopic sterilization. Office hysteroscopic sterilization under local anesthesia. Pain assessed at the time of the procedure by a 0-10 visual scale and satisfaction by a 1-5 scale. From June 2003 to June 2006, 209 patients were recruited. The mean scores for average procedural pain, most procedural pain, and average menstrual pain were 2.6+/-2.1, 3.3+/-2.5, and 3.6+/-2.6, respectively. Standardized pain scores revealed that 149 subjects (70%) experienced average pain that was less than or equal to the pain experienced with their menses. Mean satisfaction rating for the procedure was 4.7+/-0.71. Office-based hysteroscopic sterilization performed with local anesthesia alone is well tolerated, and patients are satisfied with this method for permanent sterilization. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. ASSESSMENT OF VENTILATION RATES IN 100 BASE OFFICE BUILDINGS

    EPA Science Inventory

    The U.S. EPA's Office of Radiation and Indoor Air studied 100 public and private office buildings across the U.S. from 1994-1998. The purpose of the study, entitled The Building Assessment Survey and Evaluation Study (BASE), was to: a) provide a distribution of IAQ, building, and...

  10. Design of power-plant installations pressure-loss characteristics of duct components

    NASA Technical Reports Server (NTRS)

    Henry, John R

    1944-01-01

    A correlation of what are believed to be the most reliable data available on duct components of aircraft power-plant installations is presented. The information is given in a convenient form and is offered as an aid in designing duct systems and, subject to certain qualifications, as a guide in estimating their performance. The design and performance data include those for straight ducts; simple bends of square, circular, and elliptical cross sections; compound bends; diverging and converging bends; vaned bends; diffusers; branch ducts; internal inlets; and an angular placement of heat exchangers. Examples are included to illustrate methods of applying these data in analyzing duct systems. (author)

  11. Film condensation in a horizontal rectangular duct

    NASA Technical Reports Server (NTRS)

    Lu, Qing; Suryanarayana, N. V.

    1993-01-01

    Condensation heat transfer in a horizontal rectangular duct was experimentally and analytically investigated. To prevent the dripping of condensate on the film, the experiment was conducted inside a horizontal rectangular duct with vapor condensing only on the bottom cooled plate of the duct. R-113 and FC-72 (Fluorinert Electronic Fluid developed by the 3M Company) were used as the condensing fluids. The experimental program included measurements of film thickness, local and average heat transfer coefficients, wave length, wave speed, and a study of wave initiation. The measured film thickness was used to obtain the local heat transfer coefficient. The wave initiation was studied both with condensation and with an adiabatic air-liquid flow. The test sections used in both experiments were identical.

  12. Measured Performance of a Varied Airflow Small-Diameter Duct System

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

    Poerschke, Andrew

    2017-03-01

    This study tests the performance of a variable airflow small-diameter duct heating, ventilation, and air conditioning (HVAC) system in a new construction unoccupied low-load test house in Pittsburgh, Pennsylvania. The duct system was installed entirely in conditioned space and was operated from the winter through summer seasons. Measurements were collected on the in-room temperatures and energy consumed by the air handler and heat pump unit. Operation modes with three different volumes of airflow were compared to determine the ideal airflow scenario that maximizes room-to-room thermal uniformity while minimizing fan energy consumption. Black felt infrared imagery was used as a measuremore » of diffuser throw and in-room air mixing. Measured results indicate the small-diameter, high velocity airflow system can provide comfort under some conditions. Solar heat gains resulted in southern rooms drifting beyond acceptable temperature limits. Insufficient airflow to some bedrooms also resulted in periods of potential discomfort. Homebuilders or HVAC contractors can use these results to assess whether this space conditioning strategy is an attractive alternative to a traditional duct system. The team performed a cost analysis of two duct system configurations: (1) a conventional diameter and velocity duct system, and (2) the small-diameter duct system. This work applies to both new and retrofit homes that have achieved a low heating and cooling density either by energy conservation or by operation in a mild climate with few heating or cooling degree days. Guidance is provided on cost trade-offs between the conventional duct system and the small-diameter duct system.« less

  13. Measured Performance of a Varied Airflow Small-Diameter Duct System

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

    Poerschke, Andrew

    This study tests the performance of a variable airflow small-diameter duct heating, ventilation, and air conditioning (HVAC) system in a new construction unoccupied low-load test house in Pittsburgh, Pennsylvania. The duct system was installed entirely in conditioned space and was operated from the winter through summer seasons. Measurements were collected on the in-room temperatures and energy consumed by the air handler and heat pump unit. Operation modes with three different volumes of airflow were compared to determine the ideal airflow scenario that maximizes room-to-room thermal uniformity while minimizing fan energy consumption. Black felt infrared imagery was used as a measuremore » of diffuser throw and in-room air mixing. Measured results indicate the small-diameter, high velocity airflow system can provide comfort under some conditions. Solar heat gains resulted in southern rooms drifting beyond acceptable temperature limits. Insufficient airflow to some bedrooms also resulted in periods of potential discomfort. Homebuilders or HVAC contractors can use these results to assess whether this space conditioning strategy is an attractive alternative to a traditional duct system. The team performed a cost analysis of two duct system configurations: (1) a conventional diameter and velocity duct system, and (2) the small-diameter duct system. This work applies to both new and retrofit homes that have achieved a low heating and cooling density either by energy conservation or by operation in a mild climate with few heating or cooling degree days. Guidance is provided on cost trade-offs between the conventional duct system and the small-diameter duct system.« less

  14. Systematic review with meta-analysis of studies comparing primary duct closure and T-tube drainage after laparoscopic common bile duct exploration for choledocholithiasis.

    PubMed

    Podda, Mauro; Polignano, Francesco Maria; Luhmann, Andreas; Wilson, Michael Samuel James; Kulli, Christoph; Tait, Iain Stephen

    2016-03-01

    With advances in laparoscopic instrumentation and acquisition of advanced laparoscopic skills, laparoscopic common bile duct exploration (LCBDE) is technically feasible and increasingly practiced by surgeons worldwide. Traditional practice of suturing the dochotomy with T-tube drainage may be associated with T-tube-related complications. Primary duct closure (PDC) without a T-tube has been proposed as an alternative to T-tube placement (TTD) after LCBDE. The aim of this meta-analysis was to evaluate the safety and effectiveness of PDC when compared to TTD after LCBDE for choledocholithiasis. A systematic literature search was performed using PubMed, EMBASE, MEDLINE, Google Scholar, and the Cochrane Central Register of Controlled Trials databases for studies comparing primary duct closure and T-tube drainage. Studies were reviewed for the primary outcome measures: overall postoperative complications, postoperative biliary-specific complications, re-interventions, and postoperative hospital stay. Secondary outcomes assessed were: operating time, median hospital expenses, and general complications. Sixteen studies comparing PDC and TTD qualified for inclusion in our meta-analysis, with a total of 1770 patients. PDC showed significantly better results when compared to TTD in terms of postoperative biliary peritonitis (OR 0.22, 95% CI 0.06-0.76, P = 0.02), operating time (WMD, -22.27, 95% CI -33.26 to -11.28, P < 0.00001), postoperative hospital stay (WMD, -3.22; 95% CI -4.52 to -1.92, P < 0.00001), and median hospital expenses (SMD, -1.37, 95% CI -1.96 to -0.77, P < 0.00001). Postoperative hospital stay was significantly decreased in the primary duct closure with internal biliary drainage (PDC + BD) group when compared to TTD group (WMD, -2.68; 95% CI -3.23 to -2.13, P < 0.00001). This comprehensive meta-analysis demonstrates that PDC after LCBDE is feasible and associated with fewer complications than TTD. Based on these results, primary duct closure may be considered

  15. Internally supported flexible duct joint. [device for conducting fluids in high pressure systems

    NASA Technical Reports Server (NTRS)

    Kuhn, R. F., Jr. (Inventor)

    1975-01-01

    An internally supported, flexible duct joint for use in conducting fluids under relatively high pressures in systems where relatively large deflection angles must be accommodated is presented. The joint includes a flexible tubular bellows and an elongated base disposed within the bellows. The base is connected through radiating struts to the bellows near mid-portion and to each of the opposite end portions of the bellows through a pivotal connecting body. A motion-controlling linkage is provided for linking the connecting bodies, whereby angular displacement of the joint is controlled and uniformity in the instantaneous bend radius of the duct is achieved as deflection is imposed.

  16. 24. AIRCONDITIONING DUCT, WINCH CONTROL BOX, AND SPEAKER AT STATION ...

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

    24. AIR-CONDITIONING DUCT, WINCH CONTROL BOX, AND SPEAKER AT STATION 85.5 OF MST. FOLDED-UP PLATFORM ON RIGHT OF PHOTO. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  17. A Review of Double Common Bile Duct and Its Sequelae.

    PubMed

    Kolli, Sindhura; Etienne, Denzil; Reddy, Madhavi; Shahzad, Ghulamullah

    2018-02-01

    A double or accessory common bile duct (ACBD) is a rare congenital anomaly. We report the case of a 60-year-old American Asian male, who was found to have a double or duplicated common bile duct after being admitted for evaluation of a pancreatic mass. A duplicated bile duct has the same mucosa histologically as a single bile duct. However, the opening of a duplicated bile duct lacks a sphincter allowing retrograde flow of gut contents which results in a higher probability of intraductal calculus formation. On rare occasions, it can predispose to liver abscesses, pancreatitis, pancreatic cancer, gallbladder cancer, gastric cancer, and ampullary cancer depending on the location of the opening of the ACBD. We present an integrative review of the limited cases of ACBD with correlation to the current case and discussion regarding the aspects of diagnosis and management.

  18. Sound attenuation of fiberglass lined ventilation ducts

    NASA Astrophysics Data System (ADS)

    Albright, Jacob

    Sound attenuation is a crucial part of designing any HVAC system. Most ventilation systems are designed to be in areas occupied by one or more persons. If these systems do not adequately attenuate the sound of the supply fan, compressor, or any other source of sound, the affected area could be subject to an array of problems ranging from an annoying hum to a deafening howl. The goals of this project are to quantify the sound attenuation properties of fiberglass duct liner and to perform a regression analysis to develop equations to predict insertion loss values for both rectangular and round duct liners. The first goal was accomplished via insertion loss testing. The tests performed conformed to the ASTM E477 standard. Using the insertion loss test data, regression equations were developed to predict insertion loss values for rectangular ducts ranging in size from 12-in x 18-in to 48-in x 48-in in lengths ranging from 3ft to 30ft. Regression equations were also developed to predict insertion loss values for round ducts ranging in diameters from 12-in to 48-in in lengths ranging from 3ft to 30ft.

  19. Computed tomography of the lacrimal drainage system: retrospective study of 107 cases of dacryostenosis.

    PubMed

    Francis, I C; Kappagoda, M B; Cole, I E; Bank, L; Dunn, G D

    1999-05-01

    To evaluate the role of computed tomography in patients with dacryostenosis. One hundred seven cases of dacryostenosis (94 patients) were assessed by thorough clinical and lacrimal history and examination, and lacrimal region computerized tomography (CT). The lacrimal drainage system examination included the state and position of the puncta; Jones testing; lacrimal syringing; and, in the latter half of the study, telescopic nasal endoscopy. The patients were drawn from the hospital outpatients and private office of the operating lacrimal surgeon in this series (I.C.F.). Of the 107 cases, 79 either underwent dacryocystorhinostomy surgery or had this planned. In 14 of the 107 cases (12 patients), preoperative CT led to an alteration of patient management, usually referral to an otolaryngologist for further evaluation or treatment. In addition to the detection of two tumors extrinsic to the sac, conditions such as ethmoiditis, lacrimal sac mucoceles, soft tissue opacity in the nasolacrimal duct, gross nasal polyposis, fungal sinusitis, and a dacryolith were observed by CT. Similar to the role of functional endoscopic sinus surgery in otolaryngology, CT imaging will become increasingly important in the assessment of many patients with symptoms of lacrimal drainage obstruction.

  20. Relationship Between Bile Duct Reconstruction and Complications in Living Donor Liver Transplantation.

    PubMed

    Miyagi, S; Kawagishi, N; Kashiwadate, T; Fujio, A; Tokodai, K; Hara, Y; Nakanishi, C; Kamei, T; Ohuchi, N; Satomi, S

    2016-05-01

    In living donor liver transplantation (LDLT), the recipient bile duct is thin and short. Bile duct complications often occur in LDLT, with persistent long-term adverse effects. Recently, we began to perform microsurgical reconstruction of the bile duct. The purpose of this study was to investigate the relationship between bile duct reconstruction methods and complications in LDLT. From 1991 to 2014, we performed 161 LDLTs (pediatric:adult = 90:71; left lobe:right lobe = 95:66). In this study, we retrospectively investigated the initial bile duct complications in LDLT and performed univariate and multivariate analyses to identify the independent risk factors for complications. The most frequent complication was biliary stricture (9.9%), followed by biliary leakage (6.8%). On univariate and multiple logistic regression analysis, the independent risk factors for biliary stricture were bile leakage (P = .0103) and recurrent cholangitis (P = .0077). However, there were no risk factors for biliary leakage on univariate analysis in our study. The reconstruction methods (hepaticojejunostomy or duct-to-duct anastomosis) and reconstruction technique (with or without microsurgery) were not risk factors for biliary stricture and leakage. In this study, the most frequent complication of LDLT was biliary stricture. The independent risk factors for biliary stricture were biliary leakage and recurrent cholangitis. Duct-to-duct anastomosis and microsurgical reconstruction of the bile duct were not risk factors for biliary stricture and leakage. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Office-based endovascular suite is safe for most procedures.

    PubMed

    Jain, Krishna; Munn, John; Rummel, Mark C; Johnston, Dan; Longton, Chris

    2014-01-01

    This study was conducted to identify the safety of endovascular procedures in the office endovascular suite and to assess patient satisfaction in this setting. Between May 22, 2007, and December 31, 2012, 2822 patients underwent 6458 percutaneous procedures in an office-based endovascular suite. Demographics of the patients, complications, hospital transfers, and 30-day mortality were documented in a prospective manner. Follow-up calls were made, and a satisfaction survey was conducted. Almost all dialysis procedures were done under local anesthesia and peripheral arterial procedures under conscious sedation. All patients, except those undergoing catheter removals, received hydrocodone and acetaminophen (5/325 mg), diazepam (5-10 mg), and one dose of an oral antibiotic preprocedure and three doses postprocedure. Patients who required conscious sedation received fentanyl and midazolam. Conscious sedation was used almost exclusively in patients having an arterial procedure. Measurements of blood urea nitrogen, creatinine, international normalized ratio, and partial thromboplastin time were performed before peripheral arteriograms. All other patients had no preoperative laboratory tests. Patients considered high risk (American Society of Anesthesiologists Physical Status Classification 4), those who could not tolerate the procedure with mild to moderate conscious sedation, patients with a previous bad experience, or patients who weighed >400 pounds were not candidates for office based procedures. There were 54 total complications (0.8%): venous, 2.2%; aortogram without interventions, 1%; aortogram with interventions, 2.7%; fistulogram, 0.5%; catheters, 0.3%; and venous filter-related, 2%. Twenty-six patients required hospital transfer from the office. Ten patients needed an operative intervention because of a complication. No procedure-related deaths occurred. There were 18 deaths in a 30-day period. Of patients surveyed, 99% indicated that they would come back to the

  2. Analysis of sound propagation in ducts using the wave envelope concept

    NASA Technical Reports Server (NTRS)

    Baumeister, K. J.

    1974-01-01

    A finite difference formulation is presented for sound propagation in a rectangular two-dimensional duct without steady flow for plane wave input. Before the difference equations are formulated, the governing Helmholtz equation is first transformed to a form whose solution does not oscillate along the length of the duct. This transformation reduces the required number of grid points by an order of magnitude, and the number of grid points becomes independent of the sound frequency. Physically, the transformed pressure represents the amplitude of the conventional sound wave. Example solutions are presented for sound propagation in a one-dimensional straight hard-wall duct and in a two-dimensional straight soft-wall duct without steady flow. The numerical solutions show evidence of the existence along the duct wall of a developing acoustic pressure diffusion boundary layer which is similar in nature to the conventional viscous flow boundary layer. In order to better illustrate this concept, the wave equation and boundary conditions are written such that the frequency no longer appears explicitly in them. The frequency effects in duct propagation can be visualized solely as an expansion and stretching of the suppressor duct.

  3. 14 CFR 25.1103 - Induction system ducts and air duct systems.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... between which relative motion could exist must have means for flexibility. (d) For turbine engine and... stage of the engine supercharger and of the auxiliary power unit compressor must have a drain to prevent... compartment to prevent hot gas reverse flow from burning through auxiliary power unit ducts and entering any...

  4. Comparison of Office-Based Versus Outsourced Immunization Recall Services.

    PubMed

    Bondurant, Kristina L; Wheeler, J Gary; Bursac, Zoran; Holmes, Tereasa; Tilford, J Mick

    2017-06-01

    Given poor use of recall in primary care practices, we compared outsourced versus office-based recall systems. From 2011 to 2013, we enrolled 87 individual Arkansas providers in distinct practices treating their own patients <24 months of age which were randomized to usual care (A), office-based (B), or outsourced (C) recall groups. At the end of study, recall activity was 19.4%, 55.0%, and 92.6% for Groups A, B, and C, respectively (B and C vs A: P < .001). Only 68 Group B patients were identified as needing immunizations versus 826 in Group C. The majority of successful contacts were made through mobile phone (41.3%) or text message (32.6%). The total cost per practice per week was significantly lower for Group C versus Group B ($39.50 and $53.00, respectively; P = .004). With limited electronic health record use, an outsourced recall system is more sustainable and less costly than an office-based system.

  5. Numerical and experimental investigation of conventional and un-conventional preswirl duct for VLCC

    NASA Astrophysics Data System (ADS)

    Shin, Hyun-Joon; Lee, Jong-Seung; Lee, Kang-Hoon; Han, Myung-Ryun; Hur, Eui-Beom; Shin, Sung-Chul

    2013-09-01

    This paper shows the study of preswirl duct as an effective energy saving devices that have been devised and reviewed to support the propeller performance, especially for the ship of VLCC with large block coefficients. From the bare hull wake measurements, typical upper/lower asymmetry of hull wake at the propeller disk was found. The 2 kinds of pre-swirl duct, Unconventional half circular duct and Conventional circular pre-swirl duct have been designed and reviewed to recover the loss of propeller running in that condition. The general function of the pre-swirl duct was set to work against this asymmetry of wake and generate pre-swirled flow into the propeller against the propeller rotating direction. The optimum self propulsion tests with various angle configurations were carried out and the best configuration was decided. Accordingly, cavitation test was carried out with best configuration of unconventional half circular duct. The blade surface and tip vortex cavitation behaved smoother when the duct was mounted. The hull pressure amplitudes reflected this difference, so the hull pressure amplitude with duct was smaller than that of without duct.

  6. SSME 3-D Turnaround Duct flow analysis - CFD predictions

    NASA Technical Reports Server (NTRS)

    Brankovic, Andreja; Stowers, Steven T.; Mcconnaughey, Paul

    1988-01-01

    CFD analysis is presently employed to obtain an improved flowfield for an individual flowpath in the case of the Space Shuttle Main Engine's High Pressure Fuel Turbopump Turn-Around Duct (TAD), which conducts the flow exiting from the gas turbines into the fuel bowl. It is demonstrated that the application of CFD to TAD flow analysis, giving attention to the duct's configuration and to the number, shape, and alignment of the diffuser struts, can enhance understanding of flow physics and result in improved duct design and performance.

  7. Device for temporarily closing duct-formers in well completion apparatus

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

    Zandmer, H.M.; Zandmer, S.M.

    A duct-forming device is disclosed for use in a well completion apparatus of the kind, wherein a bore hole casing is positioned in a bore hole and duct-forming devices of alkali- and acid resistant metal-such as steel-are secured at spaced levels to the casing in alignment with holes machined in the casing wall. In accordance with the invention, a closure device is arranged within the duct-forming device which permits flow of predetermined amounts of liquid, such as acid, from the interior of the casing through the duct-forming device and into the producing formation, while gradually being moved by the liquidmore » into a position in which such fluid flow is prevented. After the fluid flow has been stopped by the closure device and when the formation pressure exceeds the pressure within the duct-forming device and the casing, fluid from the formation then forces the closure device toward and into the casing space to permit thereafter free flow of formation fluid into the duct-forming device and the casing or of pressurized treatment liquid from the casing into the formation. The inventive arrangement permits inter alia the establishment of a sufficient and substantially uniform feeding rate of treatment liquid, such as acid, from the casing into the producing formation through all the duct-formers in preparation for subsequent acidification or other treatments, such as sand fracking.« less

  8. Direct numerical simulation of turbulence and heat transfer in a hexagonal shaped duct

    NASA Astrophysics Data System (ADS)

    Marin, Oana; Obabko, Aleks; Schlatter, Philipp

    2014-11-01

    Flows in hexagonal shapes frequently occur in nuclear reactor applications, and are also present in honeycomb-shaped settling chambers for e.g. wind tunnels. Whereas wall-bounded turbulence has been studied comprehensively in two-dimensional channels, and to a lesser degree also in square and rectangular ducts and triangles, only very limited data for hexagonal ducts is available, including resistance correlations and mean profiles. Here, we use resolved spectral-element simulations to compute velocity and temperature in fully-developed (periodic) hexagonal duct flow. The Reynolds number, based on the fixed flow rate and the hydraulic diameter, ranges between 2000 and 20000. The temperature assumes constant wall flux or constant wall temperature. First DNS results are focused on the mean characteristics such a head loss, Nusselt number, and critical Reynolds number for sustained turbulence. Profiles, both for mean and fluctuating quantities, are extracted and discussed in the context of square ducts and pipes. Comparisons to existing experiments, RANS and empirical correlations are supplied as well. The results show a complicated and fine-scale pattern of the in-plane secondary flow, which clearly affects the momentum and temperature distribution throughout the cross section.

  9. Laparoscopic bile duct injury: understanding the psychology and heuristics of the error.

    PubMed

    Dekker, Sidney W A; Hugh, Thomas B

    2008-12-01

    Bile duct injury is an important unsolved problem of laparoscopic cholecystectomy, occurring with unacceptable frequency even in the hands of experienced surgeons. This suggests that a systemic predisposition to the injury is intrinsic to cholecystectomy and indicates that an analysis of the psychology and heuristics of surgical decision-making in relation to duct identification may be a guide to prevention. Review of published reports on laparoscopic bile duct injury from 1997 to 2007 was carried out. An analysis was also carried out of the circumstances of the injuries in 49 patients who had transection of an extrahepatic bile duct and who were referred for reconstruction or were assessed in a medicolegal context. Special emphasis was placed on identifying the possible psychological aspects of duct misidentification. Review of published work showed an emphasis on the technical aspects of correct identification of the cystic duct, with few papers addressing the heuristics and psychology of surgical decision-making during cholecystectomy. Duct misidentification was the cause of injury in 42 out of the 49 reviewed patients (86%). The injury was not recognized at operation in 70% and delay in recognition persisted into the postoperative period in 57%. Underestimation of risk, cue ambiguity and visual misperception ('seeing what you believe') were important factors in misidentification. Delay in recognition of the injury is a feature consistent with cognitive fixation and plan continuation, which help construct and sustain the duct misidentification during the operation and beyond. Changing the 'culture' of cholecystectomy is probably the most effective strategy for preventing laparoscopic bile duct injury, especially if combined with new technical approaches and an understanding of the heuristics and psychology of the duct misidentification error. Training of surgeons for laparoscopic cholecystectomy should emphasize the need to be alert for cues that the incorrect

  10. Single-Operator Peroral Cholangioscopy for Extraction of Cystic Duct Stones in Postcholecystectomy Mirizzi Syndrome.

    PubMed

    Jones, Jason Deforest; Pawa, Rishi

    2017-01-01

    Mirizzi syndrome is an exceptionally rare diagnosis with an annual incidence of less than 1% in developed countries. In this disease process, stone burden in the cystic duct or gallbladder neck leads to common hepatic duct obstruction, either by mechanical compression or secondary inflammation. Mirizzi syndrome is classified into one of four types based on the presence and severity of cholecystobiliary fistulization. Treatment is primarily surgical in nature and largely dictated by the type of Mirizzi syndrome encountered. It is typically diagnosed in the preoperative or operative setting of cholecystectomy; however, there have been rare occurrences of postcholecystectomy diagnosis. Factors thought to predispose to postcholecystectomy disease include low insertion of the cystic duct and long remnant duct length. Few case reports exist describing this phenomenon and its management, which is made exceptionally difficult due to the presence of inflammation and surgical adhesion. We present the case of a young female with postcholecystectomy Mirizzi syndrome who underwent successful endoscopic management using peroral cholangioscopy and electrohydraulic lithotripsy. We also provide a brief overview of both Mirizzi syndrome and peroral cholangioscopy.

  11. Mammary duct ectasia: a cause of bloody nipple discharge.

    PubMed Central

    Leung, Alexander K. C.; Kao, C. Pion

    2004-01-01

    We report a 13-year-old girl with bloody nipple discharge as a result of mammary duct ectasia. Our patient is the second reported case of mammary duct ectasia in a pubertal girl. Images Figure 1 PMID:15101674

  12. Biliary reconstruction in liver transplant patients with primary sclerosing cholangitis, duct-to-duct or Roux-en-Y?

    PubMed

    Shamsaeefar, Alireza; Shafiee, Mohammad; Nikeghbalian, Saman; Kazemi, Kourosh; Mansorian, Mohsenreza; Motazedian, Nasrin; Afshinnia, Farsad; Geramizadeh, Bita; Malekhosseini, Seyed Ali

    2017-06-01

    Roux-en-Y choledochojejunostomy and duct-to-duct (D-D) anastomosis are biliary reconstruction methods for liver transplantation. However, there is a controversy over which method produces better results. We have compared the outcome of D-D anastomosis vs. Roux-en-Y hepaticojejunostomy in patients with primary sclerosing cholangitis who had undergone liver transplant in Shiraz Organ Transplant Center. The medical records of 405 patients with primary sclerosing cholangitis (PSC) who had undergone liver transplant from 1996 to 2015 were reviewed. Patients were divided into two groups: Roux-en-Y group and D-D group. Morbidity, disease recurrence, and graft and patient survival rates were compared between the two groups. Total of 143 patients underwent a D-D biliary reconstruction, and 260 patients had a Roux-en-Y loop. Biliary complication involved 4.2% of patients from the D-D group, and 3.9% from the Roux-en-Y group (P=. 863). Actuarial 1-, 3-, and 5-year patient survival for D-D and Roux-en-Y group was 92%, 85%, and 74%; and 87%, 83%, and 79%, respectively (P=.384). The corresponding 1-, 3-, and 5-year probability of biliary complication was 97%, 95%, and 92%; and 98%, 97%, and 94%, respectively (P=.61). Duct-to-duct biliary reconstruction in liver transplantation for selected patients with PSC is a good alternative instead of Roux-en-Y biliary reconstruction. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Bile Duct Cancer (Cholangiocarcinoma) Symptoms, Tests, Prognosis, and Stages (PDQ®)—Patient Version

    Cancer.gov

    Bile duct cancer, or cholangiocarcinoma, is rare. Bile ducts are tubes that carry bile between the liver, gallbladder, and small intestine. Bile duct cancer can occur in the intrahepatic, perihilar (Klatskin tumor), or distal extrahepatic area. Learn about tests to diagnose and the stages of bile duct cancer.

  14. Experimental methodology for turbocompressor in-duct noise evaluation based on beamforming wave decomposition

    NASA Astrophysics Data System (ADS)

    Torregrosa, A. J.; Broatch, A.; Margot, X.; García-Tíscar, J.

    2016-08-01

    An experimental methodology is proposed to assess the noise emission of centrifugal turbocompressors like those of automotive turbochargers. A step-by-step procedure is detailed, starting from the theoretical considerations of sound measurement in flow ducts and examining specific experimental setup guidelines and signal processing routines. Special care is taken regarding some limiting factors that adversely affect the measuring of sound intensity in ducts, namely calibration, sensor placement and frequency ranges and restrictions. In order to provide illustrative examples of the proposed techniques and results, the methodology has been applied to the acoustic evaluation of a small automotive turbocharger in a flow bench. Samples of raw pressure spectra, decomposed pressure waves, calibration results, accurate surge characterization and final compressor noise maps and estimated spectrograms are provided. The analysis of selected frequency bands successfully shows how different, known noise phenomena of particular interest such as mid-frequency "whoosh noise" and low-frequency surge onset are correlated with operating conditions of the turbocharger. Comparison against external inlet orifice intensity measurements shows good correlation and improvement with respect to alternative wave decomposition techniques.

  15. Designing insulation for cryogenic ducts

    NASA Astrophysics Data System (ADS)

    Love, C. C.

    1984-03-01

    It is pointed out that the great temperature difference between the outside of a cryogenic duct and the liquified gas it carries can cause a high heat input unless blocked by a high thermal resistance. High thermal resistance for lines needing maximum insulation is provided by metal vacuum jackets. Low-density foam is satisfactory in cases in which higher heat input can be tolerated. Attention is given to the heat transfer through a duct vacuum jacket, the calculation of heat input and the exterior surface's steady-state temperature for various thicknesses of insulation, the calculation of the heat transfer through gimbal jackets, and design specifications regarding the allowable pressure rise in the jacket's annular space.

  16. The Application of a Boundary Integral Equation Method to the Prediction of Ducted Fan Engine Noise

    NASA Technical Reports Server (NTRS)

    Dunn, M. H.; Tweed, J.; Farassat, F.

    1999-01-01

    The prediction of ducted fan engine noise using a boundary integral equation method (BIEM) is considered. Governing equations for the BIEM are based on linearized acoustics and describe the scattering of incident sound by a thin, finite-length cylindrical duct in the presence of a uniform axial inflow. A classical boundary value problem (BVP) is derived that includes an axisymmetric, locally reacting liner on the duct interior. Using potential theory, the BVP is recast as a system of hypersingular boundary integral equations with subsidiary conditions. We describe the integral equation derivation and solution procedure in detail. The development of the computationally efficient ducted fan noise prediction program TBIEM3D, which implements the BIEM, and its utility in conducting parametric noise reduction studies are discussed. Unlike prediction methods based on spinning mode eigenfunction expansions, the BIEM does not require the decomposition of the interior acoustic field into its radial and axial components which, for the liner case, avoids the solution of a difficult complex eigenvalue problem. Numerical spectral studies are presented to illustrate the nexus between the eigenfunction expansion representation and BIEM results. We demonstrate BIEM liner capability by examining radiation patterns for several cases of practical interest.

  17. Modified duval procedure for small-duct chronic pancreatitis without head dominance.

    PubMed

    Oida, Takatsugu; Aramaki, Osamu; Kano, Hisao; Mimatsu, Kenji; Kawasaki, Atsushi; Kuboi, Youichi; Fukino, Nobutada; Kida, Kazutoshi; Amano, Sadao

    2011-01-01

    In the case of small-duct chronic pancreatitis, surgery for pain relief is broadly divided into resection and drainage procedures. These procedures should be selected according to the location of dominant lesion, diameter of the pancreatic duct and extent of the disease. The appropriate procedure for the treatment of small-duct chronic pancreatitis, especially small-duct chronic pancreatitis without head dominance, remains controversial. We developed the modified Duval procedure for the treatment of small-duct chronic pancreatitis without head dominance and determined the efficacy of this procedure. We retrospectively studied 14 patients who underwent surgical drainage with or without pancreatic resection for chronic pancreatitis with small pancreatic duct (<7mm) without head dominance. These patients were divided into 2 groups; the modified Puestow procedure group and the modified Duval procedure group. No complications occurred in the modified Duval group. In the modified Puestow procedure group, complete and partial pain relief were observed in 62.5%, and 37.5% of patients respectively. In contrast, complete pain relief was observed in all the patients in the modified Duval procedure group. Our modified Duval procedure is useful and should be considered the appropriate surgical technique for the treatment of small-duct chronic pancreatitis without head dominance.

  18. 21. STATION 70.5 OF MST, WEST SIDE. AIRCONDITIONING DUCT AT ...

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

    21. STATION 70.5 OF MST, WEST SIDE. AIR-CONDITIONING DUCT AT TOP; POWER BOX ON RIGHT; WINCH ON LEFT. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  19. The Primary Duct of Bothrops jararaca Glandular Apparatus Secretes Toxins

    PubMed Central

    Sakai, Fernanda; Portes-Junior, José Antonio; Godoy Viana, Luciana; Mendes Carneiro, Sylvia; Perales, Jonas; Yamanouye, Norma

    2018-01-01

    Despite numerous studies concerning morphology and venom production and secretion in the main venom gland (and some data on the accessory gland) of the venom glandular apparatus of Viperidae snakes, the primary duct has been overlooked. We characterized the primary duct of the Bothrops jararaca snake by morphological analysis, immunohistochemistry and proteomics. The duct has a pseudostratified epithelium with secretory columnar cells with vesicles of various electrondensities, as well as mitochondria-rich, dark, basal, and horizontal cells. Morphological analysis, at different periods after venom extraction, showed that the primary duct has a long cycle of synthesis and secretion, as do the main venom and accessory glands; however, the duct has a mixed mode venom storage, both in the lumen and in secretory vesicles. Mouse anti-B. jararaca venom serum strongly stained the primary duct’s epithelium. Subsequent proteomic analysis revealed the synthesis of venom toxins—mainly C-type lectin/C-type lectin-like proteins. We propose that the primary duct’s toxin synthesis products complement the final venom bolus. Finally, we hypothesize that the primary duct and the accessory gland (components of the venom glandular apparatus) are part of the evolutionary path from a salivary gland towards the main venom gland. PMID:29533989

  20. Sound Radiation from a Supersonic Jet Passing Through a Partially Open Exhaust Duct

    NASA Technical Reports Server (NTRS)

    Kandula, Max

    2011-01-01

    The radiation of sound from a perfectly expanded Mach 2.5 cold supersonic jet of 25.4 mm exit diameter flowing through a partially open rigid-walled duct with an upstream i-deflector has been studied experimentally. In the experiments, the nozzle is mounted vertically, with the nozzle exit plane at a height of 73 jet diameters above ground level. Relative to the nozzle exit plane (NEP), the location of the duct inlet is varied at 10, 5, and -1 jet diameters. Far-field sound pressure levels were obtained at 54 jet diameters above ground with the aid of acoustic sensors equally spaced around a circular arc of radius equal to 80 jet diameters from the jet axis. Data on the jet acoustic field for the partially open duct were obtained and compared with those with a free jet and with a closed duct. The results suggest that for the partially open duct the overall sound pressure level (OASPL) decreases as the distance between the NEP and the duct inlet plane decreases, while the opposite trend is observed for the closed duct. It is also concluded that the observed peak frequency in the partially open duct increases above the free jet value as the angle from the duct axis is increased, and as the duct inlet plane becomes closer to the NEP.

  1. Evaluation of several non-reflecting computational boundary conditions for duct acoustics

    NASA Technical Reports Server (NTRS)

    Watson, Willie R.; Zorumski, William E.; Hodge, Steve L.

    1994-01-01

    Several non-reflecting computational boundary conditions that meet certain criteria and have potential applications to duct acoustics are evaluated for their effectiveness. The same interior solution scheme, grid, and order of approximation are used to evaluate each condition. Sparse matrix solution techniques are applied to solve the matrix equation resulting from the discretization. Modal series solutions for the sound attenuation in an infinite duct are used to evaluate the accuracy of each non-reflecting boundary conditions. The evaluations are performed for sound propagation in a softwall duct, for several sources, sound frequencies, and duct lengths. It is shown that a recently developed nonlocal boundary condition leads to sound attenuation predictions considerably more accurate for short ducts. This leads to a substantial reduction in the number of grid points when compared to other non-reflecting conditions.

  2. Asymptomatic T-tube remnant in common bile duct.

    PubMed

    Rozario, A; Thomas, P G; Pais, A; Ravindra, K V; Rao, V

    1999-01-01

    A 46-year-old lady presented with itching, five years after a primary common bile duct repair following cholecystectomy. Prior to this she underwent an interno-external biliary drainage. At laparotomy the horizontal limb of a T-tube was found in the common hepatic duct. Eleven months after a Roux loop hepatico-jejunostomy she is asymptomatic.

  3. Influence of bulk turbulence and entrance boundary layer thickness on the curved duct flow field

    NASA Technical Reports Server (NTRS)

    Crawford, R. A.

    1988-01-01

    The influence of bulk turbulence and boundary layer thickness on the secondary flow development in a square, 90 degree turning duct was investigated. A three-dimensional laser velocimetry system was utilized to measure the mean and fluctuating components of velocity at six cross-planes in the duct. The results from this investigation, with entrance boundary layer thickness of 20 percent, were compared with the thin boundary layer results documented in NASA CR-174811. The axial velocity profiles, cross-flow velocities, and turbulence intensities were compared and evaluated with regard to the influence of bulk turbulence intensity and boundary layer thickness, and the influence was significant. The results of this investigation expand the 90 degree curved duct experimental data base to higher turbulence levels and thicker entrance boundary layers. The experimental results provide a challenging benchmark data base for computational fluid dynamics code development and validation. The variation of inlet bulk turbulence intensity provides additional information to aid in turbulence model evaluation.

  4. Acoustic theory of axisymmetric multisectioned ducts. [reduction of turbofan engine noise

    NASA Technical Reports Server (NTRS)

    Zorumski, W. E.

    1974-01-01

    Equations are developed for the acoustic field in a duct system which is made up of a number of connected circular and annular ducts. These equations are suitable for finding the acoustic field inside of and radiated from an aircraft turbofan engine. Acoustic modes are used as generalized coordinates in order to develop a set of matrix equations for the acoustic field. Equations for these modes are given for circular and annular ducts with uniform flow. Modal source equations are derived for point acoustic sources. General equations for mode transmission and reflection are developed and detailed equations are derived for ducts with multiple sections of acoustic treatment and for ducts with circumferential splitter rings. The general theory is applied to the special case of a uniform area circular duct with multisection liners and it is shown that the mode reflection effects are proportional to differences of the acoustic admittances of adjacent liners. A numerical example is given which shows that multisection liners may provide greater noise suppression than uniform liners.

  5. Active noise control in a duct to cancel broadband noise

    NASA Astrophysics Data System (ADS)

    Chen, Kuan-Chun; Chang, Cheng-Yuan; Kuo, Sen M.

    2017-09-01

    The paper presents cancelling duct noises by using the active noise control (ANC) techniques. We use the single channel feed forward algorithm with feedback neutralization to realize ANC. Several kinds of ducts noises including tonal noises, sweep tonal signals, and white noise had investigated. Experimental results show that the proposed ANC system can cancel these noises in a PVC duct very well. The noise reduction of white noise can be up to 20 dB.

  6. Secondary flow in turbulent ducts with increasing aspect ratio

    NASA Astrophysics Data System (ADS)

    Vinuesa, R.; Schlatter, P.; Nagib, H. M.

    2018-05-01

    Direct numerical simulations of turbulent duct flows with aspect ratios 1, 3, 5, 7, 10, and 14.4 at a center-plane friction Reynolds number Reτ,c≃180 , and aspect ratios 1 and 3 at Reτ,c≃360 , were carried out with the spectral-element code nek5000. The aim of these simulations is to gain insight into the kinematics and dynamics of Prandtl's secondary flow of the second kind and its impact on the flow physics of wall-bounded turbulence. The secondary flow is characterized in terms of the cross-plane component of the mean kinetic energy, and its variation in the spanwise direction of the flow. Our results show that averaging times of around 3000 convective time units (based on duct half-height h ) are required to reach a converged state of the secondary flow, which extends up to a spanwise distance of around ≃5 h measured from the side walls. We also show that if the duct is not wide enough to accommodate the whole extent of the secondary flow, then its structure is modified as reflected through a different spanwise distribution of energy. Another confirmation of the extent of the secondary flow is the decay rate of kinetic energy of any remnant secondary motions for zc/h >5 (where zc is the spanwise distance from the corner) in aspect ratios 7, 10, and 14.4, which exhibits a decreasing level of energy with increasing averaging time ta, and in its rapid rate of decay given by ˜ta-1 . This is the same rate of decay observed in a spanwise-periodic channel simulation, which suggests that at the core, the kinetic energy of the secondary flow integrated over the cross-sectional area, , behaves as a random variable with zero mean, with rate of decay consistent with central limit theorem. Long-time averages of statistics in a region of rectangular ducts extending about the width of a well-designed channel simulation (i.e., extending about ≃3 h on each side of the center plane) indicate that ducts or experimental facilities with aspect ratios larger than 10

  7. A quantitative analysis of electrolyte exchange in the salivary duct

    PubMed Central

    Catalán, Marcelo A.; Melvin, James E.; Yule, David I.; Crampin, Edmund J.; Sneyd, James

    2012-01-01

    A healthy salivary gland secretes saliva in two stages. First, acinar cells generate primary saliva, a plasma-like, isotonic fluid high in Na+ and Cl−. In the second stage, the ducts exchange Na+ and Cl− for K+ and HCO3−, producing a hypotonic final saliva with no apparent loss in volume. We have developed a tool that aims to understand how the ducts achieve this electrolyte exchange while maintaining the same volume. This tool is part of a larger multiscale model of the salivary gland and can be used at the duct or gland level to investigate the effects of genetic and chemical alterations. In this study, we construct a radially symmetric mathematical model of the mouse salivary gland duct, representing the lumen, the cell, and the interstitium. For a given flow and primary saliva composition, we predict the potential differences and the luminal and cytosolic concentrations along a duct. Our model accounts well for experimental data obtained in wild-type animals as well as knockouts and chemical inhibitors. Additionally, the luminal membrane potential of the duct cells is predicted to be very depolarized compared with acinar cells. We investigate the effects of an electrogenic vs. electroneutral anion exchanger in the luminal membrane on concentration and the potential difference across the luminal membrane as well as how impairing the cystic fibrosis transmembrane conductance regulator channel affects other ion transporting mechanisms. Our model suggests the electrogenicity of the anion exchanger has little effect in the submandibular duct. PMID:22899825

  8. Investigation of Advanced Counterrotation Blade Configuration Concepts for High Speed Turboprop Systems. Task 2: Unsteady Ducted Propfan Analysis

    NASA Technical Reports Server (NTRS)

    Hall, Edward J.; Delaney, Robert A.; Bettner, James L.

    1991-01-01

    The primary objective was the development of a time dependent 3-D Euler/Navier-Stokes aerodynamic analysis to predict unsteady compressible transonic flows about ducted and unducted propfan propulsion systems at angle of attack. The resulting computer codes are referred to as Advanced Ducted Propfan Analysis Codes (ADPAC). A computer program user's manual is presented for the ADPAC. Aerodynamic calculations were based on a four stage Runge-Kutta time marching finite volume solution technique with added numerical dissipation. A time accurate implicit residual smoothing operator was used for unsteady flow predictions. For unducted propfans, a single H-type grid was used to discretize each blade passage of the complete propeller. For ducted propfans, a coupled system of five grid blocks utilizing an embedded C grid about the cowl leading edge was used to discretize each blade passage. Grid systems were generated by a combined algebraic/elliptic algorithm developed specifically for ducted propfans. Numerical calculations were compared with experimental data for both ducted and unducted flows.

  9. Analysis of the sound field in finite length infinite baffled cylindrical ducts with vibrating walls of finite impedance.

    PubMed

    Shao, Wei; Mechefske, Chris K

    2005-04-01

    This paper describes an analytical model of finite cylindrical ducts with infinite flanges. This model is used to investigate the sound radiation characteristics of the gradient coil system of a magnetic resonance imaging (MRI) scanner. The sound field in the duct satisfies both the boundary conditions at the wall and at the open ends. The vibrating cylindrical wall of the duct is assumed to be the only sound source. Different acoustic conditions for the wall (rigid and absorptive) are used in the simulations. The wave reflection phenomenon at the open ends of the finite duct is described by general radiation impedance. The analytical model is validated by the comparison with its counterpart in a commercial code based on the boundary element method (BEM). The analytical model shows significant advantages over the BEM model with better numerical efficiency and a direct relation between the design parameters and the sound field inside the duct.

  10. Analysis of heating, ventilation, and air conditioning ducts as a radio frequency communication channel

    NASA Astrophysics Data System (ADS)

    Nikitin, Pavel Viktorovich

    2002-01-01

    A typical HVAC duct system is a network of interconnected hollow metal pipes which can serve as waveguides and carry electromagnetic waves. This work presents an analysis of this system as a radio frequency communication channel. Two main parts of the analysis include channel modelling and antenna design. The propagation modelling approach used here is based on the waveguide mode theory and employs the transfer matrix method to describe propagation through various cascaded HVAC elements. This allows one to model the channel response in the frequency domain. Impulse response characteristics of the ducts are also analyzed in this work. The approximate transfer matrices of cylindrical straight sections, bends, and tapers are derived analytically. The transforming properties of cylindrical T-junctions are analyzed experimentally. Antenna designs in waveguides and free-space are different. In waveguides, mode excitation characteristics are important as well as the impedance match. The criteria for antenna design in waveguides are presented here. Antennas analyzed in this work are monopole antennas, dipole antennas, and antenna arrays. The developed model can predict both channel response and antenna characteristics for a given geometry and dimensions of the duct system and the antennas. The model is computationally efficient and can potentially be applied to duct systems of multiple story buildings. The accuracy of the model has been validated with extensive experimental measurements on real HVAC ducts.

  11. Duct Liner Optimization for Turbomachinery Noise Sources

    DTIC Science & Technology

    1975-11-01

    AD-A279 441lIIIflhIh* NASA TECHNICAL NASA TMA X-72789 MEMORANDUM oo £ 00 r-:. DUCT LINER OPTIMIZATION FOR TURBOMACHINERY w NOISE SOURCES By Harold C...Recipient’s r.atalog No. NASA TM X-72789! 4 Title diid Subtitle 5. Rewrt Date Duct Liner Optimization for Turbomachinery Noise Sources November 1975...profiles is combined wit., a numerical minimization algorithm to predict optimal liner configurations having one, two, and three sections. Source models

  12. Acoustic power balance in lined ducts

    NASA Technical Reports Server (NTRS)

    Eversman, W.

    1979-01-01

    It is shown that the two common definitions of acoustic energy density and intensity in uniform unlined ducts carrying uniform flow are compatible to the extent that both energy densities can be used in an appropriate variational principle to derive the convected wave equation. When the duct walls are lined both energy densities must be modified to account for the wall energy density. This results in a new energy conservation equation which utilizes a modified definition of axial power and accounts for wall dissipation. Computations in specific cases demonstrate the validity of the modified acoustic energy relation.

  13. Laser velocimeter and total pressure measurements in circular-to-rectangular transition ducts

    NASA Technical Reports Server (NTRS)

    Patrick, William P.; Mccormick, Duane C.

    1988-01-01

    A comprehensive set of total pressure and three-component laser velocimetry (LV) data were obtained within two circular-to-rectangular transition ducts at low subsonic speeds. This set of reference data was acquired for use in identifying secondary flow mechanisms and for assessing the accuracy of computational procedures for calculating such flows. Data were obtained at the inlet and exit planes of an aspect ratio three duct having a length-to-diameter ratio of one (AR310) and an aspect ratio six duct having a length-to-diameter ratio of three (AR630). Each duct was unseparated throughout its transition section. It is therefore concluded that secondary flows can play an important part in the fluid dynamics of transition ducts and needs to be addressed in computational analysis. The strength of the secondary flows depends on both the aspect ratio and relative axial duct length.

  14. Experimental study of sound propagation in a flexible duct

    PubMed

    Huang; Choy; So; Chong

    2000-08-01

    Propagation of sound in a flexible duct is investigated both theoretically and experimentally. Strong coupling of sound and flexural waves on the duct wall is found when the wall-to-air mass ratio is of the order of unity. The axial phase speed of sound approaches the in vacuo speed of flexural waves (subsonic in this case) at low frequencies. However, a speed higher than the isentropic sound speed in free space (340 m/s) is found beyond a critical frequency which is a function of the mass ratio. Experiments using a duct with a finite section of tensioned membrane are compared with the propagating modes pertaining to the infinite membrane model. Satisfactory quantitative agreement is obtained and the measured phase speed ranges from 8.3 to 1348 m/s. In the moderate frequency range, the theory predicts high spatial damping rate for the subsonic waves, which is consistent with the experimental observation that subsonic waves become increasingly undetectable as the frequency increases. Substantial sound reflection is observed at the interface between the rigid and the flexible segments of the duct without cross-section discontinuity, which, together with the high spatial damping, could form a basis for passive control of low-frequency duct noise.

  15. Finite Element Analysis of Grouting Compactness Monitoring in a Post-Tensioning Tendon Duct Using Piezoceramic Transducers

    PubMed Central

    Jiang, Tianyong; Song, Gangbing

    2017-01-01

    With the development of the post-tensioning technique, prestressed concrete structures have been widely used in civil engineering. To ensure the long-term effectiveness of the prestressed tendon, the grouting quality of the tendon duct is one of the important factors. However, it is still a challenge to monitor the grouting quality of post-tensioning tendon ducts, due to the invisibility of the grouting. The authors’ previous work proposed a real-time method that employed a stress wave-based active sensing approach with piezoceramic transducers to monitor the grouting compactness of a Post-Tensioning Tendon Duct (PTTD). To further understand the piezoceramic induced stress wave propagation in the PTTD with different grouting levels, this paper develops a two-dimensional finite element model for monitoring the grouting compactness of the tendon duct with a piezoceramic transducer. A smart aggregate (SA) developed to utilize one Lead Zirconate Titanate (PZT) transducer with marble protection is installed in the center location of the tendon duct as an actuator. Two PZT patches are bonded on the bottom and top surface of the tendon duct as the sensors. The analysis results show that the finite element analysis results are in good agreement with the experimental results, which demonstrates that the finite element analysis is feasible and reliable. For the top half of the specimen, not much stress wave could be detected before the full grouting level, except for negligible signals that may propagate through the walls of the tendon duct. When the tendon duct grouting is at 100%, the stress wave propagates to the top of the specimen, and the displacements are symmetric in both left-right and top-bottom directions before the stress waves reach the boundary. The proposed two-dimensional finite element model has the potential to be implemented to simulate the stress wave propagation principle for monitoring grouting compaction of the post-tensioning tendon duct. PMID

  16. Finite Element Analysis of Grouting Compactness Monitoring in a Post-Tensioning Tendon Duct Using Piezoceramic Transducers.

    PubMed

    Jiang, Tianyong; Zheng, Junbo; Huo, Linsheng; Song, Gangbing

    2017-09-29

    With the development of the post-tensioning technique, prestressed concrete structures have been widely used in civil engineering. To ensure the long-term effectiveness of the prestressed tendon, the grouting quality of the tendon duct is one of the important factors. However, it is still a challenge to monitor the grouting quality of post-tensioning tendon ducts, due to the invisibility of the grouting. The authors' previous work proposed a real-time method that employed a stress wave-based active sensing approach with piezoceramic transducers to monitor the grouting compactness of a Post-Tensioning Tendon Duct (PTTD). To further understand the piezoceramic induced stress wave propagation in the PTTD with different grouting levels, this paper develops a two-dimensional finite element model for monitoring the grouting compactness of the tendon duct with a piezoceramic transducer. A smart aggregate (SA) developed to utilize one Lead Zirconate Titanate (PZT) transducer with marble protection is installed in the center location of the tendon duct as an actuator. Two PZT patches are bonded on the bottom and top surface of the tendon duct as the sensors. The analysis results show that the finite element analysis results are in good agreement with the experimental results, which demonstrates that the finite element analysis is feasible and reliable. For the top half of the specimen, not much stress wave could be detected before the full grouting level, except for negligible signals that may propagate through the walls of the tendon duct. When the tendon duct grouting is at 100%, the stress wave propagates to the top of the specimen, and the displacements are symmetric in both left-right and top-bottom directions before the stress waves reach the boundary. The proposed two-dimensional finite element model has the potential to be implemented to simulate the stress wave propagation principle for monitoring grouting compaction of the post-tensioning tendon duct.

  17. Mucocele of the cystic duct remnant after orthotopic liver transplant: a problem revisited.

    PubMed

    Chatterjee, Suvadip; Das, Debasish; Hudson, Mark; Bassendine, Margaret Fiona; Scott, John; Oppong, Kofi Ernest; Sen, Gourab; French, Jeremy J

    2011-06-01

    Mucocele of the cystic duct remnant is an uncommon hepatobiliary complication of a liver transplant. Current practice usually involves either excising the cystic duct, or incorporating the distal end of the transected cystic duct into the suture line of the biliary anastomosis to ensure drainage. We report a patient who developed cystic duct remnant mucocele after the latter approach was adopted. We believe that this is likely related to delayed anastomotic stricturing, which prevented draining from the remnant cystic duct. We also discuss the incidence, pathology, investigations, and treatment of this condition.

  18. Common bile duct stricture as a late complication of upper abdominal radiotherapy.

    PubMed

    Cherqui, D; Palazzo, L; Piedbois, P; Charlotte, F; Duvoux, C; Duron, J J; Fagniez, P L; Valla, D

    1994-06-01

    We report the cases of two patients who developed symptomatic common bile duct stricture 10 years after upper abdominal radiotherapy for malignant lymphoma. Both patients were in complete remission and presented with marked obstructive jaundice. Endosonography was useful in both cases and showed segmental thickening of the bile duct wall narrowing in the lumen. Both patients underwent surgical exploration, confirming biliary obstruction due to intrinsic wall thickening, and had successful biliary drainage by Roux-en-Y hepatico-jejunostomy. Histological examination of the resected bile duct, in one case, and of a bile duct biopsy, in the other, was consistent with late irradiation injury. We conclude that stricture may be a delayed consequence of radiotherapy applied to normal bile ducts.

  19. Surveyor assay to diagnose persistent Müllerian duct syndrome in Miniature Schnauzers.

    PubMed

    Kim, Young June; Kwon, Hyuk Jin; Byun, Hyuk Soo; Yeom, Donguk; Choi, Jea-Hong; Kim, Joong-Hyun; Shim, Hosup

    2017-12-31

    Persistent Müllerian duct syndrome (PMDS) is a pseudohermaphroditism in males characterized by the presence of Müllerian duct derivatives. As PMDS dogs often lack clinical symptoms, a molecular diagnosis is essential to identify the syndrome in these animals. In this study, a new molecular method using DNA mismatch-specific Surveyor nuclease was developed. The Surveyor nuclease assay identified the AMHR2 mutation that produced PMDS in a Miniature Schnauzer as accurately as that obtained by using the conventional method based on restriction digestion. As an alternative to the current molecular diagnostic method, the new method may result in increased accuracy when detecting PMDS.

  20. Surveyor assay to diagnose persistent Müllerian duct syndrome in Miniature Schnauzers

    PubMed Central

    Kim, Young June; Kwon, Hyuk Jin; Byun, Hyuk Soo; Yeom, Donguk; Choi, Jea-Hong; Kim, Joong-Hyun

    2017-01-01

    Persistent Müllerian duct syndrome (PMDS) is a pseudohermaphroditism in males characterized by the presence of Müllerian duct derivatives. As PMDS dogs often lack clinical symptoms, a molecular diagnosis is essential to identify the syndrome in these animals. In this study, a new molecular method using DNA mismatch-specific Surveyor nuclease was developed. The Surveyor nuclease assay identified the AMHR2 mutation that produced PMDS in a Miniature Schnauzer as accurately as that obtained by using the conventional method based on restriction digestion. As an alternative to the current molecular diagnostic method, the new method may result in increased accuracy when detecting PMDS. PMID:27515263

  1. Comparison of the Standard of Air Leakage in Current Metal Duct Systems in the World

    NASA Astrophysics Data System (ADS)

    Di, Yuhui; Wang, Jiqian; Feng, Lu; Li, Xingwu; Hu, Chunlin; Shi, Junshe; Xu, Qingsong; Qiao, Leilei

    2018-01-01

    Based on the requirements of air leakage of metal ducts in Chinese design standards, technical measures and construction standards, this paper compares the development history, the classification of air pressure levels and the air tightness levels of air leakage standards of current Chinese and international metal ducts, sums up the differences, finds shortage by investigating the design and construction status and access to information, and makes recommendations, hoping to help the majority of engineering and technical personnel.

  2. Duct Protection Coating Concept Development and Test

    DTIC Science & Technology

    1993-01-01

    20 AEDC-TR-92 23 next to the virgin steel. At this time it was also learned that the "A" header has been previously painted. This raised several...mortar and pestle . Some samples were easier to powder than others and, therefore, the fineness of gnnd varied somewhat. In those cases where the rust...powder using a mortar and pestle . This rust is not as tenaciously held to the base metal as that found in the ducts. In general, the salt spray

  3. The disproportionate growth of office-based atherectomy.

    PubMed

    Mukherjee, Dipankar; Hashemi, Homayoun; Contos, Brian

    2017-02-01

    The purpose of this study was to evaluate the trends in procedure volume, clinical sites of care, and Medicare expenditure for peripheral vascular interventions (PVIs) for lower extremity occlusive disease since the Centers for Medicare and Medicaid Services instituted reimbursement policy changes that broadened payment for procedures performed in physician-owned office-based laboratories (OBLs). We analyzed fee-for-service Medicare claims data from 2011 to 2014 to obtain the frequency of use of PVI by type, care setting, and physician specialty. We also assessed changes in the total Medicare cost for PVI by setting. There was a 60% increase in atherectomy cases among Medicare beneficiaries between 2011 and 2014. During the same period, OBLs experienced a 298% increase in atherectomy volume vs a 27% increase in hospital outpatient settings and an 11% decrease for inpatient hospital settings. In 2014, OBLs were the most common setting for atherectomy. Nonatherectomy PVIs grew more modestly at just 3% but also experienced site of care shifts. Vascular surgeons and cardiologists accounted for the majority of office-based PVIs in 2014. Total Medicare costs for PVIs increased 18% from 2011 to 2014. Hospital inpatient costs declined 1%, whereas costs for hospital outpatient PVIs increased by 41% and physician office costs increased by 258%. The migration of revascularization procedures for lower extremity peripheral arterial occlusive disease continues from the inpatient to the outpatient setting and especially to OBLs. Increased use of atherectomy in all segments of the lower extremity arterial system has been observed, particularly in OBLs, without substantial evidence in the literature of increased efficacy compared with standard angioplasty with or without stenting. Generous Medicare reimbursement for in-office atherectomy procedures is likely contributing to the volume shifts observed. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All

  4. Heat Transfer Computations of Internal Duct Flows With Combined Hydraulic and Thermal Developing Length

    NASA Technical Reports Server (NTRS)

    Wang, C. R.; Towne, C. E.; Hippensteele, S. A.; Poinsatte, P. E.

    1997-01-01

    This study investigated the Navier-Stokes computations of the surface heat transfer coefficients of a transition duct flow. A transition duct from an axisymmetric cross section to a non-axisymmetric cross section, is usually used to connect the turbine exit to the nozzle. As the gas turbine inlet temperature increases, the transition duct is subjected to the high temperature at the gas turbine exit. The transition duct flow has combined development of hydraulic and thermal entry length. The design of the transition duct required accurate surface heat transfer coefficients. The Navier-Stokes computational method could be used to predict the surface heat transfer coefficients of a transition duct flow. The Proteus three-dimensional Navier-Stokes numerical computational code was used in this study. The code was first studied for the computations of the turbulent developing flow properties within a circular duct and a square duct. The code was then used to compute the turbulent flow properties of a transition duct flow. The computational results of the surface pressure, the skin friction factor, and the surface heat transfer coefficient were described and compared with their values obtained from theoretical analyses or experiments. The comparison showed that the Navier-Stokes computation could predict approximately the surface heat transfer coefficients of a transition duct flow.

  5. An unsteady Euler scheme for the analysis of ducted propellers

    NASA Technical Reports Server (NTRS)

    Srivastava, R.

    1992-01-01

    An efficient unsteady solution procedure has been developed for analyzing inviscid unsteady flow past ducted propeller configurations. This scheme is first order accurate in time and second order accurate in space. The solution procedure has been applied to a ducted propeller consisting of an 8-bladed SR7 propeller with a duct of NACA 0003 airfoil cross section around it, operating in a steady axisymmetric flowfield. The variation of elemental blade loading with radius, compares well with other published numerical results.

  6. Functional anatomy and immunological interactions of ocular surface and adnexa.

    PubMed

    Paulsen, Friedrich

    2008-01-01

    This chapter gives an overview about the structures and physiology of the ocular surface and its adnexa and focuses in a second part on the possible meaning of eye-associated lymphoid tissue (EALT) in a context with the development of dry eye. Sections deal with (1) anatomy of the ocular surface, lacrimal gland, eyelid and nasolacrimal ducts. (2) The meaning and importance of the lacrimal functional unit and the function of the mucosal innate immune system are briefly summarized. (3) Finally, the occurrence and the possible function of EALT is discussed with regard to tolerance induction and dry eye. The epithelial surface of the eye and its specialized glandular infoldings produce the components of the tear film, which include water, protective antimicrobials, cytokines, lipids as well as mucins and trefoil factor family (TFF) peptides. Antimicrobials, mucins and TFF peptides perform a number of essential functions which, collectively, provide protection of the ocular surface. Their production changes in cases of dry eye. The development of EALT is a common feature frequently occurring in symptomatically normal conjunctiva and nasolacrimal ducts. The production of antimicrobials, mucins and TFF peptides can be linked with cell signaling, tear film rheology, and antimicrobial defense at the ocular surface. Changes in the production of such peptides and proteins in cases of dry eye support the assumption that these peptides and proteins are involved in the pathophysiological events that occur at the ocular surface and lacrimal apparatus. Whether special types of bacteria, viruses, or other factors, e.g., immune deviation, are responsible for the development of EALT in humans requires further investigation in prospective and experimental studies.

  7. Excluded segmental duct bile leakage: the case for bilio-enteric anastomosis.

    PubMed

    Patrono, Damiano; Tandoi, Francesco; Romagnoli, Renato; Salizzoni, Mauro

    2014-06-01

    Excluded segmental duct bile leak is the rarest type of post-hepatectomy bile leak and presents unique diagnostic and management features. Classical management strategies invariably entail a significant loss of functioning hepatic parenchyma. The aim of this study is to report a new liver-sparing technique to handle excluded segmental duct bile leakage. Two cases of excluded segmental duct bile leak occurring after major hepatic resection were managed by a Roux-en-Y hepatico-jejunostomy on the excluded segmental duct, avoiding the sacrifice of the liver parenchyma origin of the fistula. In both cases, classical management strategies would have led to the functional loss of roughly 50 % of the liver remnant. Diagnostic and management implications are thoroughly discussed. Both cases had an uneventful postoperative course. The timing of repair was associated with a different outcome: the patient who underwent surgical repair in the acute phase developed no long-term complications, whereas the patient who underwent delayed repair developed a late stenosis requiring percutaneous dilatation. Roux-en-Y hepatico-jejunostomy on the excluded bile duct is a valuable technique in selected cases of excluded segmental duct bile leakage.

  8. TBIEM3D: A Computer Program for Predicting Ducted Fan Engine Noise. Version 1.1

    NASA Technical Reports Server (NTRS)

    Dunn, M. H.

    1997-01-01

    This document describes the usage of the ducted fan noise prediction program TBIEM3D (Thin duct - Boundary Integral Equation Method - 3 Dimensional). A scattering approach is adopted in which the acoustic pressure field is split into known incident and unknown scattered parts. The scattering of fan-generated noise by a finite length circular cylinder in a uniform flow field is considered. The fan noise is modeled by a collection of spinning point thrust dipoles. The program, based on a Boundary Integral Equation Method (BIEM), calculates circumferential modal coefficients of the acoustic pressure at user-specified field locations. The duct interior can be of the hard wall type or lined. The duct liner is axisymmetric, locally reactive, and can be uniform or axially segmented. TBIEM3D is written in the FORTRAN programming language. Input to TBIEM3D is minimal and consists of geometric and kinematic parameters. Discretization and numerical parameters are determined automatically by the code. Several examples are presented to demonstrate TBIEM3D capabilities.

  9. Vibrational response of a rectangular duct of finite length excited by a turbulent internal flow

    NASA Astrophysics Data System (ADS)

    David, Antoine; Hugues, Florian; Dauchez, Nicolas; Perrey-Debain, Emmanuel

    2018-05-01

    Gas transport ductwork in industrial plants or air conditioning networks can be subject to vibrations induced by the internal flow. Most studies in this matter have been carried out on circular ducts. This paper focuses specifically on the vibratory response of a rectangular duct of finite length excited by an internal turbulent flow. A semi-analytical model taking into account the modal response of the structure due to both aerodynamic and acoustic contributions is derived. The aerodynamic component of the excitation is applied on the basis of Corcos model where the power spectral density of the wall pressure is determined experimentally. The acoustic component is based on the propagating modes in the duct where the acoustic modal contribution are extracted via cross-spectral densities. The vibrational response is given for a 0.2 × 0.1 × 0.5 m3 duct made of 3 mm steel plates excited by 20 m/s or 30 m/s flows. Comparisons between experimental results and numerical predictions show a good agreement. The competition between acoustic and aerodynamic components is highlighted.

  10. [ENDOSONOGRAPHY IN THE DIFFERENTIAL DIAGNOSIS OF THE COMMON BILE DUCT STENOSIS].

    PubMed

    Solodinina, E N; Starkov, Y G; Shumkin, L V

    2015-01-01

    The article states the results of examination and treatment of 57 patients with stenosis of the common bile duct of various genesis. The main aim of the work is criteria definition and evaluation of diagnostic significance of endosonography in the differential diagnosis of benign and malignant common bile duct stenosis. The paper presents a methodology of endoscopic ultrasound and basic criteria for the differential diagnosis of tumors and other lesions of the extrahepatic bile ducts. A comparative analysis of endosonography, ultrasound, CT, MRCP was conducted. The sensitivity of endosonography in determining the nature of the common bile duct stenosis was 97.7%, a specificity 100% and accuracy 98.2%, which is superior to other methods of radiological diagnosis. In comprehensive surgical centers endosonography should be used as a method of specifying the final diagnosis to determine the nature of the common bile duct stenosis, particularly at low constriction location.

  11. A study of high speed flows in an aircraft transition duct. Ph.D. Thesis - Iowa State Univ.

    NASA Technical Reports Server (NTRS)

    Reichert, Bruce A.

    1991-01-01

    The study of circular-to-rectangular transition duct flows with and without inlet swirl is presented. A method was devised to create a swirling, solid body rotational flow with minimal associated disturbances. Details of the swirl generator design and construction are discussed. Coefficients based on velocities and total and static pressures measured in cross stream planes at four axial locations within the transition duct along with surface static pressures and surface oil film visualization are presented for both nonswirling and swirling incoming flows. A method was developed to acquire trace gas measurements within the transition duct at high flow velocities. Statistical methods are used to help interpret the trace gas results.

  12. Locating and Quantifying Broadband Fan Sources Using In-Duct Microphones

    NASA Technical Reports Server (NTRS)

    Dougherty, Robert P.; Walker, Bruce E.; Sutliff, Daniel L.

    2010-01-01

    In-duct beamforming techniques have been developed for locating broadband noise sources on a low-speed fan and quantifying the acoustic power in the inlet and aft fan ducts. The NASA Glenn Research Center's Advanced Noise Control Fan was used as a test bed. Several of the blades were modified to provide a broadband source to evaluate the efficacy of the in-duct beamforming technique. Phased arrays consisting of rings and line arrays of microphones were employed. For the imaging, the data were mathematically resampled in the frame of reference of the rotating fan. For both the imaging and power measurement steps, array steering vectors were computed using annular duct modal expansions, selected subsets of the cross spectral matrix elements were used, and the DAMAS and CLEAN-SC deconvolution algorithms were applied.

  13. Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®)—Patient Version

    Cancer.gov

    Treatment of bile duct cancer depends on where the cancer has formed and if it can be removed by surgery (resectable) or not (unresectable). Most bile duct cancers cannot be completely removed by surgery. Other treatments include radiation, chemotherapy, and palliative therapies like stent placement and biliary bypass.

  14. Application of "papillary-like main pancreatic duct invaginated" pancreaticojejunostomy for normal soft pancreas cases.

    PubMed

    Zhang, Bo; Xu, Jin; Liu, Chen; Long, Jiang; Liu, Liang; Xu, Yongfeng; Wu, Chuntao; Luo, Guopei; Ni, Quanxing; Li, Min; Yu, Xianjun

    2013-01-01

    Pancreaticojejunostomy is the key procedure of pancreaticoduodenectomy. Our study introduced a new pancreaticojejunal (PJ) anastomosis named "papillary-like main pancreatic duct invaginated" pancreaticojejunostomy. Nighty-two patients underwent pancreaticojejunostomy with either conventional duct-to-mucosa pancreaticojejunostomy or the new "papillary-like main pancreatic duct invaginated" techniques were analyzed retrospectively from January 2010 to September 2012. The incidence of pancreatic fistula was 15.7% (8/51) for the "papillary-like main pancreatic duct invaginated" group and 19.5% (8/41) for the duct-to-mucosa fashion respectively. It is noteworthy that the rate of grade B/C postoperative pancreatic fistula (POPF) in the "papillary-like main pancreatic duct invaginated" group was significantly lower than that of the duct-to-mucosa group (P = 0.039). There were no differences in the incidence of postoperative morbidity and mortality such as postoperative hemorrhage, delayed gastric emptying or remnant pancreatitis. The "papillary-like main pancreatic duct invaginated" pancreaticojejunostomy could provide a feasible option to pancreatic surgeons for patients with normal soft pancreas.

  15. Thermionic nuclear reactor with internal heat distribution and multiple duct cooling

    DOEpatents

    Fisher, C.R.; Perry, L.W. Jr.

    1975-11-01

    A Thermionic Nuclear Reactor is described having multiple ribbon-like coolant ducts passing through the core, intertwined among the thermionic fuel elements to provide independent cooling paths. Heat pipes are disposed in the core between and adjacent to the thermionic fuel elements and the ribbon ducting, for the purpose of more uniformly distributing the heat of fission among the thermionic fuel elements and the ducts.

  16. Iatrogenic bile duct injuries in kashmir valley.

    PubMed

    Chowdri, Nisar A; Dar, Farooq A; Naikoo, Zahoor A; Wani, Nazir A; Parray, Fazl Q; Wani, Khurshid A

    2010-08-01

    Cholecystectomy is one of the commonest operations performed throughout the world and bile duct injury is the worst complication of this procedure. In a prospective and retrospective study 25 patients were seen in a tertiary care hospital over a period of 10 years. 72% of patients were referred from other hospitals. 48% of patients presented within one month of injury. Pain was the commonest presentation (92%) followed by jaundice (80%). Liver functions were deranged in 70% of patients, USG revealed biliary dilatation in 69.6% of patients. ERCP was done in 16 patients and revealed cut off of the common hepatic duct in 43.8% of patients. Intraoperative findings revealed adhesions in 96% of patients. 48% of patients had bile duct stricture. Roux-en-Y hepaticojejunostomy was the commonest procedure performed. All patients showed improvement in liver function after surgery. Wound infection was the commonest complication seen in 32% patients. 3 patients died in our series.

  17. Paracellular transport in the collecting duct

    PubMed Central

    Hou, Jianghui

    2016-01-01

    Purpose of review The paracellular pathway through the tight junction provides an important route for chloride reabsorption in the collecting duct of the kidney. This review describes recent findings of how defects in paracellular chloride permeation pathway may cause kidney diseases and how such a pathway may be regulated to maintain normal chloride homeostasis. Recent findings The tight junction in the collecting duct expresses two important claudin genes – claudin-4 and claudin-8. Transgenic knockout of either claudin gene causes hypotension, hypochloremia, and metabolic alkalosis in experimental animals. The claudin-4 mediated chloride permeability can be regulated by a protease endogenously expressed by the collecting duct cell – Cap1. Cap1 regulates the intercellular interaction of claudin-4 and its membrane stability. KLHL3, previously identified as a causal gene for Gordon’s syndrome, also known as pseudohypoaldosteronism II (PHA-II), directly interacts with claudin-8 and regulates its ubiquitination and degradation. The dominant PHA-II mutation (R528H) in KLHL3 abolishes claudin-8 binding, ubiquitination, and degradation. Summary The paracellular chloride permeation pathway in the kidney is an important but understudied area in nephrology. It plays vital roles in renal salt handling and regulation of extracellular fluid volume and blood pressure. Two claudin proteins – claudin-4 and claudin-8 contribute to the function of this paracellular pathway. Deletion of either claudin protein from the collecting duct causes renal chloride reabsorption defects and low blood pressure. Claudins can be regulated on post-translational levels by several mechanisms involving protease and ubiquitin ligase. Deregulation of claudins may cause human hypertension as exemplified in the Gordon’s syndrome. PMID:27490784

  18. Should You Have the Air Ducts in Your Home Cleaned?

    EPA Pesticide Factsheets

    2017-02-14

    Duct cleaning generally refers to the cleaning of various heating and cooling system components of forced air systems, including the supply and return air ducts and registers, grilles and diffusers, heat exchangers heating and cooling coils.

  19. Navier-Stokes analysis and experimental data comparison of compressible flow within ducts

    NASA Technical Reports Server (NTRS)

    Harloff, G. J.; Reichert, B. A.; Sirbaugh, J. R.; Wellborn, S. R.

    1992-01-01

    Many aircraft employ ducts with centerline curvature or changing cross-sectional shape to join the engine with inlet and exhaust components. S-ducts convey air to the engine compressor from the intake and often decelerate the flow to achieve an acceptable Mach number at the engine compressor by increasing the cross-sectional area downstream. Circular-to-rectangular transition ducts are used on aircraft with rectangular exhaust nozzles to connect the engine and nozzle. To achieve maximum engine performance, the ducts should minimize flow total pressure loss and total pressure distortion at the duct exit. Changes in the curvature of the duct centerline or the duct cross-sectional shape give rise to streamline curvature which causes cross stream pressure gradients. Secondary flows can be caused by deflection of the transverse vorticity component of the boundary layer. This vortex tilting results in counter-rotating vortices. Additionally, the adverse streamwise pressure gradient caused by increasing cross-sectional area can lead to flow separation. Vortex pairs have been observed in the exit planes of both duct types. These vortices are due to secondary flows induced by pressure gradients resulting from streamline curvature. Regions of low total pressure are produced when the vortices convect boundary layer fluid into the main flow. The purpose of the present study is to predict the measured flow field in a diffusing S-duct and a circular-to-rectangular transition duct with a full Navier-Stokes computer program, PARC3D, and to compare the numerical predictions with new detailed experimental measurements. The work was undertaken to extend previous studies and to provide additional CFD validation data needed to help model flows with strong secondary flow and boundary layer separation. The S-duct computation extends the study of Smith et al, and Harloff et al, which concluded that the computation might be improved by using a finer grid and more advanced turbulence models

  20. Causes and Prevention of Laparoscopic Bile Duct Injuries

    PubMed Central

    Way, Lawrence W.; Stewart, Lygia; Gantert, Walter; Liu, Kingsway; Lee, Crystine M.; Whang, Karen; Hunter, John G.

    2003-01-01

    Objective To apply human performance concepts in an attempt to understand the causes of and prevent laparoscopic bile duct injury. Summary Background Data Powerful conceptual advances have been made in understanding the nature and limits of human performance. Applying these findings in high-risk activities, such as commercial aviation, has allowed the work environment to be restructured to substantially reduce human error. Methods The authors analyzed 252 laparoscopic bile duct injuries according to the principles of the cognitive science of visual perception, judgment, and human error. The injury distribution was class I, 7%; class II, 22%; class III, 61%; and class IV, 10%. The data included operative radiographs, clinical records, and 22 videotapes of original operations. Results The primary cause of error in 97% of cases was a visual perceptual illusion. Faults in technical skill were present in only 3% of injuries. Knowledge and judgment errors were contributory but not primary. Sixty-four injuries (25%) were recognized at the index operation; the surgeon identified the problem early enough to limit the injury in only 15 (6%). In class III injuries the common duct, erroneously believed to be the cystic duct, was deliberately cut. This stemmed from an illusion of object form due to a specific uncommon configuration of the structures and the heuristic nature (unconscious assumptions) of human visual perception. The videotapes showed the persuasiveness of the illusion, and many operative reports described the operation as routine. Class II injuries resulted from a dissection too close to the common hepatic duct. Fundamentally an illusion, it was contributed to in some instances by working too deep in the triangle of Calot. Conclusions These data show that errors leading to laparoscopic bile duct injuries stem principally from misperception, not errors of skill, knowledge, or judgment. The misperception was so compelling that in most cases the surgeon did not

  1. Erlotinib in Treating Patients With Unresectable Liver, Bile Duct, or Gallbladder Cancer

    ClinicalTrials.gov

    2013-06-03

    Adult Primary Cholangiocellular Carcinoma; Adult Primary Hepatocellular Carcinoma; Advanced Adult Primary Liver Cancer; Cholangiocarcinoma of the Extrahepatic Bile Duct; Cholangiocarcinoma of the Gallbladder; Localized Unresectable Adult Primary Liver Cancer; Recurrent Adult Primary Liver Cancer; Recurrent Extrahepatic Bile Duct Cancer; Recurrent Gallbladder Cancer; Unresectable Extrahepatic Bile Duct Cancer; Unresectable Gallbladder Cancer

  2. Performance and Flowfield Measurements on a 10-inch Ducted Rotor VTOL UAV

    NASA Technical Reports Server (NTRS)

    Martin, Preston; Tung, Chee

    2004-01-01

    A ducted fan VTOL UAV with a 10-inch diameter rotor was tested in the US Army 7-by 10-Foot Wind Tunnel. The test conditions covered a range of angle of attack from 0 to 110 degrees to the freestream. The tunnel velocity was varied from 0 (simulating a hover condition) to 128 ft/sec in propeller mode. A six-component internal balance measured the aerodynamic loads for a range of model configurations. including the isolated rotor, the isolated duct, and the full configuration of the duct and rotor. For some conditions, hotwire velocity surveys were conducted along the inner and outer surface of the duct and across the downstream wake. In addition, fluorescent oil flow visualization allowed the flow separation patterns inside and outside of the duct to be mapped for a few test conditions. Two different duct shapes were tested to determine the performance effects of leading edge radius. For each duct, a range of rotor tip gap from 1%R to 4.5%R was tested to determine the performance penalty in hover and axial flight. Measured results are presented in terms of hover performance, hover performance in a crosswind, and high angle of attack performance in propeller mode. In each case, the effects of both tip gap and duct leading edge radius are illustrated using measurements. Some of the hover performance issues were also studied using a simple analytical method, and the results agreed with the measurements.

  3. Endoscopic management of difficult common bile duct stones

    PubMed Central

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

    2013-01-01

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

  4. Effect of Right Posterior Bile Duct Anatomy on Biliary Complications in Patients Undergoing Right Lobe Living Donor Liver Transplant.

    PubMed

    Tezcaner, Tugan; Dinç, Nadire; Y Karakayalı, Feza; Kırnap, Mahir; Coşkun, Mehmet; Moray, Gökhan; Haberal, Mehmet

    2017-01-27

    Our aim was to evaluate the influence of the localization of right posterior bile duct anatomy relative to portal vein of the donors on posttransplant bile duct complications. We retrospectively investigated 141 patients who had undergone living donor liver transplant using right hemiliver grafts. The patients were classified based on the pattern of the right posterior bile duct and divided into infraportal and supraportal types. Clinical donor and recipient risk factors and surgical outcomes were compared for their relationship with biliary complications using logistic regression analyses. The 2 groups were similar according to demographic and clinical features. The biliary complication rate was 23.7% (9/38) in the infraportal group and 47.4% (37/78) in the supraportal group (P = .014). An analysis of risk factors for the development of anastomotic bile leak using logistic regression showed that a supraportal right posterior bile duct anatomy was a statistically significant positive predictor, with odds ratio of 18.905 (P = .012; confidence interval, 1.922-185.967). The distance of the right posterior bile duct from confluence was significantly lower in patients with biliary complications than in those without (mean of 7.66 vs 0.40 mm; P = .044). According to receiver operating characteristic analyses, the cut-off point for the length of right bile duct to right posterior bile duct from the hepatic confluence was 9.5 mm regarding presence of complications. Factors influencing bile duct anastomosis leakage were supraportal-type donor bile duct anatomy and length of the right main bile duct from biliary confluence. Hepatic arterial complications were similarly a risk factor for biliary strictures. Because of the multiple factors leading to complications in living donor liver transplant, it is challenging to group these patients by operative risk; however, establishing risk models may facilitate the prediction of complications.

  5. Congenital Atresia of Wharton’s Duct

    PubMed Central

    Hseu, Anne; Anne, Premchand

    2016-01-01

    This is a case report of a three-month-old male who presented to clinic with a cystic lesion under the tongue. On clinical examination, a cystic lesion was observed in the, floor-of-mouth. The patient was referred to Paediatric Otorhinolaryngology service for further management. The differential diagnoses for floor-of-mouth lesions should be reviewed with primary focus on the Wharton’s duct atresia and its management. It is crucial to recognize submandibular duct atresia in the primary Paediatric clinic in order to expedite management of lesion before complications arise including infection, enlargement of cyst, and feeding and breathing difficulties. PMID:27042492

  6. Office-based anesthesia: new frontiers, better outcomes, and emphasis on safety.

    PubMed

    Desai, Meena S

    2008-12-01

    Office-based anesthesia has grown and continues to grow very rapidly in the ever-changing medical environment. The demand of patients, surgeons and the evolving economic environment has set off a dynamic growth explosion. This explosion has created aggressive and tumultuous enhancements, some of which have been adapted well and some of which have led to disastrous results. As we institute rules and regulations to govern this 'wild west' of anesthesia, the landscape is set with some new guidelines that continue to evolve.Practice recommendations have been outlined for fire safety especially on patient fires. Closed claim studies offer valuable recommendations for MAC claims in the office based setting. Anesthesia Patient Safety Foundation and the ASA have outlined valuable information regarding the nonsilencing of equipment alarms.New equipment enhancements have generated successful mobile general anesthesia platforms. Finally, as we forge ahead we must construct measurements of our safety and success as outcome parameters are developed. The review of recent literature and technological advances has provided some valuable lessons in the evolution of patient safety and office based technology for the surgical office-based environment. As this specialty grows, measures of its outcome parameters will allow a gauge of performance.

  7. A Case of Recurrent Schneiderian Papilloma of the Lacrimal Sac Invading the Nasal Cavity

    PubMed Central

    Jang, Ji Hye; Choe, Mi Sun

    2009-01-01

    A 44-year-old man presented with a history of chronic epiphora, discharge from the right eye, and a palpable mass in the medial canthal area. Irrigation of the lacrimal system revealed bloody discharge. Orbital magnetic resonance imaging (MRI) showed a well-defined heterogeneous enhanced mass filling the lacrimal sac and upper nasolacrimal duct (NLD). A wide excision and surgical biopsy were performed. Histopathology showed the tumor to be an exophytic Schneiderian papilloma with moderate to severe dysplasia. Three months later, the mass was found to be invading the nasal cavity through the NLD. Endoscopic histopathological evaluation confirmed that it was identical to the originally identified papilloma. PMID:19568358

  8. 29. DETAIL OF OUTLET DUCTS FOR MST AIRCONDITIONING SYSTEM IN ...

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

    29. DETAIL OF OUTLET DUCTS FOR MST AIR-CONDITIONING SYSTEM IN NORTHWEST CORNER OF SLC-3W MST STATION 70.5 (LOWEST PAYLOAD SERVICE STATION). NOTE RING ATTACHMENT FOR PERSONNEL SAFETY HARNESS IN LEFT FOREGROUND. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  9. Novel immunohistochemical markers differentiate intrahepatic cholangiocarcinoma from benign bile duct lesions.

    PubMed

    Bertram, Stefanie; Padden, Juliet; Kälsch, Julia; Ahrens, Maike; Pott, Leona; Canbay, Ali; Weber, Frank; Fingas, Christian; Hoffmann, Andreas C; Vietor, Antonie; Schlaak, Joerg F; Eisenacher, Martin; Reis, Henning; Sitek, Barbara; Baba, Hideo A

    2016-07-01

    The distinction between intrahepatic cholangiocarcinoma (ICC) and benign bile duct lesions can be challenging. Using our previously identified potential biomarkers for ICC, we examined whether these are useful for the differential diagnosis of ICC, bile duct adenoma and reactive bile duct proliferations in an immunohistochemical approach and identified a diagnostic marker panel including known biomarkers. Subjects included samples from 77 patients with ICC, 33 patients with bile duct adenoma and 47 patients with ductular reactions in liver cirrhosis. Our previously identified biomarkers (stress-induced phosphoprotein 1 (STIP1), SerpinH1, 14-3-3Sigma) were tested immunohistochemically following comparison with candidates from the literature (cluster of differentiation 56, heat shock protein (HSP)27, HSP70, B-cell-lymphoma2, p53, ki67). The expression of SerpinH1 and 14-3-3Sigma was significantly higher in ICC than in bile duct adenomas and ductular reactions (p<0.05), whereas STIP1 expression was significantly higher (p<0.05) in ICC than in ductular reactions, but the difference to the bile duct adenoma group was not significant. A panel of the biomarker SerpinH1, 14-3-3Sigma and ki67 (≥2 marker positive) showed a high diagnostic accuracy (sensitivity 87.8%, specificity 95.9%, accuracy 91.8%) in the differential diagnosis of ICC versus non-malignant bile duct lesions. This suggests that 14-3-3Sigma and SerpinH1 may be useful in the differential diagnosis of malignant, benign and reactive bile duct lesions in addition to ki67 where a cut-off of >5% might be used for the distinction of malignant and non-malignant lesions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Use of hospitalists and office-based primary care physicians' productivity.

    PubMed

    Park, Jeongyoung; Jones, Karen

    2015-05-01

    Growth in the care of hospitalized patients by hospitalists has the potential to increase the productivity of office-based primary care physicians (PCPs) by allowing them to focus on outpatient practice. Our aim was to examine the association between utilization of hospitalists and the productivity of office-based PCPs. The cross-sectional study was conducted using the 2008 Health Tracking Physician Survey Restricted Use File linked to the Area Resource File. We analyzed a total of 1,158 office-based PCPs representing a weighted total of 97,355 physicians. Utilization of hospitalists was defined as the percentage of a PCP's hospitalized patients treated by a hospitalist. The measures of PCPs' productivity were: (1) number of hospital visits per week, (2) number of office and outpatient clinic visits per week, and (3) direct patient care time per visit. We found that the use of hospitalists was significantly associated with a decreased number of hospital visits. The use of hospitalists was also associated with an increased number of office visits, but this was only significant for high users. Physicians who used hospitalists for more than three-quarters of their hospitalized patients had an extra 8.8 office visits per week on average (p = 0.05), which was equivalent to a 10 % increase in productivity over the predicted mean of 87 visits for physicians who did not use hospitalists. We did not find any significant differences in direct patient care time per visit. Our study demonstrates that the increase in productivity for the one-third of PCPs who use hospitalists extensively may not be sufficient to offset the current loss of PCP workforce. However, our findings provide cautious optimism that if more PCPs effectively and efficiently used hospitalists, this could help mitigate a PCP shortage and improve access to primary care services.

  11. Liver segment IV hypoplasia as a risk factor for bile duct injury.

    PubMed

    Mercado, Miguel Angel; Franssen, Bernardo; Arriola, Juan Carlos; Garcia-Badiola, Artemio; Arámburo, Rigoberto; Elnecavé, Alejandro; Cortés-González, Rubén

    2011-09-01

    Bile duct injury remains constant in the era of laparoscopic cholecystectomy and misidentification of structures remains one of the most common causes of such injuries. Abnormalities in liver segment IV, which is fully visible during laparoscopic cholecystectomy, may contribute to misidentification as proposed herein. We describe the case of a 36-year-old female who had a bile duct injury during a laparoscopic cholecystectomy where the surgeon noticed an unusually small distance between the gallbladder and the round ligament. We define hypoplasia of liver segment IV as well as describe the variation of the biliary anatomy in the case. We also intend to fit it in a broader spectrum of developmental anomalies that have both hyopoplasia of some portion of the liver and variations in gallbladder and bile duct anatomy that may contribute to bile duct injury. To our knowledge, hypoplasia of liver segment IV has not been suggested in the literature as a risk factor for bile duct injury except in the extreme case of a left-sided gallbladder. Surgeons should be vigilant during laparoscopic cholecystectomy when they become aware of an unusually small distance between the gallbladder bed and the round ligament prior to beginning their dissection, variations in the common bile duct and cystic duct should be expected.

  12. [From Langenbuch to Strasberg: the spectrum of bile duct injuries].

    PubMed

    Mercado, Miguel Angel

    2004-01-01

    Bile duct injuries are the main serious complication of laparoscopy cholecystectomy. The frequency of this type of injuries rangers, between 1 to 3 in 1,000 cases and although this rate remains stables, their frequency has increased because of the increasing expansion of the indication of cholecystectomy. Each lesion is the individual in it's features as well as the scenario in which the surgeon faces it. Several classifications have been developed, but that developed by Strasberg most used nowadays. Intraoperative cholangiography has shown evidence in meta analytic studies that diminishes the frequency of lesions but does not abolish them. Conversion from laparoscope's to the open approach with ample and convincent dissection is probably the best maneuver to reduce the frequency of lesions, when any anatomical or technical doubt appears. No patient should be operated in critical condition. In this situation, biliary reconstruction has a secondary role and only drainage of the ducts (percutaneous or surgical) is indicated. Roux en Y hepatoyeyunostomy is the procedure of choice for almost all cases, leaving other types of procedures for selected cases. Transhepatic transanastomotical stents should be used according to the individual status of the patient when small, scared or inflamed ducts are found. High quality anastomosis is obtained when proper ducts are found. Sometimes high dissection of the ducts is needed in order to obtain adequate ducts. Nine of each ten cases are completely rehabilitated, obtaining a good quality of life.

  13. Time course of collagen peak in bile duct-ligated rats.

    PubMed

    Tarcin, Orhan; Basaranoglu, Metin; Tahan, Veysel; Tahan, Gülgün; Sücüllü, Ilker; Yilmaz, Nevin; Sood, Gagan; Snyder, Ned; Hilman, Gilbert; Celikel, Cigdem; Tözün, Nurdan

    2011-04-28

    One of the most useful experimental fibrogenesis models is the "bile duct-ligated rats". Our aim was to investigate the quantitative hepatic collagen content by two different methods during the different stages of hepatic fibrosis in bile duct-ligated rats on a weekly basis. We questioned whether the 1-wk or 4-wk bile duct-ligated model is suitable in animal fibrogenesis trials. Of the 53 male Wistar rats, 8 (Group 0) were used as a healthy control group. Bile duct ligation (BDL) had been performed in the rest. Bile duct-ligated rates were sacrificed 7 days later in group 1 (10 rats), 14 days later in group 2 (9 rats), 21 days later in group 3(9 rats) and 28 days later in group 4 (9 rats). Eight rats underwent sham-operation (Sham). Hepatic collagen measurements as well as serum levels of liver enzymes and function tests were all analysed. The peak level of collagen was observed biochemically and histomorphometricly at the end of third week (P < 0.001 and P < 0.05). Suprisingly, collagen levels had decreased with the course of time such as at the end of fourth week (P < 0.01 and P < 0.05). We have shown that fibrosis in bile duct-ligated rats is transient, i.e. reverses spontaneously after 3 weeks. This contrasts any situation in patients where hepatic fibrosis is progressive and irreversible as countless studies performed by many investigators in the same animal model.

  14. Ducted whistler-mode signals received at two widely spaced locations

    NASA Astrophysics Data System (ADS)

    Clilverd, M. A.; Thomson, N. R.; Smith, A. J.

    1996-06-01

    Whistler-mode signals from a single VLF transmitter that have propagated in the same duct, have been observed simultaneously at Faraday, Antarctica (65°S, 64°W) and Dunedin, New Zealand (46°S, 171°E). The signals received have group-delay times that differ in the order of 10 ms, which can be explained by the differences in southern-hemisphere sub-ionospheric propagation time from duct exit region to receiver for the two sites. This difference has been used to determine the location of the duct exit region, with confirmation provided by arrival-bearing information from both sites. The whistler-mode signals typically occur one or two days after geomagnetic activity, with Kpgeq5. The sub-ionospheric-propagation model, LWPC, is used to estimate the whistler-mode power radiated from the duct exit region. These results are then combined with estimated loss values for ionospheric and ducted transmission to investigate the role of wave-particle amplification or absorption. On at least half of the events studied, plasmaspheric amplification of the signals appears to be needed to explain the observed whistler-mode signal strengths.

  15. 46 CFR 32.56-60 - Ventilation ducts-T/ALL.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Ventilation ducts-T/ALL. 32.56-60 Section 32.56-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL....56-60 Ventilation ducts—T/ALL. (a) Each duct for ventilation of Category A machinery spaces that...

  16. 46 CFR 32.56-60 - Ventilation ducts-T/ALL.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Ventilation ducts-T/ALL. 32.56-60 Section 32.56-60 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL....56-60 Ventilation ducts—T/ALL. (a) Each duct for ventilation of Category A machinery spaces that...

  17. Voluntary and involuntary ligature of the bile duct in iatrogenic injuries: a nonadvisable approach.

    PubMed

    Mercado, Miguel Angel; Chan, Carlos; Jacinto, Juan Carlos; Sanchez, Norberto; Barajas, Alexandra

    2008-06-01

    Bile duct injuries related to laparoscopic and/or open cholecystectomy are a frequent finding and require surgical treatment. Complete obstruction is due to either intentionally or unintentionally placed ligatures or clips. The intentional application is usually performed to "facilitate identification of the duct by bile duct dilation." Considering that we are a national referral center for such injuries, we decided to analyze our cases of voluntary and involuntary duct ligation after iatrogenic bile duct injury. We reviewed the files of patients with voluntary or involuntary bile duct ligation. Results of preoperative evaluation of the ducts, operative treatment, and postoperative results were analyzed. A total of 413 patients were included. Forty-five patients presented with complete obstruction. In 15 cases, the ligature was intentional, and in 30 cases, occlusion was involuntary. Bile duct dilation (>10 mm) was demonstrated in one case of voluntary (6%) and three cases of involuntary ligations (10%). The remaining cases in both groups had no duct dilation and developed necrosis at the blinded duct and leakage proximal to the ligature, with different degrees of bilioperitoneum and/or biloma. In all cases, a Roux-en-Y hepatojejunostomy was performed. Bile duct ligature produces dilation in a very small number of patients (less than 10%) and usually produces necrosis of the blinded stump with subsequent bile leakage. Placement of a subhepatic drain and transference of the patient to a qualified center for reconstruction is the best approach if the primary surgeon is not able to do the repair.

  18. Measurements of compressible secondary flow in a circular S-duct

    NASA Technical Reports Server (NTRS)

    Vakili, A.; Wu, J. M.; Liver, P.; Bhat, M. K.

    1983-01-01

    This paper presents the results of an experimental study of secondary flow in a circular cross section 30 deg - 30 deg S-duct with entrance Mach number of 0.6. Local flow velocity vectors have been measured along the length of the duct at six stations. These measurements have been made using a five-port cone probe. Static and total pressure profiles in the transverse planes are obtained from the cone probe measurements. Wall static pressure measurements along three azimuth angles of 0 deg, 90 deg, and 180 deg along the duct are also made. Contour plots presenting the three dimensional velocity field as well as the total- and static-pressure fields are obtained. Surface oil flow visualization technique has been used to provide details of the flow on the S-duct boundaries. The experimental observations have been compared with typical computational results.

  19. Importance of resin ducts in reducing ponderosa pine mortality from bark beetle attack.

    PubMed

    Kane, Jeffrey M; Kolb, Thomas E

    2010-11-01

    The relative importance of growth and defense to tree mortality during drought and bark beetle attacks is poorly understood. We addressed this issue by comparing growth and defense characteristics between 25 pairs of ponderosa pine (Pinus ponderosa) trees that survived and trees that died from drought-associated bark beetle attacks in forests of northern Arizona, USA. The three major findings of our research were: (1) xylem resin ducts in live trees were >10% larger (diameter), >25% denser (no. of resin ducts mm(-2)), and composed >50% more area per unit ring growth than dead trees; (2) measures of defense, such as resin duct production (no. of resin ducts year(-1)) and the proportion of xylem ring area to resin ducts, not growth, were the best model parameters of ponderosa pine mortality; and (3) most correlations between annual variation in growth and resin duct characteristics were positive suggesting that conditions conducive to growth also increase resin duct production. Our results suggest that trees that survive drought and subsequent bark beetle attacks invest more carbon in resin defense than trees that die, and that carbon allocation to resin ducts is a more important determinant of tree mortality than allocation to radial growth.

  20. Computer analysis of three-dimensional morphological characteristics of the bile duct

    NASA Astrophysics Data System (ADS)

    Ma, Jinyuan; Chen, Houjin; Peng, Yahui; Shang, Hua

    2017-01-01

    In this paper, a computer image-processing algorithm for analyzing the morphological characteristics of bile ducts in Magnetic Resonance Cholangiopancreatography (MRCP) images was proposed. The algorithm consisted of mathematical morphology methods including erosion, closing and skeletonization, and a spline curve fitting method to obtain the length and curvature of the center line of the bile duct. Of 10 cases, the average length of the bile duct was 14.56 cm. The maximum curvature was in the range of 0.111 2.339. These experimental results show that using the computer image-processing algorithm to assess the morphological characteristics of the bile duct is feasible and further research is needed to evaluate its potential clinical values.

  1. CT differentiation of mucin-producing cystic neoplasms of the liver from solitary bile duct cysts.

    PubMed

    Kim, Hyoung Jung; Yu, Eun Sil; Byun, Jae Ho; Hong, Seung-Mo; Kim, Kyoung Won; Lee, Jong Seok; Kim, So Yeon

    2014-01-01

    The purpose of this study was to identify the CT features required for differentiating mucin-producing cystic neoplasms of the liver (mucinous cystic neoplasms and cyst-forming intraductal papillary neoplasms of the bile duct) from solitary bile duct cysts. CT images of pathologically confirmed mucinous cystic neoplasms (n = 15), cyst-forming intraductal papillary neoplasms of the bile duct (n = 16), and solitary bile duct cysts (n = 31) were reviewed. Analysis of the CT findings included shape, presence of septa, location of septa (peripheral vs central), thickness of septa (thin vs thick), mosaic pattern, mural nodules, intracystic debris, calcification, upstream bile duct dilatation, downstream bile duct dilatation, and communication between a cystic lesion and the bile duct. The maximum size of a cystic lesion and the maximum size of the largest mural nodule were measured. The presence of septa, central septa, mural nodules, upstream bile duct dilatation, and downstream bile duct dilatation were found to be significant CT findings for differentiating mucinous cystic neoplasms and cyst-forming intraductal papillary neoplasms of the bile duct from solitary bile duct cysts (p < 0.05 for each finding). When two of these five criteria were used in combination, the sensitivity and specificity for diagnosing mucin-producing cystic neoplasms and cyst-forming intraductal papillary neoplasms of the bile duct were 87% (27 of 31) and 87% (27 of 31), respectively. When two of these five criteria were used in combination, the sensitivity and specificity for diagnosing mucinous cystic neoplasms and cyst-forming intraductal papillary neoplasms of the bile duct were 87% (27 of 31) and 87% (27 of 31), respectively [corrected]. With the use of specific CT criteria, mucin-producing cystic neoplasms of the liver can be differentiated from solitary bile duct cysts with a high degree of accuracy.

  2. Investigation of Liner Characteristics in the NASA Langley Curved Duct Test Rig

    NASA Technical Reports Server (NTRS)

    Gerhold, Carl H.; Brown, Martha C.; Watson, Willie R.; Jones, Michael G.

    2007-01-01

    The Curved Duct Test Rig (CDTR), which is designed to investigate propagation of sound in a duct with flow, has been developed at NASA Langley Research Center. The duct incorporates an adaptive control system to generate a tone in the duct at a specific frequency with a target Sound Pressure Level and a target mode shape. The size of the duct, the ability to isolate higher order modes, and the ability to modify the duct configuration make this rig unique among experimental duct acoustics facilities. An experiment is described in which the facility performance is evaluated by measuring the sound attenuation by a sample duct liner. The liner sample comprises one wall of the liner test section. Sound in tones from 500 to 2400 Hz, with modes that are parallel to the liner surface of order 0 to 5, and that are normal to the liner surface of order 0 to 2, can be generated incident on the liner test section. Tests are performed in which sound is generated without axial flow in the duct and with flow at a Mach number of 0.275. The attenuation of the liner is determined by comparing the sound power in a hard wall section downstream of the liner test section to the sound power in a hard wall section upstream of the liner test section. These experimentally determined attenuations are compared to numerically determined attenuations calculated by means of a finite element analysis code. The code incorporates liner impedance values educed from measured data from the NASA Langley Grazing Incidence Tube, a test rig that is used for investigating liner performance with flow and with (0,0) mode incident grazing. The analytical and experimental results compare favorably, indicating the validity of the finite element method and demonstrating that finite element prediction tools can be used together with experiment to characterize the liner attenuation.

  3. An Integrated Optimization Design Method Based on Surrogate Modeling Applied to Diverging Duct Design

    NASA Astrophysics Data System (ADS)

    Hanan, Lu; Qiushi, Li; Shaobin, Li

    2016-12-01

    This paper presents an integrated optimization design method in which uniform design, response surface methodology and genetic algorithm are used in combination. In detail, uniform design is used to select the experimental sampling points in the experimental domain and the system performance is evaluated by means of computational fluid dynamics to construct a database. After that, response surface methodology is employed to generate a surrogate mathematical model relating the optimization objective and the design variables. Subsequently, genetic algorithm is adopted and applied to the surrogate model to acquire the optimal solution in the case of satisfying some constraints. The method has been applied to the optimization design of an axisymmetric diverging duct, dealing with three design variables including one qualitative variable and two quantitative variables. The method of modeling and optimization design performs well in improving the duct aerodynamic performance and can be also applied to wider fields of mechanical design and seen as a useful tool for engineering designers, by reducing the design time and computation consumption.

  4. Characteristics of Office-based Physician Visits, 2015.

    PubMed

    Ashman, Jill J; Rui, Pinyao; Okeyode, Titilayo

    2018-06-01

    In 2015, most Americans had a usual place to receive health care (85% of adults and 96% of children) (1,2). The majority of children and adults listed a doctor's office as the usual place they received care (1,2). In 2015, there were an estimated 990.8 million office-based physician visits in the United States (3,4). This report examines visit rates by age and sex. It also examines visit characteristics-including insurance status, reason for visit, and services-by age. Estimates use data from the 2015 National Ambulatory Medical Care Survey (NAMCS). All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  5. [Persistence of the omphalomesenteric duct. Childhood differential diagnosis of umbilical granuloma].

    PubMed

    Sánchez-Castellanos, M E; Sandoval-Tress, C; Hernández-Torres, M

    2006-01-01

    The omphalomesenteric duct is an embryonic structure which communicates the vitelline duct with the midgut. It normally disappears between the fifth and ninth weeks of intrauterine life. Anomalies related with the total or partial absence of this involution are show in 2 % of the population. We report a case of persistence of the omphalomesenteric duct and review the bibliography to establish the differences between this anomaly and umbilical granuloma, which is the main differential diagnosis.

  6. Preconditioning the Helmholtz Equation for Rigid Ducts

    NASA Technical Reports Server (NTRS)

    Baumeister, Kenneth J.; Kreider, Kevin L.

    1998-01-01

    An innovative hyperbolic preconditioning technique is developed for the numerical solution of the Helmholtz equation which governs acoustic propagation in ducts. Two pseudo-time parameters are used to produce an explicit iterative finite difference scheme. This scheme eliminates the large matrix storage requirements normally associated with numerical solutions to the Helmholtz equation. The solution procedure is very fast when compared to other transient and steady methods. Optimization and an error analysis of the preconditioning factors are present. For validation, the method is applied to sound propagation in a 2D semi-infinite hard wall duct.

  7. Endoscopic diagnosis of extrahepatic bile duct carcinoma: Advances and current limitations

    PubMed Central

    Tamada, Kiichi; Ushio, Jun; Sugano, Kentaro

    2011-01-01

    The accurate diagnosis of extrahepatic bile duct carcinoma is difficult, even now. When ultrasonography (US) shows dilatation of the bile duct, magnetic resonance cholangiopancreatography followed by endoscopic US (EUS) is the next step. When US or EUS shows localized bile duct wall thickening, endoscopic retrograde cholangiopancreatography should be conducted with intraductal US (IDUS) and forceps biopsy. Fluorescence in situ hybridization increases the sensitivity of brush cytology with similar specificity. In patients with papillary type bile duct carcinoma, three biopsies are sufficient. In patients with nodular or infiltrating-type bile duct carcinoma, multiple biopsies are warranted, and IDUS can compensate for the limitations of biopsies. In preoperative staging, the combination of dynamic multi-detector low computed tomography (MDCT) and IDUS is useful for evaluating vascular invasion and cancer depth infiltration. However, assessment of lymph nodes metastases is difficult. In resectable cases, assessment of longitudinal cancer spread is important. The combination of IDUS and MDCT is useful for revealing submucosal cancer extension, which is common in hilar cholangiocarcinoma. To estimate the mucosal extension, which is common in extrahepatic bile duct carcinoma, the combination of IDUS and cholangioscopy is required. The utility of current peroral cholangioscopy is limited by the maneuverability of the “baby scope”. A new baby scope (10 Fr), called “SpyGlass” has potential, if the image quality can be improved. Since extrahepatic bile duct carcinoma is common in the Far East, many researchers in Japan and Korea contributed these studies, especially, in the evaluation of longitudinal cancer extension. PMID:21611097

  8. Building America Case Study: High-Velocity Small-Diameter Duct System, Pittsburgh, Pennsylvania

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

    A. Poerschke

    This study tests the performance of a variable airflow small-diameter duct heating, ventilation, and air conditioning (HVAC) system in a new construction unoccupied low-load test house in Pittsburgh, Pennsylvania. The duct system was installed entirely in conditioned space and was operated from the winter through summer seasons. Measurements were collected on the in-room temperatures and energy consumed by the air handler and heat pump unit. Operation modes with three different volumes of airflow were compared to determine the ideal airflow scenario that maximizes room-to-room thermal uniformity while minimizing fan energy consumption. Black felt infrared imagery was used as a measuremore » of diffuser throw and in-room air mixing. Measured results indicate the small-diameter, high velocity airflow system can provide comfort under some conditions. Solar heat gains resulted in southern rooms drifting beyond acceptable temperature limits. Insufficient airflow to some bedrooms also resulted in periods of potential discomfort. Homebuilders or HVAC contractors can use these results to assess whether this space conditioning strategy is an attractive alternative to a traditional duct system. The team performed a cost analysis of two duct system configurations: (1) a conventional diameter and velocity duct system, and (2) the small-diameter duct system. This work applies to both new and retrofit homes that have achieved a low heating and cooling density either by energy conservation or by operation in a mild climate with few heating or cooling degree days. Guidance is provided on cost trade-offs between the conventional duct system and the small-diameter duct system.« less

  9. Evidence-based ergonomics. A comparison of Japanese and American office layouts.

    PubMed

    Noro, Kageyu; Fujimaki, Goroh; Kishi, Shinsuke

    2003-01-01

    There is a variety of alternatives in office layouts. Yet the theoretical basis and criteria for predicting how well these layouts accommodate employees are poorly understood. The objective of this study was to evaluate criteria for selecting office layouts. Intensive computer workers worked in simulated office layouts in a controlled experimental laboratory. Eye movement measures indicate that knowledge work requires both concentration and interaction. Findings pointed to one layout as providing optimum balance between these 2 requirements. Recommendations for establishing a theoretical basis and design criteria for selecting office layouts based on work style are suggested.

  10. Experiments on the Recovery of Waste Heat in Cooling Ducts, Special Report

    NASA Technical Reports Server (NTRS)

    Silverstein, Abe

    1939-01-01

    Tests have been conducted in the N.A.C.A. full-scale wind tunnel to investigate the partial recovery of the heat energy which is apparently wasted in the cooling of aircraft engines. The results indicate that if the radiator is located in an expanded duct, a part of the energy lost in cooling is recovered; however, the energy recovery is not of practical importance up to airplane speeds of 400 miles per hour. Throttling of the duct flow occurs with heated radiators and must be considered in designing the duct outlets from data obtained with cold radiators in the ducts.

  11. BETTER DUCT SYSTEMS FOR HOME HEATING AND COOLING.

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

    ANDREWS,J.

    This is a series of six guides intended to provide a working knowledge of residential heating and cooling duct systems, an understanding of the major issues concerning efficiency, comfort, health, and safety, and practical tips on installation and repair of duct systems. These guides are intended for use by contractors, system designers, advanced technicians, and other HVAC professionals. The first two guides are also intended to be accessible to the general reader.

  12. Ultrasound versus liver function tests for diagnosis of common bile duct stones.

    PubMed

    Gurusamy, Kurinchi Selvan; Giljaca, Vanja; Takwoingi, Yemisi; Higgie, David; Poropat, Goran; Štimac, Davor; Davidson, Brian R

    2015-02-26

    Ultrasound and liver function tests (serum bilirubin and serum alkaline phosphatase) are used as screening tests for the diagnosis of common bile duct stones in people suspected of having common bile duct stones. There has been no systematic review of the diagnostic accuracy of ultrasound and liver function tests. To determine and compare the accuracy of ultrasound versus liver function tests for the diagnosis of common bile duct stones. We searched MEDLINE, EMBASE, Science Citation Index Expanded, BIOSIS, and Clinicaltrials.gov to September 2012. We searched the references of included studies to identify further studies and systematic reviews identified from various databases (Database of Abstracts of Reviews of Effects, Health Technology Assessment, Medion, and ARIF (Aggressive Research Intelligence Facility)). We did not restrict studies based on language or publication status, or whether data were collected prospectively or retrospectively. We included studies that provided the number of true positives, false positives, false negatives, and true negatives for ultrasound, serum bilirubin, or serum alkaline phosphatase. We only accepted studies that confirmed the presence of common bile duct stones by extraction of the stones (irrespective of whether this was done by surgical or endoscopic methods) for a positive test result, and absence of common bile duct stones by surgical or endoscopic negative exploration of the common bile duct, or symptom-free follow-up for at least six months for a negative test result as the reference standard in people suspected of having common bile duct stones. We included participants with or without prior diagnosis of cholelithiasis; with or without symptoms and complications of common bile duct stones, with or without prior treatment for common bile duct stones; and before or after cholecystectomy. At least two authors screened abstracts and selected studies for inclusion independently. Two authors independently collected data from

  13. Duct injection for SO{sub 2} control, Design Handbook, Volume 1, Process design and engineering guidelines

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

    NONE

    PETC developed a comprehensive program of coal-related, acid-rain research and development with a major activity area centering on flue gas cleanup and control of SO{sub 2} emissions. Particular emphasis was placed on the retrofit measures for older coal-fired power plants which predate the 1971 New Source Performance Standards. Candidate emission control technologies fall into three categories, depending upon their point of application along the fuel path (i.e., pre, during, or post combustion). The post-combustion, in-duct injection of a calcium-based chemical reagent seemed promising. Preliminary studies showed that reagent injection between the existing air heater and electrostatic precipitator (ESP) could removemore » between 50-60% of the SO{sub 2} and produce an environmentally safe, dry, solid waste that is easily disposed. Although SO{sub 2} removal efficiencies were less, the estimated capital costs for duct injection technology were low making the economics of duct injection systems seem favorable when compared to conventional wet slurry scrubbers under certain circumstances. With the promulgation of the Clean Air Act Amendments of 1990 came more incentive for the development of low capital cost flue gas desulfurization (FGD) processes. A number of technical problems had to be resolved, however, before duct injection technology could be brought to a state of commercial readiness. The Duct Injection Technology Development Program was launched as a comprehensive, four-year research effort undertaken by PETC to develop this new technology. Completed in 1992, this Duct Injection Design Handbook and the three-dimensional predictive mathematical model constitute two primary end products from this development program. The aim of this design handbook and the accompanying math model is to provide utility personnel with sufficient information to evaluate duct injection technology against competing SO{sub 2} emissions reduction strategies for an existing plant.« less

  14. The Reduction of Ducted Fan Engine Noise Via A Boundary Integral Equation Method

    NASA Technical Reports Server (NTRS)

    Tweed, J.; Dunn, M.

    1997-01-01

    The development of a Boundary Integral Equation Method (BIEM) for the prediction of ducted fan engine noise is discussed. The method is motivated by the need for an efficient and versatile computational tool to assist in parametric noise reduction studies. In this research, the work in reference 1 was extended to include passive noise control treatment on the duct interior. The BEM considers the scattering of incident sound generated by spinning point thrust dipoles in a uniform flow field by a thin cylindrical duct. The acoustic field is written as a superposition of spinning modes. Modal coefficients of acoustic pressure are calculated term by term. The BEM theoretical framework is based on Helmholtz potential theory. A boundary value problem is converted to a boundary integral equation formulation with unknown single and double layer densities on the duct wall. After solving for the unknown densities, the acoustic field is easily calculated. The main feature of the BIEM is the ability to compute any portion of the sound field without the need to compute the entire field. Other noise prediction methods such as CFD and Finite Element methods lack this property. Additional BIEM attributes include versatility, ease of use, rapid noise predictions, coupling of propagation and radiation both forward and aft, implementable on midrange personal computers, and valid over a wide range of frequencies.

  15. [Spontaneous perforation of the hepatic duct during biliary lithiasis complicated by acute pancreatitis].

    PubMed

    Assadourian, R; Chometowski, S; Bourde, J; Poitout, D; Lamy, J

    1975-10-01

    The association of perforation of the common bile duct, cholecystitis and acute pancreatitis, should be emphasized. Physiopathology of perforation of the bile duct may be compared with that of pancreatitis. Repair of the bile duct may be delicate requiring hepatico-jejunostomy on an isolated loop.

  16. Study of compressible flow through a rectangular-to-semiannular transition duct

    NASA Technical Reports Server (NTRS)

    Foster, Jeffry; Okiishi, Theodore H.; Wendt, Bruce J.; Reichert, Bruce A.

    1995-01-01

    Detailed flow field measurements are presented for compressible flow through a diffusing rectangular-to-semiannular transition duct. Comparisons are made with published computational results for flow through the duct. Three-dimensional velocity vectors and total pressures were measured at the exit plane of the diffuser model. The inlet flow was also measured. These measurements are made using calibrated five-hole probes. Surface oil flow visualization and surface static pressure data were also taken. The study was conducted with an inlet Mach number of 0.786. The diffuser Reynolds based on the inlet centerline velocity and the exit diameter of the diffuser was 3,200,000. Comparison of the measured data with previously published computational results are made. Data demonstrating the ability of vortex generators to reduce flow separation and circumferential distortion is also presented.

  17. Assessment of Chronological Effects of Irreversible Electroporation on Hilar Bile Ducts in a Porcine Model

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

    Choi, Jae Woong, E-mail: cooljay@korea.ac.kr; Lu, David S. K., E-mail: dlu@mednet.ucla.edu; Osuagwu, Ferdnand, E-mail: fosuagwu@mednet.ucla.edu

    2013-11-07

    PurposeTo evaluate the chronological effects of irreversible electroporation (IRE) on large hilar bile ducts in an in vivo porcine model correlated with computed tomography (CT) cholangiography and histopathology.Materials and MethodsTwelve IRE zones were made along hilar bile ducts intraoperatively under ultrasound (US)-guidance in 11 pigs. Paired electrodes were placed either on opposing sides of the bile duct (straddle [STR]) or both on one side of the bile duct (one-sided [OSD]). The shortest electrode-to-duct distance was classified as periductal (≤2 mm) or nonperiductal (>2 mm). CT cholangiography and laboratory tests were performed before IRE and again at 2 days, 4 weeks, and 8 weeks after IRE.more » Degree of bile duct injury were graded as follows: grade 0 = no narrowing; grade 1 = ≤50 % duct narrowing; grade 2 = >50 % narrowing without proximal duct dilatation; grade 3 = grade 2 with proximal duct dilatation; and grade 4 = grade 3 with enzyme elevation. Pigs were selected for killing and histopathology at 2 days, 4, and 8 weeks.ResultsNonperiductal electrode placement produced no long-term strictures in 5 of 5 ducts. Periductal electrode placement produced mild narrowing in 6 of 7 ducts: 5 grade 1 and 1 grade 2. None showed increased enzymes. There was no significant difference between STR versus OSD electrode placement. Histopathology showed minor but relatively greater ductal mural changes in narrowed ducts.ConclusionIn the larger hilar ducts, long-term patency and mural integrity appear resistant to IRE damage with the energy deposition used, especially if the electrode is not immediately periductal in position.« less

  18. Resin duct characteristics in the wood of fire-scarred North American conifers

    Treesearch

    Estelle Arbellay; Markus Stoffel; Elaine K. Sutherland; Kevin T. Smith; Donald A. Falk

    2013-01-01

    Traumatic resin ducts form in xylem and phloem tissue of conifers in response to abiotic wounding, fungal invasion, and insect attack. Little is known about resin duct characteristics in the wood of fire-scarred trees. The aim of this study is to quantify changes in traits of both axial and radial resin ducts, along with those of associated epithelial cells and...

  19. Acoustics flow analysis in circular duct using sound intensity and dynamic mode decomposition

    NASA Astrophysics Data System (ADS)

    Weyna, S.

    2014-08-01

    Sound intensity generation in hard-walled duct with acoustic flow (no mean-flow) is treated experimentally and shown graphically. In paper, numerous methods of visualization illustrating the vortex flow (2D, 3D) can graphically explain diffraction and scattering phenomena occurring inside the duct and around open end area. Sound intensity investigation in annular duct gives a physical picture of sound waves in any duct mode. In the paper, modal energy analysis are discussed with particular reference to acoustics acoustic orthogonal decomposition (AOD). The image of sound intensity fields before and above "cut-off" frequency region are found to compare acoustic modes which might resonate in duct. The experimental results show also the effects of axial and swirling flow. However acoustic field is extremely complicated, because pressures in non-propagating (cut-off) modes cooperate with the particle velocities in propagating modes, and vice versa. Measurement in cylindrical duct demonstrates also the cut-off phenomenon and the effect of reflection from open end. The aim of experimental study was to obtain information on low Mach number flows in ducts in order to improve physical understanding and validate theoretical CFD and CAA models that still may be improved.

  20. The transmission of sound in nonuniform ducts. [carrying steady, compressible flow

    NASA Technical Reports Server (NTRS)

    Eversman, W.

    1975-01-01

    The method of weighted residuals in the form of a modified Galerkin method with boundary residuals was developed for the study of the transmission of sound in nonuniform ducts carrying a steady, compressible flow. In this development, the steady flow was modeled as essentially one dimensional but with a kinematic modification to force tangency of the flow at the duct walls. Three forms of the computational scheme were developed using for basis functions (1) the no-flow uniform duct modes, (2) positive running uniform duct modes, with flow, and (3) positive and negative running uniform duct modes, with flow. The formulation using the no-flow modes was the most highly developed, and has advantages primarily due to relative computational simplicity. Results using the three methods are shown to converge to known solutions for several special cases, and the most significant check case is against low frequency, one dimensional results over the complete subsonic Mach number range. Development of the method is continuing, with emphasis on assessing the relative accuracy and efficiency of the three implementations.

  1. Laminar heat transfer in annular sector ducts

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

    Soliman, H.M.

    1987-02-01

    The continuing interest in compact heat exchangeers has created the need for friction factor and Nusselt number data for different passage shapes. It has long been recognized that circular tube results are generally not applicable to noncircular passages even when the hydraulic diameter is used as the characteristic dimension. Hence, design data should be generated for each passage individually, and a good source of such information is Shah and London. One duct geometry for which complete design information does not appear to be available in the open literature is that of annular sector ducts. Such configuration is encountered in multipassagemore » internally finned tubes and many other compact het exchanger applications. The fluid flow problem for this configuration has been solved by Sparrow et al., and more recently by Niida. However, to the beest of the author's knowledge, the heat transfer results are not available yet. The purpose of this note is to summarize the analysis and results of fluid flow and heat transfer in annular sector ducts.« less

  2. Measure Guideline: Optimizing the Configuration of Flexible Duct Junction Boxes

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

    Beach, R.; Burdick, A.

    2014-03-01

    This measure guideline offers additional recommendations to heating, ventilation, and air conditioning (HVAC) system designers for optimizing flexible duct, constant-volume HVAC systems using junction boxes within Air Conditioning Contractors of America (ACCA) Manual D guidance (Rutkowski, H. Manual D -- Residential Duct Systems, 3rd edition, Version 1.00. Arlington, VA: Air Conditioning Contractors of America, 2009.). IBACOS used computational fluid dynamics software to explore and develop guidance to better control the airflow effects of factors that may impact pressure losses within junction boxes among various design configurations (Beach, R., Prahl, D., and Lange, R. CFD Analysis of Flexible Duct Junction Boxmore » Design. Golden, CO: National Renewable Energy Laboratory, submitted for publication 2013). These recommendations can help to ensure that a system aligns more closely with the design and the occupants' comfort expectations. Specifically, the recommendations described herein show how to configure a rectangular box with four outlets, a triangular box with three outlets, metal wyes with two outlets, and multiple configurations for more than four outlets. Designers of HVAC systems, contractors who are fabricating junction boxes on site, and anyone using the ACCA Manual D process for sizing duct runs will find this measure guideline invaluable for more accurately minimizing pressure losses when using junction boxes with flexible ducts.« less

  3. Noise from a Supersonic Round Jet Discharging Into a Duct

    NASA Technical Reports Server (NTRS)

    Zaman, K. B. M. Q.; Fagan, A. F.

    2014-01-01

    In an effort to understand an 'unwanted noise' problem occasionally encountered in ground test facilities, the interaction of a jet flow with a duct is studied in a model scale experiment. While the interaction of subsonic jets was studied earlier, that of supersonic jets is considered in this paper. The effect of the presence of a cylindrical duct in the path of the jet is studied through sound pressure level spectral measurements as well as schlieren flow visualization. When the jet involves screech tones the placement of the duct is found to make only minor effects on the tones themselves as well as on the high frequency noise. However, there is increased energy at low frequencies. The increase in low frequency noise becomes clearer when screech is eliminated from the jet by two small tabs placed at the nozzle exit. It is shown that spectral peaks and increased sound pressure levels occur at frequencies corresponding to the axial acoustic resonance modes of the duct. These peaks persist into the supersonic regime, however, their amplitudes diminish relative to increasing spectral amplitudes at other frequencies with increasing jet Mach number. A wire-mesh screen attached to the end of the duct effectively suppresses such unwanted noise at subsonic as well as supersonic conditions.

  4. Experimental and Numerical Study on Performance of Ducted Hydrokinetic Turbines with Pre-Swirl Stator Blades.

    NASA Astrophysics Data System (ADS)

    Gish, Andrew

    2015-11-01

    Ducts (also called shrouds) have been shown to improve performance of hydrokinetic turbines in some situations, bringing the power coefficient (Cp) closer to the Betz limit. Here we investigate optimization of the duct design as well as the addition of stator blades upstream of the turbine rotor to introduce pre-swirl in the flow. A small scale three-bladed turbine was tested in a towing tank. Three cases (bare turbine, with duct, and with duct and stators) were tested over a range of flow speeds. Important parameters include duct cross-sectional shape, blade-duct gap, stator cross-sectional shape, and stator angle. For each test, Cp was evaluated as a function of tip speed ratio (TSR). Experimental results were compared with numerical simulations. Results indicate that ducts and stators can improve performance at slower flow speeds and lower the stall speed compared to a bare turbine, but may degrade performance at higher speeds. Ongoing efforts to optimize duct and stator configurations will be discussed.

  5. Heat Pump Water Heater Ducting Strategies with Encapsulated Attics in Climate Zones 2 and 4

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

    Sweet, M. L.; Francisco, A.; Roberts, S. G.

    The focus of this study is on the performance of HPWHs with several different duct configurations and their effects on whole building heating, cooling, and moisture loads. A.O. Smith 60 gallon Voltex (PHPT-60) heat pump water heaters (HPWHs) were included at two project sites and ducted to or located within spray foamed encapsulated attics. The effect of ducting a HPWH's air stream does not diminish its efficiency if the ducting does not reduce intake air temperature, which expands HPWH application to confined areas. Exhaust ducts should be insulated to avoid condensation on the exterior, however this imposes a risk ofmore » condensation occurring in the duct's interior near the HPWH due to large variation of temperatures between the compressor and the duct and the presence of bulk moisture around the condenser. The HPWH's air conditioning impact on HVAC equipment loads is minimal when the intake and exhaust air streams are connected to a sealed attic and not the living space. A HPWH is not suitable as a replacement dehumidifier in sealed attics as peak moisture loads were observed to only be reduced if the heat pump operated during the morning. It appears that the intake air temperature and humidity was the most dominant variable affecting HPWH performance. Different ducting strategies such as exhaust duct only, intake duct only, and exhaust and intake ducting did not have any effect on HPWH performance.« less

  6. Patient safety issues in office-based surgery and anaesthesia in Switzerland: a qualitative study.

    PubMed

    McLennan, Stuart; Schwappach, David; Harder, Yves; Staender, Sven; Elger, Bernice

    2017-08-01

    To identify the spectrum of patient safety issues in office-based surgery and anaesthesia in Switzerland. Purposive sample of 23 experts in surgery and anaesthesia and quality and regulation in Switzerland. Data were collected via individual qualitative interviews using a researcher-developed semi-structured interview guide between March 2016 and September 2016. Interviews were transcribed and analysed using conventional content analysis. Issues were categorised under the headings "structure", "process", and "outcome". Experts identified two key overarching patient safety and regulatory issues in relation to office-based surgery and anaesthesia in Switzerland. First, experts repeatedly raised the current lack of data and transparency of the setting. It is unknown how many surgeons are operating in offices, how many and what types of operations are being done, and what the outcomes are. Secondly, experts also noted the limited oversight and regulation of the setting. While some standards exists, most experts felt that more minimal safety standards are needed regarding the requirements that must be met to do office-based surgery and what can and cannot be done in the office-based setting are needed, but they advocated a self-regulatory approach. There is a lack of empirical data regarding the quantity and quality office-based surgery and anaesthesia in Switzerland. Further research is needed to address these research gaps and inform health policy in relation to patient safety in office-based surgery and anaesthesia in Switzerland. Copyright © 2017. Published by Elsevier GmbH.

  7. Numerical study of turbulent secondary flows in curved ducts

    NASA Technical Reports Server (NTRS)

    Hur, N.; Thangam, S.; Speziale, C. G.

    1990-01-01

    The pressure driven, fully-developed turbulent flow of an incompressible viscous fluid in curved ducts of square-section is studied numerically by making use of a finite volume method. A nonlinear Kappa - Iota model is used to represent the turbulence. The results for both straight and curved ducts are presented. For the case of fully-developed turbulent flow in straight and curved ducts, the secondary flow is characterized by an eight-vortex structure for which the computed flowfield is shown to be in good agreement with available experimental data. The introduction of moderate curvature is shown to cause a substantial increase in the strength of the secondary flow and to change the secondary flow pattern to either a double-vortex or a four-vortex configuration.

  8. Numerical study of turbulent secondary flows in curved ducts

    NASA Technical Reports Server (NTRS)

    Hur, N.; Thangam, S.; Speziale, C. G.

    1989-01-01

    The pressure driven, fully-developed turbulent flow of an incompressible viscous fluid in curved ducts of square cross-section is studied numerically by making use of a finite volume method. A nonlinear Kappa - Iota model is used to represent the turbulence. The results for both straight and curved ducts are presented. For the case of fully-developed turbulent flow in straight ducts, the secondary flow is characterized by an eight-vortex structure for which the computed flowfield is shown to be in good agreement with available experimental data. The introduction of moderate curvature is shown to cause a substantial increase in the strength of the secondary flow and to change the secondary flow pattern to either a double-vortex or a four-vortex configuration.

  9. Intraductal papillary neoplasm of the bile duct: a case report.

    PubMed

    Peeters, Karen; Delvaux, Peter; Huysentruyt, Frederik

    2017-08-01

    Intraductal papillary neoplasm of the bile duct (IPNB) is a rare variant of bile duct tumors, characterized by papillary growth within the bile duct lumen and is regarded as a biliary counterpart of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. IPNBs are mainly found in patients from Far Eastern areas, where hepatolithiasis and clonorchiasis are endemic. The Western experience, however, remains limited. In this article, we report a 56-year-old man, referred to our hospital because of deranged liver function tests. Further imaging modalities showed a cystic lesion of 9 cm diameter, arising from the left hepatic duct. Inlying was a heterogeneous, lobulated mass. The patient underwent a left hemihepatectomy and adjuvant chemotherapy. Despite recent advanced technologies, diagnosis of IPNB is still challenging, especially in western countries due to its rarity. Early identification and resection of lesions, even in asymptomatic or minimally symptomatic patients, are however important prognostic factors.

  10. Embolization for Thoracic Duct Collateral Leakage in High-Output Chylothorax After Thoracic Surgery

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

    Kariya, Shuji, E-mail: kariyas@hirakata.kmu.ac.jp; Nakatani, Miyuki, E-mail: nakatanm@hirakata.kmu.ac.jp; Yoshida, Rie, E-mail: yagir@hirakata.kmu.ac.jp

    PurposeThis study was designed to investigate thoracic duct collateral leakage and the supply route of lymphatic fluid by lymphangiography and transcatheter thoracic ductography and to evaluate the results of embolization for thoracic duct collateral leakage performed to cut off this supply route.MethodsData were retrospectively collected from five patients who underwent embolization for thoracic duct collateral leakage in persistent high-output chylothorax after thoracic surgery. Extravasation of lipiodol at the ruptured thoracic duct collaterals was confirmed in all patients on lymphangiography. Transcatheter thoracic ductography was used to identify extravasation of iodinated contrast agent and to identify communication between the thoracic duct andmore » leakage site. Thoracic duct embolization (TDE) was performed using the percutaneous transabdominal approach to cut off the supply route using N-butyl cyanoacrylate (NBCA) mixed with lipiodol (1:5–1:20).ResultsClinical success (drainage volume ≤10 mL/kg/day within 7 days after TDE) was achieved in all patients. The collateral routes developed as consequence of surgical thoracic duct ligation. In three patients, NBCA-Lipiodol reached the leakage site through direct communication between the thoracic duct and the ruptured lymphatic duct. In the other two patients, direct communication and extravasation was not detected on thoracic ductography, and NBCA-Lipiodol did not reach the leakage site. However, NBCA-Lipiodol did reach the cisterna chyli, lumbar trunks, and some collateral routes via the cisterna chyli or lumbar lymphatics. As a result, leakage was stopped.ConclusionsTDE was effective for the management of leakage of the collaterals in high-output chylothorax after thoracic surgery.« less

  11. Prediction of Breast Cancer Risk by Aberrant Methylation in Mammary Duct Lavage

    DTIC Science & Technology

    2006-07-01

    Assessment of breast epithelial cells obtained by nipple duct lavage (NDL) may have value for breast cancer risk stratification. NDL was performed in 150...contribute to risk stratification. 15. SUBJECT TERMS breast cancer, DNA methylation, Methylation Specific PCR, Nipple Duct Lavage, Risk assessment 16...carcinogenesis. Nipple duct lavage (NDL) is a minimally invasive approach for obtaining breast epithelial cells. Cytological atypia identified in nipple

  12. Application of Variational Methods to the Thermal Entrance Region of Ducts

    NASA Technical Reports Server (NTRS)

    Sparrow, E. M.; Siegel. R.

    1960-01-01

    A variational method is presented for solving eigenvalue problems which arise in connection with the analysis of convective heat transfer in the thermal entrance region of ducts. Consideration is given, to both situations where the temperature profile depends upon one cross-sectional coordinate (e.g. circular tube) or upon two cross-sectional coordinates (e.g. rectangular duct). The variational method is illustrated and verified by application to laminar heat transfer in a circular tube and a parallel-plate channel, and good agreement with existing numerical solutions is attained. Then, application is made to laminar heat transfer in a square duct as a check, an alternate computation for the square duct is made using a method indicated by Misaps and Pohihausen. The variational method can, in principle, also be applied to problems in turbulent heat transfer.

  13. Duct wall impedance control as an advanced concept for acoustic impression

    NASA Technical Reports Server (NTRS)

    Dean, P. D.; Tester, B. J.

    1975-01-01

    Models and tests on an acoustic duct liner system which has the property of controlled-variable acoustic impedance are described. This is achieved by a novel concept which uses the effect of steady air flow through a multi-layer, locally reacting, resonant-cavity absorber. The scope of this work was limited to a 'proof of concept.' The test of the concept was implemented by means of a small-scale, square-section flow duct facility designed specifically for acoustic measurements, with one side of the duct acoustically lined. The test liners were designed with the aid of previously established duct acoustic theory and a semi-empirical impedance model of the liner system. Over the limited range tested, the liner behaved primarily as predicted, exhibiting significant changes in resistance and reactance, thus providing the necessary concept validation.

  14. Strengthening of bridges by post-tensioning using monostrands in substituted cable ducts

    NASA Astrophysics Data System (ADS)

    Klusáček, Ladislav; Svoboda, Adam

    2017-09-01

    Post-tensioning is suitable, reliable and durable method of strengthening existing engineering structures, especially bridges. The high efficiency of post-tensioning can be seen in many applications throughout the world. In this paper the method is extended by a structural system of substituted cable ducts, which allows for significantly widening application of prestressing so it’s convenient mostly for application on beam bridges or slab bridges (built in years 1920 - 1960). The method of substituted cable ducts is based on theoretical knowledge and technical procedures, which were made possible through the development in prestressing systems, particularly the development of prestressing tendons (monostrands) and encased anchorages, as well as progress in drilling technology. This technique is highly recommended due to minimization of interventions into the constructions, unseen method of cable arrangement and hence the absence of impact on appearance, which is appreciated not only in case of valuable historical structures but also in general. It is possible to summarise that posttensioning by monostrands in substituted cable ducts is a highly effective method of strengthening existing bridges in order to increase their load capacities in terms of current traffic load and to extend their service life.

  15. Use of a vessel sealant device for cystic duct ligation in the dog.

    PubMed

    Marvel, Sarah; Monnet, Eric

    2014-11-01

    To compare a vessel sealant device to hemostatic clips for cystic duct ligation in a canine cadaveric model. Experimental. Hepatobiliary systems were collected from normal dogs. A microtip pressure transducer was inserted into the common bile duct and a 20-24 g intravenous catheter was placed in a hepatic duct. The cystic duct was ligated with 1 of 3 techniques: vessel sealant device (VSD), 10 mm medium Endoclips™, or 10 mm large Endoclips™ with 6 specimens in each group. Methylene blue was infused until failure, which was recorded as seal/clip failure or retrograde movement of methylene blue into the liver. Mean failure pressure of the medium endoclip group was significantly lower than the large endoclip group (P = .014). There was no difference between the failure pressure of the VSD group and the medium and large endoclip groups (P = .097, P = .34, respectively). Failure by leakage at the cut surface of the cystic duct occurred in 2 specimens in the medium endoclip group while all others failed by retrograde flow of the methylene blue through the hepatic ducts. The vessel sealant device appears comparable to large endoclips for closure of the cystic duct in an acute cadaveric model, while medium endoclips may not fully compress or span the diameter of a cystic duct in large breed dogs and leak at lower pressures. © Copyright 2014 by The American College of Veterinary Surgeons.

  16. Outcomes of office-based temporomandibular joint arthroscopy: a 5-year retrospective study.

    PubMed

    Hossameldin, R H; McCain, J P

    2018-01-01

    Temporomandibular joint (TMJ) arthroscopy is a minimally invasive surgical approach for intra-articular TMJ diseases. Office-based arthroscopy using the smallest TMJ scope allows for good visualization, as well as the ability to lavage the joint in an office setting. This study aimed to assess the efficacy of an office-based TMJ arthroscopic technique. A retrospective evaluation of 363 patients with a TMJ disorder was performed. These patients underwent office-based arthroscopy using the OnPoint 1.2mm Scope System (Biomet Microfixation, Jacksonville, FL, USA) in Florida, USA, from July 2007. The following outcomes of the procedure were assessed: improvement in painless range of mandibular motion, pain on loading, and functional jaw pain; these were evaluated using a visual analog scale (VAS) over an average follow-up period of 263.81±142.1 days. The statistical analysis was performed using IBM SPSS Statistics version 20. Statistically significant improvements in TMJ pain and function, and other variables (P=0.001) were shown following TMJ arthroscopic lysis and lavage. Office-based arthroscopy using the OnPoint System was demonstrated to be a safe and efficient procedure for the treatment of patients with TMJ disorders as the first level of the algorithm of care. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. 76 FR 81518 - Notice of Issuance of Final Determination Concerning Laser-Based Multi-Function Office Machines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-28

    ... Determination Concerning Laser-Based Multi-Function Office Machines AGENCY: U.S. Customs and Border Protection... country of origin of laser-based multi-function office machines. Based upon the facts presented, CBP has... essential character of the laser-based multi-function office machine, and it is at their assembly and...

  18. The Detection of Radiated Modes from Ducted Fan Engines

    NASA Technical Reports Server (NTRS)

    Farassat, F.; Nark, Douglas M.; Thomas, Russell H.

    2001-01-01

    The bypass duct of an aircraft engine is a low-pass filter allowing some spinning modes to radiate outside the duct. The knowledge of the radiated modes can help in noise reduction, as well as the diagnosis of noise generation mechanisms inside the duct. We propose a nonintrusive technique using a circular microphone array outside the engine measuring the complex noise spectrum on an arc of a circle. The array is placed at various axial distances from the inlet or the exhaust of the engine. Using a model of noise radiation from the duct, an overdetermined system of linear equations is constructed for the complex amplitudes of the radial modes for a fixed circumferential mode. This system of linear equations is generally singular, indicating that the problem is illposed. Tikhonov regularization is employed to solve this system of equations for the unknown amplitudes of the radiated modes. An application of our mode detection technique using measured acoustic data from a circular microphone array is presented. We show that this technique can reliably detect radiated modes with the possible exception of modes very close to cut-off.

  19. Development of an Experimental Rig for Investigation of Higher Order Modes in Ducts

    NASA Technical Reports Server (NTRS)

    Gerhold, Carl H.; Cabell, Randolph H.; Brown, Martha C.

    2006-01-01

    Continued progress to reduce fan noise emission from high bypass ratio engine ducts in aircraft increasingly relies on accurate description of the sound propagation in the duct. A project has been undertaken at NASA Langley Research Center to investigate the propagation of higher order modes in ducts with flow. This is a two-pronged approach, including development of analytic models (the subject of a separate paper) and installation of a laboratory-quality test rig. The purposes of the rig are to validate the analytical models and to evaluate novel duct acoustic liner concepts, both passive and active. The dimensions of the experimental rig test section scale to between 25% and 50% of the aft bypass ducts of most modern engines. The duct is of rectangular cross section so as to provide flexibility to design and fabricate test duct liner samples. The test section can accommodate flow paths that are straight through or offset from inlet to discharge, the latter design allowing investigation of the effect of curvature on sound propagation and duct liner performance. The maximum air flow rate through the duct is Mach 0.3. Sound in the duct is generated by an array of 16 high-intensity acoustic drivers. The signals to the loudspeaker array are generated by a multi-input/multi-output feedforward control system that has been developed for this project. The sound is sampled by arrays of flush-mounted microphones and a modal decomposition is performed at the frequency of sound generation. The data acquisition system consists of two arrays of flush-mounted microphones, one upstream of the test section and one downstream. The data are used to determine parameters such as the overall insertion loss of the test section treatment as well as the effect of the treatment on a modal basis such as mode scattering. The methodology used for modal decomposition is described, as is a description of the mode generation control system. Data are presented which demonstrate the performance

  20. Preliminary Full-Scale Wind-Tunnel Investigation of Wing Ducts for Radiators, Special Report

    NASA Technical Reports Server (NTRS)

    Silverstein, Abe; Nickle, F. R.

    1938-01-01

    Wing ducts for liquid-cooled engine radiators have been investigated in the N.A.C.A. full-scale wind tunnel on a large model airplane. Th e tests were made to determine the relative merits of several types of duct and radiator installations for an airplane of a particular des ign. In the test program the principal duct dimensions were system atically varied, and the results are therefore somewhat applicable to the general problems of wing duct design, although they should be co nsidered as preliminary and only indicative of the inherent possibil ities.

  1. ASSESSMENT OF FUNGAL (PENICILLIUM CHRYSOGENUM) GROWTH ON THREE HVAC DUCT MATERIALS

    EPA Science Inventory

    The article discusses laboratory experiments to evaluate the susceptibility of three ventilation duct materials (fibrous glass ductboard, galvanized steel, and insulated flexible duct) to fungal (P. chrysogenum) growth. [NOTE: Many building investigators have documented fungal bi...

  2. Transition to Office-based Obstetric and Gynecologic Procedures: Safety, Technical, and Financial Considerations.

    PubMed

    Peacock, Lisa M; Thomassee, May E; Williams, Valerie L; Young, Amy E

    2015-06-01

    Office-based surgery is increasingly desired by patients and providers due to ease of access, overall efficiency, reimbursement, and satisfaction. The adoption of office-based surgery requires careful consideration of safety, efficacy, cost, and feasibility within a providers practice. This article reviews the currently available data regarding patient and provider satisfaction as well as practical considerations of staffing, equipment, and supplies. To aid the practitioner, issues of office-based anesthesia and safety with references to currently available national guidelines and protocols are provided. Included is a brief review of billing, coding, and reimbursement. Technical procedural aspects with information and recommendations are summarized.

  3. Viscous flow computations for elliptical two-duct version of the SSME hot gas manifold

    NASA Technical Reports Server (NTRS)

    Roger, R. P.

    1986-01-01

    The objective of the effort was to numerically simulate viscous subsonic flow in a proposed elliptical two-duct version of the fuel side Hot Gas Manifold (HGM) for the Space Shuttle Main Engine (SSME). The numerical results were to complement both water flow and air flow experiments in the two-duct geometry performed at NASA-MSFC and Rocketdyne. The three-dimensional character of the HGM consists of two essentially different geometries. The first part of the construction is a concentric shell duct structure which channels the gases from a turbine exit into the second part comprised of two cylindrically shaped transfer ducts. The initial concentric shell portion can be further subdivided into a turnaround section and a bowl section. The turnaround duct (TAD) changes the direction of the mean flow by 180 degress from a smaller radius to a larger radius duct which discharges into the bowl. The cylindrical transfer ducts are attached to the bowl on one side thus providing a plane of symmetry midway between the two. Centerline flow distance from the TAD inlet to the transfer duct exit is approximately two feet. Details of the approach used to numerically simulate laminar or turbulent flow in the HGM geometry are presented. Computational results are presented and discussed.

  4. Effects of partial portal vein arterialization on the hilar bile duct in a rat model.

    PubMed

    Guo, Shao-Hua; Li, Chong-Hui; Chen, Yong-Liang; Song, Jian-Ning; Zhang, Ai-Qun; Zhou, Cheng

    2011-10-01

    Liver revascularization is frequently required during the enlarged radical operation for hilar cholangiocarcinoma involving the hepatic artery. Researchers have carried out a number of experiments applying partial portal vein arterialization (PVA) in clinical practice. In this study we aimed to establish a theoretical basis for clinical application of partial PVA and to investigate the effects of partial PVA on rat hilar bile duct and hepatic functions. Thirty rats were randomly and equally assigned into 3 groups: control (group A), hepatic artery ligation+bile duct recanalization (group B), and partial PVA+bile duct recanalization (group C). Proliferation and apoptosis of rat hilar bile duct epithelial cells, arteriolar counts of the peribiliary plexus (PBP) of the bile duct wall, changes in serum biochemistry, and pathologic changes in the bile duct were assessed 1 month after operation. The proliferation of hilar bile duct epithelial cells in group B was greater than in groups A and C (P<0.01). No apoptotic hilar bile duct epithelial cells were detected in any of the groups. The PBP arteriolar counts of the hilar bile duct wall were similar in groups A and C (P>0.05), but the count was lower in group B than in group A (P<0.01). No statistically significant differences in alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and albumin were found in the 3 groups. The gamma-glutamyltransferase value was higher in group B than in groups A and C (P<0.01). The hepatic tissues of groups A and C showed no significant abnormality. Chronic inflammatory changes in the hilar bile duct walls were observed only in group B. Partial PVA can restore the arterial blood supply of the hilar bile duct and significantly extenuate the injury to hilar bile duct epithelial cells resulting from hepatic artery ligation.

  5. Office Education. North Dakota Validated Task Listing. Competency-Based Vocational Education.

    ERIC Educational Resources Information Center

    North Dakota State Board for Vocational Education, Bismarck.

    Intended to provide a base for vocational office education instructional programs at secondary and postsecondary levels in North Dakota, this task listing describes the skills needed to be performed by program completers, from the viewpoint of workers in office occupations. A listing of task validators (name, occupation, employer, business city,…

  6. A Minireview on Vasopressin-regulated Aquaporin-2 in Kidney Collecting Duct Cells.

    PubMed

    Park, Eui-Jung; Kwon, Tae-Hwan

    2015-06-01

    The kidney collecting duct is an important renal tubular segment for the regulation of body water and salt homeostasis. Water reabsorption in the collecting duct cells is regulated by arginine vasopressin (AVP) via the vasopressin V2-receptor (V2R). AVP increases the osmotic water permeability of the collecting duct cells through aquaporin-2 (AQP2) and aquaporin-3 (AQP3). AVP induces the apical targeting of AQP2 and transcription of AQP2 gene in the kidney collecting duct principal cells. The signaling transduction pathways resulting in the AQP2 trafficking to the apical plasma membrane of the collecting duct principal cells, include AQP2 phosphorylation, RhoA phosphorylation, actin depolymerization and calcium mobilization, and the changes of AQP2 protein abundance in water balance disorders have been extensively studied. These studies elucidate the underlying cellular and molecular mechanisms of body water homeostasis and provide the basis for the treatment of body water balance disorders.

  7. A multi-modal solution for the transmission of sound in nonuniform ducts

    NASA Technical Reports Server (NTRS)

    Eversman, W.

    1976-01-01

    The method of weighted residuals in the form of a modified Galerkin method with boundary residuals is developed for the study of the transmission of sound in nonuniform ducts carrying a steady compressible flow. In this formulation the steady flow is modeled as essentially one-dimensional but with a kinematic modification to force tangency of the flow at the duct walls. Good agreement has been obtained with known results for transmission and reflection coefficients in hard walled ducts up to near sonic velocities. In ducts with acoustically compliant boundaries good comparisons have been more difficult to achieve except at low Mach numbers. The problem of transmission in a straight, acoustically treated duct with a uniform flow has been formulated and the Galerkin method used with basis functions derived from the case when flow is absent. Results indicate that favorable comparisons with exact computations can be obtained if care is taken in choosing the basis functions.

  8. Differentiation of benign and malignant hilar bile duct stenosis.

    PubMed

    Liu, Xiaolei; Yang, Zhiying; Tan, Haidong; Shao, Chen; Liu, Liguo; Si, Shuang; Xu, Li; Sun, Yongliang

    2016-06-15

    Failure to differentiate benign and malignant hilar bile duct stenosis may lead to inappropriate treatment. We retrospectively analyzed the methods for differentiation. A total of 53 patients with hilar bile duct stenosis were included, comprising 41 malignant cases (hilar cholangiocarcinoma) and 12 benign cases (six primary sclerosing cholangitis and six IgG4-associated sclerosing cholangitis). Data of clinical histories, laboratory tests, imaging studies, and liver pathologies were collected, and comparison was made between benign and malignant groups. Compared with malignant group, patients in the benign group were more likely to have multiorgan involvement of clinical histories (P < 0.001). There was no difference on bilirubin, liver enzyme, and serum tumor marker between the two groups, whereas serum IgG4 levels were higher in the benign group (P = 0.003). Patients in the benign group were more likely to have pancreatic changes (P < 0.001) and multiple-segmental bile duct stenosis (P < 0.001) on imaging. Compared with the malignant group, patients in the benign group were more likely to show severe periportal inflammation in noninvolved liver (P < 0.001), fibrosis around intrahepatic bile duct (P < 0.001), and more IgG4-positive plasma cells (P < 0.001) on liver pathology. Benign lesion should be considered for patients with history of multiorgan involvement, pancreas changes, or multiple-segmental bile duct stenosis on imaging. Liver biopsy could be helpful for differential diagnosis before surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Application of “Papillary-Like Main Pancreatic Duct Invaginated” Pancreaticojejunostomy for Normal Soft Pancreas Cases

    PubMed Central

    Zhang, Bo; Xu, Jin; Liu, Chen; Long, Jiang; Liu, Liang; Xu, Yongfeng; Wu, Chuntao; Luo, Guopei; Ni, Quanxing; Li, Min; Yu, Xianjun

    2013-01-01

    Pancreaticojejunostomy is the key procedure of pancreaticoduodenectomy. Our study introduced a new pancreaticojejunal (PJ) anastomosis named “papillary-like main pancreatic duct invaginated” pancreaticojejunostomy. Nighty-two patients underwent pancreaticojejunostomy with either conventional duct-to-mucosa pancreaticojejunostomy or the new “papillary-like main pancreatic duct invaginated” techniques were analyzed retrospectively from January 2010 to September 2012. The incidence of pancreatic fistula was 15.7% (8/51) for the “papillary-like main pancreatic duct invaginated” group and 19.5% (8/41) for the duct-to-mucosa fashion respectively. It is noteworthy that the rate of grade B/C postoperative pancreatic fistula (POPF) in the “papillary-like main pancreatic duct invaginated” group was significantly lower than that of the duct-to-mucosa group (P = 0.039). There were no differences in the incidence of postoperative morbidity and mortality such as postoperative hemorrhage, delayed gastric emptying or remnant pancreatitis. The “papillary-like main pancreatic duct invaginated” pancreaticojejunostomy could provide a feasible option to pancreatic surgeons for patients with normal soft pancreas. PMID:23797701

  10. Intralacrimal migration of Masterka® stents.

    PubMed

    Fayet, B; Racy, E; Katowitz, W R; Katowitz, J A; Ruban, J-M; Brémond-Gignac, D

    2018-03-01

    Tearing and conjunctivitis in children are commonly due to lacrimal drainage system obstruction. Congenital nasolacrimal obstruction is a common pathology treated by probing with or without silicone stent insertion, depending upon the age of the child. The silicone stent is self-retaining and placed for at least one month. Masterka ® is a recent version of Monoka ® , which may lead to the same surgical complications, such as intralacrimal migration. The medical records of two patients surgically treated with the Masterka ® probe for nasolacrimal duct obstruction, who developed intralacrimal migration of the stent, were retrospectively reviewed and analyzed. A 41-month-old child and an 18-month-old child presented with disappearance of the silicone tube after 7 days and 2 years respectively. In the first case, the tube migrated completely within the lacrimal system and became externalized through the nose at 2 years, while in the second case, the Masterka ® was retrieved through a canalicular approach. In both cases, infants had no further tearing. The frequency self-retaining stent disappearance is estimated at 15%. Among these cases, intralacrimal migration is only reported in 0.5% of cases. To prevent intralacrimal migration, the surgical technique must follow a certain number of rules. Management, based on residual epiphora, is discussed. Prevention of intralacrimal migration of self-retaining stents involves a rigorous analysis of the relationship between the meatus and the fixation head at the time of placement. After lacrimal intubation, scheduled monitoring is necessary to screen for stent disappearance. Management is based on clinical findings, anterior rhinoscopy and even exploratory canaliculotomy. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  11. [Management of Intrahepatic Duct Stone].

    PubMed

    Cha, Sang Woo

    2018-05-25

    Intrahepatic duct (IHD) stone is the presence of calculi within the intrahepatic bile duct specifically located proximal to the confluence of the left and right hepatic ducts. This stone is characterized by its intractable nature and frequent recurrence, requiring multiple therapeutic interventions. Without proper treatment, biliary strictures and retained stones can lead to repeated episodes of cholangitis, liver abscesses, secondary biliary cirrhosis, portal hypertension, and death from sepsis or hepatic failure. The ultimate treatment goals for IHD stones are complete removal of the stone, the correction of the associated strictures, and the prevention of recurrent cholangitis. A surgical resection can satisfy the goal of treatment for hepatolithiasis, i.e., complete removal of the IHD stones, stricture, and the risk of cholangiocarcinogenesis. On the other hand, in some cases, such as bilateral IHD stones, surgery alone cannot achieve these goals. Therefore, the optimal treatments require a multidisciplinary approach, including endoscopic and radiologic interventional procedures before and/or after surgery. Percutaneous transhepatic cholangioscopic lithotomy (PTCS-L) is particularly suited for patients at poor surgical risk or who refuse surgery and those with previous biliary surgery or stones distributed in multiple segments. PTCS-L is relatively safe and effective for the treatment of IHD stones, and complete stone clearance is mandatory to reduce the sequelae of IHD stones. An IHD stricture is the main factor contributing to incomplete clearance and stone recurrence. Long-term follow-up is required because of the overall high recurrence rate of IHD stones and the association with cholangiocarcinoma.

  12. A case of peribiliary cysts accompanying bile duct carcinoma

    PubMed Central

    Miura, Fumihiko; Takada, Tadahiro; Amano, Hodaka; Yoshida, Masahiro; Isaka, Takahiro; Toyota, Naoyuki; Wada, Keita; Takagi, Kenji; Kato, Kenichiro

    2006-01-01

    A rare case of peribiliary cysts accompanying bile duct carcinoma is presented. A 54-year-old man was diagnosed as having lower bile duct carcinoma and peribiliary cysts by diagnostic imaging. He underwent pylorus preserving pancreatoduodenectomy. As for the peribiliary cysts, a course of observation was taken. Over surgery due to misdiagnosis of patients with biliary malignancy accompanied by peribiliary cysts should be avoided. PMID:16874882

  13. An office-based emergencies course for third-year dental students.

    PubMed

    Wald, David A; Wang, Alvin; Carroll, Gerry; Trager, Jonathan; Cripe, Jane; Curtis, Michael

    2013-08-01

    Although uncommon, medical emergencies do occur in the dental office setting. This article describes the development and implementation of an office-based emergencies course for third-year dental students. The course reviews the basic management of selected medical emergencies. Background information is provided that further highlights the importance of proper training to manage medical emergencies in the dental office. Details regarding course development, implementation, logistics, and teaching points are highlighted. The article provides a starting point from which dental educators can modify and adapt this course and its objectives to fit their needs or resources. This is a timely topic that should benefit both dental students and dental educators.

  14. A MATHEMATICAL MODEL FOR CALCULATING ELECTRICAL CONDITIONS IN WIRE-DUCT ELECTROSTATIC PRECIPITATION DEVICES

    EPA Science Inventory

    The article reports the development of a new method of calculating electrical conditions in wire-duct electrostatic precipitation devices. The method, based on a numerical solution to the governing differential equations under a suitable choice of boundary conditions, accounts fo...

  15. Total rupture of hydatid cyst of liver in to common bile duct: a case report.

    PubMed

    Robleh, Hassan; Yassine, Fahmi; Driss, Khaiz; Khalid, Elhattabi; Fatima-Zahra, Bensardi; Saad, Berrada; Rachid, Lefriyekh; Abdalaziz, Fadil; Najib, Zerouali Ouariti

    2014-01-01

    Rupture of hydatid liver cyst into biliary tree is frequent complications that involve the common hepatic duct, lobar biliary branches, the small intrahepatic bile ducts,but rarely rupture into common bile duct. The rupture of hydatid cyst is serious life threating event. The authors are reporting a case of total rupture of hydatid cyst of liver into common bile duct. A 50-year-old male patient who presented with acute cholangitis was diagnosed as a case of totally rupture of hydatid cyst on Abdominal CT Scan. Rupture of hydatid cyst of liver into common bile duct and the gallbladder was confirmed on surgery. Treated by cholecystectomy and T-tube drainage of Common bile duct.

  16. Preliminary Investigation of Curved Liner Sample in the NASA LaRC Curved Duct Test Rig

    NASA Technical Reports Server (NTRS)

    Gerhold, Carl H.; Jones, Michael G.; Brown, Martha C.

    2007-01-01

    This viewgraph presentation reviews the preliminary investigation of the curved liner sample in the NASA LaRC Curved Duct Test Rig (CDTR). It reviews the purpose of the Curved Duct Test Rig. Its purpose is to develop capability to investigate acoustic and aerodynamic properties in ducts. It has several features to accomplish that purpose: (1) Large scale (2) Flow rate to M = 0.275 (3) Higher order mode control (4) Curved flow path (5) Adaptable test section (6) Flexible test configurations. The liner has minimal effect on turbulence or boundary layer growth in duct. The curved duct sample attenuation is affected by mode scattering. In conclusion, the CDTR is valid tool for aerodynamic and acoustic evaluation of duct treatment

  17. 6. Interior, rear offices: operations assistant office looking north toward ...

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

    6. Interior, rear offices: operations assistant office looking north toward security operations officer's office. - Ellsworth Air Force Base, Rushmore Air Force Station, Security Central Control Building, Quesada Drive, Blackhawk, Meade County, SD

  18. Wind Turbine With Concentric Ducts

    NASA Technical Reports Server (NTRS)

    Muhonen, A. J.

    1983-01-01

    Wind Turbine device is relatively compact and efficient. Converging inner and outer ducts increase pressure difference across blades of wind turbine. Turbine shaft drives alternator housed inside exit cone. Suitable for installation on such existing structures as water towers, barns, houses, and commercial buildings.

  19. The solution of three-variable duct-flow equations

    NASA Technical Reports Server (NTRS)

    Stuart, A. R.; Hetherington, R.

    1974-01-01

    This paper establishes a numerical method for the solution of three-variable problems and is applied here to rotational flows through ducts of various cross sections. An iterative scheme is developed, the main feature of which is the addition of a duplicate variable to the forward component of velocity. Two forward components of velocity result from integrating two sets of first order ordinary differential equations for the streamline curvatures, in intersecting directions across the duct. Two pseudo-continuity equations are introduced with source/sink terms, whose strengths are dependent on the difference between the forward components of velocity. When convergence is obtained, the two forward components of velocity are identical, the source/sink terms are zero, and the original equations are satisfied. A computer program solves the exact equations and boundary conditions numerically. The method is economical and compares successfully with experiments on bent ducts of circular and rectangular cross section where secondary flows are caused by gradients of total pressure upstream.

  20. Theoretical models for duct acoustic propagation and radiation

    NASA Technical Reports Server (NTRS)

    Eversman, Walter

    1991-01-01

    The development of computational methods in acoustics has led to the introduction of analysis and design procedures which model the turbofan inlet as a coupled system, simultaneously modeling propagation and radiation in the presence of realistic internal and external flows. Such models are generally large, require substantial computer speed and capacity, and can be expected to be used in the final design stages, with the simpler models being used in the early design iterations. Emphasis is given to practical modeling methods that have been applied to the acoustical design problem in turbofan engines. The mathematical model is established and the simplest case of propagation in a duct with hard walls is solved to introduce concepts and terminologies. An extensive overview is given of methods for the calculation of attenuation in uniform ducts with uniform flow and with shear flow. Subsequent sections deal with numerical techniques which provide an integrated representation of duct propagation and near- and far-field radiation for realistic geometries and flight conditions.

  1. New tapered metallic stent for unresectable malignant hilar bile duct obstruction.

    PubMed

    Sakai, Yuji; Tsuyuguchi, Toshio; Nishikawa, Takao; Sugiyama, Harutoshi; Sasaki, Reina; Sakamoto, Dai; Watanabe, Yuto; Nakamura, Masato; Yasui, Shin; Mikata, Rintaro; Yokosuka, Osamu

    2015-10-16

    To examine the usefulness of a new tapered metallic stent (MS) in patients with unresectable malignant hilar bile duct obstruction. This new tapered MS was placed in 11 patients with Bismuth II or severer unresectable malignant hilar bile duct obstruction, as a prospective study. The subjects were six patients with bile duct carcinoma, three with gallbladder cancer, and two with metastatic bile duct obstruction. Stenosis morphology was Bismuth II: 7, IIIa: 3, and IV: 1. UMIN Clinical Trial Registry (UMIN000004758). MS placement was 100% (11/11) successful. There were no procedural accidents. The mean patency period was 208.401 d, the median survival period was 142.000 d, and the mean survival period was 193.273 d. Occlusion rate was 36.4% (4/11); the causes of occlusion were ingrowth and overgrowth in 2 patients each, 18.2%, respectively. Patients with occlusion underwent endoscopic treatment one more time and all were treatable. The tapered MS proved useful in patients with unresectable malignant hilar bile duct obstruction because it provided a long patency period, enabled re-treatment by re-intervention, and no procedural accidents occurred.

  2. Extracorporeal shock wave lithotripsy for obstructing pancreatic duct calculi.

    PubMed

    Matthews, K; Correa, R J; Gibbons, R P; Weissman, R M; Kozarek, R A

    1997-08-01

    A review was done to determine the effectiveness of extracorporeal shock wave lithotripsy (ESWL) in the treatment of impacted pancreatic duct calculi. A total of 19 patients, who were potential candidates for radical pancreatic surgery after unsuccessful endoscopic retrograde cholangiopancreatography, sphincterotomy and attempted stone extraction from the pancreatic ducts, underwent ESWL of the calculi. Followup ranged from 6 months to 6 years. Of the 19 patients 14 avoided a major operation and 6 have remained pain-free for the long term. Two patients died of causes not related to ESWL or endoscopic retrograde cholangiopancreatography. Five patients eventually underwent a Whipple or Puestow procedure for relief of symptoms or persistent obstruction. Complications were minimal. ESWL is a valuable adjunct in patients with impacted pancreatic duct calculi unretrievable by primary endoscopic retrograde cholangiopancreatography.

  3. Mode Propagation in Nonuniform Circular Ducts with Potential Flow

    NASA Technical Reports Server (NTRS)

    Cho, Y. C.; Ingard, K. U.

    1982-01-01

    A previously reported closed form solution is expanded to determine effects of isentropic mean flow on mode propagation in a slowly converging-diverging duct, a circular cosh duct. On the assumption of uniform steady fluid density, the mean flow increases the power transmission coefficient. The increase is directly related to the increase of the cutoff ratio at the duct throat. With the negligible transverse gradients of the steady fluid variables, the conversion from one mode to another is negligible, and the power transmission coefficient remains unchanged with the mean flow direction reversed. With a proper choice of frequency parameter, many different modes can be made subject to a single value of the power transmission loss. A systematic method to include the effects of the gradients of the steady fluid variables is also described.

  4. Impedance Eduction in Large Ducts Containing Higher-Order Modes and Grazing Flow

    NASA Technical Reports Server (NTRS)

    Watson, Willie R.; Jones, Michael G.

    2017-01-01

    Impedance eduction test data are acquired in ducts with small and large cross-sectional areas at the NASA Langley Research Center. An improved data acquisition system in the large duct has resulted in increased control of the acoustic energy in source modes and more accurate resolution of higher-order duct modes compared to previous tests. Two impedance eduction methods that take advantage of the improved data acquisition to educe the liner impedance in grazing flow are presented. One method measures the axial propagation constant of a dominant mode in the liner test section (by implementing the Kumarsean and Tufts algorithm) and educes the impedance from an exact analytical expression. The second method solves numerically the convected Helmholtz equation and minimizes an objective function to obtain the liner impedance. The two methods are tested first on data synthesized from an exact mode solution and then on measured data. Results show that when the methods are applied to data acquired in the larger duct with a dominant higher-order mode, the same impedance spectra are educed as that obtained in the small duct where only the plane wave mode propagates. This result holds for each higher-order mode in the large duct provided that the higher-order mode is sufficiently attenuated by the liner.

  5. Repair of a common bile duct defect with a decellularized ureteral graft

    PubMed Central

    Cheng, Yao; Xiong, Xian-Ze; Zhou, Rong-Xing; Deng, Yi-Lei; Jin, Yan-Wen; Lu, Jiong; Li, Fu-Yu; Cheng, Nan-Sheng

    2016-01-01

    AIM To evaluate the feasibility of repairing a common bile duct defect with a decellularized ureteral graft in a porcine model. METHODS Eighteen pigs were randomly divided into three groups. An approximately 1 cm segment of the common bile duct was excised from all the pigs. The defect was repaired using a 2 cm long decellularized ureteral graft over a T-tube (T-tube group, n = 6) or a silicone stent (stent group, n = 6). Six pigs underwent bile duct reconstruction with a graft alone (stentless group). The surviving animals were euthanized at 3 mo. Specimens of the common bile ducts were obtained for histological analysis. RESULTS The animals in the T-tube and stent groups survived until sacrifice. The blood test results were normal in both groups. The histology results showed a biliary epithelial layer covering the neo-bile duct. In contrast, all the animals in the stentless group died due to biliary peritonitis and cholangitis within two months post-surgery. Neither biliary epithelial cells nor accessory glands were observed at the graft sites in the stentless group. CONCLUSION Repair of a common bile duct defect with a decellularized ureteral graft appears to be feasible. A T-tube or intraluminal stent was necessary to reduce postoperative complications. PMID:28082809

  6. Sound propagation in a duct of periodic wall structure. [numerical analysis

    NASA Technical Reports Server (NTRS)

    Kurze, U.

    1978-01-01

    A boundary condition, which accounts for the coupling in the sections behind the duct boundary, is given for the sound-absorbing duct with a periodic structure of the wall lining and using regular partition walls. The soundfield in the duct is suitably described by the method of differences. For locally active walls this renders an explicit approximate solution for the propagation constant. Coupling may be accounted for by the method of differences in a clear manner. Numerical results agree with measurements and yield information which has technical applications.

  7. Simple office-based behavioral approach to patients with chronic belching.

    PubMed

    Katzka, D A

    2013-08-01

    Chronic belching can be a difficult and socially disabling symptom often attributed to reflux with poor response to therapy. In patients where aerophagia is identified as a clear cause, treatment with baclofen may not be tolerated, and biofeedback therapy is time-intensive and may still not be effective. In this pilot study, an office-based easy-to-perform method based on sustained glottal opening was used in five patients with chronic belching, in whom reflux and other causes had been excluded. Treatment consisted of having the patient breathe slowly and diaphragmatically with his or her mouth open during supine, then sitting periods to prevent belching. When this was successful, patients were then counseled on continuing this breathing with mouth slightly ajar as an outpatient using this persistently. Wide mouth opening was used for rescue therapy of belching attacks. All five patients responded to the office-based therapy with complete cessation of belching during the visit. At 1-month follow up, four patients remained asymptomatic. One patient was asymptomatic but for two breakthrough attacks easily managed with the protocol. A simple office-based procedure based on complete glottal opening can be curative for a subset of patients with chronic eructation secondary to repetitive air swallowing. © 2012 Copyright the Author. Journal compilation © 2012, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  8. Observations of Large-Amplitude, Whistler-Mode Wave Ducts in the Outer Plasmasphere

    DTIC Science & Technology

    1990-02-12

    evidence for whistler ducts [Smith and Angerami , 1968]. They showed that the spectral shape (dispersion) of whistlers arising from lightning strokes...the equatorial separation of the ducts near L z 3 ranged from 50 to 500 km and that the equatorial thicknesses were about 400 km. Angerami [1970...reported [Smith and Angerami , 1968; Angerami , 1970; Scarf and Chappell, 1973; Carpenter et al., 1981]. The half- width of the ducts and the density

  9. A time dependent difference theory for sound propagation in ducts with flow. [characteristic of inlet and exhaust ducts of turbofan engines

    NASA Technical Reports Server (NTRS)

    Baumeister, K. J.

    1979-01-01

    A time dependent numerical solution of the linearized continuity and momentum equation was developed for sound propagation in a two dimensional straight hard or soft wall duct with a sheared mean flow. The time dependent governing acoustic difference equations and boundary conditions were developed along with a numerical determination of the maximum stable time increments. A harmonic noise source radiating into a quiescent duct was analyzed. This explicit iteration method then calculated stepwise in real time to obtain the transient as well as the steady state solution of the acoustic field. Example calculations were presented for sound propagation in hard and soft wall ducts, with no flow and plug flow. Although the problem with sheared flow was formulated and programmed, sample calculations were not examined. The time dependent finite difference analysis was found to be superior to the steady state finite difference and finite element techniques because of shorter solution times and the elimination of large matrix storage requirements.

  10. Retrograde air escape via the nasolacrimal system: a previously unrecognized complication of continuous positive airway pressure in the management of obstructive sleep apnea.

    PubMed

    Singh, Narinder Pal; Walker, Robbie James Eades; Cowan, Fiona; Davidson, Arthur Craig; Roberts, David Newton

    2014-05-01

    Continuous positive airway pressure (CPAP) is the gold standard treatment for moderate to severe obstructive sleep apnoea (OSA). Eye-related side effects of CPAP are commonly attributed to a poorly sealed mask, allowing leaked air to blow over the eye. We present 3 cases where attended polysomnography (A-PSG) demonstrated CPAP-associated retrograde air escape via the nasolacrimal system (CRANS) in the absence of any mask leaks. Symptoms included dry eye, epiphora, air escape from the medial canthus, and eyelid flutter. Symptoms were controlled with a variety of surgical and nonsurgical techniques. CRANS represents a previously undescribed clinical entity. CRANS may be responsible for some CPAP-related eye side effects and possibly for rarer secondary eye complications, including conjunctivitis and corneal ulceration. CRANS should be suspected in any patient on CPAP complaining of eye symptoms. CRANS may be diagnosed through careful observation during A-PSG and confirmed by performing a "saline bubble test." Management options include nonsurgical (mask alternatives, humidification, nasopharyngeal airway) and surgical techniques (nasal airway surgery, inferior turbinate out-fracture and adhesion, injection of bulking agent around Hasner's valve).

  11. A cost analysis of operative repair of major laparoscopic bile duct injuries.

    PubMed

    Hofmeyr, S; Krige, J E J; Bornman, P C; Beningfield, S J

    2015-06-01

    Major bile duct injuries occur infrequently after laparoscopic cholecystectomy, but may result in life-threatening complications. Few data exist on the financial implications of duct repair. This study calculated the costs of operative repair in a cohort of patients who underwent reconstruction of the bile duct after major ductal injury. To calculate the total in-hospital cost of surgical repair of patients referred with major bile duct injuries. A prospective database was reviewed to identify all patients referred to the University of Cape Town Private Academic Hospital, South Africa, between 2002 and 2013 for assessment and repair of major laparoscopic bile duct injuries. The detailed clinical records and billing information were evaluated to determine all costs from admission to discharge. Total costs for each patient were adjusted for inflation between the year of repair and 2013. Results. Forty-four patients (33 women, 11 men; median age 48 years, range 30 - 78) underwent reconstruction of a major bile duct injury. First-time repairs were performed at a median of 24.5 days (range 1 - 3,662) after initial surgery. Median hospital stay was 15 days (range 6 - 86). Mean cost of repair was ZAR215,711 (range ZAR68,764 - 980,830). Major contributors to cost were theatre expenses (22%), admission to intensive care (21%), radiology (17%) and specialist fees (12%). Admission to a general ward (10%), consumables (7%), pharmacy (5%), endoscopy (3%) and laboratory costs (3%) made up the balance. The cost of repair of a major laparoscopic bile duct injury is substantial owing to prolonged hospitalisation, complex surgicalintervention and intensive imaging requirements.

  12. Use of Computational Fluid Dynamics for improving freeze-dryers design and process understanding. Part 2: Condenser duct and valve modelling.

    PubMed

    Marchisio, Daniele L; Galan, Miquel; Barresi, Antonello A

    2018-05-05

    This manuscript shows how computational models, mainly based on Computational Fluid Dynamics (CFD), can be used to simulate different parts of an industrial freeze-drying equipment and to properly design them; in particular in this part the duct connecting the chamber with the condenser, with its valves, is considered, while the chamber design and its effect on drying kinetics have been investigated in Part 1. Such an approach allows a much deeper process understanding and assessment of the critical aspects of lyophilisation. This methodology will be demonstrated on freeze-drying equipment of different sizes, investigating influence of valve type (butterfly and mushroom) and shape on duct conductance and critical flow conditions. The role of the inlet and boundary conditions considered has been assessed, also by modelling the whole apparatus including chamber and condenser, and the influence of the duct diameter has been discussed; the results show a little dependence of the relationship between critical mass flux and chamber pressure on the duct size. Results concerning the fluid dynamics of a simple disk valve, a profiled butterfly valve and a mushroom valve installed in a medium size horizontal condenser are presented. Also in these cases the maximum allowable flow when sonic flow conditions are reached can be described by a correlation similar to that found valid for empty ducts; for the mushroom valve the parameters are dependent on the valve opening length. The possibility to use the equivalent length concept, and to extend the validity of the results obtained for empty ducts will be also discussed. Finally the presence of the inert gas modifies the conductance of the duct, reducing the maximum flow rate of water that can be removed through it before the flow is choked; this also requires a proper over-sizing of the duct (or duct-butterfly valve system). Copyright © 2018. Published by Elsevier B.V.

  13. Understanding the Mechanical forces of Self-Expandable Metal Stents in the Biliary Ducts.

    PubMed

    Isayama, Hiroyuki; Nakai, Yousuke; Hamada, Tsuyoshi; Matsubara, Saburo; Kogure, Hirofumi; Koike, Kazuhiko

    2016-12-01

    Self-expandable metallic stent (SEMS) was an effective biliary endoprosthesis. Mechanical properties of SEMS, radial and axial force (RF, AF), may play important roles in the bile duct after placement. RF was well known dilation force and influenced on the occurrence of migration. AF, newly proposed by this author, was defined as the recovery force when the SEMS vended. AF was related with the cause of bile duct kinking, pancreatitis, and cholecystitis due to the compression of the bile duct, orifice of the cystic duct, and pancreatic orifice. Ideal SEMS may show high RF and low AF.

  14. A study of internal drag of small-scale ducts at Mach number 4

    NASA Technical Reports Server (NTRS)

    Graham, L. A.; Hunton, L. W.

    1972-01-01

    An experimental investigation was made to examine the applicability of methods used to determine internal drag of small ducts and to study some of the problems encountered in assessing momentum losses in such ducts. Test Mach numbers ranged from 3.7 to 4.4 at angles of attack of 0 and 5 degrees and at a constant Reynolds number of 4.3 million per foot. The configurations represented small ducts used to simulate external aerodynamics of air breathing propulsion systems and consisted of wing nacelle models of ducts with circular, square, and rectangular inlets and with a two-dimensional inlet.

  15. Integrating Buprenorphine Treatment into Office-based Practice: a Qualitative Study

    PubMed Central

    Irwin, Kevin S.; Jones, Emlyn S.; Becker, William C.; Tetrault, Jeanette M.; Sullivan, Lynn E.; Hansen, Helena; O’Connor, Patrick G.; Schottenfeld, Richard S.; Fiellin, David A.

    2008-01-01

    BACKGROUND Despite the availability and demonstrated effectiveness of office-based buprenorphine maintenance treatment (BMT), the systematic examination of physicians’ attitudes towards this new medical practice has been largely neglected. OBJECTIVE To identify facilitators and barriers to the potential or actual implementation of BMT by office-based medical providers. DESIGN Qualitative study using individual and group semi-structured interviews. PARTICIPANTS Twenty-three practicing office-based physicians in New England. APPROACH Interviews were audiotaped, transcribed, and entered into a qualitative software program. The transcripts were thematically coded using the constant comparative method by a multidisciplinary team. RESULTS Eighty percent of the physicians were white; 55% were women. The mean number of years since graduating medical school was 14 (SD = 10). The primary areas of clinical specialization were internal medicine (50%), infectious disease (20%), and addiction medicine (15%). Physicians identified physician, patient, and logistical factors that would either facilitate or serve as a barrier to their integration of BMT into clinical practice. Physician facilitators included promoting continuity of patient care, positive perceptions of BMT, and viewing BMT as a positive alternative to methadone maintenance. Physician barriers included competing activities, lack of interest, and lack of expertise in addiction treatment. Physicians’ perceptions of patient-related barriers included concerns about confidentiality and cost, and low motivation for treatment. Perceived logistical barriers included lack of remuneration for BMT, limited ancillary support for physicians, not enough time, and a perceived low prevalence of opioid dependence in physicians’ practices. CONCLUSIONS Addressing physicians’ perceptions of facilitators and barriers to BMT is crucial to supporting the further expansion of BMT into primary care and office-based practices

  16. Iodine-131 Therapy and Lacrimal Drainage System Toxicity: Nasal Localization Studies Using Whole Body Nuclear Scintigraphy and SPECT-CT.

    PubMed

    Ali, Mohammad Javed; Vyakaranam, Achyut Ram; Rao, Jyotsna Eleshwarapu; Prasad, Giri; Reddy, Palkonda Vijay Anand

    The objective of this study was to evaluate the influence of dose on nasal localization of radioactive iodine-131 (I-131) following therapy for differentiated thyroid carcinomas. Retrospective evaluation of all patients who underwent post-therapy I-131 whole body scintigraphy and single photon emission computed tomography was performed. Patients were divided into 2 groups; group A were treated with 100 millicurie (mCi) and group B with ≥150 mCi. Databases were reviewed for demographics, diagnosis, and administered dosage of I-131. Whole body scintigraphy images were retrieved and nasal uptake was analyzed and classified as nil to trace, low, moderate, and high uptake and corresponding single photon emission CTs were analyzed for radioactive nasal activity. A total of 100 patients were studied, 50 in each of the groups. The M:F ratio was 1.1:1 (27:23) in group A and 1.5:1 (30:20) in group B. The mean age was 43.12 years and 54.6 years in groups A and B, respectively. Papillary carcinoma of the thyroid was the most common type accounting for 82% (41/50) of patients in group A and 62% (31/50) in group B. Imaging studies revealed nil to trace nasal activity in 80% (40/50) in group A as compared with 56% (28/50) in group B. None of the patients in group A showed high nasal uptake, whereas 4% (2/50) in group B demonstrated such high activity. Intranasal localization of radioactive I-131 was significant in patients receiving a dose of ≥150 mCi. Intranasal localization may partly explain toxicity to nasolacrimal duct and may be a risk factor for subsequent development of nasolacrimal duct obstructions.

  17. Inaccuracy of diagnosis in a cohort of patients on the waiting list for dacryocystorhinostomy when the diagnosis was made by only syringing the lacrimal system.

    PubMed

    Beigi, B; Uddin, J M; McMullan, T F W; Linardos, E

    2007-01-01

    Accurate identification of the factors contributing to epiphora is essential in directing appropriate management and treatment strategies. The authors applied a methodical strategy of assessment for epiphora to patients who were already on the waiting list for dacryocystorhinostomy (DCR). The findings were compared to the original findings. Forty-four eyes of 35 patients listed for DCR were re-examined. All canaliculi were examined using four tests: dye disappearance, Jones 1 (dye retrieval), probing using Bowman probes, and syringing of the nasolacrimal duct (NLD) under local anesthesia. Some patients were examined using an endocanalicular mini-endoscope. Patients with NLD obstruction underwent DCR and those with canalicular and NLD stenosis underwent intubation of the lacrimal system-canaliculus, lacrimal sac, and nasolacrimal duct-using silicone stents. The authors refer to this as canaliculodacryocystoplasty (CDCP). The patients were assessed for symptoms of epiphora at 12 months. Forty-four eyes had been listed for DCR. They had been originally diagnosed, by means of lacrimal syringing, as NLD obstruction (24 eyes) or stenosis (12 eyes), and functional blocks (8 eyes). Four out of the original 44 planned DCR surgeries were performed after re-evaluation. After re-examination, 28 lacrimal systems were found to have canalicular stenosis, 4 NLD stenosis, 4 NLD obstruction, 4 punctal phimosis, 3 ocular surface disease, and 1 patient was asymptomatic. Twenty-eight lacrimal systems underwent CDCP, 4 underwent DCR, 4 had punctoplasty, and 4 had probing alone. Three had treatment for ocular surface disease and one patient required no treatment. After a follow-up of 12 months, 41 (93%) systems had improvement or were free of their Syringing of the lacrimal apparatus may result in a high false positive diagnosis of NLD obstruction. Canalicular pathology is not uncommon in this cohort of patients and may be underdiagnosed.

  18. Compact Buried Ducts in a Hot-Humid Climate House

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

    Mallay, D.

    2016-01-01

    A system of compact, buried ducts provides a high-performance and cost-effective solution for delivering conditioned air throughout the building. This report outlines research activities that are expected to facilitate adoption of compact buried duct systems by builders. The results of this research would be scalable to many new house designs in most climates and markets, leading to wider industry acceptance and building code and energy program approval.

  19. Bile Duct Diseases - Multiple Languages

    MedlinePlus

    ... of All Topics All Bile Duct Diseases - Multiple Languages To use the sharing features on this page, please enable JavaScript. French (français) ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated on 7 May 2018

  20. Ergonomics in office-based surgery: a survey-guided observational study.

    PubMed

    Esser, Adam C; Koshy, James G; Randle, Henry W

    2007-11-01

    The practice of office-based surgery is increasing in many specialties. Using Mohs surgery as a model, we investigated the role of ergonomics in office-based surgery to limit work-related musculoskeletal disorders. All Mayo Clinic surgeons currently performing Mohs surgery and Mohs surgeons trained at Mayo Clinic between 1990 and 2004 received a questionnaire survey between May 2003 and September 2004. A sample of respondents were videotaped during surgery. The main outcome measures were survey responses and an ergonomist's identification of potential causes of musculoskeletal disorders. All 17 surgeons surveyed responded. Those surveyed spend a mean of 24 hours per week in surgery. Sixteen said they had symptoms caused by or made worse by performing surgery. Symptom onset occurred on average at age 35.4 years. The most common complaints were pain and stiffness in the neck, shoulders, and lower back and headaches. Videotapes of 6 surgeons revealed problems with operating room setup, awkward posture, forceful exertion, poor positioning, lighting, and duration of procedures. Symptoms of musculoskeletal injuries are common and may begin early in a physician's career. Modifying footwear, flooring, table height, operating position, lighting, and surgical instruments may improve the ergonomics of office-based surgery.

  1. Surgical strategy for bile duct cancer: Advances and current limitations

    PubMed Central

    Akamatsu, Nobuhisa; Sugawara, Yasuhiko; Hashimoto, Daijo

    2011-01-01

    The aim of this review is to describe recent advances and topics in the surgical management of bile duct cancer. Radical resection with a microscopically negative margin (R0) is the only way to cure cholangiocarcinoma and is associated with marked survival advantages compared to margin-positive resections. Complete resection of the tumor is the surgeon’s ultimate aim, and several advances in the surgical treatment for bile duct cancer have been made within the last two decades. Multidetector row computed tomography has emerged as an indispensable diagnostic modality for the precise preoperative evaluation of bile duct cancer, in terms of both longitudinal and vertical tumor invasion. Many meticulous operative procedures have been established, especially extended hepatectomy for hilar cholangiocarcinoma, to achieve a negative resection margin, which is the only prognostic factor under the control of the surgeon. A complete caudate lobectomy and resection of the inferior part of Couinaud’s segment IV coupled with right or left hemihepatectomy has become the standard surgical procedure for hilar cholangiocarcinoma, and pylorus-preserving pancreaticoduodenectomy is the first choice for distal bile duct cancer. Limited resection for middle bile duct cancer is indicated for only strictly selected cases. Preoperative treatments including biliary drainage and portal vein embolization are also indicated for only selected patients, especially jaundiced patients anticipating major hepatectomy. Liver transplantation seems ideal for complete resection of bile duct cancer, but the high recurrence rate and decreased patient survival after liver transplant preclude it from being considered standard treatment. Adjuvant chemotherapy and radiotherapy have a potentially crucial role in prolonging survival and controlling local recurrence, but no definite regimen has been established to date. Further evidence is needed to fully define the role of liver transplantation and adjuvant

  2. Radiated noise of ducted fans

    NASA Astrophysics Data System (ADS)

    Eversman, Walter

    The differences in the radiated acoustic fields of ducted and unducted propellers of the same thrust operating under similar conditions are investigated. An FEM model is created for the generation, propagation, and radiation of steady, rotor alone noise and exit guide vane interaction noise of a ducted fan. For a specified number of blades, angular mode harmonic, and rotor angular velocity, the acoustic field is described in a cylindrical coordinate system reduced to only the axial and radial directions. It is found that, contrary to the usual understanding of the Tyler and Sofrin (1962) result, supersonic tip speed rotor noise can be cut off if the tip Mach number is only slightly in excess of unity and if the number of blades is relatively small. If there are many blades, the fundamental angular mode number is large, and the Tyler and Sofrin result for thin annuli becomes more relevant. Shrouding of subsonic tip speed propellers is a very effective means of controlling rotor alone noise.

  3. Male penile propulsion into spiraled spermathecal ducts of female chrysomelid beetles: A numerical simulation approach.

    PubMed

    Filippov, Alexander; Kovalev, Alexander; Matsumura, Yoko; Gorb, Stanislav N

    2015-11-07

    Genital diversification in animals is an interesting evolutionary phenomenon. Sexual selection is the main driving force behind the diversification. However, evolutionary mechanisms that have established and maintained variations in genitalia shape parameters observed in related species are not well understood. Here, for the first time, we used numerical simulations to test the hypothesis that variations in female spermathecal duct shapes among related beetle species mechanically interfere with penile propulsion in varying ways. Our numerical simulations showed that high curvature of the spiraled spermathecal ducts of the female have effects with a threshold-based interaction on male penile insertion. The relative size of spirals observed in the beetle, Cassida rubiginosa, studied here is not small enough to interfere with penile propulsion. But the model revealed that propulsion is impeded by the presence of reverse turns in spermathecal ducts. This type of morphology leads to an increase in the velocity of the propulsion but also to an increase in the propulsion energy cost for males. Our results showed that quantitative differences in spermathecal duct shape can mediate qualitative differences in penile motion. This explains, in part, the mechanism behind origin and maintenance of genital divergence among closely related species in general. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. A mathematical model of the pancreatic duct cell generating high bicarbonate concentrations in pancreatic juice.

    PubMed

    Whitcomb, David C; Ermentrout, G Bard

    2004-08-01

    To develop a simple, physiologically based mathematical model of pancreatic duct cell secretion using experimentally derived parameters that generates pancreatic fluid bicarbonate concentrations of >140 mM after CFTR activation. A new mathematical model was developed simulating a duct cell within a proximal pancreatic duct and included a sodium-2-bicarbonate cotransporter (NBC) and sodium-potassium pump (NaK pump) on a chloride-impermeable basolateral membrane, CFTR on the luminal membrane with 0.2 to 1 bicarbonate to chloride permeability ratio. Chloride-bicarbonate antiporters (Cl/HCO3 AP) were added or subtracted from the basolateral (APb) and luminal (APl) membranes. The model was integrated over time using XPPAUT. This model predicts robust, NaK pump-dependent bicarbonate secretion with opening of the CFTR, generates and maintains pancreatic fluid secretion with bicarbonate concentrations >140 mM, and returns to basal levels with CFTR closure. Limiting CFTR permeability to bicarbonate, as seen in some CFTR mutations, markedly inhibited pancreatic bicarbonate and fluid secretion. A simple CFTR-dependent duct cell model can explain active, high-volume, high-concentration bicarbonate secretion in pancreatic juice that reproduces the experimental findings. This model may also provide insight into why CFTR mutations that predominantly affect bicarbonate permeability predispose to pancreatic dysfunction in humans.

  5. Extrahepatic duct injury in blunt trauma: two case reports and a literature review.

    PubMed

    Zago, Thiago Messias; Pereira, Bruno Monteiro Tavares; Calderan, Thiago Rodrigues Araujo; Hirano, Elcio Shiyoiti; Fraga, Gustavo Pereira

    2014-08-01

    Traumatic injuries of the extrahepatic biliary tract are rare. Associated injuries are usually responsible for immediate indication for surgical treatment, the time when an injury to the extrahepatic biliary ducts may be diagnosed. However, missed injuries are often common. The primary aim of this paper is to describe the clinical features, diagnosis, treatment, and outcome of two patients with left hepatic duct injury after blunt abdominal trauma. As a secondary objective, a literature review is presented. The two cases presented in this study are as follows: (1) A young male, involved in a motor vehicle crash, was admitted with blunt hepatic trauma in a general hospital. Endoscopic retrograde cholangiography was conducted 3 weeks later and revealed a large leakage at the left hepatic duct. Exploratory laparotomy was performed 26 days after the initial traumatic event and identified a complete section of the left hepatic duct, treated with anastomosis. (2) A male fell from a height. On exploratory laparotomy, a 30 % partial injury of the left hepatic duct was found in addition to hemoperitoneum, liver injury, gallbladder detachment together with cystic duct rupture, retroperitoneal hematoma to the right, and cecum hematoma. A high level of suspicion is necessary to identify injuries to the hepatic ducts. Early diagnosis that occurs during laparotomy due to associated injuries is important to reduce complications.

  6. Laparoscopic managment of common bile duct stones: our initial experience.

    PubMed

    Aroori, S; Bell, J C

    2002-05-01

    The management of choledocholithiasis has changed radically since the introduction of laparoscopic cholecystectomy. However, perceived technical difficulties have deterred many surgeons from treating common bile duct stones laparoscopically at the time of cholecystectomy. This has lead to reliance on endoscopic retrograde cholangiopancreatography followed by endoscopic sphincterotomy to deal with common bile duct stones. We retrospectively reviewed the charts of patients who had laparoscopic common bile duct exploration at Downe Hospital between December 1999 and August 2001. Among 149 laparoscopic cholecystectomies done by our group in this period, 10 patients (6.7%) underwent laparoscopic CBD exploration, three by the transcystic technique and seven by choledochotomy. Three patients (2%) had unsuspected stones found on routine per- operative cholangiogram. The mean operative time was 2.34hrs (range 1.50-3.30hrs). The mean hospital post- operative stay was 3 days (range 1-6 days). Post-operative morbidity was zero. Stone clearance was achieved in all cases. We conclude, laparoscopic exploration of the common bile duct is relatively safe and straightforward method. The key skill required is the ability to perform laparoscopic suturing with confidence.

  7. Filling defects in the pancreatic duct on endoscopic retrograde pancreatography.

    PubMed

    Taylor, A J; Carmody, T J; Schmalz, M J; Wiedmeyer, D A; Stewart, E T

    1992-12-01

    Filling defects in the pancreatic duct are a frequent finding during endoscopic retrograde pancreatography (ERP) and have a variety of causes. Some filling defects may be artifactual or related to technical factors and, once their origin is recognized, can be disregarded. Others may be due to acute changes of pancreatitis and should prompt more careful injection of contrast material into the duct. Intraluminal masses may represent calculi or a neoplasm, either of which may require surgery or endoscopic intervention. The exact nature of these filling defects may not be apparent on radiographs, and other studies may be needed. This article reviews our approach to the evaluation of filling defects in the pancreatic duct.

  8. Large Eddy Simulation of turbulence induced secondary flows in stationary and rotating straight square ducts

    NASA Astrophysics Data System (ADS)

    Sudjai, W.; Juntasaro, V.; Juttijudata, V.

    2018-01-01

    The accuracy of predicting turbulence induced secondary flows is crucially important in many industrial applications such as turbine blade internal cooling passages in a gas turbine and fuel rod bundles in a nuclear reactor. A straight square duct is popularly used to reveal the characteristic of turbulence induced secondary flows which consists of two counter rotating vortices distributed in each corner of the duct. For a rotating duct, the flow can be divided into the pressure side and the suction side. The turbulence induced secondary flows are converted to the Coriolis force driven two large circulations with a pair of additional vortices on the pressure wall due to the rotational effect. In this paper, the Large Eddy Simulation (LES) of turbulence induced secondary flows in a straight square duct is performed using the ANSYS FLUENT CFD software. A dynamic kinetic energy subgrid-scale model is used to describe the three-dimensional incompressible turbulent flows in the stationary and the rotating straight square ducts. The Reynolds number based on the friction velocity and the hydraulic diameter is 300 with the various rotation numbers for the rotating cases. The flow is assumed fully developed by imposing the constant pressure gradient in the streamwise direction. For the rotating cases, the rotational axis is placed perpendicular to the streamwise direction. The simulation results on the secondary flows and the turbulent statistics are found to be in good agreement with the available Direct Numerical Simulation (DNS) data. Finally, the details of the Coriolis effects are discussed.

  9. Cooling air recycling for gas turbine transition duct end frame and related method

    DOEpatents

    Cromer, Robert Harold; Bechtel, William Theodore; Sutcu, Maz

    2002-01-01

    A method of cooling a transition duct end frame in a gas turbine includes the steps of a) directing cooling air into the end frame from a region external of the transition duct and the impingement cooling sleeve; and b) redirecting the cooling air from the end frame into the annulus between the transition duct and the impingement cooling sleeve.

  10. Narrow sidebranch arrays for low frequency duct noise control.

    PubMed

    Tang, S K

    2012-11-01

    The present study investigates the sound transmission loss across a section of an infinitely long duct where one or more narrow sidebranch tubes are installed flushed with the duct wall. The finite-element method is used to compute the wave propagation characteristics, and a simplified theoretical analysis is carried out at the same time to explain the wave mechanism at frequencies of high sound reduction. Results show that the high sound transmission loss at a particular frequency is due to the concerted actions of three consecutive sidebranch tubes with the most upstream one in the resonant state. The expansion chamber effect of the setup also plays a role in enhancing sound attenuation at non-resonance frequencies. Broadband performance of the device can be greatly enhanced by appropriate arrangements of tube lengths and/or by coupling arrays on the two sides of the duct.

  11. Building America Case Study: Compact Buried Ducts in a Hot-Humid Climate House, Lady's Island, South Carolina

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

    2016-02-01

    A system of compact, buried ducts provides a high-performance and cost-effective solution for delivering conditioned air throughout the building. This report outlines research activities that are expected to facilitate adoption of compact buried duct systems by builders. The results of this research would be scalable to many new house designs in most climates and markets, leading to wider industry acceptance and building code and energy program approval. The primary research question with buried ducts is potential condensation at the outer jacket of the duct insulation in humid climates during the cooling season. Current best practices for buried ducts rely onmore » encapsulating the insulated ducts with closed-cell spray polyurethane foam insulation to control condensation and improve air sealing. The encapsulated buried duct concept has been analyzed and shown to be effective in hot-humid climates. The purpose of this project is to develop an alternative buried duct system that performs effectively as ducts in conditioned space - durable, energy efficient, and cost-effective - in a hot-humid climate (IECC warm-humid climate zone 3A) with three goals that distinguish this project: 1) Evaluation of design criteria for buried ducts that use common materials and do not rely on encapsulation using spray foam or disrupt traditional work sequences, 2) Establishing design criteria for compact ducts and incorporate those with the buried duct criteria to further reduce energy losses and control installed costs, and 3) Developing HVAC design guidance for performing accurate heating and cooling load calculations for compact buried ducts.« less

  12. Single Mode Theory for Impedance Eduction in Large-Scale Ducts with Grazing Flow

    NASA Technical Reports Server (NTRS)

    Watson, Willie R.; Gerhold, Carl H.; Jones, Michael G.; June, Jason C.

    2014-01-01

    An impedance eduction theory for a rigid wall duct containing an acoustic liner with an unknown impedance and uniform grazing flow is presented. The unique features of the theory are: 1) non-planar waves propagate in the hard wall sections of the duct, 2) input data consist solely of complex acoustic pressures acquired on a wall adjacent to the liner, and 3) multiple higher-order modes may exist in the direction perpendicular to the liner and the opposite rigid wall. The approach is to first measure the axial propagation constant of a dominant higher-order mode in the liner sample section. This axial propagation constant is then used in conjunction with a closed-form solution to a reduced form of the convected Helmholtz equation and the wall impedance boundary condition to educe the liner impedance. The theory is validated on a conventional liner whose impedance spectrum is educed in two flow ducts with different cross sections. For the frequencies and Mach numbers of interest, no higher-order modes propagate in the hard wall sections of the smaller duct. A benchmark method is used to educe the impedance spectrum in this duct. A dominant higher-order vertical mode propagates in the larger duct for similar test conditions, and the current theory is applied to educe the impedance spectrum. Results show that when the theory is applied to data acquired in the larger duct with a dominant higher-order vertical mode, the same impedance spectra is educed as that obtained in the small duct where only the plane wave mode is present and the benchmark method is used. This result holds for each higher-order vertical mode that is considered.

  13. Double Gallbladder Originating from Left Hepatic Duct: A Case Report and Review of Literature

    PubMed Central

    Gorecki, Piotr J.; Andrei, Valeriu E; Musacchio, Tito

    1998-01-01

    Background: Double gallbladder is a rare anomaly of the biliary tract. Double gallbladder arising from the left hepatic duct was previously reported only once in the literature. Case Report: A case of symptomatic cholelithiasis in a double gallbladder, diagnosed on preoperative ultrasound, computed tomography (CT) and endoscopic retrograde cholangiopancreatogram (ERCP) is reported. At laparoscopic cholangiography via the accessory gallbladder no accessory cystic duct was visualized. After conversion to open cholecystectomy, the duplicated gallbladder was found to arise directly from the left hepatic duct; it was resected and the duct repaired. Conclusions: We emphasize that a careful intraoperative cholangiographic evaluation of the accessory gallbladder is mandatory in order to prevent inadvertent injury to bile ducts, since a large variety of ductal abnormality may exist. PMID:10036124

  14. Dact2 is expressed in the developing ureteric bud/collecting duct system of the kidney and controls morphogenetic behavior of collecting duct cells.

    PubMed

    Lee, Wen-Chin; Hough, Melinda T; Liu, Weijia; Ekiert, Robert; Lindström, Nils O; Hohenstein, Peter; Davies, Jamie A

    2010-10-01

    The overall pattern of the developing kidney is set in large part by the developing ureteric bud/collecting duct system, and dysgenesis of this system accounts for a variety of clinically significant renal diseases. Understanding how the behavior of cells in the developing ureteric bud/collecting duct is controlled is therefore important to understanding the normal and abnormal kidney. Dact proteins have recently been identified as cytoplasmic regulators of intracellular signaling. Dact1 inhibits Wnt signaling, and Dact2 inhibits transforming growth factor (TGF)-β signaling. Here, we report that Dact2 is expressed in developing and adult mouse kidneys, specifically in the ureteric bud/collecting duct epithelium, a structure whose morphogenesis is controlled partially by TGF-β. When small interfering RNA is used to knock down Dact2 expression in collecting duct cells, they show some constitutive phospho-Smad2, undetectable in controls, and elevated phospho-Smad2 in response to TGF-β. They also show defective migration and, in a monolayer wound-healing assay, they fail to assemble a leading edge "cable" of actomyosin and advance instead as a disorganized mass of lamellipodium-bearing cells. This effect is seriously exacerbated by exogenous TGF-β, although control cells tolerate it well. In three-dimensional culture, Dact2 knockdown cells form cysts and branching tubules, but the outlines of the cysts made by knockdown cells are ragged rather than smooth and the branching tubules are decorated with many fine spikes not seen in controls. These data suggest Dact2 plays a role in regulating morphogenesis by renal collecting duct cells, probably by protecting cells from overly strong TGF-β pathway activation.

  15. Partial Müllerian Duct Retention in Smad4 Conditional Mutant Male Mice.

    PubMed

    Petit, Fabrice G; Deng, Chuxia; Jamin, Soazik P

    2016-01-01

    Müllerian duct regression is a complex process which involves the AMH signalling pathway. We have previously demonstrated that besides AMH and its specific type II receptor (AMHRII), BMPR-IA and Smad5 are two essential factors implicated in this mechanism. Mothers against decapentaplegic homolog 4 (Smad4) is a transcription factor and the common Smad (co-Smad) involved in transforming growth factor beta (TGF-β) signalling pathway superfamily. Since Smad4 null mutants die early during gastrulation, we have inactivated Smad4 in the Müllerian duct mesenchyme. Specific inactivation of Smad4 in the urogenital ridge leads to the partial persistence of the Müllerian duct in adult male mice. Careful examination of the urogenital tract reveals that the Müllerian duct retention is randomly distributed either on one side or both sides. Histological analysis shows a uterus-like structure, which is confirmed by the expression of estrogen receptor α. As previously described in a β-catenin conditional mutant mouse model, β-catenin contributes to Müllerian duct regression. In our mutant male embryos, it appears that β-catenin expression is locally reduced along the urogenital ridge as compared to control mice. Moreover, the expression pattern is similar to those observed in control female mice. This study shows that reduced Smad4 expression disrupts the Wnt/β-catenin signalling leading to the partial persistence of Müllerian duct.

  16. Endoscopic modified medial maxillectomy for odontogenic cysts and tumours.

    PubMed

    Nakayama, Tsugihama; Otori, Nobuyoshi; Asaka, Daiya; Okushi, Tetsushi; Haruna, Shin-ichi

    2014-12-01

    Odontogenic maxillary cysts and tumours originate from the tooth root and have traditionally been treated through an intraoral approach. Here, we report the efficacy and utility of endoscopic modified medial maxillectomy (EMMM) for the treatment of odontogenic maxillary cysts and a tumour. We undertook EMMM under general anaesthesia in six patients: four had radicular cysts, one had a dentigerous cyst, and one had a keratocystic odontogenic tumour. The cysts and tumours were completely excised and the inferior turbinate and nasolacrimal duct were preserved in all patients. There were no peri- or postoperative complications, and no incidences of recurrence. Endoscopic modified medial maxillectomy appears to be an effective and safe technique for treating odontogenic cysts and tumours.

  17. Caffeine Inhibits Fluid Secretion by Interlobular Ducts From Guinea Pig Pancreas.

    PubMed

    Mochimaru, Yuka; Yamamoto, Akiko; Nakakuki, Miyuki; Yamaguchi, Makoto; Taniguchi, Ituka; Ishiguro, Hiroshi

    2017-04-01

    Caffeine is contained in coffee, tea, and numerous beverages and foods. We examined the direct effects of caffeine on the physiological function of pancreatic duct cells by using interlobular duct segments isolated from guinea pig pancreas. The rate of fluid secretion was continuously measured by monitoring the luminal volume of isolated duct segments. Changes in intracellular Ca concentration ([Ca]i) were estimated by microfluorometry in ducts loaded with Fura-2. Both secretin-stimulated and acetylcholine (ACh)-stimulated fluid secretions were substantially and reversibly inhibited by relatively low concentrations of caffeine as low as 0.03 mM relevant to blood levels after ingestion of caffeine-containing beverages. Caffeine inhibited ACh-induced elevation of [Ca]i and secretin-induced fluctuation of [Ca]i. Caffeine abolished thapsigargin-induced intracellular Ca release but did not affect the entry of extracellular Ca. Caffeine (0.05 mM) abolished ethanol (1 mM)-induced fluid hypersecretion in secretin-stimulated pancreatic duct. Low concentrations of caffeine directly inhibit pancreatic ductal fluid secretion stimulated by secretin or ACh and also ethanol-induced fluid hypersecretion. The inhibition by caffeine seems to be mediated by the blockade of intracellular Ca mobilization. Daily intake of caffeine may reduce the volume of pancreatic juice secretion.

  18. Office-Based Three-Dimensional Printing Workflow for Craniomaxillofacial Fracture Repair.

    PubMed

    Elegbede, Adekunle; Diaconu, Silviu C; McNichols, Colton H L; Seu, Michelle; Rasko, Yvonne M; Grant, Michael P; Nam, Arthur J

    2018-03-08

    Three-dimensional printing of patient-specific models is being used in various aspects of craniomaxillofacial reconstruction. Printing is typically outsourced to off-site vendors, with the main disadvantages being increased costs and time for production. Office-based 3-dimensional printing has been proposed as a means to reduce costs and delays, but remains largely underused because of the perception among surgeons that it is futuristic, highly technical, and prohibitively expensive. The goal of this report is to demonstrate the feasibility and ease of incorporating in-office 3-dimensional printing into the standard workflow for facial fracture repair.Patients with complex mandible fractures requiring open repair were identified. Open-source software was used to create virtual 3-dimensional skeletal models of the, initial injury pattern, and then the ideally reduced fractures based on preoperative computed tomography (CT) scan images. The virtual 3-dimensional skeletal models were then printed in our office using a commercially available 3-dimensional printer and bioplastic filament. The 3-dimensional skeletal models were used as templates to bend and shape titanium plates that were subsequently used for intraoperative fixation.Average print time was 6 hours. Excluding the 1-time cost of the 3-dimensional printer of $2500, roughly the cost of a single commercially produced model, the average material cost to print 1 model mandible was $4.30. Postoperative CT imaging demonstrated precise, predicted reduction in all patients.Office-based 3-dimensional printing of skeletal models can be routinely used in repair of facial fractures in an efficient and cost-effective manner.

  19. Use of LigaSure™ on bile duct in rats: an experimental study.

    PubMed

    Marte, Antonio; Pintozzi, Lucia

    2017-08-01

    The closure of a cystic duct during cholecystectomy by means of radiofrequency is still controversial. We report our preliminary experimental results with the use of LigaSure™ on common bile duct in rats. Thirty Wistar rats weighing 70 to 120 g were employed for this study. The animals were all anesthetized with intraperitoneal ketamine and then divided into three groups. The first group (10 rats, Group C) underwent only laparotomy and isolation of the common bile duct. The second (10 rats, Group M) underwent laparotomy and closure of the common bile duct (CBD) with monopolar coagulation. The third group (10 rats, Group L) underwent laparotomy and sealing of the common bile duct with two application of LigaSureTM. Afterwards, all rats were kept in comfortable cages and were administered dibenzamine for five days. They were all sacrificed on day 20. Through a laparotomy, the liver and bile duct were removed for histological examination. Blood samples were obtained to dose bilirubin, amylase and transaminase levels. Mortality rate was 0 in the control group (C), 3/10 rats in group M and 0 in group L. In group L, the macroscopic examination showed a large choledochocele (3-3.5 × 1.5 cm) with few adhesions. At the histological examination there was optimal sealing of the common bile duct in 9/10 rats. In group M, 2/10 rats had liver abscesses, 3/10 rats had choledochocele and 5/10 rats, biliary peritonitis. There was intense tissue inflammation and the dissection was difficult. Analyses of blood samples showed an increase in total bilirubin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in groups M and L. The preliminary results of our study confirm that radiofrequency can be safely used for the closure of the common bile duct. The choledochocele obtained with this technique could represent a good experimental model. These results could be a further step for using the LigaSureTM in clipless cholecystectomy.

  20. Can bile duct injuries be prevented? "A new technique in laparoscopic cholecystectomy"

    PubMed Central

    Sari, Yavuz Selim; Tunali, Vahit; Tomaoglu, Kamer; Karagöz, Binnur; Güneyİ, Ayhan; KaragöZ, İbrahim

    2005-01-01

    Background Over the last decade, laparoscopic cholecystectomy has gained worldwide acceptance and considered to be as "gold standard" in the surgical management of symptomatic cholecystolithiasis. However, the incidence of bile duct injury in laparoscopic cholecystectomy is still two times greater compared to classic open surgery. The development of bile duct injury may result in biliary cirrhosis and increase in mortality rates. The mostly blamed causitive factor is the misidentification of the anatomy, especially by a surgeon who is at the beginning of his learning curve. Biliary tree injuries may be decreased by direct coloration of the cystic duct, ductus choledochus and even the gall bladder. Methods gall bladder fundus was punctured by Veress needle and all the bile was aspirated. The same amount of fifty percent methylene blue diluted by saline solution was injected into the gall bladder for coloration of biliary tree. The dissection of Calot triangle was much more safely performed after obtention of coloration of the gall bladder, cystic duct and choledocus. Results Between October 2003 and December 2004, overall 46 patients (of which 9 males) with a mean age of 47 (between 24 and 74) underwent laparoscopic cholecystectomy with methylene blue injection technique. The diagnosis of chronic cholecystitis (the thickness of the gall bladder wall was normal) confirmed by pre-operative abdominal ultrasonography in all patients. The diameters of the stones were greater than 1 centimeter in 32 patients and calcula of various sizes being smaller than 1 cm. were documented in 13 cases. One patient was operated for gall bladder polyp (our first case). Successful coloration of the gall bladder, cystic duct and ductus choledochus was possible in 43 patients, whereas only the gall bladder and proximal cystic duct were visualised in 3 cases. In these cases, ductus choledochus visibility was not possible. None of the patients developed bile duct injury. Conclusion The