Science.gov

Sample records for air bleed device

  1. Engine bleed air reduction in DC-10

    NASA Technical Reports Server (NTRS)

    Newman, W. H.; Viele, M. R.

    1980-01-01

    An 0.8 percent fuel savings was achieved by a reduction in engine bleed air through the use of cabin air recirculation. The recirculation system was evaluated in revenue service on a DC-10. The cabin remained comfortable with reductions in cabin fresh air (engine bleed air) as much as 50 percent. Flight test verified the predicted fuel saving of 0.8 percent.

  2. 14 CFR 23.1109 - Turbocharger bleed air system.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Turbocharger bleed air system. 23.1109... Induction System § 23.1109 Turbocharger bleed air system. The following applies to turbocharged bleed air systems used for cabin pressurization: (a) The cabin air system may not be subject to...

  3. 14 CFR 23.1109 - Turbocharger bleed air system.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Turbocharger bleed air system. 23.1109... Induction System § 23.1109 Turbocharger bleed air system. The following applies to turbocharged bleed air systems used for cabin pressurization: (a) The cabin air system may not be subject to...

  4. 21 CFR 864.6100 - Bleeding time device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bleeding time device. 864.6100 Section 864.6100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6100 Bleeding time...

  5. 21 CFR 864.6100 - Bleeding time device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Bleeding time device. 864.6100 Section 864.6100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6100 Bleeding time...

  6. 21 CFR 864.6100 - Bleeding time device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Bleeding time device. 864.6100 Section 864.6100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6100 Bleeding time...

  7. 21 CFR 864.6100 - Bleeding time device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Bleeding time device. 864.6100 Section 864.6100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6100 Bleeding time...

  8. 21 CFR 864.6100 - Bleeding time device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Bleeding time device. 864.6100 Section 864.6100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6100 Bleeding time...

  9. 14 CFR 23.1111 - Turbine engine bleed air system.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Turbine engine bleed air system. 23.1111 Section 23.1111 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Induction System § 23.1111 Turbine engine bleed air system. For turbine engine bleed air systems,...

  10. 14 CFR 23.1111 - Turbine engine bleed air system.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Turbine engine bleed air system. 23.1111 Section 23.1111 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Induction System § 23.1111 Turbine engine bleed air system. For turbine engine bleed air systems,...

  11. Reduced bleed air extraction for DC-10 cabin air conditioning

    NASA Technical Reports Server (NTRS)

    Newman, W. H.; Viele, M. R.; Hrach, F. J.

    1980-01-01

    It is noted that a significant fuel savings can be achieved by reducing bleed air used for cabin air conditioning. Air in the cabin can be recirculated to maintain comfortable ventilation rates but the quality of the air tends to decrease due to entrainment of smoke and odors. Attention is given to a development system designed and fabricated under the NASA Engine Component Improvement Program to define the recirculation limit for the DC-10. It is shown that with the system, a wide range of bleed air reductions and recirculation rates is possible. A goal of 0.8% fuel savings has been achieved which results from a 50% reduction in bleed extraction from the engine.

  12. 14 CFR 33.66 - Bleed air system.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Bleed air system. 33.66 Section 33.66 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.66 Bleed air system....

  13. 14 CFR 33.66 - Bleed air system.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Bleed air system. 33.66 Section 33.66 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.66 Bleed air system....

  14. Acoustic resonance phenomena in air bleed channels in aviation engines

    NASA Astrophysics Data System (ADS)

    Aleksentsev, A. A.; Sazhenkov, A. N.; Sukhinin, S. V.

    2016-11-01

    The existence of axial-radial acoustic resonance oscillations of the basic air flow in bleed channels of aviation engines is demonstrated theoretically and experimentally. Numerical and analytical methods are used to determine the frequency of acoustic resonance oscillations for the lowest modes of open and closed bleed channels of the PS-90A engine. Experimental investigations reveal new acoustic resonance phenomena arising in the air flow in bleed channel cavities in the core duct of this engine owing to instability of the basic air flow. The results of numerical, analytical, and experimental studies of the resonance frequencies reached in the flow in bleed channel cavities in the core duct of the PS-90A engine are found to be in reasonable agreement. As a result, various types of resonance oscillations in bleed channels can be accurately described.

  15. Draft air deflecting device

    SciTech Connect

    Riley, J.E.

    1982-05-18

    A draft air deflecting device is mountable proximate to a window contained in a firebox and serves as a conduit which directs draft air across the inner surface of the window prior to its supporting combustion of the fuel in the firebox. In this respect , the draft air deflecting device is formed as a box which communicates with draft air holes located in the firebox and which includes a forwardly extending lip serving to define a nozzle for both increasing the velocity and directing the incoming draft air across the firebox window. The incoming draft air is thus utilized to cool and to prevent soot, creosote and other particulates from accumulating on the window.

  16. [Management of abnormal bleeding in an intrauterine device user].

    PubMed

    Desmons, F; Adam-steen, C

    1985-01-01

    Abnormal uterine bleeding is the most common complication of IUD use. Minor metrorrhagia during the insertion and the initial 2 or 3 cycles is common and has no pathological significance. The true complications are menorrhagia, or augmentation of the volume of blood, and metrorrhagia, or repeated intermenstrual bleeding. Inert IUDs increase the volume of menstrual blood loss by 100-140% and copper devices by 50-60%. Blood loss is directly related to the size and form of the IUD; copper devices cause less bleeding primarily because of their reduced surface area. Anemia secondary to menstrual problems is a serious problem in developing countries. Metrorrhagia in IUD users is often associated with pain and may lead to removal of the device. It may result from the same array of morphological and functional modifications of the endometrium as menorrhagia, but more often it signals a true complication, either utero-adnexal infection, an intra- or extrauterine pregnancy or spontaneous abortion, or an inadaptation to the uterine cavity or a displacement of the IUD, perhaps with perforation. Metrorrhagia may also result from appearance of a calcium deposit on the surface of an IUD in place for over 2 years, or it may reveal a pathology unrelated to the IUD, such as a myoma, polyp, endometrial hyperplasia, or adenomyosis. Menorrhagia is an almost inevitable consequence of IUD use, but metrorrhagia requires close surveillance. A clinical examination aided by diagnostic tests is needed to distinguish between complications requiring immediate treatment and simple intolerances that may spontaneously resolve. Sonography is indispensable, to confirm good placement of the IUD or to rule out uterine anomalies or pregnancy. Hysteroscopy can be performed with the IUD in place or not, to diagnose localized endometrial hyperplasias, polyps, poorly positioned IUDs, or partial or complete perforations. Hysterography after infection and pregnancy have been ruled out can reveal endocavity

  17. Air bag restraint device

    DOEpatents

    Marts, D.J.; Richardson, J.G.

    1995-10-17

    A rear-seat air bag restraint device is disclosed that prevents an individual, or individuals, from continuing violent actions while being transported in a patrol vehicle`s rear seat without requiring immediate physical contact by the law enforcement officer. The air bag is activated by a control switch in the front seat and inflates to independently restrict the amount of physical activity occurring in the rear seat of the vehicle while allowing the officer to safely stop the vehicle. The air bag can also provide the officer additional time to get backup personnel to aid him if the situation warrants it. The bag is inflated and maintains a constant pressure by an air pump. 8 figs.

  18. Air bag restraint device

    DOEpatents

    Marts, Donna J.; Richardson, John G.

    1995-01-01

    A rear-seat air bag restraint device is disclosed that prevents an individual, or individuals, from continuing violent actions while being transported in a patrol vehicle's rear seat without requiring immediate physical contact by the law enforcement officer. The air bag is activated by a control switch in the front seat and inflates to independently restrict the amount of physical activity occurring in the rear seat of the vehicle while allowing the officer to safely stop the vehicle. The air bag can also provide the officer additional time to get backup personnel to aid him if the situation warrants it. The bag is inflated and maintains a constant pressure by an air pump.

  19. Numerical Study of Ram Air Airfoils and Upper Surface Bleed-Air Control

    DTIC Science & Technology

    2014-06-16

    of ram -air parachute systems to complement the design and analysis of new and existing airdrop systems. In this paper an unsteady numerical study of...two-dimensional, rigid, ram -air sections with an array of upper surface bleed-air actuators is presented. Aerodynamic forces and lift-to-drag ratios of...a modified Clark-Y ram -air airfoil are calculated from unsteady Reynolds-Averaged Navier-Stokes (RANS) simulations, using the Kestrel and Cobalt flow

  20. Compressor discharge bleed air circuit in gas turbine plants and related method

    DOEpatents

    Anand, Ashok Kumar; Berrahou, Philip Fadhel; Jandrisevits, Michael

    2002-01-01

    A gas turbine system that includes a compressor, a turbine component and a load, wherein fuel and compressor discharge bleed air are supplied to a combustor and gaseous products of combustion are introduced into the turbine component and subsequently exhausted to atmosphere. A compressor discharge bleed air circuit removes bleed air from the compressor and supplies one portion of the bleed air to the combustor and another portion of the compressor discharge bleed air to an exhaust stack of the turbine component in a single cycle system, or to a heat recovery steam generator in a combined cycle system. In both systems, the bleed air diverted from the combustor may be expanded in an air expander to reduce pressure upstream of the exhaust stack or heat recovery steam generator.

  1. Compressor discharge bleed air circuit in gas turbine plants and related method

    DOEpatents

    Anand, Ashok Kumar; Berrahou, Philip Fadhel; Jandrisevits, Michael

    2003-04-08

    A gas turbine system that includes a compressor, a turbine component and a load, wherein fuel and compressor discharge bleed air are supplied to a combustor and gaseous products of combustion are introduced into the turbine component and subsequently exhausted to atmosphere. A compressor discharge bleed air circuit removes bleed air from the compressor and supplies one portion of the bleed air to the combustor and another portion of the compressor discharge bleed air to an exhaust stack of the turbine component in a single cycle system, or to a heat recovery steam generator in a combined cycle system. In both systems, the bleed air diverted from the combustor may be expanded in an air expander to reduce pressure upstream of the exhaust stack or heat recovery steam generator.

  2. Acoustic hemostasis device for automated treatment of bleeding in limbs

    NASA Astrophysics Data System (ADS)

    Sekins, K. Michael; Zeng, Xiaozheng; Barnes, Stephen; Hopple, Jerry; Kook, John; Moreau-Gobard, Romain; Hsu, Stephen; Ahiekpor-Dravi, Alexis; Lee, Chi-Yin; Ramachandran, Suresh; Maleke, Caroline; Eaton, John; Wong, Keith; Keneman, Scott

    2012-10-01

    A research prototype automated image-guided acoustic hemostasis system for treatment of deep bleeding was developed and tested in limb phantoms. The system incorporated a flexible, conformal acoustic applicator cuff. Electronically steered and focused therapeutic arrays (Tx) populated the cuff to enable dosing from multiple Tx's simultaneously. Similarly, multiple imaging arrays (Ix) were deployed on the cuff to enable 3D compounded images for targeting and treatment monitoring. To affect a lightweight cuff, highly integrated Tx electrical circuitry was implemented, fabric and lightweight structural materials were used, and components were minimized. Novel cuff and Ix and Tx mechanical registration approaches were used to insure targeting accuracy. Two-step automation was implemented: 1) targeting (3D image volume acquisition and stitching, Power and Pulsed Wave Doppler automated bleeder detection, identification of bone, followed by closed-loop iterative Tx beam targeting), and 2) automated dosing (auto-selection of arrays and Tx dosing parameters, power initiation and then monitoring by acoustic thermometry for power shut-off). In final testing the device automatically detected 65% of all bleeders (with various bleeder flow rates). Accurate targeting was achieved in HIFU phantoms with end-dose (30 sec) temperature rise reaching the desired 33-58°C. Automated closed-loop targeting and treatment was demonstrated in separate phantoms.

  3. Respiratory and Laryngeal Responses to an Oral Air Pressure Bleed during Speech

    ERIC Educational Resources Information Center

    Huber, Jessica E.; Stathopoulos, Elaine T.

    2003-01-01

    Researchers have hypothesized that the respiratory and laryngeal speech subsystems would respond to an air pressure bleed, but these responses have not been empirically studied. The present study examined the nature of the responses of the respiratory and laryngeal subsystems to an air pressure bleed in order to provide information relevant to the…

  4. Gastrointestinal bleeding in a patient with a continuous-flow biventricular assist device

    PubMed Central

    Mirasol, Raymond V; Tholany, Jason J; Reddy, Hasini; Fyfe-Kirschner, Billie S; Cheng, Christina L; Moubarak, Issam F; Nosher, John L

    2016-01-01

    The association between continuous-flow left ventricular assist devices (CF-LVADs) and gastrointestinal (GI) bleeding from angiodysplasia is well recognized. However, the association between continuous-flow biventricular assist devices (CF-BIVADs) and bleeding angiodysplasia is less understood. We report a case of GI bleeding from a patient with a CF-BIVAD. The location of GI bleeding was identified by nuclear red blood cell bleeding scan. The vascular malformation leading to the bleed was identified and localized on angiography and then by pathology. The intensity of bleeding, reflected by number of units of packed red blood cells needed for normalization of hemoglobin, as well as the time to onset of bleeding after transplantation, are similar to that seen in the literature for CF-LVADs and pulsatile BIVADs. While angiography only detected a dilated late draining vein, pathology demonstrated the presence of both arterial and venous dilation in the submucosa, vascular abnormalities characteristic of a late arteriovenous malformation. PMID:27158430

  5. Intractable Hematuria After Left Ventricular Assist Device Implantation: Can Lessons Learned from Gastrointestinal Bleeding Be Applied?

    PubMed

    Son, Andre Y; Zhao, Lee; Reyentovich, Alex; Deanda, Abe; Balsam, Leora B

    2016-01-01

    Patients with continuous-flow left ventricular assist devices (CF-LVADs) are at increased risk of bleeding. We reviewed our institutional experience with bleeding in the urinary tract after CF-LVAD implantation and quantified the impact on hospital resource utilization in comparison with bleeding in the gastrointestinal (GI) tract, the most commonly reported mucosal site of bleeding after LVAD implantation. Records were retrospectively reviewed for patients undergoing CF-LVAD implantation at our institution between October 2011 and April 2015. Major adverse events of gross hematuria and GI bleeding were identified, and patient demographics and hospital course were reviewed. Gross hematuria occurred in 3 of the 35 patients (8.6%) and in 5.1% of all hospitalizations for CF-LVAD patients. Severe hematuria occurred after traumatic urethral catheterization, urinary retention, or urologic surgery. Hospitalization for hematuria was six times less likely than hospitalization for GI bleeding; however, hematuria hospitalizations lasted 3.2 times longer than GI bleeding hospitalizations (17.0 vs. 5.3 days). Late recurrent gross hematuria occurred in all cases, with rehospitalization occurring after 109 ± 53 days. In conclusion, gross hematuria is an infrequent but morbid bleeding complication in CF-LVAD patients. Strategies to avoid this complication include strict avoidance of traumatic urethral catheterization and urinary retention in high-risk patients.

  6. Inertial impaction air sampling device

    SciTech Connect

    Dewhurst, K.H.

    1990-05-22

    An inertial impactor is designed which is to be used in an air sampling device for collection of respirable size particles in ambient air. The device may include a graphite furnace as the impaction substrate in a small-size, portable, direct analysis structure that gives immediate results and is totally self-contained allowing for remote and/or personal sampling. The graphite furnace collects suspended particles transported through the housing by means of the air flow system, and these particles may be analyzed for elements, quantitatively and qualitatively, by atomic absorption spectrophotometry. 3 figs.

  7. Influences of copper and design of intrauterine devices on endometrial bleeding in monkeys.

    PubMed

    Shaw, S T; Forino, R V; Poon, C H; Moyer, D L

    1976-07-01

    Uterine bleeding in 8 rhesus monkeys was compared in response to plain vs. a specially fitted copper-wrapped IUD. All animals had utero-cutaneous surgical fistulas for accurate IUD insertion and removal. Daily observations for uterine bleeding between menstruations and quantitation of menstrual blood loss (MBL) were made. Following control periods of observation, each monkey was inserted with either a plain or a copper-wrapped IUD and then studied for 4 consecutive menstrual periods. Each IUD was especially fashioned to an estimate of individual uterine cavity size. Some were wrapped with pure copper wire of 30 sp mm surface area. In some animals the devices were later removed from the uterus, the copper wire taken off, and the plain polyethylene oval-Ts reinserted. In some animals originally wearing plain polyethylene devices, the IUDs were removed, wrapped with copper wire, and reinserted into the same monkeys. During the observed 4 consecutive preinsertion periods, MBL averaged 1.54 ml and was the same in the 4 cycles in which a plain polyethylene oval-T device was in place. No intermenstrual bleeding was observed, except slight spotting for the first 1 or 2 days. During the 4 cycles, with the copper-wound device present, mean MBL was 1.28 ml. Having individually fitted each uterine cavity with a best-fitting IUD was considered important. The addition of copper had not increased the bleeding. In humans, especially fitted contraceptive devices may minimize complications of bleeding and pain as compared with standard designs. Bleeding and pain have been the most frequent complications leading to removal of IUDs.

  8. Inertial impaction air sampling device

    SciTech Connect

    Dewhurst, K.H.

    1987-12-10

    An inertial impactor to be used in an air sampling device for collection of respirable size particles in ambient air which may include a graphite furnace as the impaction substrate in a small-size, portable, direct analysis structure that gives immediate results and is totally self-contained allowing for remote and/or personal sampling. The graphite furnace collects suspended particles transported through the housing by means of the air flow system, and these particles may be analyzed for elements, quantitatively and qualitatively, by atomic absorption spectrophotometry. 3 figs.

  9. Inertial impaction air sampling device

    DOEpatents

    Dewhurst, Katharine H.

    1990-01-01

    An inertial impactor to be used in an air sampling device for collection of respirable size particles in ambient air which may include a graphite furnace as the impaction substrate in a small-size, portable, direct analysis structure that gives immediate results and is totally self-contained allowing for remote and/or personal sampling. The graphite furnace collects suspended particles transported through the housing by means of the air flow system, and these particles may be analyzed for elements, quantitatively and qualitatively, by atomic absorption spectrophotometry.

  10. 77 FR 41930 - Bleed Air Cleaning and Monitoring Equipment and Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-17

    ... Equipment and Technology ACTION: Notice; request for information. SUMMARY: The FAA seeks information from industry developers, manufacturers, and the public related to effective air cleaning technology and sensor technology for the engine and auxiliary power unit bleed air supplied to the passenger cabin and flight...

  11. Gastrointestinal angiodysplasia is associated with significant gastrointestinal bleeding in patients with continuous left ventricular assist devices

    PubMed Central

    Cochrane, Justin; Jackson, Christian; Schlepp, Greg; Strong, Richard

    2016-01-01

    Background and study aims: Patients with a continuous-flow left ventricular assist device (LVAD) have a 65 % incidence of bleeding events within the first year. The majority of gastrointestinal bleeding (GIB) is from gastrointestinal angiodyplasia (GIAD). The primary aim of the study was to determine whether GIAD was associated with a higher rate of significant bleeding, an increased number of bleeding events per year, and a higher rate of transfusion compared to non-GIAD sources. Patients and methods: This retrospective cohort study included 118 individuals who received a LVAD at a tertiary medical center from 2006 through 2014. Patients were subdivided into GIB and non-GIB for comparison of patient demographics, comorbid conditions, and laboratory data. GIB was further divided into sources of GIB, GIAD, obscure, or non-GIAD to establish severity of bleeding, rate of re-bleeding, and transfusion rate. Results: GIAD is associated with an increased number of bleeding events compared to non-GIAD sources of GIB (2.07 vs 1.23, P = 0.01) and a higher number of bleeding events per year (0.806 vs. 0.455 P = 0.001). GIAD compared to non-GIAD sources of GIB was associated with an increased incidence of major bleeding (100 % vs 60 %, P = 0.006) and increased rates of transfusion (8.8 vs 2.95 units, P = 0.0004). Cox Regression analysis between non-GIB and GIAD demonstrated increased risk with age (P = 0.001), history of chronic kidney disease (P = 0.005), and length of stay after LVAD implantation of more than 45 days (P = 0.04). History of hypertension (P = 0.045), diabetes mellitus (P = 0.016), and male gender was associated with decreased risk (P = 0.04). Conclusion: Patients with a continuous-flow LVAD who develop a GIB secondary to GIAD have a higher rate of major bleeding, multiple bleeding events, and require more transfusions to achieve stabilization compared to patients who do not have GIAD. PMID

  12. Computational Fluid Dynamics for the Aerodynamic Design and Modeling of a Ram-Air Parachute with Bleed-Air Actuators

    DTIC Science & Technology

    2015-01-05

    canopies , often referred to as parafoils. No numerical studies, however, have fully investigated the 3-D aerodynamic performance of these bleed-air actuators...Simulation results are presented for a finite span, ram-air canopy geometry and several configurations amenable for comparison with wind tunnel

  13. Effects of bleed air extraction on thrust levels on the F404-GE-400 turbofan engine

    NASA Technical Reports Server (NTRS)

    Yuhas, Andrew J.; Ray, Ronald J.

    1992-01-01

    A ground test was performed to determine the effects of compressor bleed flow extraction on the performance of F404-GE-400 afterburning turbofan engines. The two engines were installed in the F/A-18 High Alpha Research Vehicle at the NASA Dryden Flight Research Facility. A specialized bleed ducting system was installed onto the aircraft to control and measure engine bleed airflow while the aircraft was tied down to a thrust measuring stand. The test was conducted on each engine and at various power settings. The bleed air extraction levels analyzed included flow rates above the manufacturer's maximum specification limit. The measured relationship between thrust and bleed flow extraction was shown to be essentially linear at all power settings with an increase in bleed flow causing a corresponding decrease in thrust. A comparison with the F404-GE-400 steady-state engine simulation showed the estimation to be within +/- 1 percent of measured thrust losses for large increases in bleed flow rate.

  14. Effects of bleed air extraction of thrust levels on the F404-GE-400 turbofan engine

    NASA Technical Reports Server (NTRS)

    Yuhas, Andrew J.; Ray, Ronald J.

    1992-01-01

    A ground test was performed to determine the effects of compressor bleed flow extraction on the performance of F404-GE-400 afterburning turbofan engines. The two engines were installed in the F/A-18 High Alpha Research Vehicle at the NASA Dryden Flight Research Facility. A specialized bleed ducting system was installed onto the aircraft to control and measure engine bleed airflow while the aircraft was tied down to a thrust measuring stand. The test was conducted on each engine and at various power settings. The bleed air extraction levels analyzed included flow rates above the manufacturer's maximum specification limit. The measured relationship between thrust and bleed flow extraction was shown to be essentially linear at all power settings with an increase in bleed flow causing a corresponding decrease in thrust. A comparison with the F404-GE-400 steady-state engine simulation showed the estimation to be within +/- 1 percent of measured thrust losses for large increases is bleed flow rate.

  15. Video capsule endoscopy in left ventricular assist device recipients with obscure gastrointestinal bleeding

    PubMed Central

    Amornsawadwattana, Surachai; Nassif, Michael; Raymer, David; LaRue, Shane; Chen, Chien-Huan

    2016-01-01

    AIM: To assess whether video capsule endoscopy (VCE) affects the outcomes of left ventricular assist devices (LVADs) recipients with gastrointestinal bleeding. METHODS: This is a retrospective study of LVAD recipients with obscure gastrointestinal bleeding (OGIB) who underwent VCE at a tertiary medical center between 2005 and 2013. All patients were admitted and monitored with telemetry and all VCE and subsequent endoscopic procedures were performed as inpatients. A VCE study was considered positive only when P2 lesions were found and was regarded as negative if P1 or P0 were identified. All patients were followed until heart transplant, death, or the end of the study. RESULTS: Between 2005 and 2013, 30 patients with LVAD underwent VCE. Completion rate of VCE was 93.3% and there was no capsule retention. No interference of VCE recording or the function of LVAD was found. VCE was positive in 40% of patients (n = 12). The most common finding was active small intestinal bleeding (50%) and small intestinal angiodysplasia (33.3%). There was no difference in the rate of recurrent bleeding between patients with positive and negative VCE study (50.0% vs 55.6%, P = 1.00) during an average of 11.6 ± 9.6 mo follow up. Among patients with positive VCE, the recurrent bleeding rate did not differ whether subsequent endoscopy was performed (50% vs 50%, P = 1.00). CONCLUSION: VCE can be safely performed in LVAD recipients with a diagnostic yield of 40%. VCE does not affect recurrent bleeding in LVAD patients regardless of findings. PMID:27182165

  16. Impacts of air bleeding on membrane degradation in polymer electrolyte fuel cells

    NASA Astrophysics Data System (ADS)

    Inaba, Minoru; Sugishita, Masashi; Wada, Junpei; Matsuzawa, Koichi; Yamada, Hirohisa; Tasaka, Akimasa

    A long-term accelerated test (4600 h) of a 25 cm 2 single cell with excess air bleeding (5%) was carried out to investigate the effects of air bleeding on membrane degradation in polymer electrolyte fuel cells. The rate of membrane degradation was negligibly low (fluoride-ion release rate = 1.3 × 10 -10 mol cm -2 h -1 in average) up to 2000 h. However, membrane degradation rate was gradually increased after 2000 h. The CO tolerance of the anode gradually dropped, which indicated that the anode catalyst was deteriorated during the test. The results of the rotating ring-disk electrode measurements revealed that deterioration of Pt-Ru/C catalyst by potential cycling greatly enhances H 2O 2 formation in oxygen reduction reaction in the anode potential range (∼0 V). Furthermore, membrane degradation rate of the MEA increased after the anode catalyst was forced to be deteriorated by potential cycling. It was concluded that excess air bleeding deteriorated the anode catalyst, which greatly enhanced H 2O 2 formation upon air bleeding and resulted in the increased membrane degradation rate after 2000 h.

  17. Software Assurance Best Practices for Air Force Weapon and Information Technology Systems - Are We Bleeding

    DTIC Science & Technology

    2008-03-01

    write -in) B5-9 H2 H3 B10 H B5-10 H D12 B, D Thesis Author 21. Does the program office have access to the...negative experiences o Hindered ability to comply with regulations o Other (please write -in) o Don’t know/unsure Thesis Author 24. How is...BLEEDING? THESIS Ryan A. Maxon, Major, USAF AFIT/GIR/ENV/08-M13 DEPARTMENT OF THE AIR FORCE AIR UNIVERSITY AIR FORCE INSTITUTE

  18. Air-bubbling, hollow-fiber reactor with cell bleeding and cross-flow filtration.

    PubMed

    Nishii, K; Sode, K; Karube, I

    1990-05-01

    Continuous asymmetric reduction of dyhydrooxoisophorone (DOIP) to 4-hydroxy-2,2,6-trimethylcyclo-hexanone (4-HTMCH) was achieved by a thermophilic bacterium Bacillus stearothermophilus NK86-0151. Three reactors were used: an air-bubbling hollow-fiber reactor with cell bleeding and cross-flow filtration, an air-lift reactor, and a CSTR with PAA immobilized cells. The maximum cell concentration of 11.1 g dry wt L(-1) was obtained in an air-bubbling hollow-fiber reactor, while in the other reactors the cell densities were between 3.5 and 4.1 g dry wt L(-1) The optimum bleed ratio was 0.1 at the dilution rate 0.3 h(-1) in the hollow-fiber reactor. The highest viable cell concentration was maintained in the dilution range of 0.4-0.7 h(-1) by a combination of proper cell bleeding and cross-flow filtration. The maximum volumetric productivity of 4-HTMCH reached 826 mg L(-1) h(-1) at the dilution rate 0.54 h(-1). This value was 4 and 2 times higher than those in the air-lift reactor and CSTR, respectively. The increasing viable cell concentration increased the volumetric productivity of 4-HTMCH. A cell free product solution was continuously obtained by cross-flow filtration.

  19. Gastrointestinal bleed after left ventricular assist device implantation: incidence, management, and prevention

    PubMed Central

    Harvey, Laura; Holley, Christopher T.

    2014-01-01

    Background Continuous-flow left ventricular assist devices (CF-LVADs) have become the standard of care for patients with end-stage heart failure (HF). While these devices have improved durability compared to earlier generation left ventricular assist devices (LVADs), increased frequency in some complications has been seen, including gastrointestinal bleeding (GIB), pump thrombosis and hemolysis. We discuss the incidence, management and prevention of GIB after CF-LVAD implantation. Methods We reviewed the current literature available on the incidence, management and prevention of GIB after CF-LVAD implantation with a focus on our experience at the University of Minnesota, with data on nearly 300 patients who received a CF-LVAD from 2005 to 2013. Results The incidence of GIB after CF-LVAD varies between 18-40% in numerous studies. At the University of Minnesota, out of 233 patients who underwent HeartMate II (HMII) implantation between 2005-2013, 60 GIB episodes occurred in 51 patients (22%), with an event rate of 0.17 gastrointestinal bleeds/patient-year of support. The etiology of GIB appears to be multifactorial. The main factors which have been identified include the need for chronic anticoagulation, acquired von Willebrand syndrome, platelet dysfunction and increased incidence of arteriovenous malformations due to chronic low pulse pressure. When managing an LVAD patient with GIB, a multi-disciplinary approach is needed. The main goals of treatment are evaluating the location and severity of the bleed, holding anti-coagulants and resuscitation to maintain stable hemodynamics. Conclusions GIB is a complication with considerable morbidity. Future efforts to further understand the etiology of GIB and optimize anti-coagulation are needed to improve outcomes following CF-LVAD implantation. PMID:25452907

  20. Air Pressure Responses to Sudden Vocal Tract Pressure Bleeds during Production of Stop Consonants: New Evidence of Aeromechanical Regulation.

    ERIC Educational Resources Information Center

    Zajac, David J.; Weissler, Mark C.

    2004-01-01

    Two studies were conducted to evaluate short-latency vocal tract air pressure responses to sudden pressure bleeds during production of voiceless bilabial stop consonants. It was hypothesized that the occurrence of respiratory reflexes would be indicated by distinct patterns of responses as a function of bleed magnitude. In Study 1, 19 adults…

  1. Assessment of Bleeding and Thrombosis Based on Aspirin Responsiveness after Continuous-Flow Left Ventricular Assist Device Placement.

    PubMed

    Floroff, Catherine K; Rieger, Krista L; Veasey, Tara M; Strout, Sara E; DeNino, Walter F; Meadows, Holly B; Stroud, Martha R; Toole, John M; Heyward, Dawn P; Brisco, Meredith A; Cook, Jennifer L; Lazarchick, John; Uber, Walter E

    2017-01-26

    Pump thrombosis (PT) is a severe complication of left ventricular assist device (LVAD) support. This study evaluated PT and bleeding following LVAD placement in patients responsive to a standard aspirin dose of 81 mg using platelet inhibition monitoring compared with initial non-responders who were then titrated upward to achieve therapeutic response.Patients ≥ 18 years of age with initial placement of HeartMate II® (HMII) LVAD at our institution and at least one VerifyNow® Aspirin test performed during initial hospitalization were included. The primary endpoints were bleeding and PT compared between initial aspirin responders and non-responders.Of 85 patients, 19 (22%) were nonresponsive to initial aspirin therapy. Responders and non-responders showed similar survival (p=0.082), freedom from suspected/confirmed PT (p=0.941), confirmed PT (p=0.273), bleeding (p=0.401), and incidence rates in PT and bleeding. Among the initial responders (<500 vs 500 - 549 aspirin reaction units), there were no significant differences in survival (p = 0.177), freedom from suspected/confirmed PT (p=0.542), confirmed PT (p=0.159), bleeding (p=0.879) and incidence of PT and bleeding.Platelet function testing may detect resistance to standard aspirin regimens used in LVAD patients. Dose escalation in initially nonresponsive patients to achieve responsiveness may confer a similar PT risk to patients initially responsive to standard aspirin dosing without increased bleeding risk.

  2. Characterization of the frequency and nature of bleed air contamination events in commercial aircraft.

    PubMed

    Shehadi, M; Jones, B; Hosni, M

    2016-06-01

    Contamination of the bleed air used to pressurize and ventilate aircraft cabins is of concern due to the potential health and safety hazards for passengers and crew. Databases from the Federal Aviation Administration, NASA, and other sources were examined in detail to determine the frequency of bleed air contamination incidents. The frequency was examined on an aircraft model basis with the intent of identifying aircraft make and models with elevated frequencies of contamination events. The reported results herein may help investigators to focus future studies of bleed air contamination incidents on smaller number of aircrafts. Incident frequency was normalized by the number of aircraft, number of flights, and flight hours for each model to account for the large variations in the number of aircraft of different models. The focus of the study was on aircraft models that are currently in service and are used by major airlines in the United States. Incidents examined in this study include those related to smoke, oil odors, fumes, and any symptom that might be related to exposure to such contamination, reported by crew members, between 2007 and 2012, for US-based carriers for domestic flights and all international flights that either originated or terminated in the US. In addition to the reported frequency of incidents for different aircraft models, the analysis attempted to identify propulsion engines and auxiliary power units associated with aircrafts that had higher frequencies of incidents. While substantial variations were found in frequency of incidents, it was found that the contamination events were widely distributed across nearly all common models of aircraft.

  3. Personal cooling air filtering device

    DOEpatents

    Klett, James [Knoxville, TN; Conway, Bret [Denver, NC

    2002-08-13

    A temperature modification system for modifying the temperature of fluids includes at least one thermally conductive carbon foam element, the carbon foam element having at least one flow channel for the passage of fluids. At least one temperature modification device is provided, the temperature modification device thermally connected to the carbon foam element and adapted to modify the temperature of the carbon foam to modify the temperature of fluids flowing through the flow channels. Thermoelectric and/or thermoionic elements can preferably be used as the temperature modification device. A method for the reversible temperature modification of fluids includes the steps of providing a temperature modification system including at least one thermally conductive carbon foam element having flow channels and at least one temperature modification device, and flowing a fluid through the flow channels.

  4. Experimental Heat Transfer and Bulk Air Temperature Measurements for a Multipass Internal Cooling Model with Ribs and Bleed

    NASA Technical Reports Server (NTRS)

    Thurman, Douglas; Poinsatte, Philip

    2001-01-01

    An experimental study was made to obtain heat transfer and air temperature data for a simple three-leg serpentine test section that simulates a turbine blade internal cooling passage with trip strips and bleed holes. The objectives were to investigate the interaction of ribs and various bleed conditions on internal cooling and to gain a better understanding of bulk air temperature in an internal passage. Steady-state heat transfer measurements were obtained using a transient technique with thermochromic liquid crystals. Trip strips were attached to one wall of the test section and were located either between or near the bleed holes. The bleed holes, used for film cooling, were metered to simulate the effect of external pressure on the turbine blade. Heat transfer enhancement was found to be greater for ribs near bleed holes compared to ribs between holes, and both configurations were affected slightly by bleed rates upstream. Air temperature measurements were taken at discrete locations along one leg of the model. Average bulk air temperatures were found to remain fairly constant along one leg of the model.

  5. Experimental Heat Transfer and Bulk Air Temperature Measurements for a Multipass Internal Cooling Model with Ribs and Bleed

    NASA Technical Reports Server (NTRS)

    Thurman, Douglas; Poinsatte, Philip

    2000-01-01

    An experimental study was made to obtain heat transfer and air temperature data for a simple 3-leg serpentine test section that simulates a turbine blade internal cooling passage with trip strips and bleed holes. The objectives were to investigate the interaction of ribs and various bleed conditions on internal cooling and to gain a better understanding of bulk air temperature in an internal passage. Steady state heat transfer measurements were obtained using a transient technique with thermochromic liquid crystals. Trip strips were attached to one wall of the test section and were located either between or near the bleed holes. The bleed holes, used for film cooling, were metered to simulate the effect of external pressure on the turbine blade. Heat transfer enhancement was found to be greater for ribs near bleed holes compared to ribs between holes, and both configurations were affected slightly by bleed rates upstream. Air temperature measurements were taken at discreet locations along one leg of the model. Average bulk air temperatures were found to remain fairly constant along one leg of the model.

  6. Microwave Regenerable Air Purification Device

    NASA Technical Reports Server (NTRS)

    Atwater, James E.; Holtsnider, John T.; Wheeler, Richard R., Jr.

    1996-01-01

    The feasibility of using microwave power to thermally regenerate sorbents loaded with water vapor, CO2, and organic contaminants has been rigorously demonstrated. Sorbents challenged with air containing 0.5% CO2, 300 ppm acetone, 50 ppm trichloroethylene, and saturated with water vapor have been regenerated, singly and in combination. Microwave transmission, reflection, and phase shift has also been determined for a variety of sorbents over the frequency range between 1.3-2.7 GHz. This innovative technology offers the potential for significant energy savings in comparison to current resistive heating methods because energy is absorbed directly by the material to be heated. Conductive, convective and radiative losses are minimized. Extremely rapid heating is also possible, i.e., 1400 C in less than 60 seconds. Microwave powered thermal desorption is directly applicable to the needs of Advance Life Support in general, and of EVA in particular. Additionally, the applicability of two specific commercial applications arising from this technology have been demonstrated: the recovery for re-use of acetone (and similar solvents) from industrial waste streams using a carbon based molecular sieve; and the separation and destruction of trichloroethylene using ZSM-5 synthetic zeolite catalyst, a predominant halocarbon environmental contaminant. Based upon these results, Phase II development is strongly recommended.

  7. Failure forecast of Boeing 737 bleed air system using artificial neural networks

    NASA Astrophysics Data System (ADS)

    Al-Wadiee, Waheed

    In this study, the failure rate of different types of bleed air control valves for the Boeing 737 aircraft is modeled. Two approaches are utilized to perform this work. In the first approach, Weibull model, in which different parameters are utilized and tested, is used. In the second one, a common type of the Artificial Neural Network (ANN) modeling is used. A Feed-forward back-propagation algorithm is implemented to train the network. Subsequently, the optimum number of neurons and layers that give the best result compared to the actual data are determined. Finally, the outputs from both models are compared against the actual data. The final results show a high level of accuracy of the ANN's predictions compared to the more traditional Weibull modeling. The developed verified model lends itself to applications that extend from scheduling replacements operations of these valves, to developing plans for inventory management in any aviation engines maintenance facility.

  8. A case of a pseudo colonic mass causing gastrointestinal bleeding in a patient with a left ventricular assist device

    PubMed Central

    Huntington, Justin T.; Plews, Robert L.; Mansfield, Sara A.; Drosdeck, Joseph M.; Evans, David C.

    2016-01-01

    There are many complications associated with the left ventricular assist devices (LVADs), including gastrointestinal bleeding (GIB). We present a case of a pseudo colonic mass visualized on colonoscopy during workup for GIB in an LVAD patient necessitating a right colectomy with final pathology negative for malignancy. A review of the literature in regards to the pathology, diagnosis, and treatment of this interesting condition is included. PMID:27722118

  9. 49 CFR 179.220-17 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Gauging devices, top loading and unloading devices, venting and air inlet devices. 179.220-17 Section 179.220-17 Transportation Other Regulations Relating to... and 115AW) § 179.220-17 Gauging devices, top loading and unloading devices, venting and air...

  10. Dual control of low concentration CO poisoning by anode air bleeding of low temperature polymer electrolyte membrane fuel cells

    NASA Astrophysics Data System (ADS)

    Klages, Merle; Tjønnås, Johannes; Zenith, Federico; Halvorsen, Ivar J.; Scholta, Joachim

    2016-12-01

    Fuel impurities, fed to a polymer electrolyte membrane fuel cell, can affect stack performance by poisoning of catalyst layers. This paper describes the dynamic behaviour of a stack, including state-of-the-art membrane electrode assemblies (MEA) of three different manufacturers, at different operating conditions. The voltage transients of the step responses to CO poisoning as well as air bleed recovery are compared, revealing differences in performance loss: slow poisoning versus fast recovery, incomplete recovery and voltage oscillation. The recorded behaviour is used to develop a model, based on Tafel equation and first order dynamic response, which can be calibrated to each MEA type. Using this model to predict voltage response, a controller is built with the aim of reducing the total amount of air bleed and monitoring upstream stack processes without the need of sensors measuring the poisoning level. Two controllers are implemented in order to show the concept from a heuristic, easy to implement, and a more technical side allowing more detailed analysis of the synthesis. The heuristic algorithm, based on periodic perturbations of the manipulated variable (air-bleed), is validated on a real stack, revealing a stabilized performance without the need of detailed stack properties knowledge.

  11. Pipeline embolization device and subsequent vessel sacrifice for treatment of a bleeding carotid pseudoaneurysm at the skull base: a case report.

    PubMed

    Kadkhodayan, Yasha; Shetty, Vilaas S; Blackburn, Spiros L; Reynolds, Matthew R; Cross, DeWitte T; Moran, Christopher J

    2013-09-01

    An attempt at parent vessel reconstruction with Pipeline embolization devices to treat a mycotic pseudoaneurysm of the internal carotid artery at the skull base is presented. A 50-year-old woman with malignant otitis externa and bilateral temporal bone osteomyelitis presented with brisk bleeding from her left ear. She had bony dehiscence of the left carotid canal at CT and extravasation from a pseudoaneurysm of the carotid petrous segment at angiography. Carotid tortuosity proximally precluded placing a covered stent. After the lesion stopped bleeding spontaneously and given the presence of bilateral osteomyelitis putting the contralateral carotid at risk, the decision was made to attempt preservation of the parent vessel with flow diversion. However, bleeding recurred after 12 days, necessitating carotid sacrifice. This first reported experience in treating a carotid pseudoaneurysm at the skull base with the Pipeline device shows that transient cessation of bleeding is insufficient for flow diversion to be effective.

  12. Safety and efficacy of single-balloon enteroscopy in management of gastrointestinal bleeding in patients with a left ventricular assist device.

    PubMed

    Koul, Abhinav; Pham, Donald M; Nanda, Arjun; Woods, Kevin E; Keilin, Steven D

    2017-03-01

    Background and study aims Left ventricular assist devices (LVADs) are currently the standard of care in treatment of patients with end-stage heart failure waiting for heart transplant as well as destination therapy for non-transplant candidates. However, patients with LVADs are at increased risk of gastrointestinal bleeding due to the device's unique effects on hemodynamics. A major source of gastrointestinal bleeding in these patients are gastrointestinal angioectasias located within the small bowel that can only be reached with deep enteroscopy. The goal of our study was to determine the safety and efficacy of single-balloon enteroscopy (SBE) in treating gastrointestinal bleeding in patients with LVADs. Patients and methods We present a retrospective case series performed on patients with LVADs who underwent SBE to treat episodes of gastrointestinal bleeding. All procedures were performed at Emory University Hospital by a single endoscopist. Patient demographics, diagnosis and treatment of gastrointestinal bleeding, episodes of re-bleeding, and procedure-related complications were examined. Results A total of 27 SBE procedures performed in 14 patients were reviewed. SBE was performed in an antegrade approach in 89 % (24/27) of cases. Deep intubation was achieved in all antegrade procedures, with the distal jejunum reached in 79 % (19/24) of cases. The diagnostic yield was 78 %. There were no reported complications associated with the procedures. Conclusions SBE is a safe and effective modality to manage gastrointestinal bleeding in patients with LVADs.

  13. The effects of intrauterine contraceptive devices on the ultrastructure of the endometrium in relation to bleeding complications.

    PubMed

    Sheppard, B L; Bonnar, J

    1983-08-01

    The effects of inert (Lippes Loop D and Dalkon Shields) and medicated (copper 7, copper T, and Progestasert) intrauterine contraceptive devices (IUDs) on the ultrastructure of the endometrium were studied in intact human uteri. The most striking morphologic changes induced by the inert and copper-bearing devices were erosion of the surface epithelium and extensive microthrombosis in stromal capillaries of the endometrium in contact with the device. These abnormalities were associated with extravascular thrombi, erythrocytes, and fibrin deposition in the adjacent stroma. Capillary microthrombosis and leukocyte infiltration into the uterine cavity were most extensive around the active part of the copper-bearing devices. With the Progestasert erosion of surface epithelium was rarely seen, but the intact epithelial lining had fewer ciliated cells with flattened and shortened cilia. Large dilated venules were a common finding below the surface epithelium adjacent to the active part of the Progestasert; capillary microthrombosis was found only below the inert arms of the Progestasert. The vascular response of the endometrium to IUDs appears, therefore, to be directly related to the type and proximity of the device. The morphologic changes induced in both surface epithelium and the microvasculature of the endometrium are the likely explanation of the uterine bleeding problems associated with IUDs but are probably intrinsic to the mode of action of the IUD in interfering with implantation.

  14. 49 CFR 179.220-17 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Gauging devices, top loading and unloading devices, venting and air inlet devices. 179.220-17 Section 179.220-17 Transportation Other Regulations Relating to... DOT-111AW and 115AW) § 179.220-17 Gauging devices, top loading and unloading devices, venting and...

  15. Safety and efficacy of single-balloon enteroscopy in management of gastrointestinal bleeding in patients with a left ventricular assist device

    PubMed Central

    Koul, Abhinav; Pham, Donald M.; Nanda, Arjun; Woods, Kevin E.; Keilin, Steven D.

    2017-01-01

    Background and study aims Left ventricular assist devices (LVADs) are currently the standard of care in treatment of patients with end-stage heart failure waiting for heart transplant as well as destination therapy for non-transplant candidates. However, patients with LVADs are at increased risk of gastrointestinal bleeding due to the device’s unique effects on hemodynamics. A major source of gastrointestinal bleeding in these patients are gastrointestinal angioectasias located within the small bowel that can only be reached with deep enteroscopy. The goal of our study was to determine the safety and efficacy of single-balloon enteroscopy (SBE) in treating gastrointestinal bleeding in patients with LVADs. Patients and methods We present a retrospective case series performed on patients with LVADs who underwent SBE to treat episodes of gastrointestinal bleeding. All procedures were performed at Emory University Hospital by a single endoscopist. Patient demographics, diagnosis and treatment of gastrointestinal bleeding, episodes of re-bleeding, and procedure-related complications were examined. Results A total of 27 SBE procedures performed in 14 patients were reviewed. SBE was performed in an antegrade approach in 89 % (24/27) of cases. Deep intubation was achieved in all antegrade procedures, with the distal jejunum reached in 79 % (19/24) of cases. The diagnostic yield was 78 %. There were no reported complications associated with the procedures. Conclusions SBE is a safe and effective modality to manage gastrointestinal bleeding in patients with LVADs. PMID:28299353

  16. [Effect of combustion devices on the quality of indoor air].

    PubMed

    Ulbrich, G

    1982-01-01

    Combustion devices and the equipment conducting their effluent gases such as ducts and chimneys are factors which might have an unreasonable or even dangerous impact on the quality of air inside buildings. There is a danger of flue gases entering the indoor environment during the heating process (a) if the air-circulation associated with the operation of a combustion device is disturbed or even interrupted, (b) if the air stream - as far as flue gases are involved - flows under elevated pressure, and (c) if the combustion device and the flue gas conducting equipment are not leak-proof. These three cases and their influence on indoor air quality are extensively discussed. In the German Combustion Device Code from 1980 care is taken to minimize the pollutant concentrations in rooms with combustion devices by setting special requirements for the room in which the device is located, and by prescribing the standardization of the technical characteristics of chimneys and combustion devices.

  17. 49 CFR 179.200-16 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Gauging devices, top loading and unloading devices... and 115AW) § 179.200-16 Gauging devices, top loading and unloading devices, venting and air inlet...). In no case shall the wall thickness be less than that specified in § 179.201-1. (f) When top...

  18. 49 CFR 179.200-16 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Gauging devices, top loading and unloading devices... DOT-111AW and 115AW) § 179.200-16 Gauging devices, top loading and unloading devices, venting and air...). In no case shall the wall thickness be less than that specified in § 179.201-1. (f) When top...

  19. What is an effective portable air cleaning device? A review.

    PubMed

    Shaughnessy, R J; Sextro, R G

    2006-04-01

    The use of portable air cleaning devices in residential settings has been steadily growing over the last 10 years. Three out of every 10 households now contain a portable air cleaning device. This increased use of air cleaners is accompanied by, if not influenced by, a fundamental belief by consumers that the air cleaners are providing an improved indoor air environment. However, there is a wide variation in the performance of air cleaners that is dependent on the specific air cleaner design and various indoor factors. The most widely used method in the United States to assess the performance of new air cleaners is the procedure described in the American National Standards Institute (ANSI)/Association of Home Appliance Manufacturers (AHAM) AC-1-2002. This method describes both the test conditions and the testing protocol. The protocol yields a performance metric that is based on the measured decay rate of contaminant concentrations with the air cleaner operating compared with the measured decay rate with the air cleaner turned off. The resulting metric, the clean air delivery rate (CADR), permits both an intercomparison of performance among various air cleaners and a comparison of air cleaner operation to other contaminant removal processes. In this article, we comment on the testing process, discuss its applicability to various contaminants, and evaluate the resulting performance metrics for effective air cleaning.

  20. Active Clearance of Chest Tubes Reduces Re-Exploration for Bleeding After Ventricular Assist Device Implantation

    PubMed Central

    Davis, Mary E.; Haglund, Nicholas A.; Perrault, Louis; Kushwaha, Sudhir S.; Stulak, John M.; Boyle, Edward M.

    2016-01-01

    Chest tubes are utilized to evacuate shed blood after left ventricular assist device (LVAD) implantation, however, they can become clogged, leading to retained blood. We implemented a protocol for active tube clearance (ATC) of chest tubes to determine if this might reduce interventions for retained blood. A total of 252 patients underwent LVAD implantation. Seventy-seven patients had conventional chest tube drainage (group 1), whereas 175 patients had ATC (group 2). A univariate and multivariate analysis adjusting for the use of conventional sternotomy (CS) and minimally invasive left thoracotomy (MILT) was performed. Univariate analysis revealed a 65% reduction in re-exploration (43–15%, p < 0.001), and an 82% reduction in delayed sternal closure (DSC; 34–6%, p <0.001). In a sub-analysis of CS only, there continued to be statistically significant 53% reduction in re-exploration (45% vs. 21%, p = 0.0011), and a 77% reduction in DSC (35% vs. 8%, p < 0.001) in group 2. Using a logistic regression model adjusting for CS versus MILT, there was a significant reduction in re-exploration (odds ratio [OR] = 0.44 [confidence interval {CI} = 0.23–0.85], p = 0.014) and DSC (OR = 0.20 [CI = 0.08–0.46], p <0.001) in group 2. Actively maintaining chest tube patency after LVAD implantation significantly reduces re-exploration and DSC. PMID:27556153

  1. Menorrhagia (Heavy Menstrual Bleeding)

    MedlinePlus

    ... effect of using a nonhormonal intrauterine device for birth control. When an IUD is the cause of excessive menstrual bleeding, you may need to remove it. Pregnancy complications. A single, heavy, late period may be due to a miscarriage. If ...

  2. A Conductivity Device for Measuring Sulfur Dioxide in the Air

    ERIC Educational Resources Information Center

    Craig, James C.

    1972-01-01

    Described is a general electroconductivity device enabling students to determine sulfur dioxide concentration in a particular location, hopefully leading to a deeper understanding of the problem of air pollution. (DF)

  3. 49 CFR 179.200-16 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Gauging devices, top loading and unloading devices, venting and air inlet devices. 179.200-16 Section 179.200-16 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF...

  4. 49 CFR 179.220-17 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Gauging devices, top loading and unloading devices, venting and air inlet devices. 179.220-17 Section 179.220-17 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF...

  5. 49 CFR 179.200-16 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Gauging devices, top loading and unloading devices, venting and air inlet devices. 179.200-16 Section 179.200-16 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF...

  6. Calculated effects of turbine rotor-blade cooling-air flow, altitude, and compressor bleed point on performance of a turbojet engine

    NASA Technical Reports Server (NTRS)

    Arne, Vernon L; Nachtigall, Alfred J

    1951-01-01

    Effects of air-cooling turbine rotor blades on performance of a turbojet engine were calculated for a range of altitudes from sea level to 40,000 feet and a range of coolant flows up to 3 percent of compressor air flow, for two conditions of coolant bleed from the compressor. Bleeding at required coolant pressure resulted in a sea-level thrust reduction approximately twice the percentage coolant flow and in an increase in specific fuel consumption approximately equal to percentage coolant flow. For any fixed value of coolant flow ratio the percentage thrust reduction and percentage increase in specific fuel consumption decreased with altitude. Bleeding coolant at the compressor discharge resulted in an additional 1 percent loss in performance at sea level and in smaller increase in loss of performance at higher altitudes.

  7. Application of semipermeable membrane devices (SPMDs) as passive air samplers

    USGS Publications Warehouse

    Petty, Jimmie D.; Huckins, James N.; Zajicek, James L.

    1993-01-01

    The semipermeable membrane device (SPMD), consisting of a neutral lipid (triolein) enclosed in polyethylene layflat tubing, is demonstrated to be a highly efficient passive air sampler. These devices readily sequester lipophilic organic contaminants from the vapor phase. Specifically, the SPMDs are shown to concentrate polychlorinated biphenyl (PCB) residues from a laboratory atmosphere in a linear manner through 28 days. Under the conditions of this study, a three device composite (1.4 g triolein) extracted PCB residues from ≈ 7 m3 of air per day.

  8. A simple novel device for air sampling by electrokinetic capture

    DOE PAGES

    Gordon, Julian; Gandhi, Prasanthi; Shekhawat, Gajendra; ...

    2015-12-27

    A variety of different sampling devices are currently available to acquire air samples for the study of the microbiome of the air. All have a degree of technical complexity that limits deployment. Here, we evaluate the use of a novel device, which has no technical complexity and is easily deployable. An air-cleaning device powered by electrokinetic propulsion has been adapted to provide a universal method for collecting samples of the aerobiome. Plasma-induced charge in aerosol particles causes propulsion to and capture on a counter-electrode. The flow of ions creates net bulk airflow, with no moving parts. A device and electrodemore » assembly have been re-designed from air-cleaning technology to provide an average air flow of 120 lpm. This compares favorably with current air sampling devices based on physical air pumping. Capture efficiency was determined by comparison with a 0.4 μm polycarbonate reference filter, using fluorescent latex particles in a controlled environment chamber. Performance was compared with the same reference filter method in field studies in three different environments. For 23 common fungal species by quantitative polymerase chain reaction (qPCR), there was 100 % sensitivity and apparent specificity of 87%, with the reference filter taken as “gold standard.” Further, bacterial analysis of 16S RNA by amplicon sequencing showed equivalent community structure captured by the electrokinetic device and the reference filter. Unlike other current air sampling methods, capture of particles is determined by charge and so is not controlled by particle mass. We analyzed particle sizes captured from air, without regard to specific analyte by atomic force microscopy: particles at least as low as 100 nM could be captured from ambient air. This work introduces a very simple plug-and-play device that can sample air at a high-volume flow rate with no moving parts and collect particles down to the sub-micron range. In conclusion, the performance of

  9. A simple novel device for air sampling by electrokinetic capture

    SciTech Connect

    Gordon, Julian; Gandhi, Prasanthi; Shekhawat, Gajendra; Frazier, Angel; Hampton-Marcell, Jarrad; Gilbert, Jack A.

    2015-12-27

    A variety of different sampling devices are currently available to acquire air samples for the study of the microbiome of the air. All have a degree of technical complexity that limits deployment. Here, we evaluate the use of a novel device, which has no technical complexity and is easily deployable. An air-cleaning device powered by electrokinetic propulsion has been adapted to provide a universal method for collecting samples of the aerobiome. Plasma-induced charge in aerosol particles causes propulsion to and capture on a counter-electrode. The flow of ions creates net bulk airflow, with no moving parts. A device and electrode assembly have been re-designed from air-cleaning technology to provide an average air flow of 120 lpm. This compares favorably with current air sampling devices based on physical air pumping. Capture efficiency was determined by comparison with a 0.4 μm polycarbonate reference filter, using fluorescent latex particles in a controlled environment chamber. Performance was compared with the same reference filter method in field studies in three different environments. For 23 common fungal species by quantitative polymerase chain reaction (qPCR), there was 100 % sensitivity and apparent specificity of 87%, with the reference filter taken as “gold standard.” Further, bacterial analysis of 16S RNA by amplicon sequencing showed equivalent community structure captured by the electrokinetic device and the reference filter. Unlike other current air sampling methods, capture of particles is determined by charge and so is not controlled by particle mass. We analyzed particle sizes captured from air, without regard to specific analyte by atomic force microscopy: particles at least as low as 100 nM could be captured from ambient air. This work introduces a very simple plug-and-play device that can sample air at a high-volume flow rate with no moving parts and collect particles down to the sub-micron range. In conclusion, the performance of the

  10. Bleeding Disorders

    MedlinePlus

    Normally, if you get hurt, your body forms a blood clot to stop the bleeding. For blood ... body needs cells called platelets and proteins known as clotting factors. If you have a bleeding disorder, ...

  11. Bleeding gums

    MedlinePlus

    ... periodontal exam. DO NOT use tobacco, since it makes bleeding gums worse. Control gum bleeding by applying pressure directly on the gums with a gauze pad soaked in ice water. If you have been diagnosed with a ...

  12. Fuel-air munition and device

    DOEpatents

    Carlson, Gary A.

    1976-01-01

    An aerially delivered fuel-air munition consisting of an impermeable tank filled with a pressurized liquid fuel and joined at its two opposite ends with a nose section and a tail assembly respectively to complete an aerodynamic shape. On impact the tank is explosively ruptured to permit dispersal of the fuel in the form of a fuel-air cloud which is detonated after a preselected time delay by means of high explosive initiators ejected from the tail assembly. The primary component in the fuel is methylacetylene, propadiene, or mixtures thereof to which is added a small mole fraction of a relatively high vapor pressure liquid diluent or a dissolved gas diluent having a low solubility in the primary component.

  13. Advances in gastrointestinal bleeding.

    PubMed

    Lanas, Ángel

    2016-09-01

    The main innovations of the latest meeting of the Gastroenterological Association (2016) concerning upper gastrointestinal bleeding from the clinician's perspective can be summarised as follows: a) The Glasgow-Blatchford scale has the best accuracy in predicting the need for surgical intervention and hospital mortality; b) Prognostic scales for non-variceal upper gastrointestinal bleeding are also useful for lower gastrointestinal bleeding; c) Preliminary data suggest that treatment with hemospray does not seem to be superior to current standard treatment in controlling active peptic ulcer bleeding; d) Either famotidine or a proton pump inhibitor may be effective in preventing haemorrhagic recurrence in patients taking aspirin, but this finding needs to be confirmed in further studies; e) There was confirmation of the need to re-introduce antiplatelet therapy as early as possible in patients with antiplatelet-associated gastrointestinal bleeding in order to prevent cardiovascular mortality; f) Routine clinical practice suggests that gastrointestinal or cardiovascular complications with celecoxib or traditional NSAIDs are very low; g) Dabigatran is associated with an increased incidence of gastrointestinal bleeding compared with apixaban or warfarin. At least half of the episodes are located in the lower gastrointestinal tract; h) Implant devices for external ventricular circulatory support are associated with early gastrointestinal bleeding in up to one third of patients; the bleeding is often secondary to arteriovenous malformations.

  14. Intraplatelet reactive oxygen species, mitochondrial damage and platelet apoptosis augment non-surgical bleeding in heart failure patients supported by continuous-flow left ventricular assist device.

    PubMed

    Mondal, Nandan K; Sorensen, Erik N; Hiivala, Nicholas J; Feller, Erika D; Pham, Si M; Griffith, Bartley P; Wu, Zhongjun J

    2015-01-01

    Non-surgical bleeding (NSB) is the most common clinical complication among heart failure (HF) patients supported by continuous-flow left ventricular assist devices (CF-LVADs). Understanding the role of platelet functionality contributing to NSB after CF-LVAD implantation is crucial for prevention and management of this adverse event. The aim of this study was to examine the role of intraplatelet reactive oxygen species (ROS) and platelet damage on the incidence of bleeding events after CF-LVAD implantation in HF patients. We recruited 25 HF patients implanted with CF-LVADs and 11 healthy volunteers as the control. Intraplatelet ROS generation, platelet mitochondrial damage and platelet apoptosis were quantified by flow cytometry. Among 25 patients, 8 patients developed non-surgical bleeding within one month after CF-LVAD implantation. Intraplatelet ROS, depolarized and apoptotic platelet were found to be pre-existing conditions in all baseline samples of the 25 HF patients when compared to the healthy volunteers. There was no significant difference in the levels of ROS between the non-bleeder and the bleeder groups prior to CF-LVAD implantation, although we noticed 2-fold and 1.5-fold rise in depolarized and apoptotic platelets, respectively, in the bleeder group compared to those in the non-bleeder group. Post implant levels of intraplatelet ROS, depolarized and apoptotic platelets increased and remained elevated in the bleeder group, whereas periodic decreases were noticed in the non-bleeder group, suggesting the potential role of platelet damage on bleeding incidence. ROS generation after CF-LVAD implantation positively associated with platelet apoptosis (ρ = 0.4263, p = 0.0023) and depolarized platelets (ρ = 0.4774, p = 0.0002), especially the latter. In conclusion, elevated intraplatelet ROS and platelet damage may be linked to the NSB among HF patients supported by CF-LVAD. These results provide mechanistic insights into the bleeding complication in

  15. APPLICATION OF SEMIPERMEABLE MEMBRANE DEVICES TO INDOOR AIR SAMPLING

    EPA Science Inventory

    Semipermeable membrane devices (SPMDs) are a relatively new passive sampling technique for nonpolar organic compounds that have been extensively used for surface water sampling. A small body of literature indicates that SPMDs are also useful for air sampling. Because SPMDs ha...

  16. New Radiofrequency Device to Reduce Bleeding after Core Needle Biopsy: Experimental Study in a Porcine Liver Model

    PubMed Central

    Lim, Sanghyeok; Lee, Min Woo; Song, Kyoung Doo; Kang, Tae Wook; Kim, Young-sun; Lim, Hyo Keun

    2017-01-01

    Objective To evaluate the in vivo efficiency of the biopsy tract radiofrequency ablation for hemostasis after core biopsy of the liver in a porcine liver model, including situations with bleeding tendency and a larger (16-gauge) core needle. Materials and Methods A preliminary study was performed using one pig to determine optimal ablation parameters. For the main experiment, four pigs were assigned to different groups according to heparinization use and biopsy needle caliber. In each pig, 14 control (without tract ablation) and 14 experimental (tract ablation) ultrasound-guided core biopsies were performed using either an 18- or 16-gauge needle. Post-biopsy bleeding amounts were measured by soaking up the blood for five minutes. The results were compared using the Mann-Whitney U test. Results The optimal parameters for biopsy tract ablation were determined as a 2-cm active tip electrode set at 40-watt with a tip temperature of 70–80℃. The bleeding amounts in all experimental groups were smaller than those in the controls; however they were significant in the non-heparinized pig biopsied with an 18-gauge needle and in two heparinized pigs (p < 0.001). In the heparinized pigs, the mean blood loss in the experimental group was 3.5% and 13.5% of the controls biopsied with an 18- and 16-gauge needle, respectively. Conclusion Radiofrequency ablation of hepatic core biopsy tract ablation may reduce post-biopsy bleeding even under bleeding tendency and using a larger core needle, according to the result from in vivo porcine model experiments. PMID:28096727

  17. Portable microwave air plasma device for wound healing

    NASA Astrophysics Data System (ADS)

    Kang, S. K.; Kim, H. Y.; Yun, G. S.; Lee, J. K.

    2015-06-01

    A portable microwave air plasma has been developed for safe and effective wound healing. The device is operated by a fixed microwave power and two different air gas flows (main and cooling air flow). It was found that the speeds of the two air flows determine the stability of the plasma jet and gas temperature and thereby regulate the concentrations of the individual reactive species. Two different regimes, i.e. the NO abundant (0.1 slm main air flow) and ozone abundant regimes (4 slm main air flow), were identified as suitable for wound healing without thermal damage and toxicity. These regimes show similar plasma characteristics (e.g. less than 40 °C at the treatment point, less than 4 ppm of NO2) except for different NO and ozone amounts. Both regimes show more than twice as fast wound healing speed compared with the untreated case without any histological damages. Faster healing speed with intrinsic ozone safety make the NO abundant regime the best operation regime for wound healing. Finally, the stability of the developed device was demonstrated by a one-hour continuous operation test with a 24 V battery.

  18. Thermoelectric Air/Soil Energy-Harvesting Device

    NASA Technical Reports Server (NTRS)

    Snyder, Jeffrey; Fleurial, Jean-Pierre; Lawrence, Eric

    2005-01-01

    A proposed thermoelectric device would exploit natural temperature differences between air and soil to harvest small amounts of electric energy. Because the air/soil temperature difference fluctuates between nighttime and daytime, it is almost never zero, and so there is almost always some energy available for harvesting. Unlike photovoltaic cells, the proposed device could operate in the absence of sunlight. Unlike a Stirling engine, which could be designed to extract energy from the air/soil temperature difference, the proposed device would contain no moving parts. The main attractive feature of the proposed device would be high reliability. In a typical application, this device would be used for low-power charging of a battery that would, in turn, supply high power at brief, infrequent intervals for operating an instrumentation package containing sensors and communication circuits. The device (see figure) would include a heat exchanger buried in soil and connected to a heat pipe extending up to a short distance above the ground surface. A thermoelectric microgenerator (TEMG) would be mounted on top of the heat pipe. The TEMG could be of an advanced type, now under development, that could maintain high (relative to prior thermoelectric generators) power densities at small temperature differentials. A heat exchanger exposed to the air would be mounted on top of the TEMG. It would not matter whether the air was warmer than the soil or the soil warmer than the air: as long as there was a nonzero temperature difference, heat would flow through the device and electricity would be generated. A study of factors that could affect the design and operation of the device has been performed. These factors include the thermal conductances of the soil, the components of the device, the contacts between the components of the device, and the interfaces between the heat exchangers and their environments. The study included experiments that were performed on a model of the device

  19. Acceleration of high-pressure-ratio single-spool turbojet engine as determined from component performance characteristics I : effect of air bleed at compressor outlet

    NASA Technical Reports Server (NTRS)

    Rebeske, John J , Jr; Rohlik, Harold E

    1953-01-01

    An analytical investigation was made to determine from component performance characteristics the effect of air bleed at the compressor outlet on the acceleration characteristics of a typical high-pressure-ratio single-spool turbojet engine. Consideration of several operating lines on the compressor performance map with two turbine-inlet temperatures showed that for a minimum acceleration time the turbine-inlet temperature should be the maximum allowable, and the operating line on the compressor map should be as close to the surge region as possible throughout the speed range. Operation along such a line would require a continuously varying bleed area. A relatively simple two-step area bleed gives only a small increase in acceleration time over a corresponding variable-area bleed. For the modes of operation considered, over 84 percent of the total acceleration time was required to accelerate through the low-speed range ; therefore, better low-speed compressor performance (higher pressure ratios and efficiencies) would give a significant reduction in acceleration time.

  20. Device for improved air and fuel distribution to a combustor

    SciTech Connect

    Laster, Walter R.; Schilp, Reinhard

    2016-05-31

    A flow conditioning device (30, 50, 70, 100, 150) for a can annular gas turbine engine, including a plurality of flow elements (32, 34, 52, 54, 72, 74, 102) disposed in a compressed air flow path (42, 60, 80, 114, 122) leading to a combustor (12), configured such that relative adjustment of at least one flow directing element (32, 52, 72, 110) with respect to an adjacent flow directing element (34, 54, 74, 112, 120) during operation of the gas turbine engine is effective to adjust a level of choking of the compressed air flow path (42, 60, 80, 114, 122).

  1. [Gastrointestinal bleeding].

    PubMed

    Lanas, Ángel

    2015-09-01

    In the Digestive Disease Week in 2015 there have been some new contributions in the field of gastrointestinal bleeding that deserve to be highlighted. Treatment of celecoxib with a proton pump inhibitor is safer than treatment with nonselective NSAID and a proton pump inhibitor in high risk gastrointestinal and cardiovascular patients who mostly also take acetylsalicylic acid. Several studies confirm the need to restart the antiplatelet or anticoagulant therapy at an early stage after a gastrointestinal hemorrhage. The need for urgent endoscopy before 6-12 h after the onset of upper gastrointestinal bleeding episode may be beneficial in patients with hemodynamic instability and high risk for comorbidity. It is confirmed that in Western but not in Japanese populations, gastrointestinal bleeding episodes admitted to hospital during weekend days are associated with a worse prognosis associated with delays in the clinical management of the events. The strategy of a restrictive policy on blood transfusions during an upper GI bleeding event has been challenged. Several studies have shown the benefit of identifying the bleeding vessel in non varicose underlying gastric lesions by Doppler ultrasound which allows direct endoscopic therapy in the patient with upper GI bleeding. Finally, it has been reported that lower gastrointestinal bleeding diverticula band ligation or hemoclipping are both safe and have the same long-term outcomes.

  2. A clinical comparison of the efficacy of an electromechanical flossing device or manual flossing in affecting interproximal gingival bleeding and plaque accumulation.

    PubMed

    Anderson, N A; Barnes, C M; Russell, C M; Winchester, K R

    1995-01-01

    This one-month clinical trial was designed to compare the effect of an electromechanical flossing device and manual flossing on reducing interproximal gingival bleeding and plaque accumulation in a cohort of 60 healthy adults. After baseline evaluation of interproximal gingival bleeding, soft tissue trauma and plaque, patients were randomly assigned to one of the two experimental groups, given flossing instructions, and had their teeth cleaned. At 30 days all three clinical parameters were again evaluated. The results showed a reduction in GI from baseline to follow-up in each group. This effect is significant (p<0.0001) in the analysis of variance. There was no overall difference in the groups (p=0.93). There was no difference in the reduction in GI from baseline to follow-up between the two groups (p=0.91); interaction). As with the GI, there was a significant reduction in PI from baseline to follow-up in each group (p<0.0001). There was no overall difference between the groups (p=0.24). There was no difference in the reduction in PI from baseline to follow-up between the two groups (p=0.59; interaction). No soft tissue trauma was noted at the baseline examination or at the follow-up examination after 30 days.

  3. Efficiencies of free-air gas fumigation devices

    SciTech Connect

    Lipfert, F.W.; Hendrey, G.R.; Lewin, K.F.; Nagy, J.

    1992-03-01

    One of the key uncertainties relative to future increases in atmospheric CO{sub 2} is the extent to which growth in future emissions will be accommodated by increased uptake by terrestrial vegetation, the so-called fertilization'' effect. Research on this issue is currently pursued by many research groups around the world, using various experimental protocols and devices. These range from leaf cuvettes to various types of enclosures and glass-houses to various types of open-field gas enrichment or fumigation systems. As research priorities move from crops to forests and natural ecosystems, these experimental devices tend to become large and enrichment gas (i.e., CO{sub 2}) requirements and costs become a major factor in experimental design. This paper considers the relative efficiencies of gas usage for different types of systems currently in use. One of these is the Free Air CO{sub 2} Enrichment System (FACE) designed and developed at Brookhaven National Laboratory (BNL). In this paper, we develop some nondimensional groups of parameters for the purpose of characterizing performance, i.e., enrichment gas usage. These nondimensional groups are then used as figures of merit and basically allow the required flow rates of CO{sub 2} to be predicted based on the geometry of the device, wind speed, and the incremental gas concentration desired. The parameters chosen to comprise a useful nondimensional group must not only have the correct dimensions, they must also represent an appropriate physical relationship.

  4. Efficiencies of free-air gas fumigation devices

    SciTech Connect

    Lipfert, F.W.; Hendrey, G.R.; Lewin, K.F.; Nagy, J.

    1992-03-01

    One of the key uncertainties relative to future increases in atmospheric CO{sub 2} is the extent to which growth in future emissions will be accommodated by increased uptake by terrestrial vegetation, the so-called ``fertilization`` effect. Research on this issue is currently pursued by many research groups around the world, using various experimental protocols and devices. These range from leaf cuvettes to various types of enclosures and glass-houses to various types of open-field gas enrichment or fumigation systems. As research priorities move from crops to forests and natural ecosystems, these experimental devices tend to become large and enrichment gas (i.e., CO{sub 2}) requirements and costs become a major factor in experimental design. This paper considers the relative efficiencies of gas usage for different types of systems currently in use. One of these is the Free Air CO{sub 2} Enrichment System (FACE) designed and developed at Brookhaven National Laboratory (BNL). In this paper, we develop some nondimensional groups of parameters for the purpose of characterizing performance, i.e., enrichment gas usage. These nondimensional groups are then used as figures of merit and basically allow the required flow rates of CO{sub 2} to be predicted based on the geometry of the device, wind speed, and the incremental gas concentration desired. The parameters chosen to comprise a useful nondimensional group must not only have the correct dimensions, they must also represent an appropriate physical relationship.

  5. 40 CFR 89.414 - Air flow measurement specifications.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Air flow measurement specifications... Emission Test Procedures § 89.414 Air flow measurement specifications. (a) The air flow measurement method... incorporates devices that affect the air flow measurement (such as air bleeds) that result in......

  6. 40 CFR 89.414 - Air flow measurement specifications.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Air flow measurement specifications... Emission Test Procedures § 89.414 Air flow measurement specifications. (a) The air flow measurement method... incorporates devices that affect the air flow measurement (such as air bleeds) that result in......

  7. 40 CFR 89.414 - Air flow measurement specifications.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Air flow measurement specifications. 89... Test Procedures § 89.414 Air flow measurement specifications. (a) The air flow measurement method used... incorporates devices that affect the air flow measurement (such as air bleeds) that result in......

  8. 40 CFR 89.414 - Air flow measurement specifications.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Air flow measurement specifications... Emission Test Procedures § 89.414 Air flow measurement specifications. (a) The air flow measurement method... incorporates devices that affect the air flow measurement (such as air bleeds) that result in......

  9. 40 CFR 89.414 - Air flow measurement specifications.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Air flow measurement specifications... Emission Test Procedures § 89.414 Air flow measurement specifications. (a) The air flow measurement method... incorporates devices that affect the air flow measurement (such as air bleeds) that result in......

  10. 40 CFR 60.2141 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspection? 60.2141 Section 60.2141 Protection of Environment... initial air pollution control device inspection? (a) The initial air pollution control device inspection... startup. (b) Within 10 operating days following an air pollution control device inspection, all...

  11. 40 CFR 60.2141 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspection? 60.2141 Section 60.2141 Protection of Environment... initial air pollution control device inspection? (a) The initial air pollution control device inspection... startup. (b) Within 10 operating days following an air pollution control device inspection, all...

  12. Bleeding Disorders in Women

    MedlinePlus

    ... Button Past Emails CDC Features Bleeding Disorders in Women Language: English Español (Spanish) Recommend on Facebook Tweet ... a bleeding disorder. What is excessive bleeding in women? Women with excessive bleeding may experience heavy, hard- ...

  13. Coronary air embolism in off-pump surgery caused by blower-mister device.

    PubMed

    Korkmaz, Askin Ali; Guden, Mustafa; Korkmaz, Feride; Yuce, Murat

    2008-01-01

    Gaseous emboli caused by the blower-mister result in air locks within coronary vessels. We describe the case of a coronary air embolism caused by a blower-mister device on off-pump surgery. The tip of the device unexpectedly entered the coronary artery through arteriotomy and caused the air emboli. Air locks in the coronary circulation led to hemodynamic deterioration, and cardiopulmonary bypass was started following the emergency cannulation.

  14. Fertility regulation in nursing women. IX. Contraceptive performance, duration of lactation, infant growth, and bleeding patterns during use of progesterone vaginal rings, progestin-only pills, Norplant implants, and Copper T 380-A intrauterine devices.

    PubMed

    Díaz, S; Zepeda, A; Maturana, X; Reyes, M V; Miranda, P; Casado, M E; Peralta, O; Croxatto, H B

    1997-10-01

    This study evaluated the performance of progesterone vaginal rings (n = 187), progestin-only pills (n = 117), Norplant implants (n = 120), and Copper T 380-A intrauterine devices (n = 122) in lactating women. Contraceptive efficacy, bleeding pattern, and influence of the method upon breastfeeding duration and infant growth were compared with those of untreated women (n = 236) who relied on lactational infertility. Participants were healthy, 18 to 38 years, had had a normal delivery, and were intending to breastfeed for as long as possible. Contraceptives were initiated at day 57 +/- 3 postpartum. Results are reported for the first year of use. All methods were highly effective, with pregnancy rates below 1%. None affected breastfeeding performance or the rate of infant growth. Users of the progestin-only methods experienced a period of lactational amenorrhea 4 to 5 months longer than did users of Copper T or untreated women. More than half of the women in each contraceptive group reported a bleeding in the first month after treatment initiation, which was not considered in the calculation of the duration of amenorrhea. Prolonged or frequent bleedings were infrequent. The proportion of bleedings lasting more than 10 days ranged from 0 in the progestin-only pills group to 7% in the Norplant implants group. The four methods, initiated around the eighth postpartum week, provided effective contraception with no negative effects upon lactation or infant growth and without the bleeding problems associated with their use in nonlactating women.

  15. 30 CFR 75.320 - Air quality detectors and measurement devices.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Air quality detectors and measurement devices... COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.320 Air quality detectors and measurement devices. (a) Tests for methane shall be made by a qualified person...

  16. 30 CFR 75.320 - Air quality detectors and measurement devices.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Air quality detectors and measurement devices... COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Ventilation § 75.320 Air quality detectors and measurement devices. (a) Tests for methane shall be made by a qualified person...

  17. 40 CFR 60.2151 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspection? 60.2151 Section 60.2151 Protection of Environment... annual air pollution control device inspection? On an annual basis (no more than 12 months following the previous annual air pollution control device inspection), you must complete the air pollution...

  18. 40 CFR 60.2151 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspection? 60.2151 Section 60.2151 Protection of Environment... annual air pollution control device inspection? On an annual basis (no more than 12 months following the previous annual air pollution control device inspection), you must complete the air pollution...

  19. Bleeding esophageal varices

    MedlinePlus

    ... medicine may be injected into the varices. A rubber band may be placed around the bleeding veins ( ... nadolol that reduce the risk of bleeding. A rubber band can be placed around the bleeding veins ...

  20. Mechanistic insight of platelet apoptosis leading to non-surgical bleeding among heart failure patients supported by continuous-flow left ventricular assist devices.

    PubMed

    Mondal, Nandan K; Li, Tielou; Chen, Zengsheng; Chen, Hegang H; Sorensen, Erik N; Pham, Si M; Sobieski, Michael A; Koenig, Steven C; Slaughter, Mark S; Griffith, Bartley P; Wu, Zhongjun J

    2017-03-25

    Non-surgical bleeding (NSB) is the most common clinical complication in heart failure (HF) patients supported by continuous-flow left ventricular assist devices (CF-LVADs). In this study, oxidative stress and alteration of signal pathways leading to platelet apoptosis were investigated. Thirty-one HF patients supported by CF-LVADs were divided into bleeder (n = 12) and non-bleeder (n = 19) groups. Multiple blood samples were collected at pre-implant (baseline) and weekly up to 1-month post-implant. A single blood sample was collected from healthy subjects (reference). Production of reactive oxygen species (ROS) in platelets, total antioxidant capacity (TAC), oxidized low-density lipoproteins (oxLDL), expression of Bcl-2 and Bcl-xL, Bax and release of cytochrome c (Cyt.c), platelet mitochondrial membrane potential (Δψ m), activation of caspases, gelsolin cleavage and platelet apoptosis were examined. Significantly elevated ROS, oxLDL and depleted TAC were evident in the bleeder group compared to non-bleeder group (p < 0.05). Platelet pro-survival proteins (Bcl-2, Bcl-xL) were significantly reduced in the bleeder group in comparison to the non-bleeder group (p < 0.05). Translocation of Bax into platelet mitochondria membrane and subsequent release of Cyt.c were more prevalent in the bleeder group. Platelet mitochondrial damage, activation of caspases, gelsolin cleavage, and ultimate platelet apoptosis in the bleeder group were observed. Oxidative stress and activation of both intrinsic and extrinsic pathways of platelet apoptosis may be linked to NSB in CF-LVAD patients. Additionally, biomarkers of oxidative stress, examination of pro-survivals and pro-apoptotic proteins in platelets, mitochondrial damage, caspase activation, and platelet apoptosis may be used to help identify HF patients at high risk of NSB post-implant.

  1. Vaginal bleeding between periods

    MedlinePlus

    ... periods; Intermenstrual bleeding; Spotting; Metrorrhagia Images Female reproductive anatomy Bleeding between periods Uterus References Bulun SE. The physiology and pathology of the female reproductive axis. In: ...

  2. 40 CFR 60.2706 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspection? 60.2706 Section 60.2706 Protection of Environment... pollution control device inspection? (a) The initial air pollution control device inspection must be... meeting the amended emission limitations. (b) Within 10 operating days following an air pollution...

  3. 40 CFR 62.14441 - When must I inspect my HMIWI equipment and air pollution control devices?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and air pollution control devices? 62.14441 Section 62.14441 Protection of Environment ENVIRONMENTAL... my HMIWI equipment and air pollution control devices? (a) You must inspect your large, medium, small... inspect the air pollution control devices on your large, medium, small or small rural HMIWI by May...

  4. 40 CFR 60.2706 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspection? 60.2706 Section 60.2706 Protection of Environment... Requirements § 60.2706 By what date must I conduct the initial air pollution control device inspection? (a) The initial air pollution control device inspection must be conducted within 60 days after installation of...

  5. 40 CFR 62.14441 - When must I inspect my HMIWI equipment and air pollution control devices?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... and air pollution control devices? 62.14441 Section 62.14441 Protection of Environment ENVIRONMENTAL... my HMIWI equipment and air pollution control devices? (a) You must inspect your large, medium, small... inspect the air pollution control devices on your large, medium, small or small rural HMIWI by May...

  6. 40 CFR 60.2141 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspection? 60.2141 Section 60.2141 Protection of Environment... Compliance Requirements § 60.2141 By what date must I conduct the initial air pollution control device inspection? (a) The initial air pollution control device inspection must be conducted within 60 days...

  7. 40 CFR 60.2141 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspection? 60.2141 Section 60.2141 Protection of Environment... Compliance Requirements § 60.2141 By what date must I conduct the initial air pollution control device inspection? (a) The initial air pollution control device inspection must be conducted within 60 days...

  8. 40 CFR 60.2706 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspection? 60.2706 Section 60.2706 Protection of Environment... pollution control device inspection? (a) The initial air pollution control device inspection must be... meeting the amended emission limitations. (b) Within 10 operating days following an air pollution...

  9. 40 CFR 60.2706 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspection? 60.2706 Section 60.2706 Protection of Environment... pollution control device inspection? (a) The initial air pollution control device inspection must be... meeting the amended emission limitations. (b) Within 10 operating days following an air pollution...

  10. 40 CFR 60.2716 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspection? 60.2716 Section 60.2716 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... annual air pollution control device inspection), you must complete the air pollution control...

  11. 40 CFR 60.2716 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspection? 60.2716 Section 60.2716 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... annual air pollution control device inspection), you must complete the air pollution control...

  12. 40 CFR 60.2716 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspection? 60.2716 Section 60.2716 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... annual air pollution control device inspection), you must complete the air pollution control...

  13. Contribution of a portable air plasma torch to rapid blood coagulation as a method of preventing bleeding

    NASA Astrophysics Data System (ADS)

    Kuo, S. P.; Tarasenko, O.; Chang, J.; Popovic, S.; Chen, C. Y.; Fan, H. W.; Scott, A.; Lahiani, M.; Alusta, P.; Drake, J. D.; Nikolic, M.

    2009-11-01

    The effectiveness and mechanism of a low temperature air plasma torch in clotting blood are explored. Both blood droplets and smeared blood samples were used in the tests. The treated droplet samples reveal how blood clotting depends on the distance at which the torch operated, and for how long the droplets have been exposed to the torch. Microscopy and cell count of smeared blood samples shed light on dependencies of erythrocyte and platelet counts on torch distance and exposure time. With an increase of torch distance, the platelet count of treated blood samples increases but is less than that of the control. The flux of reactive atomic oxygen (RAO) and the degree of blood clotting decreased. With an increase of exposure time, platelet count of treated samples decreased, while the degree of clot increased. The correlation among these dependencies and published data support a blood clotting mechanism that RAO as well as other likely reactive oxygen species generated by the plasma torch activate erythrocyte-platelets interactions and induces blood coagulation.

  14. NEW APPLICATION OF PASSIVE SAMPLING DEVICES FOR ASSESSMENT OF RESPIRATORY EXPOSURE TO PESTICIDES IN INDOOR AIR

    EPA Science Inventory

    The United States Environmental Protection Agency (EPA) has long maintained an interest in potential applications of passive sampling devices (PSDs) for estimating the concentrations of various pollutants in air. Typically PSDs were designed for the workplace monitoring of vola...

  15. The effects of compressor seventh-stage bleed air extraction on performance of the F100-PW-220 afterburning turbofan engine

    NASA Technical Reports Server (NTRS)

    Evans, Alison B.

    1991-01-01

    A study was conducted to determine the effects of seventh-stage compressor bleed on the performance of the F100 afterburning turbofan engine. The effects of bleed on thrust, specific fuel consumption, fan turbine inlet temperature, bleed total pressure, and bleed total temperature were obtained from the engine manufacturer's status deck computer simulation. These effects were determined for power settings of intermediate, partial afterburning, and maximum afterburning for Mach numbers between 0.6 and 2.2 and for altitudes of 30,000, 40,000, and 50,000 ft. It was found that thrust loss and specific fuel consumption increase were approximately linear functions of bleed flow and, based on a percent-thrust change basis, were approximately independent of power setting.

  16. Use of ozone generating devices to improve indoor air quality.

    PubMed

    Boeniger, M F

    1995-06-01

    Room ozonization has been in widespread use to "freshen" indoor air for more than 100 years. This use is sometimes promoted with the claim that ozone can oxidize airborne gases, and even particulates, to simple carbon dioxide and water vapor. Aside from whether ozone can improve indoor air quality, the potentially deleterious consequences to public health of overexposure to ozone are of concern. The literature on both allegations is reviewed. It indicates that ozone is not a practical and effective means of improving indoor air quality, especially in light of its potentially serious risk to health.

  17. A SURVEY OF INDOOR AIR CONTAMINATES USING SEMIPERMEABLE MEMBRANE DEVICES

    EPA Science Inventory

    Semipermeable membrane devices (SPMDs) were deployed in indoor areas in approximately 50 residences along the border between Arizona and Mexico to measure airborne contaminants. The results of the primary analyses and gas chromatographic/mass spectrometric confirmation for org...

  18. Hollow Fiber Membrane Dehumidification Device for Air Conditioning System

    PubMed Central

    Zhao, Baiwang; Peng, Na; Liang, Canzeng; Yong, Wai Fen; Chung, Tai-Shung

    2015-01-01

    In order to provide a comfortable living and working environment indoors in tropical countries, the outdoor air often needs to be cooled and dehumidified before it enters the rooms. Membrane separation is an emerging technology for air dehumidification and it is based on the solution diffusion mechanism. Water molecules are preferentially permeating through the membranes due to its smaller kinetic diameter and higher condensability than the other gases. Compared to other dehumidification technologies such as direct cooling or desiccation, there is no phase transition involved in membrane dehumidification, neither the contact between the fresh air stream and the desiccants. Hence, membrane dehumidification would not only require less energy consumption but also avoid cross-contamination problems. A pilot scale air dehumidification system is built in this study which comprises nine pieces of one-inch PAN/PDMS hollow fiber membrane modules. A 150 h long-term test shows that the membrane modules has good water vapor transport properties by using a low vacuum force of only 0.78 bar absolute pressure at the lumen side. The water vapor concentration of the feed humid air decreases dramatically from a range of 18–22 g/m3 to a range of 13.5–18.3 g/m3. Most importantly, the total energy saving is up to 26.2% compared with the conventional air conditioning process. PMID:26580660

  19. Hollow Fiber Membrane Dehumidification Device for Air Conditioning System.

    PubMed

    Zhao, Baiwang; Peng, Na; Liang, Canzeng; Yong, Wai Fen; Chung, Tai-Shung

    2015-11-16

    In order to provide a comfortable living and working environment indoors in tropical countries, the outdoor air often needs to be cooled and dehumidified before it enters the rooms. Membrane separation is an emerging technology for air dehumidification and it is based on the solution diffusion mechanism. Water molecules are preferentially permeating through the membranes due to its smaller kinetic diameter and higher condensability than the other gases. Compared to other dehumidification technologies such as direct cooling or desiccation, there is no phase transition involved in membrane dehumidification, neither the contact between the fresh air stream and the desiccants. Hence, membrane dehumidification would not only require less energy consumption but also avoid cross-contamination problems. A pilot scale air dehumidification system is built in this study which comprises nine pieces of one-inch PAN/PDMS hollow fiber membrane modules. A 150 h long-term test shows that the membrane modules has good water vapor transport properties by using a low vacuum force of only 0.78 bar absolute pressure at the lumen side. The water vapor concentration of the feed humid air decreases dramatically from a range of 18-22 g/m³ to a range of 13.5-18.3 g/m³. Most importantly, the total energy saving is up to 26.2% compared with the conventional air conditioning process.

  20. Trial of a negative ion generator device in remediating problems related to indoor air quality

    SciTech Connect

    Daniell, W.; Camp, J.; Horstman, S. )

    1991-06-01

    It has been suggested that supplementation of indoor air with negative ions can improve air quality. This study examined the effects of a negative ion-generator device on air contaminants and symptom reporting in two office buildings. Separate sets of functional and nonfunctional negative ion generators were monitored using a double blind, crossover design involving two 5-week exposure periods. There were no detectable direct or residual effects of negative ion generator use on air ion levels, airborn particulates, carbon dioxide levels, or symptom reporting. Symptom reporting declined at both sites initially and appeared to be consistent with placebo effect. Job dissatisfaction was an apparent contributor to symptom reporting, with a magnitude comparable to presumed effects of air quality. Further testing of such devices is needed before they should be considered for office air quality problems.

  1. Development of an Ultrasonic Airflow Measurement Device for Ducted Air

    PubMed Central

    Raine, Andrew B.; Aslam, Nauman; Underwood, Christopher P.; Danaher, Sean

    2015-01-01

    In this study, an in-duct ultrasonic airflow measurement device has been designed, developed and tested. The airflow measurement results for a small range of airflow velocities and temperatures show that the accuracy was better than 3.5% root mean square (RMS) when it was tested within a round or square duct compared to the in-line Venturi tube airflow meter used for reference. This proof of concept device has provided evidence that with further development it could be a low-cost alternative to pressure differential devices such as the orifice plate airflow meter for monitoring energy efficiency performance and reliability of ventilation systems. The design uses a number of techniques and design choices to provide solutions to lower the implementation cost of the device compared to traditional airflow meters. The design choices that were found to work well are the single sided transducer arrangement for a “V” shaped reflective path and the use of square wave transmitter pulses ending with the necessary 180° phase changed pulse train to suppress transducer ringing. The device is also designed so that it does not have to rely on high-speed analogue to digital converters (ADC) and intensive digital signal processing, so could be implemented using voltage comparators and low-cost microcontrollers. PMID:25954952

  2. Air processed organic photovoltaic devices incorporating a MoOx anode buffer layer

    NASA Astrophysics Data System (ADS)

    Bovill, Edward S. R.; Griffin, Jonathan; Wang, Tao; Kingsley, James W.; Yi, Hunan; Iraqi, Ahmed; Buckley, Alastair R.; Lidzey, David G.

    2013-05-01

    Molybdenum oxide (MoOx) has been shown to act as an efficient hole extraction layer in organic photovoltaic (OPV) devices. However, exposing MoOx films to air is problematic as it is hygroscopic; the uptake of moisture having a negative impact on its electronic properties. Here, we use spectroscopic ellipsometry to characterise the uptake of water, and fabricate PCDTBT:PC70BM based OPVs to determine its effects on device performance. We then show that thermally annealing MoOx reduces its hygroscopicity, permitting it to be processed in air. Using this process, we create air-processsed OPVs having PCEs (power conversion efficiencies) of up to 5.36%.

  3. Training augmentation device for the Air Force satellite Control Network

    NASA Technical Reports Server (NTRS)

    Shoates, Keith B.

    1993-01-01

    From the 1960's and into the early 1980's satellite operations and control were conducted by Air Force Systems Command (AFSC), now Air Force Materiel Command (AFMC), out of the Satellite Control Facility at Onizuka AFB, CA. AFSC was responsible for acquiring satellite command and control systems and conducting routine satellite operations. The daily operations, consisting of satellite health and status contacts and station keeping activities, were performed for AFSC by a Mission Control Team (MCT) staffed by civilian contractors who were responsible for providing their own technically 'qualified' personnel as satellite operators. An MCT consists of five positions: mission planner, ground controller, planner analyst, orbit analyst, and ranger controller. Most of the training consisted of On-the-Job-Training (OJT) with junior personnel apprenticed to senior personnel until they could demonstrate job proficiency. With most of the satellite operators having 15 to 25 years of experience, there was minimal risk to the mission. In the mid 1980's Air Force Space Command (AFSPACOM) assumed operational responsibility for a newly established control node at Falcon AFB (FAFB) in CO. The satellites and ground system program offices (SPO's) are organized under AFSC's Space and Missiles Systems Center (SMC) to function as a systems engineering and acquisition agency for AFSPACECOM. The collection of the satellite control nodes, ground tracking stations, computer processing equipment, and connecting communications links is referred to as the Air Force Satellite Control Network (AFSCN).

  4. The fate of mercury collected from air pollution control devices

    EPA Science Inventory

    The mercury that enters a coal-fired power plant, originates from the coal that is burned, and leaves through the output streams that include stack emissions and air pollution control (APC) residues (either in solid or liquid form). This article describes recent fmdings on the fa...

  5. Cold start fuel/air mixture supply device for spark ignition internal combustion engines

    SciTech Connect

    Ross, G.E.D.

    1984-06-05

    A combined accelerator pump and cold start fuel/air mixture supply device has an automatic throttle valve in a mixture supply passage, a fuel control valve controlling flow of fuel drawn into the passage through an inlet upstream of the throttle valve, and an air valve upstream of the fuel inlet. A primary spring tends to seat the air valve. A light, secondary spring urges a plunger against the air valve to augment the load of the primary spring for a predetermined time interval after the engine begins to run under its own power. A valve in a pipe opens automatically at the end of the predetermined time interval to apply engine inlet manifold depression to the end of the plunger remote from the air valve and thereby to separate the plunger from the air valve so that only the primary spring acts on the air valve.

  6. Bruising and Bleeding

    MedlinePlus

    ... immunodeficiency virus (HIV) infection, pregnancy, systemic lupus erythematosus (lupus), or kidney failure Prior excessive or unusual bleeding or transfusions Family history of excessive bleeding People are asked about use ...

  7. Vaginal bleeding - hormonal

    MedlinePlus

    ... abnormal uterine bleeding is caused by a hormone imbalance. DUB is more common in teenagers or in women who are approaching menopause. DUB is unpredictable. The bleeding may be very heavy or light and can occur often or randomly.

  8. 40 CFR 60.5215 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution control device used to comply with the emission limits, according to § 60.5220(c), no later than 12 months following the previous annual air pollution control...

  9. 40 CFR 424.10 - Applicability; description of the open electric furnaces with wet air pollution control devices...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... electric furnaces with wet air pollution control devices subcategory. 424.10 Section 424.10 Protection of... MANUFACTURING POINT SOURCE CATEGORY Open Electric Furnaces With Wet Air Pollution Control Devices Subcategory § 424.10 Applicability; description of the open electric furnaces with wet air pollution control...

  10. 40 CFR 60.2151 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspection? 60.2151 Section 60.2151 Protection of Environment... Compliance Requirements § 60.2151 By what date must I conduct the annual air pollution control device inspection? On an annual basis (no more than 12 months following the previous annual air pollution...

  11. 40 CFR 60.4895 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Compliance Requirements § 60.4895 By what date must I conduct annual air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution... following the previous annual air pollution control device inspection. (b) Within 10 operating...

  12. 40 CFR 60.4895 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Compliance Requirements § 60.4895 By what date must I conduct annual air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution... following the previous annual air pollution control device inspection. (b) Within 10 operating...

  13. 40 CFR 60.5215 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution control device used to comply with the emission limits, according to § 60.5220(c), no later than 12 months following the previous annual air pollution control...

  14. 40 CFR 60.4895 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Compliance Requirements § 60.4895 By what date must I conduct annual air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution... following the previous annual air pollution control device inspection. (b) Within 10 operating...

  15. 40 CFR 60.2151 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspection? 60.2151 Section 60.2151 Protection of Environment... Compliance Requirements § 60.2151 By what date must I conduct the annual air pollution control device inspection? On an annual basis (no more than 12 months following the previous annual air pollution...

  16. 40 CFR 60.5215 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution control device used to comply with the emission limits, according to § 60.5220(c), no later than 12 months following the previous annual air pollution control...

  17. 40 CFR 424.10 - Applicability; description of the open electric furnaces with wet air pollution control devices...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... electric furnaces with wet air pollution control devices subcategory. 424.10 Section 424.10 Protection of... MANUFACTURING POINT SOURCE CATEGORY Open Electric Furnaces With Wet Air Pollution Control Devices Subcategory § 424.10 Applicability; description of the open electric furnaces with wet air pollution control...

  18. 40 CFR 424.10 - Applicability; description of the open electric furnaces with wet air pollution control devices...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... electric furnaces with wet air pollution control devices subcategory. 424.10 Section 424.10 Protection of... MANUFACTURING POINT SOURCE CATEGORY Open Electric Furnaces With Wet Air Pollution Control Devices Subcategory § 424.10 Applicability; description of the open electric furnaces with wet air pollution control...

  19. 40 CFR 424.10 - Applicability; description of the open electric furnaces with wet air pollution control devices...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... electric furnaces with wet air pollution control devices subcategory. 424.10 Section 424.10 Protection of... MANUFACTURING POINT SOURCE CATEGORY Open Electric Furnaces With Wet Air Pollution Control Devices Subcategory § 424.10 Applicability; description of the open electric furnaces with wet air pollution control...

  20. 40 CFR 60.4895 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Compliance Requirements § 60.4895 By what date must I conduct annual air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution... following the previous annual air pollution control device inspection. (b) Within 10 operating...

  1. 40 CFR 60.2716 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspection? 60.2716 Section 60.2716 Protection of Environment... Requirements § 60.2716 By what date must I conduct the annual air pollution control device inspection? On an annual basis (no more than 12 months following the previous annual air pollution control...

  2. 40 CFR 424.10 - Applicability; description of the open electric furnaces with wet air pollution control devices...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... electric furnaces with wet air pollution control devices subcategory. 424.10 Section 424.10 Protection of... MANUFACTURING POINT SOURCE CATEGORY Open Electric Furnaces With Wet Air Pollution Control Devices Subcategory § 424.10 Applicability; description of the open electric furnaces with wet air pollution control...

  3. 40 CFR 60.5215 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution control device used to comply with the emission limits, according to § 60.5220(c), no later than 12 months following the previous annual air pollution control...

  4. Fate of mercury collected from air pollution control devices

    SciTech Connect

    Constance L. Senior; Susan Thorneloe; Bernine Khan; David Goss

    2009-07-15

    Mercury that enters a coal-fired power plant originates from the coal that is burned and leaves through the output streams, which include stack emissions and air pollution control (APC) residues (either in solid or liquid form). This article describes recent findings on the fate and environmental stability of mercury in coal combustion residues (CCRs) such as fly ash and solid products from flue gas desulfurization (FGD) scrubbers when either disposed or reused in agricultural, commercial, or engineering applications. 19 refs., 4 figs., 5 tabs.

  5. Bleeding during cancer treatment

    MedlinePlus

    ... throwing up blood or your vomit looks like coffee grounds Long or heavy periods (women) Headaches that do not go away or are very bad Blurry or double vision Abdominal pains Alternative Names Cancer treatment - bleeding; Chemotherapy - bleeding; Radiation - bleeding; Bone marrow ...

  6. Abnormal Uterine Bleeding FAQ

    MedlinePlus

    ... PROBLEMS Abnormal Uterine Bleeding • What is a normal menstrual cycle? • When is bleeding abnormal? • At what ages is ... treat abnormal bleeding? •Glossary What is a normal menstrual cycle? The normal length of the menstrual cycle is ...

  7. A portable air jet actuator device for mechanical system identification

    NASA Astrophysics Data System (ADS)

    Belden, Jesse; Staats, Wayne L.; Mazumdar, Anirban; Hunter, Ian W.

    2011-03-01

    System identification of limb mechanics can help diagnose ailments and can aid in the optimization of robotic limb control parameters and designs. An interesting fluid phenomenon—the Coandă effect—is utilized in a portable actuator to provide a stochastic binary force disturbance to a limb system. The design of the actuator is approached with the goal of creating a portable device which could be deployed on human or robotic limbs for in situ mechanical system identification. The viability of the device is demonstrated by identifying the parameters of an underdamped elastic beam system with fixed inertia and stiffness and variable damping. The nonparametric compliance impulse response yielded from the system identification is modeled as a second-order system and the resultant parameters are found to be in excellent agreement with those found using more traditional system identification techniques. The current design could be further miniaturized and developed as a portable, wireless, unrestrained mechanical system identification instrument for less intrusive and more widespread use.

  8. A portable air jet actuator device for mechanical system identification.

    PubMed

    Belden, Jesse; Staats, Wayne L; Mazumdar, Anirban; Hunter, Ian W

    2011-03-01

    System identification of limb mechanics can help diagnose ailments and can aid in the optimization of robotic limb control parameters and designs. An interesting fluid phenomenon--the Coandă effect--is utilized in a portable actuator to provide a stochastic binary force disturbance to a limb system. The design of the actuator is approached with the goal of creating a portable device which could be deployed on human or robotic limbs for in situ mechanical system identification. The viability of the device is demonstrated by identifying the parameters of an underdamped elastic beam system with fixed inertia and stiffness and variable damping. The nonparametric compliance impulse response yielded from the system identification is modeled as a second-order system and the resultant parameters are found to be in excellent agreement with those found using more traditional system identification techniques. The current design could be further miniaturized and developed as a portable, wireless, unrestrained mechanical system identification instrument for less intrusive and more widespread use.

  9. A novel membrane device for the removal of water vapor and water droplets from air

    NASA Technical Reports Server (NTRS)

    Ray, Rod; Newbold, David D.; Mccray, Scott B.; Friesen, Dwayne T.; Kliss, Mark

    1992-01-01

    One of the key challenges facing NASA engineers is the development of systems for separating liquids and gases in microgravity environments. In this paper, a novel membrane-based phase separator is described. This device, known as a water recovery heat exchanger (WRHEX), overcomes the inherent deficiencies of current phase-separation technology. Specifically, the WRHEX cools and removes water vapor or water droplets from feed-air streams without the use of a vacuum or centrifugal force. As is shown in this paper, only a low-power air blower and a small stream of recirculated cool water is required for WRHEX operation. This paper presents the results of tests using this novel membrane device over a wide range of operating conditions. The data show that the WRHEX produces a dry air stream containing no entrained or liquid water - even when the feed air contains water droplets or mist. An analysis of the operation of the WRHEX is presented.

  10. The influence of air bags and restraining devices on extremity injuries in motor vehicle collisions.

    PubMed

    McGovern, M K; Murphy, R X; Okunski, W J; Wasser, T E

    2000-05-01

    The influence of air bags and other restraining devices on injury after motor vehicle collisions is not well defined. This study examined the relationship between the use of restraining devices and the incidence of extremity injuries in motor vehicle collisions. A retrospective analysis was performed on motor vehicle collision data submitted to the Pennsylvania Trauma Outcome Study database from 1990 through 1995. Criteria for submission included trauma patients who were admitted to the intensive care unit, who died during hospitalization, who were hospitalized for more than 72 hours, or who were transferred in or out of the receiving hospital. A total of 21,875 patients met these criteria. These patients were analyzed for the presence or absence of upper and lower extremity injuries and were compared based on their use of restraining devices. Restraining devices were categorized into four groups: air bag alone, air bag and seat belt, seat belt or carseat without air bag, and no restraining device. Statistical analysis was performed using the chi-squared test of association. For contingency tables with small expected frequencies, Fisher's exact test was used. Study participants included 11,688 men and 10,185 women with a mean age of 38 +/- 20 years. There were 16,033 drivers and 5,842 passengers. Air bags were deployed in 472 instances. In 297 of these cases, additional restraint was provided with a seat belt. In 6,632 cases, air bags were not deployed; however, patients were restrained with either a seat belt or a carseat. In 14,771 cases, patients were not restrained. When comparing restraining devices as a group vs. no restraint, there was a significant decrease in the incidence of upper (p = 0.018) and lower (p < 0.001) extremity injuries. Air bags, however, were associated with an increased incidence of both upper (p = 0.033) and lower (p = 0.002) extremity injuries when compared with no restraint or when compared among patients who were restrained. As a group

  11. Air-cathode microbial fuel cell array: a device for identifying and characterizing electrochemically active microbes.

    PubMed

    Hou, Huijie; Li, Lei; de Figueiredo, Paul; Han, Arum

    2011-01-15

    Microbial fuel cells (MFCs) have generated excitement in environmental and bioenergy communities due to their potential for coupling wastewater treatment with energy generation and powering diverse devices. The pursuit of strategies such as improving microbial cultivation practices and optimizing MFC devices has increased power generating capacities of MFCs. However, surprisingly few microbial species with electrochemical activity in MFCs have been identified because current devices do not support parallel analyses or high throughput screening. We have recently demonstrated the feasibility of using advanced microfabrication methods to fabricate an MFC microarray. Here, we extend these studies by demonstrating a microfabricated air-cathode MFC array system. The system contains 24 individual air-cathode MFCs integrated onto a single chip. The device enables the direct and parallel comparison of different microbes loaded onto the array. Environmental samples were used to validate the utility of the air-cathode MFC array system and two previously identified isolates, 7Ca (Shewanella sp.) and 3C (Arthrobacter sp.), were shown to display enhanced electrochemical activities of 2.69 mW/m(2) and 1.86 mW/m(2), respectively. Experiments using a large scale conventional air-cathode MFC validated these findings. The parallel air-cathode MFC array system demonstrated here is expected to promote and accelerate the discovery and characterization of electrochemically active microbes.

  12. Novel Air Stimulation MR-Device for Intraoral Quantitative Sensory Cold Testing.

    PubMed

    Brönnimann, Ben; Meier, Michael L; Hou, Mei-Yin; Parkinson, Charles; Ettlin, Dominik A

    2016-01-01

    The advent of neuroimaging in dental research provides exciting opportunities for relating excitation of trigeminal neurons to human somatosensory perceptions. Cold air sensitivity is one of the most frequent causes of dental discomfort or pain. Up to date, devices capable of delivering controlled cold air in an MR-environment are unavailable for quantitative sensory testing. This study therefore aimed at constructing and evaluating a novel MR-compatible, computer-controlled cold air stimulation apparatus (CASA) that produces graded air puffs. CASA consisted of a multi-injector air jet delivery system (AJS), a cold exchanger, a cooling agent, and a stimulus application construction. Its feasibility was tested by performing an fMRI stimulation experiment on a single subject experiencing dentine cold sensitivity. The novel device delivered repetitive, stable air stimuli ranging from room temperature (24.5°C ± 2°C) to -35°C, at flow rates between 5 and 17 liters per minute (l/min). These cold air puffs evoked perceptions similar to natural stimuli. Single-subject fMRI-analysis yielded brain activations typically associated with acute pain processing including thalamus, insular and cingulate cortices, somatosensory, cerebellar, and frontal brain regions. Thus, the novel CASA allowed for controlled, repetitive quantitative sensory testing by using air stimuli at graded temperatures (room temperature down to -35°C) while simultaneously recording brain responses. No MR-compatible stimulation device currently exists that is capable of providing non-contact natural-like stimuli at a wide temperature range to tissues in spatially restricted areas such as the mouth. The physical characteristics of this novel device thus holds promise for advancing the field of trigeminal and spinal somatosensory research, namely with respect to comparing therapeutic interventions for dentine hypersensitivity.

  13. Novel Air Stimulation MR-Device for Intraoral Quantitative Sensory Cold Testing

    PubMed Central

    Brönnimann, Ben; Meier, Michael L.; Hou, Mei-Yin; Parkinson, Charles; Ettlin, Dominik A.

    2016-01-01

    The advent of neuroimaging in dental research provides exciting opportunities for relating excitation of trigeminal neurons to human somatosensory perceptions. Cold air sensitivity is one of the most frequent causes of dental discomfort or pain. Up to date, devices capable of delivering controlled cold air in an MR-environment are unavailable for quantitative sensory testing. This study therefore aimed at constructing and evaluating a novel MR-compatible, computer-controlled cold air stimulation apparatus (CASA) that produces graded air puffs. CASA consisted of a multi-injector air jet delivery system (AJS), a cold exchanger, a cooling agent, and a stimulus application construction. Its feasibility was tested by performing an fMRI stimulation experiment on a single subject experiencing dentine cold sensitivity. The novel device delivered repetitive, stable air stimuli ranging from room temperature (24.5°C ± 2°C) to −35°C, at flow rates between 5 and 17 liters per minute (l/min). These cold air puffs evoked perceptions similar to natural stimuli. Single-subject fMRI-analysis yielded brain activations typically associated with acute pain processing including thalamus, insular and cingulate cortices, somatosensory, cerebellar, and frontal brain regions. Thus, the novel CASA allowed for controlled, repetitive quantitative sensory testing by using air stimuli at graded temperatures (room temperature down to −35°C) while simultaneously recording brain responses. No MR-compatible stimulation device currently exists that is capable of providing non-contact natural-like stimuli at a wide temperature range to tissues in spatially restricted areas such as the mouth. The physical characteristics of this novel device thus holds promise for advancing the field of trigeminal and spinal somatosensory research, namely with respect to comparing therapeutic interventions for dentine hypersensitivity. PMID:27445771

  14. Air-Q intubating laryngeal airway: A study of the second generation supraglottic airway device

    PubMed Central

    Attarde, Viren Bhaskar; Kotekar, Nalini; Shetty, Sarika M

    2016-01-01

    Background and Aims: Air-Q intubating laryngeal mask airway (ILA) is used as a supraglottic airway device and as a conduit for endotracheal intubation. This study aims to assess the efficacy of the Air-Q ILA regarding ease of insertion, adequacy of ventilation, rate of successful intubation, haemodynamic response and airway morbidity. Methods: Sixty patients presenting for elective surgery at our Medical College Hospital were selected. Following adequate premedication, baseline vital parameters, pulse rate and blood pressure were recorded. Air-Q size 3.5 for patients 50-70 kg and size 4.5 for 70-100 kg was selected. After achieving adequate intubating conditions, Air-Q ILA was introduced. Confirming adequate ventilation, appropriate sized endotracheal tube was advanced through the Air-Q blindly to intubate the trachea. Placement of the endotracheal tube in trachea was confirmed. Results: Air-Q ILA was successfully inserted in 88.3% of patients in first attempt and 11.7% patients in second attempt. Ventilation was adequate in 100% of patients. Intubation was successful in 76.7% of patients with Air-Q ILA. 23.3% of patients were intubated by direct laryngoscopy following failure with two attempts using Air-Q ILA. Post-intubation the change in heart rate was statistically significant (P < 0.0001). 10% of patients were noted to have a sore throat and 5% of patients had mild airway trauma. Conclusion: Air-Q ILA is a reliable device as a supraglottic airway ensuring adequate ventilation as well as a conduit for endotracheal intubation. It benefits the patient by avoiding the stress of direct laryngoscopy and is also superior alternative device for use in a difficult airway. PMID:27212722

  15. Critical Evaluation of Air-Liquid Interface Exposure Devices for In Vitro Assessment of Atmospheric Pollutants

    EPA Science Inventory

    Exposure of cells to atmospheric pollutants at the air-liquid interface (ALI) is a more realistic approach than exposures of attached cells submerged in liquid medium. However, there is still limited understanding of the ideal ALI device design features that permit reproducible a...

  16. Development and evaluation of an air permeability test device for concrete

    NASA Astrophysics Data System (ADS)

    Guth, Dena Lee

    The use of non-destructive testing is increasing as a way to determine the quality of concrete infrastructure. A good concrete should be durable, and low permeability is one indication of durable concrete. This research focused on the development of a device with two concentric chambers capable of measuring the permeability of concrete in a non-destructive manner. The method measures the rate at which pressure in the inner chamber increases as air flows from the outer chamber through the concrete and into the inner chamber. The device is attached to the concrete surface by suction force created by vacuum. The surface around the device is sealed to limit the area from which air may enter the inner chamber. A computer program was developed to model the flow of air through the concrete. The axisymmetric nature of the device was used and an equation modeling steady-state flow was applied at small time increments to estimate the actual condition of non-steady flow. The program produces a family of curves which may be combined with the experimental data to estimate the permeability of the concrete. A parametric study was conducted to correlate the new device to standardized permeability test methods. Age, the use of a pozzolan, and different water-to-cementitious material ratios were the main variables in the test program.

  17. Design, fabrication and characterization of an air-driven micro turbine device

    NASA Astrophysics Data System (ADS)

    Shan, X. C.; Zhang, Qide; Sun, Yaofeng; Wang, Zhenfeng

    2006-04-01

    Micro turbine is one of the important components in a micro gas turbine engine. This paper reports on the development and investigations of a micro turbine device driven by compressed air, which consists of three layers of silicon wafers and two layers of acrylic plates. The rotor has an outer diameter of 8.4 mm with a thickness of 0.76 mm. The key challenges to develop a successful high-speed turbine device are geometry design and fabrication of micro blade profiles as well as air-bearings. The micro air bearings have been designed, and a deep reactive ion etching (DRIE) process has been used for fabricating micro journal bearings with high aspect ratio. The micro turbine has reached a rotating speed of 9,000 rpm during test.

  18. Regenerable device for scrubbing breathable air of CO2 and moisture without special heat exchanger equipment

    NASA Technical Reports Server (NTRS)

    Tepper, E. H. (Inventor)

    1977-01-01

    The device concerns the circulation of cabin air through canisters which absorb and adsorb carbon dioxide, together with excess moisture, and return the scrubbed air to the cabin for recirculation. A coating on an inert substrate in granular form absorbs and adsorbs the impurities at standard temperatures and pressures, but desorbs such impurities at low pressures (vacuum) and standard temperatures. This fact is exploited by making the device in a stack of cells consisting of layers or cells which are isolated from one another flow-wise and are connected to separate manifolds and valving systems into two separate subsets. A first subset may be connected for the flow breathable air therethrough until the polyethyleneimine of its cells is saturated with CO2 and H2O. During the same period the second subset of cells is manifolded to a vacuum source.

  19. Sampling technologies and air pollution control devices for gaseous and particulate arsenic: a review.

    PubMed

    Helsen, Lieve

    2005-09-01

    Direct measurement of arsenic release requires a good sampling and analysis procedure in order to capture and detect the total amount of metals emitted. The literature is extensively reviewed in order to evaluate the efficiency of full field-scale and laboratory scale techniques for capturing particulate and gaseous emissions of arsenic from the thermo-chemical treatment of different sources of arsenic. Furthermore, trace arsenic concentrations in ambient air, national standard sampling methods and arsenic analysis methods are considered. Besides sampling techniques, the use of sorbents is also reviewed with respect to both approaches (1) to prevent the metals from exiting with the flue gas and (2) to react or combine with the metals in order to be collected in air pollution control systems. The most important conclusion is that submicron arsenic fumes are difficult to control in conventional air pollution control devices. Complete capture of the arsenic species requires a combination of particle control and vapour control devices.

  20. A survey of results for passive air and water sampling via semipermeable membrane devices

    SciTech Connect

    Prest, H.F.; Jacobson, L.; Hodgins, M.; Huckins, J.N.; Petty, J.D.; Richardson, B.; Wilson, M.; Martin, M.

    1994-12-31

    Passive sampling techniques have progressed and are providing new possibilities for measuring trace contaminants in environmental compartments. One such device, the semipermeable membrane device (SPMD) developed by Huckins, et al in Columbia, MO. is especially promising. The authors present an overview of results for sampling in air and water with semipermeable membrane devices (SPMDS) for organochlorines and polynuclear aromatic hydrocarbons (PAHs) and comment on possible future applications and potential. Differences in organohalogen profiles for SPMDs and green-lipped mussels deployed along transacts of Corio Bay, Australia show marked differences in sequestering ``windows``. An illustration of the application of SPMDs to the measurement of the half-life of chemicals is presented using PAH data from SPMD deployments in an irrigation canal in New Mexico. Results for simultaneous sampling of water and coastal air in Northern California illustrate the promise of SPMDs as global monitors.

  1. Bleeding and cupping.

    PubMed Central

    Turk, J. L.; Allen, E.

    1983-01-01

    Bleeding and cupping have been used in medicine since ancient times in the treatment of fevers and local inflammatory disorders. Local bleeding, by 'wet cupping', was effected by a scarificator or by leeches. John Hunter recommended venesection in moderation but preferred leeches for local bleeding. Bleeding as an accepted therapeutic practice went out of vogue in the middle of the nineteenth century as a result of the introduction of modern scientific methods. Dry cupping and the use of leeches, as counter irritants, persisted until the middle of this century. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 PMID:6338802

  2. [The pewter bleeding bowls].

    PubMed

    Renner, Claude

    2004-01-01

    In the late seventeenth century, then along the eighteen and nineteenth centuries the amount of the bloodlettings was measured by means of three pewter bleeding bowls that held three ounces of blood, about 300 millilitres. In the middle of the nineteenth century new and large bleeding bowls with metric graduations were manufactured only by the Parisian potters.

  3. Gastrointestinal Bleeding in Athletes.

    ERIC Educational Resources Information Center

    Eichner, Edward R.

    1989-01-01

    Describes the scope and importance of gastrointestinal bleeding in runners and other athletes, discussing causes, sites, and implications of exercise-related bleeding. Practical tips to mitigate the problem, potentially more troublesome in women because of lower iron stores, are presented (e.g., gradual conditioning and avoidance of prerace…

  4. Factors that influence the tribocharging of pulverulent materials in compressed-air devices

    NASA Astrophysics Data System (ADS)

    Das, S.; Medles, K.; Mihalcioiu, A.; Beleca, R.; Dragan, C.; Dascalescu, L.

    2008-12-01

    Tribocharging of pulverulent materials in compressed-air devices is a typical multi-factorial process. This paper aims at demonstrating the interest of using the design of experiments methodology in association with virtual instrumentation for quantifying the effects of various process varaibles and of their interactions, as a prerequisite for the development of new tribocharging devices for industrial applications. The study is focused on the tribocharging of PVC powders in compressed-air devices similar to those employed in electrostatic painting. A classical 2 full-factorial design (3 factors at two levels) was employed for conducting the experiments. The response function was the charge/mass ratio of the material collected in a modified Faraday cage, at the exit of the tribocharging device. The charge/mass ratio was found to increase with the injection pressure and the vortex pressure in the tribocharging device, and to decrease with the increasing of the feed rate. In the present study an in-house design of experiments software was employed for statistical analysis of experimental data and validation of the experimental model.

  5. Surgical bleeding in microgravity

    NASA Technical Reports Server (NTRS)

    Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd

    1993-01-01

    A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

  6. Wearable air supply for pneumatic artificial hearts and ventricular assist devices.

    PubMed

    Sipin, A J; Fabrey, W J; Smith, S H; Doussourd, J D; Olsen, D B

    1992-08-01

    An experimental wearable air supply for pneumatic artificial hearts and ventricular assist devices has been built and tested. The unit eliminates the need for tethering to a large, stationery driver. The miniaturized air supply is designed for ambulatory patients with implanted pulsatile pneumatic total artificial hearts (TAH) or pneumatic left-ventricular assist devices (LVAD), to permit mobility in clinical and home settings. The device has major short-term utility as a supply for pneumatic TAH or VAD bridges in patients awaiting heart transplants. The system design for the wearable driver includes a novel, fast rotary compressor, driven by a brushless direct current (DC) motor to supply air to the ventricle through an electromagnetically actuated directional valve, all controlled by a microcomputer. Stroke volume from 0 to 200 cc; pulse rate from 60 to 160 bpm, and duty cycle from 33% to 50% are selected on a keyboard, and the selected or measured parameters can be shown on a liquid crystal display. For control of delivery from a single ventricular assist device, stroke volume is controlled by variation of compressor speed. In the wearable air supply for a TAH, a single compressor drives both ventricles alternately through a double-acting directional valve. Air volume delivered to the left ventricle is adjusted by variation of compressor speed, and air volume to the right ventricle by variation of ejection time. The effect on blood flow rate of the lower impedance to the right ventricle is compensated by provision of a two-stage compressor, in which a single stage drives the right ventricle, and both stages connected in parallel drive the left ventricle. The overall dimensions of the prototype air supply for driving either a TAH or LVAD are 4.5 by 7.8 by 4.5 inches, including an emergency battery with a duration of 15 to 30 min depending on load. The weight is presently 5.5 lb, but this will be reduced in a production design and for a dedicated LVAD air supply

  7. Upper GI Bleeding in Children

    MedlinePlus

    Upper GI Bleeding in Children What is upper GI Bleeding? Irritation and ulcers of the lining of the esophagus, stomach or duodenum can result in upper GI bleeding. When this occurs the child may vomit ...

  8. Risk factors for major bleeding in the SEATTLE II trial

    PubMed Central

    Sadiq, Immad; Goldhaber, Samuel Z; Liu, Ping-Yu; Piazza, Gregory

    2017-01-01

    Ultrasound-facilitated, catheter-directed, low-dose fibrinolysis minimizes the risk of intracranial bleeding compared with systemic full-dose fibrinolytic therapy for pulmonary embolism (PE). However, major bleeding is nevertheless a potential complication. We analyzed the 150-patient SEATTLE II trial of submassive and massive PE patients to describe those who suffered major bleeding events following ultrasound-facilitated, catheter-directed, low-dose fibrinolysis and to identify risk factors for bleeding. Major bleeding was defined as GUSTO severe/life-threatening or moderate bleeds within 72 hours of initiation of the procedure. Of the 15 patients with major bleeding, four (26.6%) developed access site-related bleeding. Multiple venous access attempts were more frequent in the major bleeding group (27.6% vs 3.6%; p<0.001). All patients with major bleeding had femoral vein access for device delivery. Patients who developed major bleeding had a longer intensive care stay (6.8 days vs 4.7 days; p=0.004) and longer hospital stay (12.9 days vs 8.4 days; p=0.004). The frequency of inferior vena cava filter placement was 40% in patients with major bleeding compared with 13% in those without major bleeding (p=0.02). Massive PE (adjusted odds ratio 3.6; 95% confidence interval 1.01–12.9; p=0.049) and multiple venous access attempts (adjusted odds ratio 10.09; 95% confidence interval 1.98–51.46; p=0.005) were independently associated with an increased risk of major bleeding. In conclusion, strategies for improving venous access should be implemented to reduce the risk of major bleeding associated with ultrasound-facilitated, catheter-directed, low-dose fibrinolysis. ClinicalTrials.gov Identifier: NCT01513759; EKOS Corporation 10.13039/100006522 PMID:27913777

  9. Risk factors for major bleeding in the SEATTLE II trial.

    PubMed

    Sadiq, Immad; Goldhaber, Samuel Z; Liu, Ping-Yu; Piazza, Gregory

    2017-02-01

    Ultrasound-facilitated, catheter-directed, low-dose fibrinolysis minimizes the risk of intracranial bleeding compared with systemic full-dose fibrinolytic therapy for pulmonary embolism (PE). However, major bleeding is nevertheless a potential complication. We analyzed the 150-patient SEATTLE II trial of submassive and massive PE patients to describe those who suffered major bleeding events following ultrasound-facilitated, catheter-directed, low-dose fibrinolysis and to identify risk factors for bleeding. Major bleeding was defined as GUSTO severe/life-threatening or moderate bleeds within 72 hours of initiation of the procedure. Of the 15 patients with major bleeding, four (26.6%) developed access site-related bleeding. Multiple venous access attempts were more frequent in the major bleeding group (27.6% vs 3.6%; p<0.001). All patients with major bleeding had femoral vein access for device delivery. Patients who developed major bleeding had a longer intensive care stay (6.8 days vs 4.7 days; p=0.004) and longer hospital stay (12.9 days vs 8.4 days; p=0.004). The frequency of inferior vena cava filter placement was 40% in patients with major bleeding compared with 13% in those without major bleeding ( p=0.02). Massive PE (adjusted odds ratio 3.6; 95% confidence interval 1.01-12.9; p=0.049) and multiple venous access attempts (adjusted odds ratio 10.09; 95% confidence interval 1.98-51.46; p=0.005) were independently associated with an increased risk of major bleeding. In conclusion, strategies for improving venous access should be implemented to reduce the risk of major bleeding associated with ultrasound-facilitated, catheter-directed, low-dose fibrinolysis. ClinicalTrials.gov Identifier: NCT01513759; EKOS Corporation 10.13039/100006522.

  10. Far-field dispersal modeling for fuel-air-explosive devices

    SciTech Connect

    Glass, M.W.

    1990-05-01

    A computer model for simulating the explosive dispersal of a fuel agent in the far-field regime is described and is applied to a wide variety of initial conditions to judge their effect upon the resulting fuel/air cloud. This work was directed toward modeling the dispersal process associated with Fuel-Air-Explosives devices. The far-field dispersal regime is taken to be that time after the initial burster charge detonation in which the shock forces no longer dominate the flow field and initial canister and fuel mass breakup has occurred. The model was applied to a low vapor pressure fuel, a high vapor pressure fuel and a solid fuel. A strong dependence of the final cloud characteristics upon the initial droplet size distribution was demonstrated. The predicted fuel-air clouds were highly non-uniform in concentration. 18 refs., 86 figs., 4 tabs.

  11. Vaginal bleeding in pregnancy

    MedlinePlus

    ... 9 , bleeding may be a sign of: The placenta separating from the inner wall of the uterus ... the baby is born ( abruptio placentae ) Miscarriage The placenta is covering all or part of the opening ...

  12. Bleeding into the skin

    MedlinePlus

    Protect aging skin. Avoid trauma such as bumping or pulling on skin areas. For a cut or scrape, use direct pressure to stop the bleeding. If you have a drug reaction, ask your provider about stopping the drug. Otherwise, follow ...

  13. GI bleeding - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100162.htm GI bleeding - series—Normal anatomy To use the sharing ... colon, and finally, the rectum and anus. The GI tract is a long, hollow, muscular tube through ...

  14. 40 CFR 60.5195 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.5195 Section 60.5195... air pollution control device inspection and make any necessary repairs? (a) You must conduct an air... approved state plan, Federal plan, or delegation, as applicable. For air pollution control...

  15. 40 CFR 60.5195 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.5195 Section 60.5195... air pollution control device inspection and make any necessary repairs? (a) You must conduct an air... approved state plan, Federal plan, or delegation, as applicable. For air pollution control...

  16. 40 CFR 60.5195 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.5195 Section 60.5195... air pollution control device inspection and make any necessary repairs? (a) You must conduct an air... approved state plan, Federal plan, or delegation, as applicable. For air pollution control...

  17. 40 CFR 60.5195 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.5195 Section 60.5195... air pollution control device inspection and make any necessary repairs? (a) You must conduct an air... approved state plan, Federal plan, or delegation, as applicable. For air pollution control...

  18. Relationship of air sampling rates of semipermeable membrane devices with the properties of organochlorine pesticides.

    PubMed

    Zhu, Xiuhua; Ding, Guanghui; Levy, Walkiria; Jakobi, Gert; Schramm, Karl-Werner

    2011-06-01

    The organochlorine pesticides (OCP) in Eastern-Barvaria at Haidel 1160 m a.s.l. were monitored with a low volume active air sampler and semi-permeable membrane devices (SPMD). The air sampling rates (Rair) of SPMD for OCP were calculated. Quantitative structure-property relationship (QSPR) models of Rair of SPMD were developed for OCP with partial least square (PLS) regression. Quantum chemical descriptors computed by semi-empirical PM6 method were used as predictor variables. The cumulative variance of the dependent variable explained by the PLS components and determined by cross-validation (Q(2)cum), for the optimal models, is 0.637, indicating that the model has good predictive ability and robustness, and could be used to estimate Rair values of OCP. The main factors governing Rair of OCP are intermolecular interactions and the energy required for cave-forming in dissolution of OCP into triolein of SPMD.

  19. Rapid PCR amplification using a microfluidic device with integrated microwave heating and air impingement cooling.

    PubMed

    Shaw, Kirsty J; Docker, Peter T; Yelland, John V; Dyer, Charlotte E; Greenman, John; Greenway, Gillian M; Haswell, Stephen J

    2010-07-07

    A microwave heating system is described for performing polymerase chain reaction (PCR) in a microfluidic device. The heating system, in combination with air impingement cooling, provided rapid thermal cycling with heating and cooling rates of up to 65 degrees C s(-1) and minimal over- or under-shoot (+/-0.1 degrees C) when reaching target temperatures. In addition, once the required temperature was reached it could be maintained with an accuracy of +/-0.1 degrees C. To demonstrate the functionality of the system, PCR was successfully performed for the amplification of the Amelogenin locus using heating rates and quantities an order of magnitude faster and smaller than current commercial instruments.

  20. Flight tests of a simple airborne device for predicting clear air turbulence encounters

    NASA Technical Reports Server (NTRS)

    Kurkowski, R. L.; Duller, C. E., III; Kuhn, P. M.

    1978-01-01

    An airborne clear-air turbulence detector is being flight-tested on board NASA's C-141 and Learjet aircraft. The device is an infrared (IR) sensor in the water vapor band and is designed to detect changes in vapor concentrations associated with turbulence in shear conditions. Warnings of about 5 min have been demonstrated at flight altitudes from 9.1 to 13.7 km (30,000 to 45,000 ft). Encounter predictions were obtained 80% of the time, and false alarms were given about 6% of the time. Several simple algorithms were studied for use as signal output analyzers and for alert triggering.

  1. 76 FR 34845 - Medical Devices; Ear, Nose, and Throat Devices; Classification of the Wireless Air-Conduction...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-15

    ... Drug Administration 21 CFR Part 874 Medical Devices; Ear, Nose, and Throat Devices; Classification of... established by this final rule create ``requirements'' for specific medical devices under 21 U.S.C. 360k, even..., 1976 (the date of enactment of the Medical Device Amendments of 1976), generally referred to...

  2. Idiopathic omental bleeding

    PubMed Central

    Henry, D; Satgunam, S

    2012-01-01

    Omental bleeding without any evidence of trauma, aneurysms, or other pathology has been rarely described in the literature. We report a case of a 24 year-old female on aspirin/acetaminophen/caffeine for migraines who presented with abdominal pain and tachycardia. Computed tomography angiography revealed active extravasation in the right lower quadrant. During exploratory laparotomy, a small bleeding artery within the greater omentum was suture ligated, and two liters of fresh and clotted blood were evacuated. The patient recovered successfully. We review the diagnosis and management of this rare condition. PMID:24960788

  3. Bleeding Avoidance Strategies: Consensus and Controversy

    PubMed Central

    Dauerman, Harold L.; Rao, Sunil V.; Resnic, Frederic S.; Applegate, Robert J.

    2011-01-01

    Bleeding complications after coronary intervention are associated with prolonged hospitalization, increased hospital costs, patient dissatisfaction, morbidity and one year mortality. Bleeding Avoidance Strategies represent a term incorporating multiple modalities that aim to reduce bleeding and vascular complications after cardiovascular catheterization. Recent improvements in the rates of bleeding complications after invasive cardiovascular procedures suggests that the clinical community has successfully embraced specific strategies and improved patient care in this area. There remains controversy regarding the efficacy, safety and/or practicality of 3 key bleeding avoidance strategies for cardiac catheterization and coronary intervention: procedural (radial artery approach, safezone arteriotomy), pharmacologic (multiple agents) and technological (vascular closure devices) approaches to improved access. In this article, we address areas of consensus with respect to selected modalities in order to define the role of each strategy in current practice. Furthermore, we focus on areas of controversy for selected modalities in order to define key areas warranting cautious clinical approaches and the need for future randomized clinical trials in this area. PMID:21700085

  4. Bleeding avoidance strategies. Consensus and controversy.

    PubMed

    Dauerman, Harold L; Rao, Sunil V; Resnic, Frederic S; Applegate, Robert J

    2011-06-28

    Bleeding complications after coronary intervention are associated with prolonged hospitalization, increased hospital costs, patient dissatisfaction, morbidity, and 1-year mortality. Bleeding avoidance strategies is a term incorporating multiple modalities that aim to reduce bleeding and vascular complications after cardiovascular catheterization. Recent improvements in the rates of bleeding complications after invasive cardiovascular procedures suggest that the clinical community has successfully embraced specific strategies and improved patient care in this area. There remains controversy regarding the efficacy, safety, and/or practicality of 3 key bleeding avoidance strategies for cardiac catheterization and coronary intervention: procedural (radial artery approach, safezone arteriotomy), pharmacological (multiple agents), and technological (vascular closure devices) approaches to improved access. In this paper, we address areas of consensus with respect to selected modalities in order to define the role of each strategy in current practice. Furthermore, we focus on areas of controversy for selected modalities in order to define key areas warranting cautious clinical approaches and the need for future randomized clinical trials in this area.

  5. Passive cathodic water/air management device for micro-direct methanol fuel cells

    NASA Astrophysics Data System (ADS)

    Peng, Hsien-Chih; Chen, Po-Hon; Chen, Hung-Wen; Chieng, Ching-Chang; Yeh, Tsung-Kuang; Pan, Chin; Tseng, Fan-Gang

    A high efficient passive water/air management device (WAMD) is proposed and successfully demonstrated in this paper. The apparatus consists of cornered micro-channels and air-breathing windows with hydrophobicity arrangement to regulate liquids and gases to flow on their predetermined pathways. A high performance water/air separation with water removal rate of about 5.1 μl s -1 cm -2 is demonstrated. The performance of the proposed WAMD is sufficient to manage a cathode-generated water flux of 0.26 μl s -1 cm -2 in the micro-direct methanol fuel cells (μDMFCs) which are operated at 100 mW cm -2 or 400 mA cm -2. Furthermore, the condensed vapors can also be collected and recirculated with the existing micro-channels which act as a passive water recycling system for μDMFCs. The durability testing shows that the fuel cells equipped with WAMD exhibit improved stability and higher current density.

  6. Research on measurement-device-independent quantum key distribution based on an air-water channel

    NASA Astrophysics Data System (ADS)

    Zhou, Yuan-yuan; Zhou, Xue-jun; Xu, Hua-bin; Cheng, Kang

    2016-11-01

    A measurement-device-independent quantum key distribution (MDI-QKD) method with an air-water channel is researched. In this method, the underwater vehicle and satellite are the legitimate parties, and the third party is at the airwater interface in order to simplify the unilateral quantum channel to water or air. Considering the condition that both unilateral transmission distance and transmission loss coefficient are unequal, a perfect model of the asymmetric channel is built. The influence of asymmetric channel on system loss tolerance and secure transmission distance is analyzed. The simulation results show that with the increase of the channel's asymmetric degree, the system loss tolerance will descend, one transmission distance will be reduced while the other will be increased. When the asymmetric coefficient of channel is between 0.068 and 0.171, MDI-QKD can satisfy the demand of QKD with an air-water channel, namely the underwater transmission distance and atmospheric transmission distance are not less than 60 m and 12 km, respectively.

  7. Air core poloidal magnetic field system for a toroidal plasma producing device

    DOEpatents

    Marcus, Frederick B.

    1978-01-01

    A poloidal magnetics system for a plasma producing device of toroidal configuration is provided that reduces both the total volt-seconds requirement and the magnitude of the field change at the toroidal field coils. The system utilizes an air core transformer wound between the toroidal field (TF) coils and the major axis outside the TF coils. Electric current in the primary windings of this transformer is distributed and the magnetic flux returned by air core windings wrapped outside the toroidal field coils. A shield winding that is closely coupled to the plasma carries a current equal and opposite to the plasma current. This winding provides the shielding function and in addition serves in a fashion similar to a driven conducting shell to provide the equilibrium vertical field for the plasma. The shield winding is in series with a power supply and a decoupling coil located outside the TF coil at the primary winding locations. The present invention requires much less energy than the usual air core transformer and is capable of substantially shielding the toroidal field coils from poloidal field flux.

  8. Enzyme incorporated microfluidic device for in-situ glucose detection in water-in-air microdroplets.

    PubMed

    Piao, Yunxian; Han, Dong Ju; Azad, Mohammad Reza; Park, Minsu; Seo, Tae Seok

    2015-03-15

    Droplet generating microfluidic systems can provide miniaturized bioanalytical tools by using the homogenous and high-throughput droplets as nanoreactors. In this study, we demonstrated a sensitive and in-situ glucose monitoring system using water-in-air droplets in an enzyme incorporated microfluidic device. A thin film structure of a glucose oxidase (GOx) enzyme immobilized hydrogel was constructed in the middle of the microfluidic channel, and nanoliter scaled water-in-air droplets which contain a glucose sample, horseradish peroxidase (HRP), and an Amplex Red substrate were generated by flow focusing of water phase with air. Once the droplets passed through the enzyme trapped hydrogel, the droplets temporarily halted and a GOx mediated catalytic reaction with glucose proceeded, resulting in producing fluorescent resorufin products in the droplets. With optimized conditions such as the thickness of a hydrogel film and the size and flowing rate of droplets, fluorescence intensities of the released droplets linearly increased in proportional to the glucose concentration up to 3mM, and the limit of detection was calculated as 6.64µM. A spiked glucose in a real urine sample was also successfully analyzed, and the functionality of the proposed enzyme immobilized microfluidic chip was maintained for at least two weeks without loss of enzymatic activity and detection sensitivity. Thus, our methodology suggests a novel droplet based glucose sensing chip which can monitor glucose in a real-time and high-throughput manner.

  9. Rare Jejunal Diverticular Bleeding

    PubMed Central

    Christman, Emily; Hassell, Lewis A.; Kastens, Donald

    2016-01-01

    Severe gastrointestinal bleeding (GIB) secondary to jejunal diverticulosis (JD) is very rare. Delay in establishing a diagnosis is common and GIB from JD is associated with significant morbidity and mortality. We report an illustrative case diagnosed by push enteroscopy and managed with surgery. PMID:27800518

  10. 40 CFR 60.4875 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.4875 Section 60.4875... Initial Compliance Requirements § 60.4875 By what date must I conduct the initial air pollution control device inspection and make any necessary repairs? (a) You must conduct an air pollution control...

  11. 40 CFR 60.4875 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.4875 Section 60.4875... Initial Compliance Requirements § 60.4875 By what date must I conduct the initial air pollution control device inspection and make any necessary repairs? (a) You must conduct an air pollution control...

  12. 40 CFR 60.4875 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.4875 Section 60.4875... Initial Compliance Requirements § 60.4875 By what date must I conduct the initial air pollution control device inspection and make any necessary repairs? (a) You must conduct an air pollution control...

  13. 40 CFR 60.4875 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.4875 Section 60.4875... Initial Compliance Requirements § 60.4875 By what date must I conduct the initial air pollution control device inspection and make any necessary repairs? (a) You must conduct an air pollution control...

  14. Vaginal bleeding in late pregnancy

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000627.htm Vaginal bleeding in late pregnancy To use the sharing ... JavaScript. One out of 10 women will have vaginal bleeding during their 3rd trimester. At times, it ...

  15. Anemia Due to Excessive Bleeding

    MedlinePlus

    ... Anemia Due to Excessive Bleeding Iron Deficiency Anemia Vitamin Deficiency Anemia Anemia of Chronic Disease Aplastic Anemia Autoimmune ... Anemia Due to Excessive Bleeding Iron Deficiency Anemia Vitamin Deficiency Anemia Anemia of Chronic Disease Aplastic Anemia Autoimmune ...

  16. Changes in cervical muscle activity according to the traction force of an air-inflatable neck traction device

    PubMed Central

    Kang, Jong Ho; Park, Tae-Sung

    2015-01-01

    [Purpose] The purpose of this study was to analyze cervical muscle activity at different traction forces of an air-inflatable neck traction device. [Subjects] Eighteen males participated in this study. [Methods] The subjects put on an air-inflatable neck traction device and the traction forces administered were 40, 80, and 120 mmHg. The electromyography (EMG) signals of the splenius capitis, and upper trapezius were measured to assess the muscle activity. [Results] The muscle activity of the splenius capitis was significantly higher at 80, and 120 mmHg compared to 40 mmHg. The muscle activity of the upper trapezius did not show significant differences among the traction forces. [Conclusion] Our research result showed that the air-inflatable home neck traction device did not meet the condition of muscle relaxation. PMID:26504278

  17. Changes in cervical muscle activity according to the traction force of an air-inflatable neck traction device.

    PubMed

    Kang, Jong Ho; Park, Tae-Sung

    2015-09-01

    [Purpose] The purpose of this study was to analyze cervical muscle activity at different traction forces of an air-inflatable neck traction device. [Subjects] Eighteen males participated in this study. [Methods] The subjects put on an air-inflatable neck traction device and the traction forces administered were 40, 80, and 120 mmHg. The electromyography (EMG) signals of the splenius capitis, and upper trapezius were measured to assess the muscle activity. [Results] The muscle activity of the splenius capitis was significantly higher at 80, and 120 mmHg compared to 40 mmHg. The muscle activity of the upper trapezius did not show significant differences among the traction forces. [Conclusion] Our research result showed that the air-inflatable home neck traction device did not meet the condition of muscle relaxation.

  18. A simple atmospheric pressure room-temperature air plasma needle device for biomedical applications

    NASA Astrophysics Data System (ADS)

    Lu, X.; Xiong, Z.; Zhao, F.; Xian, Y.; Xiong, Q.; Gong, W.; Zou, C.; Jiang, Z.; Pan, Y.

    2009-11-01

    Rather than using noble gas, room air is used as the working gas for an atmospheric pressure room-temperature plasma. The plasma is driven by submicrosecond pulsed directed current voltages. Several current spikes appear periodically for each voltage pulse. The first current spike has a peak value of more than 1.5 A with a pulse width of about 10 ns. Emission spectra show that besides excited OH, O, N2(C-B), and N2+(B-X) emission, excited NO, N2(B-A), H, and even N emission are also observed in the plasma, which indicates that the plasma may be more reactive than that generated by other plasma jet devices. Utilizing the room-temperature plasma, preliminary inactivation experiments show that Enterococcus faecalis can be killed with a treatment time of only several seconds.

  19. A device for precision neutralization of electric charge of small drops using ionized air

    NASA Astrophysics Data System (ADS)

    Fan, Sewan; Kim, Peter C.; Lee, Eric R.; Lee, Irwin T.; Perl, Martin L.; Rogers, Howard; Loomba, Dinesh

    2003-10-01

    For use in our Millikan type liquid drop searches for fractional charge elementary particles we have developed a simple ionized air device for neutralizing a narrow stream of small drops. The neutralizer has been used for drops ranging in diameter from 10 to 25 μm. The width of the produced charge distribution is given by the Boltzmann equilibrium charge distribution and the mean of the distribution is set by a bias voltage. Using the bias voltage, the mean can be set with a precision of better than e, the electron charge. The use of the neutralizer is illustrated in an application to mineral oil drops produced with charges of the order of 1000e. We also show the interesting case of silicone oil drops that are produced in our drop generator with a charge distribution narrower than the Boltzmann equilibrium charge distribution, the charge distribution being broadened by the neutralizer.

  20. Air-over-ground calculations of the neutron, prompt, and secondary-gamma free-in-air tissue kerma from the Hiroshima and Nagasaki devices

    SciTech Connect

    Pace, J.V. III; Knight, J.R.; Bartine, D.E.

    1982-01-01

    This paper reports preliminary results of the two-dimensional discrete-ordinate, calculations for the air-over-ground transport of radiation from the Hiroshima and Nagasaki weapon devices. It was found that the gamma-ray kerma dominated the total kerma for both environments.

  1. Novel atmospheric pressure plasma device releasing atomic hydrogen: reduction of microbial-contaminants and OH radicals in the air

    NASA Astrophysics Data System (ADS)

    Nojima, Hideo; Park, Rae-Eun; Kwon, Jun-Hyoun; Suh, Inseon; Jeon, Junsang; Ha, Eunju; On, Hyeon-Ki; Kim, Hye-Ryung; Choi, Kyoung Hui; Lee, Kwang-Hee; Seong, Baik-Lin; Jung, Hoon; Kang, Shin Jung; Namba, Shinichi; Takiyama, Ken

    2007-01-01

    A novel atmospheric pressure plasma device releasing atomic hydrogen has been developed. This device has specific properties such as (1) deactivation of airborne microbial-contaminants, (2) neutralization of indoor OH radicals and (3) being harmless to the human body. It consists of a ceramic plate as a positive ion generation electrode and a needle-shaped electrode as an electron emission electrode. Release of atomic hydrogen from the device has been investigated by the spectroscopic method. Optical emission of atomic hydrogen probably due to recombination of positive ions, H+(H2O)n, generated from the ceramic plate electrode and electrons emitted from the needle-shaped electrode have been clearly observed in the He gas (including water vapour) environment. The efficacy of the device to reduce airborne concentrations of influenza virus, bacteria, mould fungi and allergens has been evaluated. 99.6% of airborne influenza virus has been deactivated with the operation of the device compared with the control test in a 1 m3 chamber after 60 min. The neutralization of the OH radical has been investigated by spectroscopic and biological methods. A remarkable reduction of the OH radical in the air by operation of the device has been observed by laser-induced fluorescence spectroscopy. The cell protection effects of the device against OH radicals in the air have been observed. Furthermore, the side effects have been checked by animal experiments. The harmlessness of the device has been confirmed.

  2. A survey of recent results in passive sampling of water and air by semipermeable membrane devices

    USGS Publications Warehouse

    Prest, Harry F.; Huckins, James N.; Petty, Jimmie D.; Herve, Sirpa; Paasivirta, Jaakko; Heinonen, Pertti

    1995-01-01

    A survey is presented of some recent results for passive sampling of water and air for trace organic contaminants using lipid-filled semipermeable membrane devices (SPMDs). Results of water sampling for trace organochlorine compounds using simultaneously exposed SPMDs and the most universally applied biomonitor (bivalves) are discussed. In general, the total amounts of accumulated analytes available for analysis in bivalves and SPMDs were comparable. However, SPMD controls typically had negligible levels of contamination, which was not always the case for transplanted bivalves, even after prolonged depuration prior to exposure. In surveys of the spatial trends of organochlorines at a series of sites, data from bivalves and SPMDs provided the same picture of contaminant distribution and severity. An exception was ionizable contaminants such as the chlorinated phenolic compounds and their transformation products found in pulp mill effluents. In these cases the two monitoring approaches compliment each other, i.e. what is not found in bivalves appears in SPMDs and vice versa. SPMDs have also been applied in environments where biomonitoring is not feasible. SPMDs have shown their utility in studies of trace levels of polyaromatic hydrocarbons by locating and characterizing point sources. An example is given of their application to the calculation of contaminant half-lives from aqueous SPMD residues, a direct measurement of the persistence of contaminants in an environmental compartment. Similarly, results of air sampling with SPMDs in a relatively pristine coastal location are cited which reveal a tremendous enhancement in p,p′-DDE relative to open ocean values.

  3. A Portable, Air-Jet-Actuator-Based Device for System Identification

    NASA Astrophysics Data System (ADS)

    Staats, Wayne; Belden, Jesse; Mazumdar, Anirban; Hunter, Ian

    2010-11-01

    System identification (ID) of human and robotic limbs could help in diagnosis of ailments and aid in optimization of control parameters and future redesigns. We present a self-contained actuator, which uses the Coanda effect to rapidly switch the direction of a high speed air jet to create a binary stochastic force input to a limb for system ID. The design of the actuator is approached with the goal of creating a portable device, which could deployed on robot or human limbs for in situ identification. The viability of the device is demonstrated by performing stochastic system ID on an underdamped elastic beam system with fixed inertia and stiffness, and variable damping. The non-parametric impulse response yielded from the stochastic system ID is modeled as a second order system, and the resultant parameters are found to be in excellent agreement with those found using more traditional system ID techniques. The current design could be further miniaturized and developed as a portable, wireless, on-site multi-axis system identification system for less intrusive and more widespread use.

  4. Facts about Vitamin K Deficiency Bleeding

    MedlinePlus

    ... Button Information For... Media Policy Makers Facts about Vitamin K Deficiency Bleeding Recommend on Facebook Tweet Share Compartir Vitamins ... serious bleeding problems if not supplemented. What is Vitamin K Deficiency Bleeding or VKDB? Vitamin K deficiency bleeding or ...

  5. Evaluation of mercury speciation and removal through air pollution control devices of a 190 MW boiler.

    PubMed

    Wu, Chengli; Cao, Yan; Dong, Zhongbing; Cheng, Chinmin; Li, Hanxu; Pan, Weiping

    2010-01-01

    Air pollution control devices (APCDs) are installed at coal-fired power plants for air pollutant regulation. Selective catalytic reduction (SCR) and wet flue gas desulfurization (FGD) systems have the co-benefits of air pollutant and mercury removal. Configuration and operational conditions of APCDs and mercury speciation affect mercury removal efficiently at coal-fired utilities. The Ontario Hydro Method (OHM) recommended by the U.S. Environmental Protection Agency (EPA) was used to determine mercury speciation simultaneously at five sampling locations through SCR-ESP-FGD at a 190 MW unit. Chlorine in coal had been suggested as a factor affecting the mercury speciation in flue gas; and low-chlorine coal was purported to produce less oxidized mercury (Hg2+) and more elemental mercury (Hg0) at the SCR inlet compared to higher chlorine coal. SCR could oxidize elemental mercury into oxidized mercury when SCR was in service, and oxidation efficiency reached 71.0%. Therefore, oxidized mercury removal efficiency was enhanced through a wet FGD system. In the non-ozone season, about 89.5%-96.8% of oxidized mercury was controlled, but only 54.9%-68.8% of the total mercury was captured through wet FGD. Oxidized mercury removal efficiency was 95.9%-98.0%, and there was a big difference in the total mercury removal efficiencies from 78.0% to 90.2% in the ozone season. Mercury mass balance was evaluated to validate reliability of OHM testing data, and the ratio of mercury input in the coal to mercury output at the stack was from 0.84 to 1.08.

  6. Air Cleaning Devices for HVAC Supply Systems in Schools. Technical Bulletin.

    ERIC Educational Resources Information Center

    Wheeler, Arthur E.

    Guidelines for maintaining indoor air quality in schools with HVAC air cleaning systems are provided in this document. Information is offered on the importance of air cleaning, sources of air contaminants and indoor pollutants, types of air cleaners and particulate filters used in central HVAC systems, vapor and gas removal, and performance…

  7. Detection of airborne bacteria in a duck production facility with two different personal air sampling devices for an exposure assessment.

    PubMed

    Martin, Elena; Dziurowitz, Nico; Jäckel, Udo; Schäfer, Jenny

    2015-01-01

    Prevalent airborne microorganisms are not well characterized in industrial animal production buildings with respect to their quantity or quality. To investigate the work-related microbial exposure, personal bioaerosol sampling during the whole working day is recommended. Therefore, bioaerosol sampling in a duck hatchery and a duck house with two personal air sampling devices, a filter-based PGP and a NIOSH particle size separator, was performed. Subsequent, quantitative and qualitative analyses were carried out with" culture independent methods. Total cell concentrations (TCC) determined via fluorescence microscopy showed no difference between the two devices. In average, 8 × 10(6) cells/m(3) were determined in the air of the duck hatchery and 5 × 10(7) cells/m(3) in the air of the duck house. A Generated Restriction Fragment Length Polymorphism (RFLP) pattern revealed deviant bacterial compositions comparing samples collected with both devices. Clone library analyses based on 16S rRNA gene sequence analysis from the hatchery's air showed 65% similarity between the two sampling devices. Detailed 16S rRNA gene sequence analyses showed the occurrence of bacterial species like Acinetobacter baumannii, Enterococcus faecalis, Escherichia sp., and Shigella sp.; and a group of Staphylococcus delphini, S. intermedius, and S. pseudintermedius that provided the evidence of potential exposure to risk group 2 bacteria at the hatchery workplace. Size fractionated sampling with the developed by the Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA) device revealed that pathogenic bacteria would deposit in the inhalable, the thorax, and possibly alveolar dust fraction according to EN481. TCC analysis showed the deposition of bacterial cells in the third stage (< 1μm) at the NIOSH device which implies that bacteria can reach deep into the lungs and contaminate the alveolus after inhalation. Nevertheless, both personal sampling devices

  8. Air

    MedlinePlus

    ... do to protect yourself from dirty air . Indoor air pollution and outdoor air pollution Air can be polluted indoors and it can ... this chart to see what things cause indoor air pollution and what things cause outdoor air pollution! Indoor ...

  9. Airborne pathogens inside automobiles for domestic use: Assessing in-car air decontamination devices using Staphylococcus aureus as the challenge.

    PubMed

    Sattar, Syed A; Zargar, Bahram; Wright, Kathryn E; Rubino, Joseph R; Ijaz, M Khalid

    2017-04-07

    Family cars represent ∼74% of the yearly global output of motorized vehicles. With the life-expectancy of ∼8 decades in many countries, one spends >100 minutes daily inside the confined and often shared space of the car with exposure to a mix of potentially harmful microbes. Can commercial in-car air microbial decontamination devices mitigate the risk? Three such devices (designated as Device #s1-3) with HEPA filters were tested in the modified passenger cabin (3.25 m3) of a four-door sedan housed within a biosafety level 3 containment facility. Staphylococcus aureus (ATCC 6538) was suspended in a soil load to simulate the presence of body fluids and aerosolized into the car's cabin with a 6-jet Collison nebulizer. A muffin fan (80 mm X 80 mm, with an output of 0.17 cubic meter/minute) circulated the air inside. Plates (150 mm diam.) of Trypticase-soy agar, placed inside a programmable slit-to-agar sampler, were held at 36±1°C for 18-24 h and examined for CFU. The input dose of the test bacterium, its rate of biological decay and the log10 reductions by the test devices were analyzed. The arbitrarily-set performance criterion was the time in h a device took for a 3-log10 reduction in the level of airborne challenge bacterium. On average, the level of S. aureus challenge in the air varied between 4.2 log10CFU/m(3)and 5.5 log10 CFU/m(3), and its rate of biological decay was -0.0213±0.0021 log10CFU/m3/min. Devices #1-3, took 2.3, 1.5, and 9.7 h, respectively, to meet the performance criterion. While the experimental set-up was tested using S. aureus as an archetypical airborne pathogen, it can be readily adapted to test other types of pathogens and technologies.Importance: This is the first study designed to test the survival of airborne pathogens in the confined and shared space of a family automobile as well as to assess claims of devices marketed for in-car air decontamination. The basic experimental set-up and the test protocols reported are versatile

  10. Bleeding manifestations in snake bite.

    PubMed

    Devaraj, T

    1979-06-01

    Bleeding following bites by the Malayan Pit Viper can either be local or systemic. Bleeding at the site of the bite is due to the local action of the venom as a vasculotoxin. Systemic bleeding occurs with severe poisoning and appears to be mainly dependent on platelet deficiency and the co-existing defibrination syndrome appears to play a minor role in the initiation of bleeding. Thus in the clinical situation non-clotting blood with no overt bleeding can continue up to weeks when specific antivenene is not given. Assessment of the severity of poisoning can easily be made at the bedside. Specific viper antivenene rapidly corrects the spontaneous bleeding and clotting defect of severe systemic poisoning but has no effect on local poisoning.

  11. Octreotide in variceal bleeding.

    PubMed Central

    Burroughs, A K

    1994-01-01

    Bleeding from oesophageal varices has a high death rate. Injection sclerotherapy is the most appropriate treatment but facilities for this are not always available. Balloon tamponade and vasoactive therapy may be used as stop gap measures. Somatostatin and octreotide are therapeutic candidates for the treatment of variceal bleeding and there are several trials that have compared somatostatin and octreotide with other treatments for this condition. The results of these trials are summarised and discussed. A meta analysis of the group of trials of placebo or H2 antagonists v somatostatin or octreotide showed a significant advantage of somatostatin or octreotide in terms of efficacy, but no difference in mortality. The trials discussed seem to show that somatostatin and octreotide are at least as effective as other treatments, with the benefit of fewer adverse effects, and thus represent the best vasoactive agents. Additionally, they may have a role as adjuvant treatment to emergency sclerotherapy for active bleeders and this must be further investigated. PMID:8206396

  12. Liquefied Bleed for Stability and Efficiency of High Speed Inlets

    NASA Technical Reports Server (NTRS)

    Saunders, J. David; Davis, David; Barsi, Stephen J.; Deans, Matthew C.; Weir, Lois J.; Sanders, Bobby W.

    2014-01-01

    A mission analysis code was developed to perform a trade study on the effectiveness of liquefying bleed for the inlet of the first stage of a TSTO vehicle. By liquefying bleed, the vehicle weight (TOGW) could be reduced by 7 to 23%. Numerous simplifying assumptions were made and lessons were learned. Increased accuracy in future analyses can be achieved by: Including a higher fidelity model to capture the effect of rescaling (variable vehicle TOGW). Refining specific thrust and impulse models ( T m a and Isp) to preserve fuel-to-air ratio. Implementing LH2 for T m a and Isp. Correlating baseline design to other mission analyses and correcting vehicle design elements. Implementing angle-of-attack effects on inlet characteristics. Refining aerodynamic performance (to improve L/D ratio at higher Mach numbers). Examining the benefit with partial cooling or densification of the bleed air stream. Incorporating higher fidelity weight estimates for the liquefied bleed system (heat exchange and liquid storage versus bleed duct weights) could be added when more fully developed. Adding trim drag or 6-degree-of-freedom trajectory analysis for higher fidelity. Investigating vehicle optimization for each of the bleed configurations.

  13. Anode reactive bleed and injector shift control strategy

    DOEpatents

    Cai, Jun [Rochester, NY; Chowdhury, Akbar [Pittsford, NY; Lerner, Seth E [Honeoye Falls, NY; Marley, William S [Rush, NY; Savage, David R [Rochester, NY; Leary, James K [Rochester, NY

    2012-01-03

    A system and method for correcting a large fuel cell voltage spread for a split sub-stack fuel cell system. The system includes a hydrogen source that provides hydrogen to each split sub-stack and bleed valves for bleeding the anode side of the sub-stacks. The system also includes a voltage measuring device for measuring the voltage of each cell in the split sub-stacks. The system provides two levels for correcting a large stack voltage spread problem. The first level includes sending fresh hydrogen to the weak sub-stack well before a normal reactive bleed would occur, and the second level includes sending fresh hydrogen to the weak sub-stack and opening the bleed valve of the other sub-stack when the cell voltage spread is close to stack failure.

  14. Statistical estimate of mercury removal efficiencies for air pollution control devices of municipal solid waste incinerators.

    PubMed

    Takahashi, Fumitake; Kida, Akiko; Shimaoka, Takayuki

    2010-10-15

    Although representative removal efficiencies of gaseous mercury for air pollution control devices (APCDs) are important to prepare more reliable atmospheric emission inventories of mercury, they have been still uncertain because they depend sensitively on many factors like the type of APCDs, gas temperature, and mercury speciation. In this study, representative removal efficiencies of gaseous mercury for several types of APCDs of municipal solid waste incineration (MSWI) were offered using a statistical method. 534 data of mercury removal efficiencies for APCDs used in MSWI were collected. APCDs were categorized as fixed-bed absorber (FA), wet scrubber (WS), electrostatic precipitator (ESP), and fabric filter (FF), and their hybrid systems. Data series of all APCD types had Gaussian log-normality. The average removal efficiency with a 95% confidence interval for each APCD was estimated. The FA, WS, and FF with carbon and/or dry sorbent injection systems had 75% to 82% average removal efficiencies. On the other hand, the ESP with/without dry sorbent injection had lower removal efficiencies of up to 22%. The type of dry sorbent injection in the FF system, dry or semi-dry, did not make more than 1% difference to the removal efficiency. The injection of activated carbon and carbon-containing fly ash in the FF system made less than 3% difference. Estimation errors of removal efficiency were especially high for the ESP. The national average of removal efficiency of APCDs in Japanese MSWI plants was estimated on the basis of incineration capacity. Owing to the replacement of old APCDs for dioxin control, the national average removal efficiency increased from 34.5% in 1991 to 92.5% in 2003. This resulted in an additional reduction of about 0.86Mg emission in 2003. Further study using the methodology in this study to other important emission sources like coal-fired power plants will contribute to better emission inventories.

  15. Vertical cavity surface emitting laser based on gallium arsenide/air-gap distributed Bragg reflectors: From concept to working devices

    NASA Astrophysics Data System (ADS)

    Mo, Qingwei

    Vertical-cavity surface-emitting lasers (VCSELs) have created new opportunities in optoelectronics. However, VCSELs have so far been commercialized mainly for operation at 0.85 mum, despite their potential importance at other wavelengths, such as 1.3 mum and 1.55 mum. The limitations at these longer wavelengths come from material characteristics, such as a low contrast ratio in mirror materials, lower mirror reflectivity, and smaller optical gain for longer wavelength materials versus AlGaAs/GaAs quantum wells. A similar situation, insufficient gain relative to the cavity loss, existed in the past for shorter wavelength VCSELs before high quality epitaxial mirrors were developed. Semiconductor/air-gap Distributed Bragg Reflectors (DBRs) are attractive due to their high index contrast, which leads to a high reflectivity, wide stop band and low optical loss mirror with a small number of pairs. This concept is ready to be integrated into material systems other than AlGaAs/GaAs, which is studied in this work. Therefore, the impact of these DBRs can be extended into both visible and longer infrared wavelengths as a solution to the trade-off between DBR and active region materials. Air-gap DBRs can also be used as basic building blocks of micro-opto-electro-mechanical systems (MOEMS). The high Q microcavity formed by the air-gap DBRs also provide a good platform for microcavity physics study. Air-gap DBRs are modeled using the transmission matrix formulae of the Maxwell equations. A comparison to existing DBR technology shows the great advantage and potential that the air-gap DBR possesses. Two types of air-gap are proposed and developed. The first one includes multiple GaAs/air pairs while the second one combines a single air-gap with metal and dielectric mirrors. New device structures and processing designs, especially an all-epitaxial lateral current and optical confinement technique, are carried out to incorporate air-gap DBRs into VCSEL structures. The first VCSEL

  16. Small Bowel Bleeding

    MedlinePlus

    ... for air and barium to be instilled. The advantage of this study is that pictures from enteroclysis ... these tests is perfect at finding abnormalities, the advantage of these tests is that they can sometimes ...

  17. Modeled Effectiveness of Ventilation with Contaminant Control Devices on Indoor Air Quality in a Swine Farrowing Facility

    PubMed Central

    Anthony, T. Renée; Altmaier, Ralph; Park, Jae Hong; Peters, Thomas M.

    2016-01-01

    Because adverse health effects experienced by swine farm workers in concentrated animal feeding operations (CAFOs) have been associated with exposure to dust and gases, efforts to reduce exposures are warranted, particularly in winter seasons when exposures increase due to decreased ventilation. Simulation of air quality and operating costs for ventilating swine CAFO, including treating and recirculating air through a farrowing room, was performed using mass and energy balance equations over a 90-day winter season. System operation required controlling heater operation to achieve room temperatures optimal to ensure animal health (20 to 22.5°C). Five air pollution control devices, four room ventilation rates, and five recirculation patterns were examined. Inhalable dust concentrations were easily reduced using standard industrial air pollution control devices, including a cyclone, filtration, and electrostatic precipitator. Operating ventilation systems at 0.94 m3 s−1 (2000 cfm) with 75 to 100% recirculation of treated air from cyclone, electrostatic precipitator, and shaker dust filtration system achieves adequate particle control with operating costs under $1.00 per pig produced ($0.22 to 0.54), although carbon dioxide (CO2) concentrations approach 2000 ppm using in-room ventilated gas fired heaters. In no simulation were CO2 concentrations below industry recommended concentrations (1540 ppm), but alternative heating devices could reduce CO2 to acceptable concentrations. While this investigation does not represent all production swine farrowing barns, which differ in characteristics including room dimensions and swine occupancy, the simulation model and ventilation optimization methods can be applied to other production sites. This work shows that ventilation may be a cost-effective control option in the swine industry to reduce exposures. PMID:24433305

  18. Modeled effectiveness of ventilation with contaminant control devices on indoor air quality in a swine farrowing facility.

    PubMed

    Anthony, T Renée; Altmaier, Ralph; Park, Jae Hong; Peters, Thomas M

    2014-01-01

    Because adverse health effects experienced by swine farm workers in concentrated animal feeding operations (CAFOs) have been associated with exposure to dust and gases, efforts to reduce exposures are warranted, particularly in winter seasons when exposures increase due to decreased ventilation. Simulation of air quality and operating costs for ventilating swine CAFO, including treating and recirculating air through a farrowing room, was performed using mass and energy balance equations over a 90-day winter season. System operation required controlling heater operation to achieve room temperatures optimal to ensure animal health (20 to 22.5 °C). Five air pollution control devices, four room ventilation rates, and five recirculation patterns were examined. Inhalable dust concentrations were easily reduced using standard industrial air pollution control devices, including a cyclone, filtration, and electrostatic precipitator. Operating ventilation systems at 0.94 m3 s(-1) (2000 cfm) with 75 to 100% recirculation of treated air from cyclone, electrostatic precipitator, and shaker dust filtration system achieves adequate particle control with operating costs under $1.00 per pig produced ($0.22 to 0.54), although carbon dioxide (CO2) concentrations approach 2000 ppm using in-room ventilated gas fired heaters. In no simulation were CO2 concentrations below industry recommended concentrations (1540 ppm), but alternative heating devices could reduce CO2 to acceptable concentrations. While this investigation does not represent all production swine farrowing barns, which differ in characteristics including room dimensions and swine occupancy, the simulation model and ventilation optimization methods can be applied to other production sites. This work shows that ventilation may be a cost-effective control option in the swine industry to reduce exposures.

  19. Vaginal Bleeding: MedlinePlus Health Topic

    MedlinePlus

    ... Bleeding (American Academy of Family Physicians) Also in Spanish Abnormal Uterine Bleeding (Beyond the Basics) (UpToDate) Abnormal ... College of Obstetricians and Gynecologists) - PDF Also in Spanish Vaginal Bleeding (Mayo Foundation for Medical Education and ...

  20. Vitamin K deficiency bleeding of the newborn

    MedlinePlus

    Vitamin K deficiency bleeding of the newborn (VKDB) is a bleeding disorder in babies. It most often develops shortly ... Control and Prevention. Notes from the field: late vitamin K deficiency bleeding in infants whose parents declined vitamin K ...

  1. A Community-Based Approach to Developing a Mobile Device for Measuring Ambient Air Exposure, Location, and Respiratory Health

    DOE PAGES

    Rohlman, Diana; Syron, Laura; Hobbie, Kevin; ...

    2015-08-15

    In west Eugene (Oregon), community research indicates residents are disproportionately exposed to industrial air pollution and exhibit increased asthma incidence. In Carroll County (Ohio), recent increases in unconventional natural gas drilling sparked air quality concerns. These community concerns led to the development of a prototype mobile device to measure personal chemical exposure, location, and respiratory function. Working directly with the environmental justice (EJ) communities, the prototype was developed to (1) meet the needs of the community and; (2) evaluate the use in EJ communities. The prototype was evaluated in 3 community focus groups (n=25) to obtain feedback on the prototypemore » and feasibility study design to evaluate the efficacy of the device to address community concerns. Focus groups were recorded and qualitatively analyzed with discrete feedback tabulated for further refinement. The prototype was improved by community feedback resulting in 8 alterations/additions to software and instructional materials. Overall, focus group participants were supportive of the device and believed it would be a useful environmental health tool. The use of focus groups ensured that community members were engaged in the research design and development of a novel environmental health tool. We found that community-based research strategies resulted in a refined device as well as relevant research questions, specific to the EJ community needs and concerns.« less

  2. A Community-Based Approach to Developing a Mobile Device for Measuring Ambient Air Exposure, Location, and Respiratory Health

    SciTech Connect

    Rohlman, Diana; Syron, Laura; Hobbie, Kevin; Anderson, Kim A.; Scaffidi, Christopher; Sudakin, Daniel; Peterson, Elena S.; Waters, Katrina M.; Haynes, Erin; Arkin, Lisa; Feezel, Paul; Kincl, Laurel

    2015-08-15

    In west Eugene (Oregon), community research indicates residents are disproportionately exposed to industrial air pollution and exhibit increased asthma incidence. In Carroll County (Ohio), recent increases in unconventional natural gas drilling sparked air quality concerns. These community concerns led to the development of a prototype mobile device to measure personal chemical exposure, location, and respiratory function. Working directly with the environmental justice (EJ) communities, the prototype was developed to (1) meet the needs of the community and; (2) evaluate the use in EJ communities. The prototype was evaluated in 3 community focus groups (n=25) to obtain feedback on the prototype and feasibility study design to evaluate the efficacy of the device to address community concerns. Focus groups were recorded and qualitatively analyzed with discrete feedback tabulated for further refinement. The prototype was improved by community feedback resulting in 8 alterations/additions to software and instructional materials. Overall, focus group participants were supportive of the device and believed it would be a useful environmental health tool. The use of focus groups ensured that community members were engaged in the research design and development of a novel environmental health tool. We found that community-based research strategies resulted in a refined device as well as relevant research questions, specific to the EJ community needs and concerns.

  3. A no bleed implant.

    PubMed

    Ersek, R A; Navarro, J A; Nemeth, D Z; Sas, G

    1993-01-01

    Breast implants have evolved from the original saline-filled, smooth-surfaced silicone rubber bag to silicone gel-filled smooth-walled sacs to a combination of a silicone gel-filled bag within a saline-filled sac, and, most recently, a reversed, double-lumen implant with a saline bag inside of a gel-filled bag. Texture-surfaced implants were first used in 1970 when the standard silicone gel-filled implant was covered with a polyurethane foam. Because of concerns about the degradation products of this foam, they were removed from the market in 1991. In 1975 double-lumen silicone textured implants were developed, followed by silicone gel-filled textured implants. In 1990 a new radiolucent, biocompatible gel was produced that reduced the problem of radioopacity of silicone implants. Because of the gel's sufficiently low coefficient of friction, leakage caused by fold flaw fracture may also be decreased. We present a case where this new biocompatible gel implant was repositioned after four months. The resulting scar capsule in this soft breast was thin [< 0.002 cm (0.008 in.)] and evenly textured as a mirror image of the textured silicone surface. Scanning electron microscopy and x-ray defraction spectrophotometry revealed no silicone bleed.

  4. Battery-operated, portable, and flexible air microplasma generation device for fabrication of microfluidic paper-based analytical devices on demand.

    PubMed

    Kao, Peng-Kai; Hsu, Cheng-Che

    2014-09-02

    A portable microplasma generation device (MGD) operated in ambient air is introduced for making a microfluidic paper-based analytical device (μPAD) that serves as a primary healthcare platform. By utilizing a printed circuit board fabrication process, a flexible and lightweight MGD can be fabricated within 30 min with ultra low-cost. This MGD can be driven by a portable power supply (less than two pounds), which can be powered using 12 V-batteries or ac-dc converters. This MGD is used to perform maskless patterning of hydrophilic patterns with sub-millimeter spatial resolution on hydrophobic paper substrates with good pattern transfer fidelity. Using this MGD to fabricate μPADs is demonstrated. With a proper design of the MGD electrode geometry, μPADs with 500-μm-wide flow channels can be fabricated within 1 min and with a cost of less than $USD 0.05/device. We then test the μPADs by performing quantitative colorimetric assay tests and establish a calibration curve for detection of glucose and nitrite. The results show a linear response to a glucose assay for 1-50 mM and a nitrite assay for 0.1-5 mM. The low cost, miniaturized, and portable MGD can be used to fabricate μPADs on demand, which is suitable for in-field diagnostic tests. We believe this concept brings impact to the field of biomedical analysis, environmental monitoring, and food safety survey.

  5. A solvent replenishment solution for managing evaporation of biochemical reactions in air-matrix digital microfluidics devices

    DOE PAGES

    Jebrail, Mais J.; Renzi, Ronald F.; Sinha, Anupama; ...

    2014-10-01

    Digital microfluidics (DMF) is a powerful technique for sample preparation and analysis for a broad range of biological and chemical applications. In many cases, it is desirable to carry out DMF on an open surface, such that the matrix surrounding the droplets is ambient air. However, the utility of the air-matrix DMF format has been severely limited by problems with droplet evaporation, especially when the droplet-based biochemical reactions require high temperatures for long periods of time. We present a simple solution for managing evaporation in air-matrix DMF: just-in-time replenishment of the reaction volume using droplets of solvent. We demonstrate thatmore » this solution enables DMF-mediated execution of several different biochemical reactions (RNA fragmentation, first-strand cDNA synthesis, and PCR) over a range of temperatures (4–95 °C) and incubation times (up to 1 h or more) without use of oil, humidifying chambers, or off-chip heating modules. Reaction volumes and temperatures were maintained roughly constant over the course of each experiment, such that the reaction kinetics and products generated by the air-matrix DMF device were comparable to those of conventional benchscale reactions. As a result, this simple yet effective solution for evaporation management is an important advance in developing air-matrix DMF for a wide variety of new, high-impact applications, particularly in the biomedical sciences.« less

  6. A solvent replenishment solution for managing evaporation of biochemical reactions in air-matrix digital microfluidics devices

    SciTech Connect

    Jebrail, Mais J.; Renzi, Ronald F.; Sinha, Anupama; Van De Vreugde, Jim; Gondhalekar, Carmen; Ambriz, Cesar; Meagher, Robert J.; Branda, Steven S.

    2014-10-01

    Digital microfluidics (DMF) is a powerful technique for sample preparation and analysis for a broad range of biological and chemical applications. In many cases, it is desirable to carry out DMF on an open surface, such that the matrix surrounding the droplets is ambient air. However, the utility of the air-matrix DMF format has been severely limited by problems with droplet evaporation, especially when the droplet-based biochemical reactions require high temperatures for long periods of time. We present a simple solution for managing evaporation in air-matrix DMF: just-in-time replenishment of the reaction volume using droplets of solvent. We demonstrate that this solution enables DMF-mediated execution of several different biochemical reactions (RNA fragmentation, first-strand cDNA synthesis, and PCR) over a range of temperatures (4–95 °C) and incubation times (up to 1 h or more) without use of oil, humidifying chambers, or off-chip heating modules. Reaction volumes and temperatures were maintained roughly constant over the course of each experiment, such that the reaction kinetics and products generated by the air-matrix DMF device were comparable to those of conventional benchscale reactions. As a result, this simple yet effective solution for evaporation management is an important advance in developing air-matrix DMF for a wide variety of new, high-impact applications, particularly in the biomedical sciences.

  7. A solvent replenishment solution for managing evaporation of biochemical reactions in air-matrix digital microfluidics devices.

    PubMed

    Jebrail, Mais J; Renzi, Ronald F; Sinha, Anupama; Van De Vreugde, Jim; Gondhalekar, Carmen; Ambriz, Cesar; Meagher, Robert J; Branda, Steven S

    2015-01-07

    Digital microfluidics (DMF) is a powerful technique for sample preparation and analysis for a broad range of biological and chemical applications. In many cases, it is desirable to carry out DMF on an open surface, such that the matrix surrounding the droplets is ambient air. However, the utility of the air-matrix DMF format has been severely limited by problems with droplet evaporation, especially when the droplet-based biochemical reactions require high temperatures for long periods of time. We present a simple solution for managing evaporation in air-matrix DMF: just-in-time replenishment of the reaction volume using droplets of solvent. We demonstrate that this solution enables DMF-mediated execution of several different biochemical reactions (RNA fragmentation, first-strand cDNA synthesis, and PCR) over a range of temperatures (4-95 °C) and incubation times (up to 1 h or more) without use of oil, humidifying chambers, or off-chip heating modules. Reaction volumes and temperatures were maintained roughly constant over the course of each experiment, such that the reaction kinetics and products generated by the air-matrix DMF device were comparable to those of conventional benchscale reactions. This simple yet effective solution for evaporation management is an important advance in developing air-matrix DMF for a wide variety of new, high-impact applications, particularly in the biomedical sciences.

  8. Vaginal or uterine bleeding - overview

    MedlinePlus

    Vaginal bleeding normally occurs during a woman's menstrual cycle, when she gets her period. Every woman's period is different. Most women have cycles between 24 and 34 days apart. It usually lasts ...

  9. Bleeding varices: 1. Emergency management.

    PubMed Central

    Hanna, S S; Warren, W D; Galambos, J T; Millikan, W J

    1981-01-01

    The aim of the emergency management of bleeding varices is to stop the hemorrhage nonoperatively if possible, avoiding emergency shunt surgery, an operation that has a higher mortality than elective shunt surgery. Patients with an upper gastrointestinal hemorrhage should undergo endoscopy immediately to verify the diagnosis of bleeding varices. They can then be categorized according to whether they stop bleeding spontaneously (group 1), continue to bleed slowly (group 2) or continue to bleed rapidly (group 3). Group 1 patients are discussed in the second part of this two-part series. Group 2 patients are initially treated with vasopressin given intravenously; those who fail to respond should undergo emergency angiography and receive vasopressin intra-arterially. If this fails, patients at low surgical risk should undergo urgent shunt surgery; those at high risk do better with endoscopic sclerotherapy. Group 3 patients are also given an intravenous infusion of vasopressin. Patients at low surgical risk who continue to bleed then receive tamponade with a Sengstaken--Blakemore tube. If this fails, they undergo emergency creation of an H-shaped mesocaval shunt. Patients at high surgical risk who fail to respond to vasopressin given intravenously are next treated intra-arterially. If this fails they are given either endoscopic or transhepatic sclerotherapy. PMID:7006779

  10. CACD (Complex Air Cleaning Devices) of the GTE (Gas turbine electrostation)-110: Problems and solutions

    NASA Astrophysics Data System (ADS)

    Budakov, I. V.; Neuimin, V. M.

    2015-12-01

    The paper considers CACD of the compressor of the GTE-110 gas turbine. The CACD efficiency has been tested under different conditions of the GTE-325 of the Ivanovo combined cycle plant (CCP) JSC INTER RAO-Electrogeneration Exploitation. It sets out the requirements for the dust collector, de-icing system, and air intake tract CACD. De-icing and air preparation methods are shown.

  11. Minimization of temperature ranges between the top and bottom of an air flow controlling device through hybrid control in a plant factory.

    PubMed

    Moon, Seung-Mi; Kwon, Sook-Youn; Lim, Jae-Hyun

    2014-01-01

    To maintain the production timing, productivity, and product quality of plant factories, it is necessary to keep the growth environment uniform. A vertical multistage type of plant factory involves different levels of growing trays, which results in the problem of difference in temperature among vertically different locations. To address it, it is necessary to install air flow devices such as air flow fan and cooling/heating device at the proper locations in order to facilitate air circulation in the facility as well as develop a controlling technology for efficient operation. Accordingly, this study compares the temperature and air distribution within the space of a vertical multistage closed-type plant factory by controlling cooling/heating devices and air flow fans harmoniously by means of the specially designed testbed. The experiment results indicate that in the hybrid control of cooling and heating devices and air flow fans, the difference in temperature decreased by as much as 78.9% compared to that when only cooling and heating devices were operated; the air distribution was improved by as much as 63.4%.

  12. Minimization of Temperature Ranges between the Top and Bottom of an Air Flow Controlling Device through Hybrid Control in a Plant Factory

    PubMed Central

    2014-01-01

    To maintain the production timing, productivity, and product quality of plant factories, it is necessary to keep the growth environment uniform. A vertical multistage type of plant factory involves different levels of growing trays, which results in the problem of difference in temperature among vertically different locations. To address it, it is necessary to install air flow devices such as air flow fan and cooling/heating device at the proper locations in order to facilitate air circulation in the facility as well as develop a controlling technology for efficient operation. Accordingly, this study compares the temperature and air distribution within the space of a vertical multistage closed-type plant factory by controlling cooling/heating devices and air flow fans harmoniously by means of the specially designed testbed. The experiment results indicate that in the hybrid control of cooling and heating devices and air flow fans, the difference in temperature decreased by as much as 78.9% compared to that when only cooling and heating devices were operated; the air distribution was improved by as much as 63.4%. PMID:25013867

  13. A study of hear sink performance in air and soil for use in a thermoelectric energy harvesting device

    NASA Technical Reports Server (NTRS)

    Snyder, J.; Lawrence, E. E.

    2002-01-01

    A suggested application of a thermoelectric generator is to exploit the natural temperature difference between the air and the soil to generate small amounts of electrical energy. Since the conversion efficiency of even the best thermoelectric generators available is very low, the performance of the heat sinks providing the heat flow is critical. By providing a constant heat input to various heat sinks, field tests of their thermal conductances in soil and in air were performed. Aprototype device without a thermoelectric generator was constructed, buried, and monitored to experimentally measure the heat flow achievable in such a system. Theoretical considerations for design and selection of improved heat sinks are also presented. In particular, the method of shape factoranalysis is used to give rough estimates and upper bounds for the thermal conductance of a passive heat sink buried in soil.

  14. Results from prototypes of environmental and health alarm devices based on gaseous detectors operating in air in counting mode

    NASA Astrophysics Data System (ADS)

    Charpak, G.; Benaben, P.; Breuil, P.; Martinengo, P.; Nappi, E.; Peskov, V.

    2011-02-01

    We have developed and successfully tested two prototypes of detectors of dangerous gases based on wire-type counters operating in air in avalanche mode: one is for radon (Rn) detection whereas the other one is for the detection of gases with an ionization potential less than the air components. Due to the operation in pulse counting mode these prototypes have sensitivities comparable to (in the case of the Rn detector) or much higher than (in the case of the detector for low ionization gases) the best commercial devices currently available on the market. We believe that due to their high sensitivity, simplicity and low cost such new detectors will find massive applications. One of them, discussed in this paper, could be the on-line monitoring of Rn for the prediction of earthquakes.

  15. Performances of Different Global Positioning System Devices for Time-Location Tracking in Air Pollution Epidemiological Studies

    PubMed Central

    Wu, Jun; Jiang, Chengsheng; Liu, Zhen; Houston, Douglas; Jaimes, Guillermo; McConnell, Rob

    2010-01-01

    Background: People’s time-location patterns are important in air pollution exposure assessment because pollution levels may vary considerably by location. A growing number of studies are using global positioning systems (GPS) to track people’s time-location patterns. Many portable GPS units that archive location are commercially available at a cost that makes their use feasible for epidemiological studies. Methods: We evaluated the performance of five portable GPS data loggers and two GPS cell phones by examining positional accuracy in typical locations (indoor, outdoor, in-vehicle) and factors that influence satellite reception (building material, building type), acquisition time (cold and warm start), battery life, and adequacy of memory for data storage. We examined stationary locations (eg, indoor, outdoor) and mobile environments (eg, walking, traveling by vehicle or bus) and compared GPS locations to highly-resolved US Geological Survey (USGS) and Digital Orthophoto Quarter Quadrangle (DOQQ) maps. Results: The battery life of our tested instruments ranged from <9 hours to 48 hours. The acquisition of location time after startup ranged from a few seconds to >20 minutes and varied significantly by building structure type and by cold or warm start. No GPS device was found to have consistently superior performance with regard to spatial accuracy and signal loss. At fixed outdoor locations, 65%–95% of GPS points fell within 20-m of the corresponding DOQQ locations for all the devices. At fixed indoor locations, 50%–80% of GPS points fell within 20-m of the corresponding DOQQ locations for all the devices except one. Most of the GPS devices performed well during commuting on a freeway, with >80% of points within 10-m of the DOQQ route, but the performance was significantly impacted by surrounding structures on surface streets in highly urbanized areas. Conclusions: All the tested GPS devices had limitations, but we identified several devices which showed

  16. Surgical management of presacral bleeding

    PubMed Central

    Ausobsky, JR; Vowden, P

    2014-01-01

    Introduction Presacral venous bleeding is an uncommon but potentially life threatening complication of rectal surgery. During the posterior rectal dissection, it is recommended to proceed into the plane between the fascia propria of the rectum and the presacral fascia. Incorrect mobilisation of the rectum outside the Waldeyer’s fascia can tear out the lower presacral venous plexus or the sacral basivertebral veins, causing what may prove to be uncontrollable bleeding. Methods A systematic search of the MEDLINE® and Embase™ databases was performed to obtain primary data published in the period between 1 January 1960 and 31 July 2013. Each article describing variables such as incidence of presacral venous bleeding, surgical approach, number of cases treated and success rate was included in the analysis. Results A number of creative solutions have been described that attempt to provide good tamponade of the presacral haemorrhage, eliminating the need for second operation. However, few cases are reported in the literature. Conclusions As conventional haemostatic measures often fail to control this type of haemorrhage, several alternative methods to control bleeding definitively have been described. We propose a practical comprehensive classification of the available techniques for the management of presacral bleeding. PMID:24780015

  17. The STOP the Bleeding Campaign

    PubMed Central

    2013-01-01

    According to the World Health Organization, traumatic injuries worldwide are responsible for over 5 million deaths annually. Post-traumatic bleeding caused by traumatic injury-associated coagulopathy is the leading cause of potentially preventable death among trauma patients. Despite these facts, awareness of this problem is insufficient and treatment options are often unclear. The STOP the Bleeding Campaign therefore aims to increase awareness of the phenomenon of post-traumatic coagulopathy and its appropriate management by publishing European guidelines for the management of the bleeding trauma patient, by promoting and monitoring the implementation of these guidelines and by preparing promotional and educational material, organising activities and developing health quality management tools. The campaign aims to reduce the number of patients who die within 24 hours after arrival in the hospital due to exsanguination by a minimum of 20% within the next 5 years. PMID:23635083

  18. Design of a Prototype Microcomputer Driven Training Device for an Air Force Maintenance School

    DTIC Science & Technology

    1979-08-01

    digital system." 3. Kargo, Donald W. and Steffen, Dale A. Performance Training Carrel for Electronics Principles Course, Sept 76, AFHRL-TR 76-62(1), pg 1...June 1977 Kargo, Donald W. and Steffen, Dale A. Performance Training Corral for Electronics Principles Course, AFHRL-TR 76-62(i), Air Force Human

  19. 30 CFR 75.320 - Air quality detectors and measurement devices.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... calibrated with a known methane-air mixture at least once every 31 days. (b) Tests for oxygen deficiency shall be made by a qualified person with MSHA approved oxygen detectors that are maintained in permissible and proper operating condition and that can detect 19.5 percent oxygen with an accuracy of...

  20. 30 CFR 75.320 - Air quality detectors and measurement devices.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... calibrated with a known methane-air mixture at least once every 31 days. (b) Tests for oxygen deficiency shall be made by a qualified person with MSHA approved oxygen detectors that are maintained in permissible and proper operating condition and that can detect 19.5 percent oxygen with an accuracy of...

  1. 30 CFR 75.320 - Air quality detectors and measurement devices.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... calibrated with a known methane-air mixture at least once every 31 days. (b) Tests for oxygen deficiency shall be made by a qualified person with MSHA approved oxygen detectors that are maintained in permissible and proper operating condition and that can detect 19.5 percent oxygen with an accuracy of...

  2. En Route Air Traffic Control Input Devices for the Next Generation

    NASA Technical Reports Server (NTRS)

    Mainini, Matthew J.

    2010-01-01

    The purpose of this study was to investigate the usefulness of different input device configurations when trial planning new routes for aircraft in an advanced simulation of the en route workstation. The task of trial planning is one of the futuristic tools that is performed by the graphical manipulation of an aircraft's trajectory to reroute the aircraft without voice communication. In this study with two input devices, the FAA's current trackball and a basic optical computer mouse were evaluated with "pick" button in a click-and-hold state and a click-and-release state while the participant dragged the trial plan line. The trial plan was used for three different conflict types: Aircraft Conflicts, Weather Conflicts, and Aircraft + Weather Conflicts. Speed and accuracy were the primary dependent variables. Results indicate that the mouse conditions were significantly faster than the trackball conditions overall with no significant loss of accuracy. Several performance ratings and preference ratings were analyzed from post-run and post-simulation questionnaires. The release conditions were significantly more useful and likable than the hold conditions. The results suggest that the mouse in the release button state was the fastest and most well liked device configuration for trial planning in the en route workstation. Keywords-input devices, en route, controller, workstation, mouse, trackball, NextGen

  3. Control of air emissions from hazardous-waste combustion sources: field evaluations of pilot-scale air-pollution-control devices

    SciTech Connect

    Westbrook, C.W.; Tatsch, C.E.; Cottone, L.

    1986-01-01

    Pilot-scale air-pollution control devices supplied by Hydro-Sonic Systems, ETS, Inc., and Vulcan Engineering Company were installed at the ENSCO, Inc. Incinerator in El Dorado, Arkansas, in the spring of 1984. Each of these units treated an uncontrolled slipstream of the incinerator exhaust gas. Simultaneous measurement of the total particulate and HCl in the gas streams were made at the inlet to and exit from the units using an EPA Method 5 sampling train. Particle sizing at both locations using Andersen impactors was also done. The units supplied by Hydro-Sonics Systems and ETS, Inc. exhibited a high degree of HCl and particulate matter control. The Hydro-Sonic Tandem Nozzle SuperSub Model 100 gave the best overall performance for HCl and particulate control and ability to accommodate the variable composition of the exhaust gas.

  4. Improved Wetting of Mixed Ionic/Electronic Conductors Used in Electrochemical Devices with Ternary Reactive Air Braze Filler Metals

    SciTech Connect

    Hardy, John S; Kim, Jin Yong Y; Thomsen, Ed C; Weil, K Scott

    2007-01-19

    This paper reports on the wetting behavior, reactivity, and long-term electrical conductance of a series of ternary filler metals being considered for brazing lanthanum strontium cobalt ferrite (LSCF) based oxygen separation membranes. Mixed ionic/electronic conducting perovskite oxides such as LSCF and various doped barium cerates are currently being considered for use in high-temperature electrochemical devices such as oxygen and hydrogen concentrators and solid oxide fuel cells. However to take full advantage of the unique properties of these materials, reliable joining techniques need to be developed. Furthermore, if the proposed joining technique were to yield a hermetic ceramic-to-metal junction that was also electrically conductive, it would additionally benefit the device by allowing current to be drawn from or carried to the electrochemically active mixed conducting oxide component without requiring an separate current collector. A newly developed brazing technique known as air brazing is one such method of joining. In its present form, air brazing uses a silver-copper oxide based filler metal that can be melted directly in air to form a compliant joint that is electrically conductive. Recently, it has been shown that the addition of titania can enhance the wetting behavior of Ag-CuO filler metals on alumina. Here the effect of this wetting agent on the surface wettability, long-term electrical resistance at 750°C, and reactivity with La0.6Sr0.4Co0.2Fe0.8O3- (LSCF-6428 or LSCF) substrates is discussed.

  5. An experimental wind-tunnel investigation of a ram-air-spoiler roll-control device on a forward-control missile at supersonic speeds

    NASA Technical Reports Server (NTRS)

    Blair, A. B., Jr.

    1978-01-01

    A parametric experimental wind-tunnel investigation was made at supersonic Mach numbers to provide design data on a ram-air-spoiler roll-control device that is to be used on forward-control cruciform missile configurations. The results indicate that the ram-air-spoiler tail fin is an effective roll-control device and that roll control is generally constant with vehicle attitude and Mach number unless direct canard and/or forebody shock impingement occurs. The addition of the ram-air-spoiler tail fins resulted in only small changes in aerodynamic-center location. For the ram-air-spoiler configuration tested, there are large axial force coefficient effects associated with the increased fin thickness and ram-air momentum loss.

  6. Early-phase strength gains during traditional resistance training compared with an upper-body air-resistance training device.

    PubMed

    McGinley, Cian; Jensen, Randall L; Byrne, Ciarán A; Shafat, Amir

    2007-05-01

    The purpose of this study was to examine the early-phase adaptations of traditional dynamic constant external resistance (DCER) training vs. a portable upper-body training device (Fortex). The Fortex is a concentric training device based on air resistance. Contractions using this device are slow (1.5-3 s) and have a limited range of motion. The exercises potentially allow maximal muscle action during each contraction. Healthy, sedentary men (n = 30) were assigned to begin either 8 weeks of weight training (W, n = 12) or 8 weeks of Fortex training (F, n = 9), and were compared with a control group (C, n = 9). Exercises were chosen for the W group that would train similar muscle groups and contain a similar volume of repetitions as the F group. However, movement patterns and force curves were not identical. Increases in the upper-arm cross-sectional area were not detected in any of the groups. Both training groups showed strength gains in the various strength tests that were distinct from each other. Our results indicate that both Fortex and DCER training proved effective in eliciting strength gains in sedentary men over an 8-week training period. There are, however, limitations with the Fortex in terms of progression needs and training asymmetry that indicate it should be used as a complement to other training.

  7. A cryogen-free refrigerating preconcentration device for the measurement of C2 to C4 hydrocarbons in ambient air.

    PubMed

    Peng, Hong; Wang, Jianwei; Shen, Zheng; Wu, Dapeng; Guan, Yafeng

    2011-02-07

    A cryogen-free refrigerating preconcentration device for the enrichment of trace amounts of highly volatile organic compounds in the atmosphere prior to analysis has been designed and evaluated. The device consists of a microtrap housed in an insulated box, which is cooled by a conventional refrigeration unit. Experimental parameters, including adsorbent mass, trapping temperature, and thermal desorption temperature, were optimized. The on-line coupling of the device to a GC allows sufficient enrichment and separation of C2 to C4 hydrocarbons in less than 40 min without a second cryotrap. The target compounds analysis showed good linearity (correlation coefficients >0.99) and repeatability (relative standard deviation <5%). Detection limits for the 10 volatile organic compounds ranged from 14 ppt to 52 ppt, under the conditions of a 500 mL sampling volume and -10 °C trapping temperature. Real air sample measurements were conducted at an urban site, and five VOCs including ethane, ethene, propane, propene and 1-butene were detected and quantified.

  8. Endoscopic Management of Peptic Ulcer Bleeding

    PubMed Central

    Kim, Joon Sung; Park, Sung Min

    2015-01-01

    Acute upper gastrointestinal bleeding is a common medical emergency around the world and the major cause is peptic ulcer bleeding. Endoscopic treatment is fundamental for the management of peptic ulcer bleeding. Despite recent advances in endoscopic treatment, mortality from peptic ulcer bleeding has still remained high. This is because the disease often occurs in elderly patients with frequent comorbidities and are taking ulcerogenic medications. Therefore, the management of peptic ulcer bleeding is still a challenge for clinicians. This article reviews the various endoscopic methods available for management of peptic ulcer bleeding and the techniques in using these methods. PMID:25844337

  9. Endoscopic management of peptic ulcer bleeding.

    PubMed

    Kim, Joon Sung; Park, Sung Min; Kim, Byung-Wook

    2015-03-01

    Acute upper gastrointestinal bleeding is a common medical emergency around the world and the major cause is peptic ulcer bleeding. Endoscopic treatment is fundamental for the management of peptic ulcer bleeding. Despite recent advances in endoscopic treatment, mortality from peptic ulcer bleeding has still remained high. This is because the disease often occurs in elderly patients with frequent comorbidities and are taking ulcerogenic medications. Therefore, the management of peptic ulcer bleeding is still a challenge for clinicians. This article reviews the various endoscopic methods available for management of peptic ulcer bleeding and the techniques in using these methods.

  10. Effects of an Air-Powder Abrasive Device When Used during Periodontal Flap Surgery in Dogs.

    DTIC Science & Technology

    1983-01-01

    some of the effects of an air- powder abrasive system when used during periodontal flap surgery in dogs. In the first part of the study, periodontal...Histologically, signi- ficantly less inflammation was found on the experimental side at four days. In the second part of the study, the possible localized...apparent histologically in all the dogs through day seven. The third part of the study examined the possible damage which might occur if a periodontal flap

  11. Information measuring systems with mobile devices for identification of air pollution parameters caused by transport

    NASA Astrophysics Data System (ADS)

    Mokin, Vitalii B.; Goriachev, Georgii V.; Dziuniak, Dmytro Y.; Bondaletov, Konstantin O.; Zhukov, Serhii O.; Duk, Mariusz; Sailarbek, Saltanat

    2016-09-01

    The analysis of modern information measuring systems (IMS) for identification model parameters of the air pollution is carried out. That allows to increase the accuracy of this identification due to their complex application. The known model based on the fuzzy knowledge base was adapted to this task. It is specified how the offered IMS can increase the accuracy of the parameters identification. The results of the experiment with the use of the offered IMS in Vinnytsia city presented in the paper.

  12. Conceptual Design Study of Air Bearing/Suction Hold-Down Devices for Vertical Landing Aircraft

    DTIC Science & Technology

    1977-03-21

    Centrigual fans were available that would develop cushion pressures down to approximately -2.5 psig; however, the volume flow of these fans is very...provide a stable retraction/deployment system in all three axes and allow for installation of the necessaiy pumps , fans and ducting, the twin paral...devices, shutting down the fans, and maintaining an "up load in the cylinders. In the "up" position, the automatic latches are engaged and hydraulic pumps

  13. Vaginal bleeding in early pregnancy

    MedlinePlus

    ... sex? Did you bleed afterward? What is your blood type? Your provider can test your blood type. If it is Rh negative, you will need treatment with a medicine called Rho(D) immune globulin to prevent complications with future pregnancies. ... If something other than blood comes out, call ...

  14. Mobile selected ion flow tube mass spectrometry (SIFT-MS) devices and their use for pollution exposure monitoring in breath and ambient air-pilot study.

    PubMed

    Storer, Malina; Salmond, Jennifer; Dirks, Kim N; Kingham, Simon; Epton, Michael

    2014-09-01

    Studies of health effects of air pollution exposure are limited by inability to accurately determine dose and exposure of air pollution in field trials. We explored the feasibility of using a mobile selected ion flow tube mass spectrometry (SIFT-MS) device, housed in a van, to determine ambient air and breath levels of benzene, xylene and toluene following exercise in areas of high motor vehicle traffic. The breath toluene, xylene and benzene concentration of healthy subjects were measured before and after exercising close to a busy road. The concentration of the volatile organic compounds (VOCs), in ambient air were also analysed in real time. Exercise close to traffic pollution is associated with a two-fold increase in breath VOCs (benzene, xylene and toluene) with levels returning to baseline within 20 min. This effect is not seen when exercising away from traffic pollution sources. Situating the testing device 50 m from the road reduced any confounding due to VOCs in the inspired air prior to the breath testing manoeuvre itself. Real-time field testing for air pollution exposure is possible using a mobile SIFT-MS device. This device is suitable for exploring exposure and dose relationships in a number of large scale field test scenarios.

  15. Swallowable fluorometric capsule for wireless triage of gastrointestinal bleeding.

    PubMed

    Nemiroski, A; Ryou, M; Thompson, C C; Westervelt, R M

    2015-12-07

    Real-time detection of gastrointestinal bleeding remains a major challenge because there does not yet exist a minimally invasive technology that can both i) monitor for blood from an active hemorrhage and ii) uniquely distinguish it from blood left over from an inactive hemorrhage. Such a device would be an important tool for clinical triage. One promising solution, which we have proposed previously, is to inject a fluorescent dye into the blood stream and to use it as a distinctive marker of active bleeding by monitoring leakage into the gastrointestinal tract with a wireless fluorometer. This paper reports, for the first time to our knowledge, the development of a swallowable, wireless capsule with a built-in fluorometer capable of detecting fluorescein in blood, and intended for monitoring gastrointestinal bleeding in the stomach. The embedded, compact fluorometer uses pinholes to define a microliter sensing volume and to eliminate bulky optical components. The proof-of-concept capsule integrates optics, low-noise analog sensing electronics, a microcontroller, battery, and low power Zigbee radio, all into a cylindrical package measuring 11 mm × 27 mm and weighing 10 g. Bench-top experiments demonstrate wireless fluorometry with a limit-of-detection of 20 nM aqueous fluorescein. This device represents a major step towards a technology that would enable simple, rapid detection of active gastrointestinal bleeding, a capability that would save precious time and resources and, ultimately, reduce complications in patients.

  16. EPA (Environmental Protection Agency) evaluation of the Cyclone-Z device under Section 511 of the Motor Vehicle Information and Cost Savings Act. Technical report

    SciTech Connect

    Syria, S.L.

    1983-01-01

    This document announces the conclusions of the EPA evaluation of the Cyclone-Z device under the provisions of Section 511 of the Motor Vehicle Information and Cost Savings Act. The evaluation of the Cyclone-Z device was conducted upon receiving an application from the marketer. The device is claimed to improve fuel economy and driveability and to reduce exhaust emissions. EPA fully considered all of the information submitted by the applicant. The evaluation of the Cyclone-Z device was based on that information, EPA's engineering judgement, and its experience with other air bleed devices.

  17. Gastrointestinal Bleeding: MedlinePlus Health Topic

    MedlinePlus

    ... Bleeding (National Institute of Diabetes and Digestive and Kidney Diseases) Also in Spanish GI bleeding - slideshow (Medical Encyclopedia) Also in Spanish Diagnosis and Tests Abdominal Pain (Stomach Pain), Long-Term ( ...

  18. Ag-Al based air braze for high temperature electrochemical devices

    SciTech Connect

    Kim, Jin Yong Y.; Hardy, John S.; Weil, K. Scott

    2007-11-01

    Silver-aluminum based air brazing was attempted using an in-situ alloying and brazing process. In this process, layers of foils of aluminum and silver were laid up between alumina plates in alternating fashion to achieve three target compositions representing Ag, Ag3Al, and Ag2Al phases. Each alloy composition revealed different microstructure, mechanical properties and fracture mechanisms. Joints brazed with foils containing 9.8 at% Al formed a long continuous layer parallel to the direction of the original aluminum foil. The fracture occurred through the interface between this long alumina layer and the braze filler, resulting in low bend strength (6 ~ 12 MPa). Joints containing 26.5 at% Al in the braze filler metal experienced the series of phase transformations, leading to cracks in as-brazed specimens. The fracture initiated through these pre-existing cracks, thus the joint strength observed in these specimens was extremely low. The joints prepared using foils with 35.1 at% Al exhibited a good interface even though interfacial alumina particles formed during air brazing. Crack propagation occurred through the interface between the alumina substrate and in-situ formed interfacial alumina particles or directly through these particles and the best bend strength (46 ~ 52 MPa) among Al-added braze compositions was achieved.

  19. Assessing upper gastrointestinal bleeding in adults.

    PubMed

    Pezzulo, Gabrielle; Kruger, Danielle

    2014-09-01

    Acute upper gastrointestinal (GI) bleeding is a potentially life-threatening condition requiring accurate, prompt, and appropriate patient evaluation and management. Clinicians of all specialties must know the best practices for preventing and managing upper GI bleeding. This article focuses on assessing and managing adults with acute nonvariceal upper GI bleeding.

  20. Ram-air sample collection device for a chemical warfare agent sensor

    DOEpatents

    Megerle, Clifford A.; Adkins, Douglas R.; Frye-Mason, Gregory C.

    2002-01-01

    In a surface acoustic wave sensor mounted within a body, the sensor having a surface acoustic wave array detector and a micro-fabricated sample preconcentrator exposed on a surface of the body, an apparatus for collecting air for the sensor, comprising a housing operatively arranged to mount atop the body, the housing including a multi-stage channel having an inlet and an outlet, the channel having a first stage having a first height and width proximate the inlet, a second stage having a second lower height and width proximate the micro-fabricated sample preconcentrator, a third stage having a still lower third height and width proximate the surface acoustic wave array detector, and a fourth stage having a fourth height and width proximate the outlet, where the fourth height and width are substantially the same as the first height and width.

  1. Predictors of re-bleeding after endoscopic hemostasis for delayed post-endoscopic sphincterotomy bleeding

    PubMed Central

    Lee, Mu-Hsien; Tsou, Yung-Kuan; Lin, Cheng-Hui; Lee, Ching-Song; Liu, Nai-Jen; Sung, Kai-Feng; Cheng, Hao-Tsai

    2016-01-01

    AIM: To predict the re-bleeding after endoscopic hemostasis for delayed post-endoscopic sphincterotomy (ES) bleeding. METHODS: Over a 15-year period, data from 161 patients with delayed post-ES bleeding were retrospectively collected from a single medical center. To identify risk factors for re-bleeding after initial successful endoscopic hemostasis, parameters before, during and after the procedure of endoscopic retrograde cholangiopancreatography were analyzed. These included age, gender, blood biochemistry, co-morbidities, endoscopic diagnosis, presence of peri-ampullary diverticulum, occurrence of immediate post-ES bleeding, use of needle knife precut sphincterotomy, severity of delayed bleeding, endoscopic features on delayed bleeding, and type of endoscopic therapy. RESULTS: A total of 35 patients (21.7%) had re-bleeding after initial successful endoscopic hemostasis for delayed post-ES bleeding. Univariate analysis revealed that malignant biliary stricture, serum bilirubin level of greater than 10 mg/dL, initial bleeding severity, and bleeding diathesis were significant predictors of re-bleeding. By multivariate analysis, serum bilirubin level of greater than 10 mg/dL and initial bleeding severity remained significant predictors. Re-bleeding was controlled by endoscopic therapy in a single (n = 23) or multiple (range, 2-7; n = 6) sessions in 29 of the 35 patients (82.9%). Four patients required transarterial embolization and one went for surgery. These five patients had severe bleeding when delayed post-ES bleeding occurred. One patient with decompensated liver cirrhosis died from re-bleeding. CONCLUSION: Re-bleeding occurs in approximately one-fifth of patients after initial successful endoscopic hemostasis for delayed post-ES bleeding. Severity of initial bleeding and serum bilirubin level of greater than 10 mg/dL are predictors of re-bleeding. PMID:27003996

  2. Development of an algorithm to regulate pump output for a closed air-loop type pneumatic biventricular assist device.

    PubMed

    Nam, Kyoung Won; Lee, Jung Joo; Hwang, Chang Mo; Choi, Jaesoon; Choi, Hyuk; Choi, Seong Wook; Sun, Kyung

    2009-12-01

    The closed air space-type of extracorporeal pneumatic ventricular assist device (VAD) developed by the Korea Artificial Organ Center utilizes a bellows-transforming mechanism to generate the air pressure required to pump blood. This operating mechanism can reduce the size and weight of the driving unit; however, the output of the blood pump can be affected by the pressure loading conditions of the blood sac. Therefore, to guarantee a proper pump output level, regardless of the pressure loading conditions that vary over time, automatic pump output regulation of the blood pump is required. We describe herein a pump output regulation algorithm that was developed to maintain pump output around a reference level against various afterload pressures, and verified the pump performance in vitro. Based on actual operating conditions in animal experiments, the pumping rate was limited to 40-84 beats per minute, and the afterload pressure was limited to 80-150 mm Hg. The tested reference pump output was 4.0 L/min. During experiments, the pump output was successfully and automatically regulated within the preset area regardless of the varying afterload conditions. The results of this preliminary experiment can be used as the basis for an automatic control algorithm that can enhance the stability and reliability of the applied VAD.

  3. A Comparison between Temperature-Controlled Laminar Airflow Device and a Room Air-Cleaner in Reducing Exposure to Particles While Asleep

    PubMed Central

    Spilak, Michal P.; Sigsgaard, Torben; Takai, Hisamitsu; Zhang, Guoqiang

    2016-01-01

    People spend approximately one third of their life sleeping. Exposure to pollutants in the sleep environment often leads to a variety of adverse health effects, such as development and exacerbation of asthma. Avoiding exposure to these pollutants by providing a sufficient air quality in the sleep environment might be a feasible method to alleviate these health symptoms. We performed full-scale laboratory measurements using a thermal manikin positioned on an experimental bed. Three ventilation settings were tested: with no filtration system operated, use of portable air cleaner and use of a temperature-controlled laminar airflow (TLA) device. The first part of the experiment investigated the air-flow characteristics in the breathing zone. In the second part, particle removal efficiency was estimated. Measured in the breathing zone, the room air cleaner demonstrated high turbulence intensity, high velocity and turbulence diffusivity level, with a particle reduction rate of 52% compared to baseline after 30 minutes. The TLA device delivered a laminar airflow to the breathing zone with a reduction rate of 99.5%. During a periodical duvet lifting mimicking a subject’s movement in bed, the particle concentration was significantly lower with the TLA device compared to the room air cleaner. The TLA device provided a barrier which significantly reduced the introduction of airborne particles into the breathing zone. Further studies should be conducted for the understanding of the transport of resuspended particles between the duvet and the laying body. PMID:27898693

  4. Fast response air-to-fuel ratio measurements using a novel device based on a wide band lambda sensor

    NASA Astrophysics Data System (ADS)

    Regitz, S.; Collings, N.

    2008-07-01

    A crucial parameter influencing the formation of pollutant gases in internal combustion engines is the air-to-fuel ratio (AFR). During transients on gasoline and diesel engines, significant AFR excursions from target values can occur, but cycle-by-cycle AFR resolution, which is helpful in understanding the origin of deviations, is difficult to achieve with existing hardware. This is because current electrochemical devices such as universal exhaust gas oxygen (UEGO) sensors have a time constant of 50-100 ms, depending on the engine running conditions. This paper describes the development of a fast reacting device based on a wide band lambda sensor which has a maximum time constant of ~20 ms and enables cyclic AFR measurements for engine speeds of up to ~4000 rpm. The design incorporates a controlled sensor environment which results in insensitivity to sample temperature and pressure. In order to guide the development process, a computational model was developed to predict the effect of pressure and temperature on the diffusion mechanism. Investigations regarding the sensor output and response were carried out, and sensitivities to temperature and pressure are examined. Finally, engine measurements are presented.

  5. Portable device for use in starting air-start-units for aircraft and having cable lead testing capability

    NASA Technical Reports Server (NTRS)

    Rosier, W. R.; Volk, G. G. (Inventor)

    1980-01-01

    A portable device for starting aircraft engines and the like is disclosed. The device includes a lead testing and motor starting circuit characterized by: (1) a direct current voltage source, (2) a pair of terminal plugs connected with the circuit (each being characterized by a first, second, and third terminal) (3) a pair of manually operable switches for connecting the first terminal of each plug of the pair to the positive side of the voltage source, (4) a circuit lead connecting to the second terminal of each plug the negative side of said source, (5) a pair of electrical cables adapted to connect said first and second terminals of each plug to an air-start unit, and means for connecting each cable of the pair of cables between the first terminal of one plug and the third terminal of the other plug of the pair, and (6) a second pair of manually operable switches for selectivity connecting the third terminal of each plug of the pair to the negative side of the voltage source.

  6. Simultaneous sampling and analysis of indoor air infested with Cimex lectularius L. (Hemiptera: Cimicidae) by solid phase microextraction, thin film microextraction and needle trap device.

    PubMed

    Eom, In-Yong; Risticevic, Sanja; Pawliszyn, Janusz

    2012-02-24

    Air in a room infested by Cimex lectularius L. (Hemiptera: Cimicidae) was sampled simultaneously by three different sampling devices including solid phase microextraction (SPME) fiber coatings, thin film microextraction (TFME) devices, and needle trap devices (NTDs) and then analyzed by gas chromatography-mass spectrometry (GC-MS). The main focus of this study was to fully characterize indoor air by identifying compounds extracted by three different microextraction formats and, therefore, perform both the device comparison and more complete characterization of C. lectularius pheromone. The NTD technique was capable of extracting both (E)-2-hexenal and (E)-2-octenal, which were previously identified as alarm pheromones of bedbugs, and superior NTD recoveries for these two components allowed reliable identification based on mass spectral library searching and linear temperature programmed retention index (LTPRI) technique. While the use of DVB/CAR/PDMS SPME fiber coatings provided complementary sample fingerprinting and profiling results, TFME sampling devices provided discriminative extraction coverage toward highly volatile analytes. In addition to two alarm pheromones, relative abundances of all other analytes were recorded for all three devices and aligned across all examined samples, namely, highly infested area, less infested area, and control samples which were characterized by different bedbug populations. The results presented in the current study illustrate comprehensive characterization of infested indoor air samples through the use of three different non-invasive SPME formats and identification of novel components comprising C. lectularius pheromone, therefore, promising future alternatives for use of potential synthetic pheromones for detection of infestations.

  7. Research on Supersonic Inlet Bleed

    NASA Technical Reports Server (NTRS)

    Davis, David O.; Vyas, Manan A.; Slater, John W.

    2012-01-01

    Phase I data results of the Fundamental Inlet Bleed Experiments project at NASA Glenn Research Center (GRC) are presented which include flow coefficient results for two single-hole boundary-layer bleed configurations. The bleed configurations tested are round holes at inclination angles of 90deg and 20deg both having length-to-diameter ratios of 2.0. Results were obtained at freestream Mach numbers of 1.33, 1.62, 1.98, 2.46, and 2.92 and unit Reynolds numbers of 0.984, 1.89, and 2.46 10(exp 7)/m. Approach boundary-layer data are presented for each flow condition and the flow coefficient results are compared to existing multi-hole data obtained under similar conditions. For the 90deg hole, the single and multi-hole distributions agree fairly well with the exception that under supercritical operation, the multi-hole data chokes at higher flow coefficient levels. This behavior is also observed for the 20deg hole but to a lesser extent. The 20deg hole also shows a markedly different characteristic at subcritical operation. Also presented are preliminary results of a Computational Fluid Dynamics (CFD) analysis of both configurations at the Mach 1.33 and a unit Reynolds number of 2.46 10(exp 7)/m. Comparison of the results shows the agreement to be very good.

  8. WETTING AND REACTIVE AIR BRAZING OF BSCF FOR OXYGEN SEPARATION DEVICES

    SciTech Connect

    LaDouceur, Richard M.; Meier, Alan; Joshi, Vineet V.

    2014-10-13

    Reactive air brazes Ag-CuO and Ag-V2O5 were evaluated for brazing Ba0.5Sr0.5Co0.8Fe0.2O(3-δ) (BSCF). BSCF has been determined in previous work to have the highest potential mixed ionic/electronic conducting (MIEC) ceramic material based on the design and oxygen flux requirements of an oxy-fuel plant such as an integrated gasification combined cycle (IGCC) used to facilitate high-efficiency carbon capture. Apparent contact angles were observed for Ag-CuO and Ag-V2O5 mixtures at 1000 °C for isothermal hold times of 0, 10, 30, and 60 minutes. Wetting apparent contact angles (θ<90°) were obtained for 1%, 2%, and 5% Ag-CuO and Ag-V2O5 mixtures, with the apparent contact angles between 74° and 78° for all compositions and furnace dwell times. Preliminary microstructural analysis indicates that two different interfacial reactions are occurring: Ag-CuO interfacial microstructures revealed the same dissolution of copper oxide into the BSCF matrix to form copper-cobalt-oxygen rich dissolution products along the BSCF grain boundaries and Ag-V2O5 interfacial microstructures revealed the infiltration and replacement of cobalt and iron with vanadium and silver filling pores in the BSCF microstructure. The Ag-V2O5 interfacial reaction product layer was measured to be significantly thinner than the Ag-CuO reaction product layer. Using a fully articulated four point flexural bend test fixture, the flexural fracture strength for BSCF was determined to be 95 ± 33 MPa. The fracture strength will be used to ascertain the success of the reactive air braze alloys. Based on these results, brazes were fabricated and mechanically tested to begin to optimize the brazing parameters for this system. Ag-2.5% CuO braze alloy with a 2.5 minute thermal cycle achieved a hermetic seal with a joint flexural strength of 34 ± 15 MPa and Ag-1% V2O5 with a 30 minute thermal cycle had a joint flexural strength of 20 ± 15 MPa.

  9. A device for sampling and determination of total particulate mercury in ambient air.

    PubMed

    Lu, J Y; Schroeder, W H; Berg, T; Munthe, J; Schneeberger, D; Schaedlich, F

    1998-06-01

    A miniaturized device, which serves as both particulate trap and pyrolyzer for airborne particulate mercury species, is described. It has been used in combination with amalgamation/thermal desorption/cold vapor atomic fluorescence spectrometry detection for the determination of total particulate mercury (TPM) associated with atmospheric aerosols. A standard reference material (SRM 1633b, NIST) has been used for validating of the pyrolysis technique, and a relative error smaller than 3% has been obtained. Contrary to most methods currently employed, this new technique does not require any sample preparation (e.g., extraction/digestion), no manual sample transfer or sample handling, and no addition of chemicals or reagents. Hence the risk of contamination is low. The time for complete analysis is less than 10 min per sample. The concentrations of TPM determined in metropolitan Toronto ranged from 3 to 91 pg m(-)(3) with standard deviations of <±2 pg m(-)(3) for simultaneous sets of four samples. These atmospheric TPM concentration values fall within the range reported in the literature. Good agreement was obtained by the three methods compared in a field study at Ny-Ålesund (78°54'N, 11°53'E), Svalbard. The elevated values of TPM concentrations obtained using the method developed in this work may arise from the Arctic springtime conversion of atmospheric mercury from gas-phase to particulate-phase Hg species.

  10. Paper-Based Analytical Devices Relying on Visible-Light-Enhanced Glucose/Air Biofuel Cells.

    PubMed

    Wu, Kaiqing; Zhang, Yan; Wang, Yanhu; Ge, Shenguang; Yan, Mei; Yu, Jinghua; Song, Xianrang

    2015-11-04

    A strategy that combines visible-light-enhanced biofuel cells (BFCs) and electrochemical immunosensor into paper-based analytical devices was proposed for sensitive detection of the carbohydrate antigen 15-3 (CA15-3). The gold nanoparticle modified paper electrode with large surface area and good conductibility was applied as an effective matrix for primary antibodies. The glucose dehydrogenase (GDH) modified gold-silver bimetallic nanoparticles were used as bioanodic biocatalyst and signal magnification label. Poly(terthiophene) (pTTh), a photoresponsive conducting polymer, served as catalyst in cathode for the reduction of oxygen upon illumination by visible light. In the bioanode, electrons were generated through the oxidation of glucose catalyzed by GDH. The amount of electrons is determined by the amount of GDH, which finally depended on the amount of CA15-3. In the cathode, electrons from the bioanode could combine with the generated holes in the HOMO energy level of cathode catalysts pTTh. Meanwhile, the high energy level photoexcited electrons were generated in the LUMO energy level and involved in the oxygen reduction reaction, finally resulting in an increasing current and a decreasing overpotential. According to the current signal, simple and efficient detection of CA15-3 was achieved.

  11. Intramuscular bleeding of the tongue in the victims of house fire.

    PubMed

    Hashimoto, Yoshiaki; Moriya, Fumio; Nakanishi, Akinori

    2003-03-01

    Intramuscular bleeding of the tongue is frequently observed in autopsy cases of house fire victims. The meaning of this finding has not yet been fully discussed. We examined 69 autopsy cases of house fire victims and investigated several factors contributing to intramuscular bleeding of the tongue. Victims comprised 45 males and 24 females, ranging in age from 1 to 95 years old. Sixty-four cases (93%) involved severely charred bodies, while the remaining five bodies displayed slight burns. Factors studied were age, sex, posture of the body at the scene of the fire, degree of burn injury and carboxyhemoglobin (CO-Hb) levels in blood. CO-Hb level proved to be the only factor relevant to intramuscular bleeding of the tongue. Of 69 autopsy cases, 23 (33%) demonstrated intramuscular bleeding of the tongue (13 cases of slight bleeding, ten cases of severe bleeding). Low concentrations of CO-Hb (bleeding. Of 46 cases without intramuscular bleeding, ten (22%) displayed low concentrations of CO-Hb. These results may indicate that severe burn injuries occurring before inhaling air containing high levels of carbon monoxide represent the cause of intramuscular bleeding of the tongue in fire victims. The burned regions of the body in the early stage of the fire process were unclear due to severe charring in most victims. However, asphyxiation due to neck compression is known to often induce intramuscular bleeding of the tongue. Lack of skin elasticity following burns, particularly in the neck, might act in a similar manner to asphyxial neck compression. In conclusion, intramuscular bleeding of the tongue in fire victims may occur as a vital reaction to burns.

  12. Bleeding

    MedlinePlus

    ... 2009:chap 39. Simon BC, Hern HG. Wound management principles. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier ...

  13. Efficient halal bleeding, animal handling, and welfare: A holistic approach for meat quality.

    PubMed

    Aghwan, Z A; Bello, A U; Abubakar, A A; Imlan, J C; Sazili, A Q

    2016-11-01

    Traditional halal slaughter and other forms of religious slaughter are still an issue of debate. Opposing arguments related to pre-slaughter handling, stress and pain associated with restraint, whether the incision is painful or not, and the onset of unconsciousness have been put forward, but no consensus has been achieved. There is a need to strike a balance between halal bleeding in the light of science and animal welfare. There is a paucity of scientific data with respect to animal welfare, particularly the use of restraining devices, animal handling, and efficient halal bleeding. However, this review found that competent handling of animals, proper use of restraining devices, and the efficient bleeding process that follows halal slaughter maintains meat eating quality. In conclusion, halal bleeding, when carried out in accordance with recommended animal welfare procedures, will not only maintain the quality and wholesomeness of meat but could also potentially reduce suffering and pain. Maintained meat quality increases consumer satisfaction and food safety.

  14. A Source-Term Based Boundary Layer Bleed/Effusion Model for Passive Shock Control

    NASA Technical Reports Server (NTRS)

    Baurle, Robert A.; Norris, Andrew T.

    2011-01-01

    A modeling framework for boundary layer effusion has been developed based on the use of source (or sink) terms instead of the usual practice of specifying bleed directly as a boundary condition. This framework allows the surface boundary condition (i.e. isothermal wall, adiabatic wall, slip wall, etc.) to remain unaltered in the presence of bleed. This approach also lends itself to easily permit the addition of empirical models for second order effects that are not easily accounted for by simply defining effective transpiration values. Two effusion models formulated for supersonic flows have been implemented into this framework; the Doerffer/Bohning law and the Slater formulation. These models were applied to unit problems that contain key aspects of the flow physics applicable to bleed systems designed for hypersonic air-breathing propulsion systems. The ability of each model to predict bulk bleed properties was assessed, as well as the response of the boundary layer as it passes through and downstream of a porous bleed system. The model assessment was performed with and without the presence of shock waves. Three-dimensional CFD simulations that included the geometric details of the porous plate bleed systems were also carried out to supplement the experimental data, and provide additional insights into the bleed flow physics. Overall, both bleed formulations fared well for the tests performed in this study. However, the sample of test problems considered in this effort was not large enough to permit a comprehensive validation of the models.

  15. Therapeutic Options for Unscheduled Bleeding Associated with Long-Acting Reversible Contraception.

    PubMed

    Friedlander, EmmaKate; Kaneshiro, Bliss

    2015-12-01

    Long-acting reversible contraception (LARC) is the most effective form of reversible contraception. Although most women are satisfied with LARC methods, unscheduled bleeding and spotting are common reasons for method dissatisfaction and discontinuation. This systematic analysis of the current literature delineates treatment options for unscheduled bleeding related to LARC use. Although consistent results are lacking, all devices seem to have the best response to nonsteroidal antiinflammatory drugs for 5 to 7 days or the antifibrinolytic agent tranexamic acid. Additional studies are necessary to identify improved treatment interventions for unscheduled bleeding with LARC use.

  16. Effect of municipal solid waste incinerator types on characteristics of ashes from different air pollution control devices.

    PubMed

    Lu, Chien-Hsing; Chuang, Kui-Hao

    2016-01-01

    The purpose of this paper is to investigate the characteristics of fly and bottom ashes sampled from both fluidized bed (FB) and mass-burning (MB) municipal solid waste incinerators (MSWIs), respectively. Fly ashes from different locations at FB and MB MSWIs equipped with a cyclone, a semi-dry scrubber, and a bag filter as air pollution control devices were examined to provide the baseline information between physicochemical properties and leaching ability. Experimental results of leachability indicated that the bag filter fly ash (FB-FA(B)) from the FB incinerator meets Taiwan regulatory standards set through the toxicity characteristic leaching procedure. X-ray diffraction results revealed the presence of Cr5O12 and Pb2O3 in the cyclone fly ash (MB-FA(C)) and bag filter fly ash (MB-FA(B)), respectively, from the MB incinerator. To observe lead incorporation mechanism, mixture of simulate lead-laden waste with bed material were fired between 600 °C and 900 °C in a laboratory scale FB reactor. The results clearly demonstrate a substantial decrease in lead leaching ratio for products with an appropriate temperature. The concentration of Pb in the MB-FA(B) was 250 times that in the FB-FA(B), suggesting that incineration of MSW in FB is a good strategy for stabilizing hazardous metals.

  17. Development of a unique multi-contaminant air sampling device for a childhood asthma cohort in an agricultural environment†

    PubMed Central

    Fitzpatrick, Cole F.; Loftus, Christine T.; Yost, Michael G.; Tchong-French, Maria; Karr, Catherine J.

    2016-01-01

    This research describes the design, deployment, performance, and acceptability of a novel outdoor active air sampler to provide simultaneous measurements of multiple contaminants at timed intervals for the Aggravating Factors of Asthma in Rural Environment (AFARE) study—a longitudinal cohort of 50 children in Yakima Valley, Washington. The sampler was constructed of multiple sampling media connected to individual critical orifices and a rotary vane vacuum pump. It was connected to a timed control valve system to collect 24 hours samples every six days over 18 months. We describe a spatially representative approach with both quantitative and qualitative location criteria to deploy a network of 14 devices at participant residences in a rural region (20 × 60 km). Overall the sampler performed well, as the concurrent mean sample flow rates were within or above the ranges of recommended sampling rates for each exposure metric of interest. Acceptability was high among the study population of Hispanic farmworker participant households. The sampler design may prove useful for future urban and rural community-based studies with aims at collecting multiple contaminant data during specific time periods. PMID:23896655

  18. Gastrointestinal bleeding and possible hypothyroidism.

    PubMed

    Marshall, Leisa L

    2012-03-01

    An 88-year-old female, living independently in the community, developed duodenal and gastric ulcers from using overthe-counter naproxen sodium for pain related to a shoulder fracture and arthritis of the knees. She was hospitalized and received packed red blood cells and intravenous proton pump inhibitor therapy. During her hospitalization, she developed atrial fibrillation (AF). Warfarin was not prescribed for stroke prevention because of the gastrointestinal (GI) bleeding. The patient was initially placed on atenolol, and then amiodarone was added. After a two-week hospital stay she was discharged to a nursing facility to gain strength, further correct her anemia, and receive physical therapy for the shoulder and ambulation problems from arthritis of the knees. The amiodarone was continued in the nursing facility. After 15 days of amiodarone therapy (hospital and nursing facility), a laboratory report indicated an elevated thyroid-stimulating hormone level. Levothyroxine was prescribed. The patient was eventually discharged to an assisted living facility once her strength returned and her ambulation improved. GI bleeding with anemia and weakness from nonsteroidal anti-inflammatory drug use and changes in thyroid function with amiodarone therapy for AF will be discussed.

  19. Intraoperative scintigraphy for active small intestinal bleeding

    SciTech Connect

    Biener, A.; Palestro, C.; Lewis, B.S.; Katz, L.B. )

    1990-11-01

    Localizing active sites of bleeding within the small intestine remains a difficult task. Endoscopic, angiographic or scintigraphic studies may point to the small intestine as the site of blood loss, but at operation, without a palpable lesion, the exact site of bleeding remains elusive. Patients are managed at laparotomy with intraoperative endoscopy, angiography, multiple enterotomies, blind resections, or placement of an enterostomy. We describe two patients in whom intraoperative scintigraphy accurately identified active sites of bleeding in the small intestine when other modalities failed. Intraoperative scintigraphy is rapid, easy to perform and is an effective means of identifying active sites of bleeding within the small intestine.

  20. Nonsurgical techniques to control massive bleeding.

    PubMed

    Zentai, Christian; Grottke, Oliver; Spahn, Donat R; Rossaint, Rolf

    2013-03-01

    Significant advancements in nonsurgical and surgical approaches to control bleeding in severely injured patients have also improved the treatment of critical trauma-related coagulopathy. Nonsurgical procedures such as angiographic embolization are progressively considered to terminate arterial bleeding from pelvic fractures. The disturbance of coagulation may aggravate bleeding and hamper surgical procedures. The administration of coagulation factors and factor concentrates may be useful for correcting systemic coagulopathy and reducing the need for fresh frozen plasma, platelet, and red blood cell transfusions, which are associated with various adverse outcomes. In this review, nonsurgical management of critical trauma bleeding is discussed.

  1. Small bowel bleeding: a comprehensive review

    PubMed Central

    Gunjan, Deepak; Sharma, Vishal; Bhasin, Deepak K

    2014-01-01

    The small intestine is an uncommon site of gastro-intestinal (GI) bleeding; however it is the commonest cause of obscure GI bleeding. It may require multiple blood transfusions, diagnostic procedures and repeated hospitalizations. Angiodysplasia is the commonest cause of obscure GI bleeding, particularly in the elderly. Inflammatory lesions and tumours are the usual causes of small intestinal bleeding in younger patients. Capsule endoscopy and deep enteroscopy have improved our ability to investigate small bowel bleeds. Deep enteroscopy has also an added advantage of therapeutic potential. Computed tomography is helpful in identifying extra-intestinal lesions. In cases of difficult diagnosis, surgery and intra-operative enteroscopy can help with diagnosis and management. The treatment is dependent upon the aetiology of the bleed. An overt bleed requires aggressive resuscitation and immediate localisation of the lesion for institution of appropriate therapy. Small bowel bleeding can be managed by conservative, radiological, pharmacological, endoscopic and surgical methods, depending upon indications, expertise and availability. Some patients, especially those with multiple vascular lesions, can re-bleed even after appropriate treatment and pose difficult challenge to the treating physician. PMID:24874805

  2. Detailed heat transfer distributions in two-pass smooth and turbulated square channels with bleed holes

    SciTech Connect

    Ekkad, S.V.; Huang, Y.; Han, J.C.

    1996-12-31

    Modern gas turbine blades have internal serpentine passage for providing effective cooling. Rib turbulators are added periodically on the cooling passage surface to enhance heat transfer. Some of the cooling air is ejected out through bleed (or film) holes for external blade film cooling. The presence of periodic rib turbulators and bleed holes creates strong axial and spanwise variations in the heat transfer distributions on the passage surface. Detailed heat transfer coefficient distributions are presented in this study for a two-pass square channel with a 180{degree} turn. One wall of the channel has periodically placed bleed holes. Four different configurations of 90{degree} parallel, 60{degree} parallel, 60{degree} V ribs, and 60{degree} inverted V ribs are studied in conjunction with the effect of bleed holes on the same wall. The surface is coated with a thin layer of thermochromic liquid crystals and a transient test is run to obtain the detailed heat transfer distributions. The 60{degree} parallel, 60{degree} V, and 60{degree} inverted ribbed channels produce similar levels of heat transfer enhancement in the first pass. However, the 60{degree} inverted V ribbed channel produces higher enhancement in the second pass. Regional averaged heat transfer results indicate that a test surface with bleed holes provides similar heat transfer enhancement as that for a test surface without bleed holes although 20--25% of the inlet mass flow exits through the bleed holes.

  3. Safety and effectiveness of a synthetic hemostatic patch for intraoperative soft tissue bleeding

    PubMed Central

    Schuhmacher, Christoph; Pratschke, Johann; Weiss, Sascha; Schneeberger, Stefan; Mihaljevic, André L; Schirren, Rebekka; Winkler, Michael; Emmanouilidis, Nikos

    2015-01-01

    Background Continuous bleeding after using conventional hemostatic methods involving energy, sutures, or clips, is a serious and costly surgical complication. Many topical agents have been developed to promote intraoperative hemostasis, but improvement is needed in both decreasing time to hemostasis and increasing ease of use. Veriset™ hemostatic patch is CE-marked for controlling bleeding on the liver and in soft tissue. In the current study, we aimed to gather further evidence for the safety and effectiveness of Veriset™ hemostatic patch in soft tissue bleeding during a variety of surgical procedures. Methods Thirty patients scheduled for nonemergency surgery, each with an intraoperative soft tissue bleeding site, were treated with Veriset™ hemostatic patch. Time to hemostasis was monitored, and adverse events were assessed during the 90 days after surgery. Results When Veriset™ hemostatic patch was used, hemostasis occurred within 5 minutes in 29/30 (96.7%) subjects and within 1 minute in 21/30 (70.0%) subjects. No device-related serious adverse events were recorded during the 30 days after surgery, and no reoperations for device-related bleeding complications were performed during the 5 days after surgery. Conclusions Veriset™ hemostatic patch is a safe and effective hemostat for controlling soft tissue bleeding during a variety of surgical procedures. PMID:25878513

  4. Characteristics of ashes from different locations at the MSW incinerator equipped with various air pollution control devices.

    PubMed

    Song, Geum-Ju; Kim, Ki-Heon; Seo, Yong-Chil; Kim, Sam-Cwan

    2004-01-01

    The characteristics of ashes from different locations at a municipal solid waste incinerator (MSWI) equipped with a water spray tower (WST) as a cooling system, and a spray dryer adsorber (SDA), a bag filter (BF) and a selective catalytic reactor (SCR) as air pollution control devices (APCD) was investigated to provide the basic data for further treatment of ashes. A commercial MSWI with a capacity of 100 tons per day was selected. Ash was sampled from different locations during the normal operation of the MSWI and was analyzed to obtain chemical composition, basicity, metal contents and leaching behavior of heavy metals. Basicity and pH of ash showed a broad range between 0.08-9.07 and 3.5-12.3, respectively. Some major inorganics in ash were identified and could affect the basicity. This could be one of the factors to determine further treatment means. Partitioning of hazardous heavy metals such as Pb, Cu, Cr, Hg and Cd was investigated. Large portions of Hg and Cd were emitted from the furnace while over 90% of Pb, Cu and Cr remained in bottom ash. However 54% of Hg was captured by WST and 41% by SDA/BF and 3.6% was emitted through the stack, while 81.5% of Cd was captured by SDA/BF. From the analysis data of various metal contents in ash and leach analysis, such capturing of metal was confirmed and some heavy metals found to be easily released from ash. Based on the overall characteristics of ash in different locations at the MSWI during the investigation, some considerations and suggestions for determining the appropriate treatment methods of ash were made as conclusions.

  5. Characteristics of ashes from different locations at the MSW incinerator equipped with various air pollution control devices

    SciTech Connect

    Song, Geum-Ju; Kim, Ki-Heon; Seo, Yong-Chil; Kim, Sam-Cwan

    2004-07-01

    The characteristics of ashes from different locations at a municipal solid waste incinerator (MSWI) equipped with a water spray tower (WST) as a cooling system, and a spray dryer adsorber (SDA), a bag filter (BF) and a selective catalytic reactor (SCR) as air pollution control devices (APCD) was investigated to provide the basic data for further treatment of ashes. A commercial MSWI with a capacity of 100 tons per day was selected. Ash was sampled from different locations during the normal operation of the MSWI and was analyzed to obtain chemical composition, basicity, metal contents and leaching behavior of heavy metals. Basicity and pH of ash showed a broad range between 0.08-9.07 and 3.5-12.3, respectively. Some major inorganics in ash were identified and could affect the basicity. This could be one of the factors to determine further treatment means. Partitioning of hazardous heavy metals such as Pb, Cu, Cr, Hg and Cd was investigated. Large portions of Hg and Cd were emitted from the furnace while over 90% of Pb, Cu and Cr remained in bottom ash. However 54% of Hg was captured by WST and 41% by SDA/BF and 3.6% was emitted through the stack, while 81.5% of Cd was captured by SDA/BF. From the analysis data of various metal contents in ash and leach analysis, such capturing of metal was confirmed and some heavy metals found to be easily released from ash. Based on the overall characteristics of ash in different locations at the MSWI during the investigation, some considerations and suggestions for determining the appropriate treatment methods of ash were made as conclusions.

  6. Managing acute upper GI bleeding, preventing recurrences.

    PubMed

    Albeldawi, Mazen; Qadeer, Mohammed A; Vargo, John J

    2010-02-01

    Acute upper gastrointestinal (GI) bleeding is common and potentially life-threatening and needs a prompt assessment and aggressive medical management. All patients need to undergo endoscopy to diagnose, assess, and possibly treat any underlying lesion. In addition, patients found to have bleeding ulcers should receive a proton pump inhibitor, the dosage and duration of treatment depending on the endoscopic findings and clinical factors.

  7. Treatment modalities for bleeding esophagogastric varices.

    PubMed

    Yoshida, Hiroshi; Mamada, Yasuhiro; Taniai, Nobuhiko; Yoshioka, Masato; Hirakata, Atsushi; Kawano, Youichi; Mizuguchi, Yoshiaki; Shimizu, Tetsuya; Ueda, Junji; Uchida, Eiji

    2012-01-01

    Bleeding from esophageal varices (EVs) or gastric varices (GVs) is a catastrophic complication of chronic liver disease. In this paper, we review the management of bleeding EVs and GVs. DIAGNOSIS OF EVS AND GVS: The grading system for esophagogastric varices proposed by the Japan Society for Portal Hypertension classifies GVs into those involving the cardia (Lg-c), the fundus (Lg-f), and both the cardia and the fundus (Lg-cf). In this review, we divide GVs into 2 categories: Lg-c (cardiac varices: CVs) and Lg-cf or Lg-f (fundal varices: FVs). TREATMENT MODALITIES FOR EVS AND GVS: Treatment modalities for EVs and GVs include placement of a Sengstaken-Blakemore tube, pharmacologic therapy, surgery, interventional radiology, and endoscopic treatment. MANAGEMENT OF BLEEDING EVS AND GVS: In Japan, endoscopic treatment has recently become the therapy of choice for bleeding EVs or GVs. In other countries, especially the United States, vasoactive drugs and endoscopic treatment are routinely used to manage variceal hemorrhage. BLEEDING EVS: Endoscopic variceal ligation is useful for controlling bleeding from EVs. However, confirmation of ligation precisely at the site of bleeding is usually difficult in patients with massive variceal bleeding. The site of acute bleeding can generally be identified by means of water instillation and suction. Ligation is then performed at the bleeding point. If endoscopic hemostasis is unsuccessful, a Sengstaken-Blakemore tube is used as a temporary bridge to other treatments. Transportal obliteration is useful for blocking variceal blood flow. BLEEDING GVS: Endoscopic injection sclerotherapy with a tissue adhesive, such as N-butyl-cyanoacrylate or isobutyl-2-cyanoacrylate, is effective for acute bleeding from GVs. However, bleeding from the GV injection site and rebleeding from the rupture point have been reported in patients receiving endoscopic injection sclerotherapy. If endoscopic hemostasis is unsuccessful, a Sengstaken-Blakemore tube

  8. Identification of Hospital Outliers in Bleeding Complications After Percutaneous Coronary Intervention

    PubMed Central

    Hess, Connie N.; Rao, Sunil V.; McCoy, Lisa A.; Neely, Megan L.; Singh, Mandeep; Spertus, John A.; Krone, Ronald J.; Weaver, W. Douglas; Peterson, Eric D.

    2014-01-01

    Background Post-percutaneous coronary intervention (PCI) bleeding complications are an important quality metric. We sought to characterize site-level variation in post-PCI bleeding and explore the influence of patient and procedural factors on hospital bleeding performance. Methods and Results Hospital-level bleeding performance was compared pre- and post-adjustment using the newly-revised CathPCI Registry® bleeding risk model (c-index 0.77) among 1,292 NCDR® hospitals performing >50 PCIs from 7/2009–9/2012 (n=1,984,998 procedures). Using random effects models, outlier sites were identified based on 95% confidence intervals around the hospital’s random intercept. Bleeding 72 hours post-PCI was defined as: arterial access site, retroperitoneal, gastrointestinal, or genitourinary bleeding; intracranial hemorrhage; cardiac tamponade; non-bypass surgery-related blood transfusion with pre-procedure hemoglobin ≥8 g/dl; or absolute decrease in hemoglobin value ≥3g/dl with pre-procedure hemoglobin ≤16 g/dl. Overall, the median unadjusted post-PCI bleeding rate was 5.2% and varied among hospitals from 2.6%–10.4% (5th, 95th percentiles). Center-level bleeding variation persisted after case-mix adjustment (2.8%–9.5%; 5th, 95th percentiles). While hospitals’ observed and risk-adjusted bleeding ranks were correlated (Spearman’s rho 0.88), individual rankings shifted after risk-adjustment (median Δ rank order ± 91.5; IQR 37.0, 185.5). Outlier classification changed post-adjustment for 29.3%, 16.1%, and 26.5% of low-, non-, and high-outlier sites, respectively. Hospital use of bleeding avoidance strategies (bivalirudin, radial access, or vascular closure device) was associated with risk-adjusted bleeding rates. Conclusions Despite adjustment for patient case-mix, there is wide variation in rates of hospital PCI-related bleeding in the United States. Opportunities may exist for best performers to share practices with other sites. PMID:25424242

  9. Air-gating and chemical-gating in transistors and sensing devices made from hollow TiO2 semiconductor nanotubes.

    PubMed

    Alivov, Yahya; Funke, Hans; Nagpal, Prashant

    2015-07-24

    Rapid miniaturization of electronic devices down to the nanoscale, according to Moore's law, has led to some undesirable effects like high leakage current in transistors, which can offset additional benefits from scaling down. Development of three-dimensional transistors, by spatial extension in the third dimension, has allowed higher contact area with a gate electrode and better control over conductivity in the semiconductor channel. However, these devices do not utilize the large surface area and interfaces for new electronic functionality. Here, we demonstrate air gating and chemical gating in hollow semiconductor nanotube devices and highlight the potential for development of novel transistors that can be modulated using channel bias, gate voltage, chemical composition, and concentration. Using chemical gating, we reversibly altered the conductivity of nanoscaled semiconductor nanotubes (10-500 nm TiO2 nanotubes) by six orders of magnitude, with a tunable rectification factor (ON/OFF ratio) ranging from 1-10(6). While demonstrated air- and chemical-gating speeds were slow here (∼seconds) due to the mechanical-evacuation rate and size of our chamber, the small nanoscale volume of these hollow semiconductors can enable much higher switching speeds, limited by the rate of adsorption/desorption of molecules at semiconductor interfaces. These chemical-gating effects are completely reversible, additive between different chemical compositions, and can enable semiconductor nanoelectronic devices for 'chemical transistors', 'chemical diodes', and very high-efficiency sensing applications.

  10. Vitamin K antagonists: beyond bleeding.

    PubMed

    Krüger, Thilo; Floege, Jürgen

    2014-01-01

    Warfarin is the most widely used oral anticoagulant in clinical use today. Indications range from prosthetic valve replacement to recurrent thromboembolic events due to antiphospholipid syndrome. In hemodialysis (HD) patients, warfarin use is even more frequent than in the nonrenal population due to increased cardiovascular comorbidities. The use of warfarin in dialysis patients with atrial fibrillation requires particular caution because side effects may outweigh the assumed benefit of reduced stroke rates. Besides increased bleeding risk, coumarins exert side effects which are not in the focus of clinical routine, yet they deserve special consideration in dialysis patients and should influence the decision of whether or not to prescribe vitamin K antagonists in cases lacking clear guidelines. Issues to be taken into consideration in HD patients are the induction or acceleration of cardiovascular calcifications, a 10-fold increased risk of calciphylaxis and problems related to maintaining a target INR range. New anticoagulants like direct thrombin inhibitors are promising but have not yet been approved for ESRD patients. Here, we summarize the nontraditional side effects of coumarins and give recommendations about the use of vitamin K antagonists in ESRD patients.

  11. Application of a high surface area solid-phase microextraction air sampling device: collection and analysis of chemical warfare agent surrogate and degradation compounds.

    PubMed

    Stevens, Michael E; Tipple, Christopher A; Smith, Philip A; Cho, David S; Mustacich, Robert V; Eckenrode, Brian A

    2013-09-17

    This work examines a recently improved, dynamic air sampling technique, high surface area solid-phase microextraction (HSA-SPME), developed for time-critical, high-volume sampling and analysis scenarios. The previously reported HSA-SPME sampling device, which provides 10-fold greater surface area compared to commercially available SPME fibers, allowed for an increased analyte uptake per unit time relative to exhaustive sampling through a standard sorbent tube. This sampling device has been improved with the addition of a type-K thermocouple and a custom heater control circuit for direct heating, providing precise (relative standard deviation ∼1%) temperature control of the desorption process for trapped analytes. Power requirements for the HSA-SPME desorption process were 30-fold lower than those for conventional sorbent-bed-based desorption devices, an important quality for a device that could be used for field analysis. Comparisons of the HSA-SPME device when using fixed sampling times for the chemical warfare agent (CWA) surrogate compound, diisopropyl methylphosphonate (DIMP), demonstrated that the HSA-SPME device yielded a greater chromatographic response (up to 50%) relative to a sorbent-bed method. Another HSA-SPME air sampling approach, in which two devices are joined in tandem, was also evaluated for very rapid, low-level, and representative analysis when using discrete sampling times for the compounds of interest. The results indicated that subparts per billion by volume concentration levels of DIMP were detectable with short sampling times (∼15 s). Finally, the tandem HSA-SPME device was employed for the headspace sampling of a CWA degradation compound, 2-(diisopropylaminoethyl) ethyl sulfide, present on cloth material, which demonstrated the capability to detect trace amounts of a CWA degradation product that is estimated to be less volatile than sarin. The rapid and highly sensitive detection features of this device may be beneficial in decision

  12. Direct Percutaneous Embolization of Bleeding Stomal Varices

    SciTech Connect

    Naidu, Sailen G.; Castle, Erik P.; Kriegshauser, J. Scott; Huettl, Eric A.

    2010-02-15

    Stomal variceal bleeding can develop in patients with underlying cirrhosis and portal hypertension. Most patients are best treated with transjugular intrahepatic portosystemic shunt (TIPS) creation because this addresses the underlying problem of portal hypertension. However, some patients are not good candidates for TIPS creation because they have end-stage liver disease or encephalopathy. We describe such a patient who presented with recurrent bleeding stomal varices, which was successfully treated with percutaneous coil embolization. The patient had bleeding-free survival for 1 month before death from unrelated causes.

  13. Detection of gastrointestinal bleeding by radionuclide scintigraphy

    SciTech Connect

    Gupta, S.; Luna, E.; Kingsley, S.; Prince, M.; Herrera, N.

    1984-01-01

    Scanning with Technetium /sup 99m/ labeled autologous red blood cells was performed in 59 patients with clinical suspicion of acute and/or intermittent, chronic gastrointestinal bleeding. In 36 patients (61%), a definite site of bleeding could be demonstrated. A strong correlation with other modalities such as upper and lower gastrointestinal endoscopy, contrast angiography, and surgical exploration was found. Overall sensitivity of the procedure was 91%; specificity 100% and accuracy 93.3%. It is suggested that radionuclide scintigraphy provides a completely noninvasive, simple, and sensitive procedure which may be routinely used for the detection and localization of gastrointestinal bleeding.

  14. Compressor bleed cooling fluid feed system

    DOEpatents

    Donahoo, Eric E; Ross, Christopher W

    2014-11-25

    A compressor bleed cooling fluid feed system for a turbine engine for directing cooling fluids from a compressor to a turbine airfoil cooling system to supply cooling fluids to one or more airfoils of a rotor assembly is disclosed. The compressor bleed cooling fluid feed system may enable cooling fluids to be exhausted from a compressor exhaust plenum through a downstream compressor bleed collection chamber and into the turbine airfoil cooling system. As such, the suction created in the compressor exhaust plenum mitigates boundary layer growth along the inner surface while providing flow of cooling fluids to the turbine airfoils.

  15. Electrosurgical device for both mechanical cutting and coagulation of bleeding

    DOEpatents

    Doss, J.D.; McCabe, C.W.

    1985-02-08

    Bipolar electrical coagulation of tissue using radiofrequency energy is combined with the functions of conventional surgical pressure tissue cutting instruments without significant modification thereof in a single instrument with the result that a surgeon can perform both procedures without having to redirect his attention from the area of the surgery. 4 figs.

  16. Electrosurgical device for both mechanical cutting and coagulation of bleeding

    DOEpatents

    Doss, James D.; McCabe, Charles W.

    1987-01-01

    Bipolar electrical coagulation of tissue using radio-frequency energy is combined with the functions of conventional surgical pressure tissue cutting instruments without significant modification thereof in a single instrument with the result that a surgeon can perform both procedures without having to redirect his attention from the area of the surgery.

  17. Cleaning devices

    NASA Technical Reports Server (NTRS)

    Schneider, Horst W. (Inventor)

    1981-01-01

    Cleaning devices are described which include a vacuum cleaner nozzle with a sharp rim for directing incoming air down against the floor; a vacuum cleaner wherein electrostatically charged brushes that brush dirt off a floor, are electrically grounded to remove charges that could tend to hold dirt to the brushes; a vacuum cleaner head having slots that form a pair of counter-rotating vortices, and that includes an outlet that blows a stream of air at the floor region which lies between the vortices; a cleaning device that sweeps a group of brushes against the ground along a first direction, and then sweeps them along the same ground area but in a second direction angled from the first by an amount such as 90.degree., to sweep up particles lying in crevices extending along any direction; a device that gently cleans a surface to remove bacteria for analysis, including an inclined wall along which cleaning fluid flows onto the surface, a vacuum chamber for drawing in the cleaning fluid, and a dividing wall spaced slightly from the surface to separate the fluid source from the vacuum cleaner chamber; and a device for providing pulses of pressured air including a chamber to which pressured air is supplied, a ball that circulates around the chamber to repeatedly close an outlet, and an air source that directs air circumferentially to move the ball around the chamber.

  18. Menstrual bleeding from an endometriotic lesion.

    PubMed

    Burney, Richard O; Lathi, Ruth B

    2009-05-01

    We present a case in which endometriotic lesions were observed to be focally hemorrhagic at laparoscopy performed during menstruation. Red vesicular lesions likely represent early disease with intact capacity for hormonally induced menstrual bleeding.

  19. Dysfunctional Uterine Bleeding (DUB) (For Teens)

    MedlinePlus

    ... develop AUB. Some illnesses (like thyroid disease or polycystic ovary syndrome ) can mess with the body's hormones. Problems like ... sex. Doctors ask these questions because conditions like polycystic ovary syndrome and some STDs can cause abnormal bleeding. If ...

  20. Laboratory evaluation of a bleeding patient.

    PubMed Central

    Wallerstein, R O

    1989-01-01

    Most causes of abnormal bleeding can be determined from a complete blood count including platelet count and bleeding, prothrombin, activated partial thromboplastin, and thrombin times. Occasionally, further evaluation is necessary, such as tests of factor XIII function, fibrinolysis, and vascular integrity. Possible diagnoses include disseminated intravascular coagulation, thrombotic thrombocytopenic purpura, vitamin K deficiency, von Willebrand's disease, heparin-induced thrombocytopenia, acquired inhibitors of factor VIII, lupus anticoagulants, and coagulation disorders related to the acquired immunodeficiency syndrome. PMID:2660407

  1. NANODEVICE: Novel Concepts, Methods, and Technologies for the Production of Portable, Easy-to-use Devices for the Measurement and Analysis of Airborne Engineered Nanoparticles in Workplace Air

    NASA Astrophysics Data System (ADS)

    Sirviö, Sari; Savolainen, Kai

    2011-07-01

    NANODEVICE is a research project funded by the European Commission in the context of the 7th Framework Programme. The duration is 48 months starting 1st of April 2009. Due to their unique properties, engineered nanoparticles (ENP) are now used for a myriad of novel applications, and have a great economic and technological importance. However, some of these properties, especially their surface reactivity, have raised health concerns due to their potential health effects. There is currently a shortage of field-worthy, cost-effective ways - especially in real time - for reliable assessment of exposure levels to ENP in workplace air. NANODEVICE will provide new information on the physico-chemical properties of engineered nanoparticles (ENP) and information about their toxicology. The main emphasis of the project is in the development of novel measuring devices to assess the exposure to ENP's from workplace air. The purpose of the project is also to promote the safe use of ENP through guidance, standards and education, implementing of safety objectives in ENP production and handling, and promotion of safety related collaborations through an international nanosafety forum. The main project goal is to develop innovative concepts and reliable methods for characterizing ENP in workplace air with novel, portable and easy-to-use devices suitable for workplaces.

  2. Co-stimulation of HaCaT keratinization with mechanical stress and air-exposure using a novel 3D culture device

    PubMed Central

    Jung, Moon Hee; Jung, Sang-Myung; Shin, Hwa Sung

    2016-01-01

    Artificial skin or skin equivalents have been used for clinical purpose to skin graft and as substitutes for animal experiments. The culture of cell lines such as HaCaT has the potential to produce large amounts of artificial skin at a low cost. However, there is a limit to keratinization due to the restriction of differentiation in HaCaT. In this study, a culture device that mimics the in vivo keratinization mechanism, co-stimulated by air-exposure and mechanical stimulation, was developed to construct skin equivalents. The device can reconstruct the epidermal morphology, including the cornified layer, similar to its formation in vivo. Under the condition, epidermis was differentiated in the spinous and granular layers. Formation of the stratum corneum is consistent with the mRNA and protein expressions of differentiation markers. The device is the first of its kind to combine air-exposure with mechanical stress to co-stimulate keratinization, which can facilitate the economically viable production of HaCaT-based artificial skin substitutes. PMID:27670754

  3. Treatment and prognosis in peptic ulcer bleeding.

    PubMed

    Laursen, Stig Borbjerg

    2014-02-01

    Peptic ulcer bleeding is a frequent cause of admission. Despite several advances in treatment the 30-day mortality seems unchanged at a level around 11%. Use of risk scoring systems is shown to be advantageous in the primary assessment of patients presenting with symptoms of peptic ulcer bleeding. Studies performed outside Denmark have demonstrated that use of risk scoring systems facilitates identification of low-risk patients suitable for outpatient management. Nevertheless, these systems have not been implemented for routine use in Denmark. This is mainly explained by concerns about the external validity due to considerable inter-country variation in patients' characteristics. In recent years, transcatheter arterial embolization (TAE) has become increasingly used for achievement of haemostasis in patients with peptic ulcer bleeding not responding to endoscopic therapy. As rebleeding is associated with poor outcome TAE could, in theory, also be beneficial as a supplementary treatment in patients with ulcer bleeding responding to endoscopic therapy. This has not been examined previously. Several studies have concluded that peptic ulcer bleeding is associated with excess long-term mortality. These findings are, however, questioned as the studies were based on life-table analysis, unmatched control groups, or did not perform adequate adjustment for comorbidity. Treatment with blood transfusion is, among patients undergoing cardiac bypass surgery, shown to increase the long-term mortality. Despite frequent use of blood transfusion in treatment of peptic ulcer bleeding a possible adverse effect of on long-term survival has not been examined in these patients.

  4. [Intrauterine devices].

    PubMed

    Delavest, P; Engelmann, P

    1980-12-11

    Medicated IUDs such as copper IUDs and progesterone-releasing IUDs represent a new development in this form of contraception. All IUDs act by causing an inflammatory reaction at the endometrial level. Techniques of insertion vary from one model to the other; insertion always requires an experienced practitioner, and postabortion or midmenstruation insertions are to be preferred. Pregnancy with IUD in situ is a rare occurrence; the IUD must then be immediately removed. Ectopic pregnancies are about 5-10% of all pregnancies with the device in situ. IUD complications are uterine perforation, mostly done at time of insertion, and pelvic infection which, if untreated, can cause infertility; this is the reason why an IUD is never recommended to a nullipara. Pain and bleeding are the most common side effects. When the strings of the device are not visible, translocation of the device inside the uterine cavity must be suspected. The choice of the wrong type of IUD or a bad insertion can cause spontaneous expulsion of the device. IUD wearers must be regularly seen by a doctor; there is no correlation between IUD use and cervical or endometrial carcinoma.

  5. TRALI Syndrome Complicated by Retroperitoneal Bleeding.

    PubMed

    Singh, Vijay A; Zeltsman, David

    2011-09-01

    Transfusion-related acute lung injury (TRALI) is an underdiagnosed and underreported syndrome which by itself is the third leading cause of transfusion-related mortality. The incidence of TRALI is reported to be 1 in 2000 to 5000 transfusions. When combined with uncontrollable bleeding, survival is unachievable. We report the case of a 25-year-old man, who underwent open heart surgery as an infant to correct his congenital heart disease in association with right pulmonary artery atresia. He presented with hemoptysis secondary to aspergilloma and required a pneumonectomy of the nonfunctional right lung. During pneumolysis, significant bleeding occurred from the superior vena cava. The patient required a blood transfusion and was placed on cardiopulmonary bypass to control the bleeding. Simultaneous occurrence of severe pulmonary edema and retroperitoneal bleeding were noted. Approximately 8 L of frothy edema fluid were drained from the only functional left lung starting ~15 minutes after the transfusion and lasting for several hours until the end of the case. It most likely represented TRALI syndrome. Increasing abdominal girth and poor volume return to the pump were consistent with and pathognomonic for retroperitoneal bleeding. Though primary surgical bleeding in the chest was controlled successfully and a pneumonectomy performed without further difficulty, we were unable to separate the patient from cardiopulmonary bypass due to the inability to oxygenate. As a result, we could not reverse the anti-coagulation which potentially exacerbated the retroperitoneal bleeding. After multiple unsuccessful attempts the patient succumbed. This ill-fated case demonstrates the quandary of obtaining vascular access for emergency cardiopulmonary bypass while in the right thoracotomy position. It may be beneficial to have both the femoral artery and vein cannulated before positioning a patient in a lateral decubitus position. In addition, early direct access to the right atrium

  6. Statement on intrauterine devices.

    PubMed

    1981-12-01

    These policy statements and guidelines from the International Planned Parenthood Federation's (IPPF) International Medical Advisory Panel (IMAP) concern IUDs. The following contraindications to IUD use are recognized: 1) pelvic inflaminatory disease, 2) known or suspected pregnancy, 3) history of previous ectopic pregnancy, 4) gynecological bleeding disorders, 5) suspected malignancy of the genital tract, 6) congenital uterine abnormalities or fibroids distorting the cavity, and 7) anemia, blood coagulation, severe cervical stenosis, copper allergy, Wilson's disease, and others. Generalities regarding appropriate IUDs are: 1) non-medicated devices (e.g. Lippes Loop) are studied for women who may not return for regular check-ups, 2) smaller medicated devices usually cause less menstrual blood loss than the non-medicated devices, 3) smaller devices are better for a smaller uterus and larger devices for the larger uterus, and 4) when a smaller device is expelled it is advisable to try a larger one and vice versa. Dalkon Shields should not be used by the IPPF system and all women using them should have the device removed. Correct insertion of IUDs is important and should be done by properly trained personnel. The timing of insertion is best during the menstrual period. Withdrawal of the applicator while leaving the device in place is the recommended insertion technique. Sterilization of IUDs should follow instructions on bulk-packaged IUDs. Complications include perforation, bleeding and pain, infection, and ectopic pregnancy. IUD removal should be done during menstruation. Good clinical management and follow-up care are recommended.

  7. Prevention of Vitamin K Deficiency Bleeding.

    PubMed

    Phillippi, Julia C; Holley, Sharon L; Morad, Anna; Collins, Michelle R

    2016-07-07

    The risk that a newborn will develop vitamin K deficiency bleeding is 1700/100,000 (one out of 59) if vitamin K is not administered. When intramuscular vitamin K is administered, the risk of vitamin K deficiency bleeding is reduced to 1/100,000. While women may have misconceptions about vitamin K prophylaxis for their newborns, health care providers should be prepared with factual information. Prophylaxis is needed even for healthy newborns without risk factors for bleeding. Other forms of vitamin K supplementation, including oral administration of Food and Drug Administration-approved vitamin K preparations and maternal supplements during pregnancy or lactation, do not have the same effectiveness as the parenteral form. The formulations of vitamin K approved for use in the United States have not been associated with childhood leukemia or other childhood health problems. Care providers need to give accurate information to families regarding the risks and benefits of vitamin K prophylaxis. An interprofessional approach to education can be effective in increasing acceptance of vitamin K prophylaxis and decreasing the incidence of vitamin K deficiency bleeding. This article uses a case study approach to highlight common misconceptions about vitamin K prophylaxis and discuss a recent interprofessional collaboration to prevent vitamin K deficiency bleeding.

  8. Aerodynamic Control using Distributed Active Bleed

    NASA Astrophysics Data System (ADS)

    Kearney, John; Glezer, Ari

    2015-11-01

    The global aerodynamic loads on a stationary and pitching airfoil at angles of attack beyond the static and dynamic stall margins, respectively are controlled in wind tunnel experiments using regulated distributed bleed driven by surface pressure differences. High-speed PIV and proper orthogonal decomposition of the vorticity flux on the static airfoil show that the bleed engenders trains of discrete vortices that advect along the surface and are associated with a local instability that is manifested by a time-averaged bifurcation of the vorticity layer near the bleed outlets and alters the vorticity flux over the airfoil and thereby the aerodynamic loads. Active bleed is used on a dynamically pitching airfoil (at reduced frequencies up to k = 0.42) to modulate the evolution of vorticity concentrations during dynamic stall. Time-periodic bleed improved the pitch stability by reducing adverse pitching moment (``negative damping'') that can precipitate structural instabilities. At the same time, the maintains the cycle-average loads to within 5% of the base flow levels by segmenting the vorticity layer during upstroke and promoting early flow attachment during downstroke segments of the pitch cycle. Supported by Georgia Tech VLRCOE.

  9. Installation of a flow control device in an inclined air-curtain fume hood to control wake-induced exposure.

    PubMed

    Chen, Jia-Kun

    2016-08-01

    An inclined plate for flow control was installed at the lower edge of the sash of an inclined air-curtain fume hood to reduce the effects of the wake around a worker standing in front of the fume hood. Flow inside the fume hood is controlled by the inclined air-curtain and deflection plates, thereby forming a quad-vortex flow structure. Controlling the face velocity of the fume hood resulted in convex, straight, concave, and attachment flow profiles in the inclined air-curtain. We used the flow visualization and conducted a tracer gas test with a mannequin to determine the performance of two sash geometries, namely, the half-cylinder and inclined plate designs. When the half-cylinder design was used, the tracer gas test registered a high leakage concentration at Vf ≦ 57.1 fpm or less. This concentration occurred at the top of the sash opening, which was close to the breathing zone of the mannequin placed in front of the fume hood. When the inclined plate design was used, the containment was good, with concentrations of 0.002-0.004 ppm, at Vf ≦ 63.0 fpm. Results indicate that an inclined plate effectively reduces the leakage concentration induced by recirculation flow structures that form in the wake of a worker standing in front of an inclined air-curtain fume hood.

  10. Bayesian network modelling of upper gastrointestinal bleeding

    NASA Astrophysics Data System (ADS)

    Aisha, Nazziwa; Shohaimi, Shamarina; Adam, Mohd Bakri

    2013-09-01

    Bayesian networks are graphical probabilistic models that represent causal and other relationships between domain variables. In the context of medical decision making, these models have been explored to help in medical diagnosis and prognosis. In this paper, we discuss the Bayesian network formalism in building medical support systems and we learn a tree augmented naive Bayes Network (TAN) from gastrointestinal bleeding data. The accuracy of the TAN in classifying the source of gastrointestinal bleeding into upper or lower source is obtained. The TAN achieves a high classification accuracy of 86% and an area under curve of 92%. A sensitivity analysis of the model shows relatively high levels of entropy reduction for color of the stool, history of gastrointestinal bleeding, consistency and the ratio of blood urea nitrogen to creatinine. The TAN facilitates the identification of the source of GIB and requires further validation.

  11. Endoscopic laser Doppler flowmetry in the experiment and in the bleeding gastric and duodenal ulcer clinic

    NASA Astrophysics Data System (ADS)

    Kapralov, S. V.; Shapkin, Y. G.; Lychagov, V. V.; Tuchin, V. V.

    2007-05-01

    One of the most complex problems of emergency surgery is the choice of surgical tactics to deal with bleeding peptic ulcer. Endoscopic hemostasis is prescribed to patients with continuing bleedings and prerelapse syndrome. But till nowdays the objective verification of the prerelapse condition had not been worked out. What is more there are no objective criteria to judge the effectiveness of the carried endohemostasis. The aim of the study was to work out a new objective diagnostic method of pre-recurrence syndrome that can be able to make prognosis for possible gastroduodenal ulcer bleeding recurrence more precise. Laser Doppler flowmetry was the method of studies the regional perfusion. The device used in this work was made at the Optics and Biophysics Department of Saratov State University.

  12. A novel needle trap device with single wall carbon nanotubes sol-gel sorbent packed for sampling and analysis of volatile organohalogen compounds in air.

    PubMed

    Heidari, Mahmoud; Bahrami, Abdolrahman; Ghiasvand, Ali Reza; Shahna, Farshid Ghorbani; Soltanian, Ali Reza

    2012-11-15

    This paper describes a new approach that combines needle trap devices (NTDs) with a newly synthesized silanated nano material as sorbent for sampling and analysis of HVOCs in air. The sol-gel technique was used for preparation of the single wall carbon nanotube (SWCNT)/silica composite as sorbent, packed inside a 21-gauge NTD. Application of this method as an exhaustive sampler device was investigated under different laboratory conditions in this study. Predetermined concentrations of each analyte were prepared in a home-made standard chamber, and the effects of experimental parameters, such as temperature, humidity, sampling air flow rate, breakthrough volume and storage time on NTD, and the sorbent performance were investigated. The proposed NTD was used in two different modes and two different injection methods, and an NTD with a side hole, a narrow neck glass liner and syringe pump assisted injection of carrier gas were applied. The NTD packed with SWCNTs/silica composite was compared to the NTD packed with PDMS and also SPME with CAR/PDMS. For four compounds, LOD was 0.001-0.01 ng mL(-1), LOQ was 0.007-0.03 ng mL(-1), and the relative standard division for repeatability of method was 2.5-6.7%. The results show that the incorporation of NTD and SWCNTs/silica composite is a reliable and effective approach for the sampling and analysis of HVOCs in air. Coupling this system to GC-MS make it more sensitive and powerful technique.

  13. Angiography in gastrointestinal bleeding in children

    SciTech Connect

    Meyerovitz, M.F.; Fellows, K.E.

    1984-10-01

    Twenty-seven children aged 1 day to 16 years studied arteriographically for acute or chronic gastrointestinal bleeding were reviewed. Children with known esophageal varices and portal hypertension were excluded. Final diagnoses were made in 25 patients by means of surgery, endoscopy, biopsy, laboratory data, and clinical follow-up. Of these 25 cases, arteriography gave a correct diagnosis in 64% and was falsely negative in 36%. The common causes of bleeding in this study were gastric and duodenal ulcers, gastritis, vascular malformations, and typhlitis. Transcatheter therapy was attempted in six acute bleeders, with success in three (50%).

  14. Endoscopic management of acute peptic ulcer bleeding.

    PubMed

    Lu, Yidan; Chen, Yen-I; Barkun, Alan

    2014-12-01

    This review discusses the indications, technical aspects, and comparative effectiveness of the endoscopic treatment of upper gastrointestinal bleeding caused by peptic ulcer. Pre-endoscopic considerations, such as the use of prokinetics and timing of endoscopy, are reviewed. In addition, this article examines aspects of postendoscopic care such as the effectiveness, dosing, and duration of postendoscopic proton-pump inhibitors, Helicobacter pylori testing, and benefits of treatment in terms of preventing rebleeding; and the use of nonsteroidal anti-inflammatory drugs, antiplatelet agents, and oral anticoagulants, including direct thrombin and Xa inhibitors, following acute peptic ulcer bleeding.

  15. Acid inhibition and peptic ulcer bleeding.

    PubMed

    Štimac, D; Franjić, N; Krznarić, Ž

    2011-01-01

    Peptic ulcer bleeding is one of the most common emergency situations in medicine. Combined pharmacological and endoscopic therapy together with emerging interventional radiological procedures are successfully treating peptic ulcer disease, reserving surgical procedures for only a small portion of patients unresponsive to 'conventional' therapy. Technological advancement has seen a great improvement in the field of endoscopic treatment in the form of various methods of hemostasis. However, pharmacological therapy with proton pump inhibitors still plays the central role in the peptic ulcer bleeding treatment algorithm.

  16. Evaluation for bleeding disorders in suspected child abuse.

    PubMed

    Anderst, James D; Carpenter, Shannon L; Abshire, Thomas C

    2013-04-01

    Bruising or bleeding in a child can raise the concern for child abuse. Assessing whether the findings are the result of trauma and/or whether the child has a bleeding disorder is critical. Many bleeding disorders are rare, and not every child with bruising/bleeding concerning for abuse requires an evaluation for bleeding disorders. In some instances, however, bleeding disorders can present in a manner similar to child abuse. The history and clinical evaluation can be used to determine the necessity of an evaluation for a possible bleeding disorder, and prevalence and known clinical presentations of individual bleeding disorders can be used to guide the extent of the laboratory testing. This clinical report provides guidance to pediatricians and other clinicians regarding the evaluation for bleeding disorders when child abuse is suspected.

  17. Therapeutic and prophylactic ethanol lock therapy in patients with bleeding disorders.

    PubMed

    Rajpurkar, M; McGrath, E; Joyce, J; Boldt-MacDonald, K; Chitlur, M; Lusher, J

    2014-01-01

    Obtaining a reliable venous access is a limiting factor for early initiation of clotting factor prophylaxis and immune tolerance induction. To circumvent this issue, central venous access devices (CVADs) are increasingly being used. Catheter-related infections (CRIs) remain the primary complication of insertion of CVAD. Thus, newer strategies for treatment and prevention of CRI are needed. Ethanol lock therapy (ELT) has been used to treat and prevent CRI in non-bleeding disorder patients. The aim of this study was to assess the efficacy of ELT in treating and preventing CRI in bleeding disorder patients. The medical charts of patients with bleeding disorders who underwent ELT for antimicrobial resistant CRIs were reviewed and data were analysed. ELT was effective in catheter salvage in 87% of patients with antimicrobial resistant CRI by a wide variety of pathogens. Prophylactic therapy with ethanol lock was associated with catheter dysfunction especially in mediports. ELT should be considered prior to removal of catheters in bleeding disorder patients with resistant CRIs. Further studies are needed for using prophylactic ethanol lock in prevention of CRIs in bleeding disorder patients.

  18. Flight vibrations and bleeding in helicoptered patients with pelvic fracture.

    PubMed

    Carchietti, Elio; Cecchi, Adriana; Valent, Francesca; Rammer, Raphael

    2013-01-01

    Depending on their amplitude and frequency, vibrations may facilitate bleeding and worsen the prognosis of patients with pelvic fractures transported by helicopter emergency medical services (HEMS). We measured the range of frequencies and amplitudes of forced vibrations produced by the helicopter used by the HEMS of the Italian Friuli Venezia Giulia region on the pelvis of transported persons. We performed 3 flight tests with 3 different volunteers (mass 70, 80, and 90 kg, respectively) loaded on the helicopter's stretcher and recorded the amplitudes and frequencies of vibrations through a triaxis sensor placed on the HEMS stretcher in the pelvis area. The flight profile planned was identical for each of the 3 iterations. Over the whole flight, the frequencies of vibration were between 26.4 and 53.5 Hz, and the greastest amplitude was 0.035 mm. The vibrations recorded in the helicopter may facilitate bleeding in unstable fractures. In the management of patients with pelvic fractures, HEMS crews should provide prehospital care that includes the use of specific splinting devices in addition to the spinal board, which allows an early immobilization of fractures and the limitation of pelvic motion.

  19. Use of electrospinning and dynamic air focusing to create three-dimensional cell culture scaffolds in microfluidic devices.

    PubMed

    Chen, Chengpeng; Mehl, Benjamin T; Sell, Scott A; Martin, R Scott

    2016-09-21

    Organs-on-a-chip has emerged as a powerful tool for pharmacological and physiological studies. A key part in the construction of such a model is the ability to pattern or culture cells in a biomimetic fashion. Most of the reported cells-on-a-chip models integrate cells on a flat surface, which does not accurately represent the extracellular matrix that they experience in vivo. Electrospinning, a technique used to generate sub-micron diameter polymer fibers, has been used as an in vitro cell culture substrate and for tissue engineering applications. Electrospinning of fibers directly into a fully sealed fluidic channel using a conventional setup has not been possible due to issues of confining the fibers into a discrete network. In this work, a dynamic focusing method was developed, with this approach enabling direct deposition of electrospun fibers into a fully sealed fluidic channel, to act as a matrix for cell culture and subsequent studies under continuous flowing conditions. Scanning electron microscopy of electrospun polycaprolactone fibers shows that this method enables the formation of fibrous layers on the inner wall of a 3D-printed fluidic device (mean fiber size = 1.6 ± 0.6 μm and average pore size = 113 ± 19 μm(2)). Cells were able to be cultured in this 3D scaffold without the addition of adhesion proteins. Media was pumped through the channel at high flow rates (up to 400 μL min(-1)) during a dynamic cell culture process and both the fibers and the cells were found to be strongly adherent. A PDMS fluidic device was also prepared (from a 3D printed mold) and coated with polycaprolactone fibers. The PDMS device enables optical detection and confocal imaging of cultured cells on the fibers. Finally, macrophages were cultured in the devices to study how the fibrous scaffold can affect cell behavior. It was found that under lipopolysaccharide stimulation, macrophages cultured on PCL fibers inside of a channel secreted significantly more cytokines than

  20. Diagnosis of gastrointestinal bleeding: A practical guide for clinicians

    PubMed Central

    Kim, Bong Sik Matthew; Li, Bob T; Engel, Alexander; Samra, Jaswinder S; Clarke, Stephen; Norton, Ian D; Li, Angela E

    2014-01-01

    Gastrointestinal bleeding is a common problem encountered in the emergency department and in the primary care setting. Acute or overt gastrointestinal bleeding is visible in the form of hematemesis, melena or hematochezia. Chronic or occult gastrointestinal bleeding is not apparent to the patient and usually presents as positive fecal occult blood or iron deficiency anemia. Obscure gastrointestinal bleeding is recurrent bleeding when the source remains unidentified after upper endoscopy and colonoscopic evaluation and is usually from the small intestine. Accurate clinical diagnosis is crucial and guides definitive investigations and interventions. This review summarizes the overall diagnostic approach to gastrointestinal bleeding and provides a practical guide for clinicians. PMID:25400991

  1. Duodenal variceal bleed: an unusual cause of upper gastrointestinal bleed and a difficult diagnosis to make

    PubMed Central

    Bhagani, Shradha; Winters, Conchubhair; Moreea, Sulleman

    2017-01-01

    We present a case of recurrent upper gastrointestinal (GI) bleeding in a man aged 57 years with primary biliary cholangitis who was ultimately diagnosed with an isolated duodenal variceal bleed, which was successfully treated with histoacryl glue injection. Duodenal varices are an uncommon presentation of portal hypertension and can result in significant GI bleeding with a high mortality. Diagnosis can be difficult and therapeutic options limited. Endoscopic variceal sclerotherapy with histoacryl glue provides an effective treatment, though endoscopists need to remain aware of and vigilant for the serious complications of this treatment option. PMID:28242804

  2. Italian Registry of Congenital Bleeding Disorders

    PubMed Central

    Giampaolo, Adele; Abbonizio, Francesca; Arcieri, Romano; Hassan, Hamisa Jane

    2017-01-01

    In Italy, the surveillance of people with bleeding disorders is based on the National Registry of Congenital Coagulopathies (NRCC) managed by the Italian National Institute of Health (Istituto Superiore di Sanità). The NRCC collects epidemiological and therapeutic data from the 54 Hemophilia Treatment Centers, members of the Italian Association of Hemophilia Centres (AICE). The number of people identified with bleeding disorders has increased over the years, with the number rising from approx. 7000 in 2000 to over 11,000 in 2015. The NRCC includes 4020 patients with hemophilia A and 859 patients with hemophilia B. The prevalence of the rare type 3 vWD is 0.20/100,000 inhabitants. Less common congenital bleeding disorders include the following deficiencies: Factor I (fibrinogen), Factor II (prothrombin), Factor V, Factor VII, Factor X, Factor XI and Factor XIII, which affect 1953 patients. Hepatitis C Virus (HCV) infection affects 1561 patients, more than 200 of whom have two infections (HCV + HIV). Estimated hemophilia-related drug consumption in 2015 was approx. 550 million IU of FVIII for hemophilia A patients and approx. 70 million IU of FIX for hemophilia B patients. The NRCC, with its bleeding disorder data set, is a tool that can provide answers to fundamental questions in public health, monitoring care provision and drug treatment, as well as facilitating clinical and epidemiological research. PMID:28335488

  3. [OMEPRAZOL VS RANITIDINE IN UPPER DIGESTIVE BLEEDING

    PubMed

    Regis R, Regina; Bisso A, Aland; Rebaza, Segundo

    1999-01-01

    Pectic ulcer is the most frequent cause of gastrointestinal bleeding. The homeostatic mechanism of bleeding, and coagulation, does not happen with values of pH less than 5,0. Therefore neutralization of gastric acidity (pH more than 5,0) is a recourse of control, improve the evolution and healing of peptic ulcer and to avoid a new bleeding. The aim of this study was to compare the results of treatment with omeprazole and ranitidine, in 57 patients admitted at emergency room of the Hospital Central de la Polic a Nacional del Per with endoscopic diagnosis of peptic ulcer, using Forrest classification. Patients received omeprazole 40 mg in bolus IV, followed by continuos infusion of 8 mg/hour for 72 hours (group A) or ranitidine 50 mg IV each 8 hours for 72 hours (group B). A new endoscopy was made 72 hours after admission demostrated a succesful therapy in both group. Bleeding stopped in 26/27 patients in group A (96,2%) and in 23/30 patients in group B (76,6%) (p<0,05). The results of this study show that the omeprazole IV is more effective than ranitidine IV in the control of UGB because of peptic ulcer and provides a faster healing.

  4. Acute diquat poisoning with intracerebral bleeding

    PubMed Central

    Saeed, S; Wilks, M; Coupe, M

    2001-01-01

    A case of severe diquat poisoning complicated by the development of aggressive behaviour, oliguric renal failure, and intracerebral bleeding is described. The patient was successfully managed and made a complete recovery. In this paper special attention has been given to the major clinical differences between diquat and paraquat intoxication.


Keywords: poisoning; diquat; paraquat PMID:11320278

  5. Air Apparent.

    ERIC Educational Resources Information Center

    Harbster, David A.

    1988-01-01

    Explains the principle upon which a barometer operates. Describes how to construct two barometric devices for use in the classroom that show air's changing pressure. Cites some conditions for predicting weather. (RT)

  6. Microfluidic device for robust generation of two-component liquid-in-air slugs with individually controlled composition

    PubMed Central

    Liu, Kan; Chen, Yi-Chun; Tseng, Hsian-Rong

    2010-01-01

    Using liquid slugs as microreactors and microvessels enable precise control over the conditions of their contents on short-time scales for a wide variety of applications. Particularly for screening applications, there is a need for control of slug parameters such as size and composition. We describe a new microfluidic approach for creating slugs in air, each comprising a size and composition that can be selected individually for each slug. Two-component slugs are formed by first metering the desired volume of each reagent, merging the two volumes into an end-to-end slug, and propelling the slug to induce mixing. Volume control is achieved by a novel mechanism: two closed chambers on the chip are initially filled with air, and a valve in each is briefly opened to admit one of the reagents. The pressure of each reagent can be individually selected and determines the amount of air compression, and thus the amount of liquid that is admitted into each chamber. We describe the theory of operation, characterize the slug generation chip, and demonstrate the creation of slugs of different compositions. The use of microvalves in this approach enables robust operation with different liquids, and also enables one to work with extremely small samples, even down to a few slug volumes. The latter is important for applications involving precious reagents such as optimizing the reaction conditions for radiolabeling biological molecules as tracers for positron emission tomography. Electronic supplementary material The online version of this article (doi:10.1007/s10404-010-0617-0) contains supplementary material, which is available to authorized users. PMID:20930933

  7. Microcoil Embolization for Acute Lower Gastrointestinal Bleeding

    SciTech Connect

    D'Othee, Bertrand Janne Surapaneni, Padmaja; Rabkin, Dmitry; Nasser, Imad; Clouse, Melvin

    2006-02-15

    Purpose. To assess outcomes after microcoil embolization for active lower gastrointestinal (GI) bleeding. Methods. We retrospectively studied all consecutive patients in whom microcoil embolization was attempted to treat acute lower GI bleeding over 88 months. Baseline, procedural, and outcome parameters were recorded following current Society of Interventional Radiology guidelines. Outcomes included technical success, clinical success (rebleeding within 30 days), delayed rebleeding (>30 days), and major and minor complication rates. Follow-up consisted of clinical, endoscopic, and pathologic data. Results. Nineteen patients (13 men, 6 women; mean age {+-} 95% confidence interval = 70 {+-} 6 years) requiring blood transfusion (10 {+-} 3 units) had angiography-proven bleeding distal to the marginal artery. Main comorbidities were malignancy (42%), coagulopathy (28%), and renal failure (26%). Bleeding was located in the small bowel (n = 5), colon (n 13) or rectum (n = 1). Technical success was obtained in 17 patients (89%); 2 patients could not be embolized due to vessel tortuosity and stenoses. Clinical follow-up length was 145 {+-} 75 days. Clinical success was complete in 13 (68%), partial in 3 (16%), and failed in 2 patients (11%). Delayed rebleeding (3 patients, 27%) was always due to a different lesion in another bowel segment (0 late rebleeding in embolized area). Two patients experienced colonic ischemia (11%) and underwent uneventful colectomy. Two minor complications were noted. Conclusion. Microcoil embolization for active lower GI bleeding is safe and effective in most patients, with high technical and clinical success rates, no procedure-related mortality, and a low risk of bowel ischemia and late rebleeding.

  8. Endovascular Management of Acute Bleeding Arterioenteric Fistulas

    SciTech Connect

    Leonhardt, Henrik Mellander, Stefan; Snygg, Johan; Loenn, Lars

    2008-05-15

    The objective of this study was to review the outcome of endovascular transcatheter repair of emergent arterioenteric fistulas. Cases of abdominal arterioenteric fistulas (defined as a fistula between a major artery and the small intestine or colon, thus not the esophagus or stomach), diagnosed over the 3-year period between December 2002 and December 2005 at our institution, were retrospectively reviewed. Five patients with severe enteric bleeding underwent angiography and endovascular repair. Four presented primary arterioenteric fistulas, and one presented a secondary aortoenteric fistula. All had massive persistent bleeding with hypotension despite volume substitution and transfusion by the time of endovascular management. Outcome after treatment of these patients was investigated for major procedure-related complications, recurrence, reintervention, morbidity, and mortality. Mean follow-up time was 3 months (range, 1-6 months). All massive bleeding was controlled by occlusive balloon catheters. Four fistulas were successfully sealed with stent-grafts, resulting in a technical success rate of 80%. One patient was circulatory stabilized by endovascular management but needed immediate further open surgery. There were no procedure-related major complications. Mean hospital stay after the initial endovascular intervention was 19 days. Rebleeding occurred in four patients (80%) after a free interval of 2 weeks or longer. During the follow-up period three patients needed reintervention. The in-hospital mortality was 20% and the 30-day mortality was 40%. The midterm outcome was poor, due to comorbidities or rebleeding, with a mortality of 80% within 6 months. In conclusion, endovascular repair is an efficient and safe method to stabilize patients with life-threatening bleeding arterioenteric fistulas in the emergent episode. However, in this group of patients with severe comorbidities, the risk of rebleeding is high and further intervention must be considered

  9. The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation

    PubMed Central

    O'Brien, Emily C.; Simon, DaJuanicia N.; Thomas, Laine E.; Hylek, Elaine M.; Gersh, Bernard J.; Ansell, Jack E.; Kowey, Peter R.; Mahaffey, Kenneth W.; Chang, Paul; Fonarow, Gregg C.; Pencina, Michael J.; Piccini, Jonathan P.; Peterson, Eric D.

    2015-01-01

    Background Therapeutic decisions in atrial fibrillation (AF) are often influenced by assessment of bleeding risk. However, existing bleeding risk scores have limitations. Objectives We sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based AF population. Methods We analysed data from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF), a prospective registry that enrolled incident and prevalent AF patients at 176 US sites. Using Cox proportional hazards regression, we identified factors independently associated with major bleeding among patients taking oral anticoagulation (OAC) over a median follow-up of 2 years (interquartile range = 1.6–2.5). We also created a numerical bedside risk score that included the five most predictive risk factors weighted according to their strength of association with major bleeding. The predictive performance of the full model, the simple five-item score, and two existing risk scores (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile INR, elderly, drugs/alcohol concomitantly, HAS-BLED, and anticoagulation and risk factors in atrial fibrillation, ATRIA) were then assessed in both the ORBIT-AF cohort and a separate clinical trial population, Rivaroxaban Once-daily oral direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation (ROCKET-AF). Results Among 7411 ORBIT-AF patients taking OAC, the rate of major bleeding was 4.0/100 person-years. The full continuous model (12 variables) and five-factor ORBIT risk score (older age [75+ years], reduced haemoglobin/haematocrit/history of anaemia, bleeding history, insufficient kidney function, and treatment with antiplatelet) both had good ability to identify those who bled vs. not (C-index 0.69 and 0.67, respectively). These scores both had

  10. Intrauterine devices containing progesterone.

    PubMed

    Murad, F

    1977-05-01

    Characteristics of progesterone-releasing IUDs are reported. At present, the only progesterone-containing IUD on the market is Progestasert, a T-shaped ethylene vinyl acetate copolymer device containing 38 mg progesterone in silicone. The device releases approximately 65 mcg/day into the uterine cavity over the course of 1-year. The device does not alter pituitary function or ovulation, nor does it depend on a local mechanical effect. Rather, it may exert its effect by inhibiting sperm capacitation or survival, or it may prevent nidation by alterning the endometrium. The reported pregnancy rate for Progestasert is 1.9% in parous women and 2.5% in nulliparous women. This efficacy rate is similar to that for other IUDs and low-dose progestin-only oral contraceptives. Breakthrough bleeding is the most common side effect, and perhaps 10-15% of the acceptors will have the device removed for either bleeding, pain, or infection. The rate of spontaneous expulsion of the device is about 3-8%. It is recommended that the device be inserted during or shortly after the menstrual period.

  11. Stent Patients Face Higher Risk of Death After Bleeding, Clots

    MedlinePlus

    ... 164108.html Stent Patients Face Higher Risk of Death After Bleeding, Clots Prolonged treatment to prevent clots ... some patients are still at increased risk of death if they suffer either blockages or bleeding events, ...

  12. Hemostatic Powders in Gastrointestinal Bleeding: A Systematic Review.

    PubMed

    Chen, Yen-I; Barkun, Alan N

    2015-07-01

    Topical hemostatic agents and powders are an emerging modality in the endoscopic management of upper and lower gastrointestinal bleeding. This systematic review demonstrates the effectiveness and safety of these agents with special emphasis on TC-325 and Ankaferd Blood Stopper. The unique noncontact/nontraumatic application, ability to cover large areas of bleed, and ease of use make these hemostatic agents an attractive option in certain clinical situations, such as massive bleeding with poor visualization, salvage therapy, and diffuse bleeding from luminal malignancies.

  13. Gastrointestinal angiodysplasia and bleeding in von Willebrand disease.

    PubMed

    Franchini, M; Mannucci, P M

    2014-09-02

    Von Willebrand disease (VWD), the most common genetic bleeding disorder, is characterised by a quantitative or qualitative defect of von Willebrand factor (VWF). Patients with VWD suffer from mucocutaneous bleeding, of severity usually proportional to the degree of VWF defect. In particular, gastrointestinal bleeding associated with angiodysplasia is often a severe symptom of difficult management. This review focuses on the pathophysiology, diagnosis and treatment of VWD-associated gastrointestinal angiodysplasia and related bleeding.

  14. Heat tube device

    NASA Technical Reports Server (NTRS)

    Khattar, Mukesh K. (Inventor)

    1990-01-01

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

  15. Comparison of Lichen, Conifer Needles, Passive Air Sampling Devices, and Snowpack as Passive Sampling Media to Measure Semi-Volatile Organic Compounds in Remote Atmospheres

    PubMed Central

    SCHRLAU, JILL E.; GEISER, LINDA; HAGEMAN, KIMBERLY J.; LANDERS, DIXON H.

    2011-01-01

    A wide range of semi-volatile organic compounds (SOCs), including pesticides and polycyclic aromatic hydrocarbons (PAHs), were measured in lichen, conifer needles, snowpack and XAD-based passive air sampling devices (PASDs) collected from 19 different U.S. national parks in order to compare the magnitude and mechanism of SOC accumulation in the different passive sampling media. Lichen accumulated the highest SOC concentrations, in part because of its long (and unknown) exposure period, while PASDs accumulated the lowest concentrations. However, only the PASD SOC concentrations can be used to calculate an average atmospheric gas-phase SOC concentration because the sampling rates are known and the media is uniform. Only the lichen and snowpack SOC accumulation profiles were statistically significantly correlated (r = 0.552, p-value <0.0001) because they both accumulate SOCs present in the atmospheric particle-phase. This suggests that needles and PASDs represent a different composition of the atmosphere than lichen and snowpack and that the interpretation of atmospheric SOC composition is dependent on the type of passive sampling media used. All four passive sampling media preferentially accumulated SOCs with relatively low air-water partition coefficients, while snowpack accumulated SOCs with higher log KOA values compared to the other media. Lichen accumulated more SOCs with log KOA > 10 relative to needles and showed a greater accumulation of particle-phase PAHs. PMID:22087860

  16. Comparison of lichen, conifer needles, passive air sampling devices, and snowpack as passive sampling media to measure semi-volatile organic compounds in remote atmospheres.

    PubMed

    Schrlau, Jill E; Geiser, Linda; Hageman, Kimberly J; Landers, Dixon H; Simonich, Staci Massey

    2011-12-15

    A wide range of semivolatile organic compounds (SOCs), including pesticides and polycyclic aromatic hydrocarbons (PAHs), were measured in lichen, conifer needles, snowpack and XAD-based passive air sampling devices (PASDs) collected from 19 different U.S. national parks in order to compare the magnitude and mechanism of SOC accumulation in the different passive sampling media. Lichen accumulated the highest SOC concentrations, in part because of its long (and unknown) exposure period, whereas PASDs accumulated the lowest concentrations. However, only the PASD SOC concentrations can be used to calculate an average atmospheric gas-phase SOC concentration because the sampling rates are known and the media is uniform. Only the lichen and snowpack SOC accumulation profiles were statistically significantly correlated (r = 0.552, p-value <0.0001) because they both accumulate SOCs present in the atmospheric particle-phase. This suggests that needles and PASDs represent a different composition of the atmosphere than lichen and snowpack and that the interpretation of atmospheric SOC composition is dependent on the type of passive sampling media used. All four passive sampling media preferentially accumulated SOCs with relatively low air-water partition coefficients, while snowpack accumulated SOCs with higher log K(OA) values compared to the other media. Lichen accumulated more SOCs with log K(OA) > 10 relative to needles and showed a greater accumulation of particle-phase PAHs.

  17. Gallbladder bleeding-related severe gastrointestinal bleeding and shock in a case with end-stage renal disease

    PubMed Central

    Tsai, Jun-Li; Tsai, Shang-Feng

    2016-01-01

    Abstract Gallbladder (GB) bleeding is very rare and it is caused by cystic artery aneurysm and rupture, or GB wall rupture. For GB rupture, the typical findings are positive Murphy's sign and jaundice. GB bleeding mostly presented as hemobilia. This is the first case presented with severe GI bleeding because of GB rupture-related GB bleeding. After comparing computed tomography, one gallstone spillage was noticed. In addition to gallstones, uremic coagulopathy also worsens the bleeding condition. This is also the first case that patients with GB spillage-related rupture and bleeding were successfully treated by nonsurgical management. Clinicians should bear in mind the rare causes of GI bleeding. Embolization of the bleeding artery should be attempted as soon as possible. PMID:27281100

  18. Emissions and fuel economy effects of vehicle exhaust emission control device (revision). Technical report

    SciTech Connect

    Johnson, H.

    1998-10-01

    This report describes testing by EPA of the Vehicle Exhaust Emission Control Device (VEECD) retrofit device under Section 32918 of Title 49 U.S.C. Retrofit Devices (RD). The VEECD is described by the developer in the international patent application as an embodiment of air bleed principle. It is intended to be retrofitted to vehicles produced without any, or with earlier-technology emission control systems. The developer claims (RD Application Appendix A) that the valve significantly reduces CO and HC emissions without substantially increasing CO{sub 2} or NOx emissions. Incidental city fuel economy enhancement was also claimed. Non-FTP test data obtained for 1986/87 European vehicles from two laboratories in the UK was submitted. This data (Appendix B) was analyzed using the t-test for the difference of constant speed data (30/60/85MPH) at 95% confidence level.

  19. The mechanisms of refilling of xylem conduits and bleeding of tall birch during spring.

    PubMed

    Westhoff, M; Schneider, H; Zimmermann, D; Mimietz, S; Stinzing, A; Wegner, L H; Kaiser, W; Krohne, G; Shirley, St; Jakob, P; Bamberg, E; Bentrup, F-W; Zimmermann, U

    2008-09-01

    Seasonal variations in osmolality and components of xylem sap in tall birch trees were determined using several techniques. Xylem sap was extracted from branch and trunk sections of 58 trees using the very rapid gas bubble-based jet-discharge method. The 5-cm long wood pieces were taken at short intervals over the entire tree height. The data show that large biphasic osmolality gradients temporarily exist within the conducting xylem conduits during leaf emergence (up to 272 mosmol x kg(-1) at the apex). These gradients (arising mainly from glucose and fructose) were clearly held within the xylem conduit as demonstrated by (1)H NMR imaging of intact twigs. Refilling experiments with benzene, sucrose infusion, electron and light microscopy, as well as (1)H NMR chemical shift microimaging provided evidence that the xylem of birch represents a compartment confined by solute-reflecting barriers (radial: lipid linings/lipid bodies; axial: presumably air-filled spaces). These features allow transformation of osmolality gradients into osmotic pressure gradients. Refilling of the xylem occurs by a dual mechanism: from the base (by root pressure) and from the top (by hydrostatic pressure generated by xylem-bound osmotic pressure). The generation of osmotic pressure gradients was accompanied by bleeding. Bleeding could be observed at a height of up to 21 m. Bleeding rates measured at a given height decreased exponentially with time. Evidence is presented that the driving force for bleeding is the weight of the static water columns above the bleeding point. The pressure exerted by the water columns and the bleeding volume depend on the water-filling status of (communicating) vessels.

  20. Secondary prophylaxis for esophageal variceal bleeding.

    PubMed

    Albillos, Agustín; Tejedor, Marta

    2014-05-01

    Combination therapy with beta-blockers and endoscopic band ligation (EBL) is the standard prophylaxis of esophageal variceal rebleeding in cirrhosis. Beta-blockers are the backbone of combination therapy, since their benefit extend to other complications of portal hypertension. EBL carries the risk of post-banding ulcer bleeding, which explains why overall rebleeding is reduced when beta-blockers are added to EBL, and not when EBL is added to beta-blockers. TIPS is the rescue treatment, but it could be considered as first choice in patients that first bleed while on beta-blockers, those with contraindications to beta-blockers or with refractory ascites, and those with fundal varices.

  1. Multiple Polypoid Angiodysplasia with Obscure Overt Bleeding.

    PubMed

    Lee, Jooyoung; Hwang, Sung Wook; Kim, Jihye; Kang, Jinwoo; Kang, Gyeong Hoon; Park, Kyu Joo; Im, Jong Pil; Kim, Joo Sung

    2016-01-01

    Angiodysplasia (AD) is increasingly being recognized as a major cause of gastrointestinal bleeding. Morphologically flat lesions are common types of AD, whereas the polypoid types are rare. We report a case of multiple polypoid AD in the small bowel causing severe anemia and requiring surgical treatment. A 60-year-old male patient visited our hospital with dyspnea and hematochezia. He had a history of myocardial infarction and was taking both aspirin and clopidogrel. Capsule endoscopy, enteroscopy, computed tomography, and angiography revealed multifocal vascular lesions with a polypoid shape in the jejunum. Surgical resection was performed because endoscopic treatment was considered impossible with the number and the location of lesions. The risk of recurrent bleeding related to the use of antiplatelet agents also contributed to the decision to perform surgery. AD was histologically diagnosed from the surgical specimen. He resumed taking both aspirin and clopidogrel after surgery. He fully recovered and has been doing well during the several months of follow-up.

  2. Automated Analysis of Vital Signs Identified Patients with Substantial Bleeding Prior to Hospital Arrival

    DTIC Science & Technology

    2015-10-01

    culminating with the first and only deployment of an automated emergency care decision system on board active air ambulances: the APPRAISE system , a...hardware/software platform for automated, real-time analysis of vital-sign data. After developing the APPRAISE system using data from trauma patients...APPRAISE system provided consistent determination of whether or not patients were bleeding. We found that the automated APPRAISE system using a

  3. The role of endoscopy in pediatric gastrointestinal bleeding

    PubMed Central

    Franke, Markus; Geiß, Andrea; Greiner, Peter; Wellner, Ulrich; Richter-Schrag, Hans-Jürgen; Bausch, Dirk; Fischer, Andreas

    2016-01-01

    Background and study aims: Gastrointestinal bleeding in children and adolescents accounts for up to 20 % of referrals to gastroenterologists. Detailed management guidelines exist for gastrointestinal bleeding in adults, but they do not encompass children and adolescents. The aim of this study was to assess gastrointestinal bleeding in pediatric patients and to determine an investigative management algorithm accounting for the specifics of children and adolescents. Patients and methods: Pediatric patients with gastrointestinal bleeding admitted to our endoscopy unit from 2001 to 2009 (n = 154) were identified. Retrospective statistical and neural network analysis was used to assess outcome and to determine an investigative management algorithm. Results: The source of bleeding could be identified in 81 % (n = 124/154). Gastrointestinal bleeding was predominantly lower gastrointestinal bleeding (66 %, n = 101); upper gastrointestinal bleeding was much less common (14 %, n = 21). Hematochezia was observed in 94 % of the patients with lower gastrointestinal bleeding (n = 95 of 101). Hematemesis (67 %, n = 14 of 21) and melena (48 %, n = 10 of 21) were associated with upper gastrointestinal bleeding. The sensitivity and specificity of a neural network to predict lower gastrointestinal bleeding were 98 % and 63.6 %, respectively and to predict upper gastrointestinal bleeding were 75 % and 96 % respectively. The sensitivity and specifity of hematochezia alone to predict lower gastrointestinal bleeding were 94.2 % and 85.7 %, respectively. The sensitivity and specificity for hematemesis and melena to predict upper gastrointestinal bleeding were 82.6 % and 94 %, respectively. We then developed an investigative management algorithm based on the presence of hematochezia and hematemesis or melena. Conclusions: Hematochezia should prompt colonoscopy and hematemesis or melena should prompt esophagogastroduodenoscopy. If no

  4. Progress in the treatment of bleeding disorders.

    PubMed

    Bergman, Garrett E

    2011-01-01

    The availability of plasma-derived and recombinant coagulation factors has transformed the management of patients with bleeding disorders, such as hemophilia and von Willebrand disease (VWD). However, several important clinical challenges remain that have become the focus of current research in coagulation therapy. Two prospective, non-interventional studies (HyQoL-Europe and HyQoL-Canada) are evaluating the impact of major transitional life events, such as changes in social, work and living situations, on the quality of life of adolescents and young adults with hemophilia A who are treated with the recombinant factor VIII (rFVIII) concentrate Helixate®. A better understanding of the impact of these transitional life events on quality of life may help to develop improved interventions and counseling techniques that minimize the negative effects of these events on patients with bleeding disorders. A new clinical development program has been launched to evaluate the safety and efficacy of the low-volume, highly active, plasma-derived von Willebrand factor (VWF)/FVIII concentrate Biostate®. The program, known as SWIFT (Studies with von Willebrand factor/factor VIII) includes four clinical trials involving adult and pediatric patients with hemophilia A or VWD. Lastly, fusion of human recombinant albumin to recombinant coagulation factor IX (rFIX) has created a new fusion protein (rIX-FP) that retains the biological activity of rFIX and has a more favorable pharmacokinetic profile due to the longer half-life. The use of this novel fusion protein may offer several advantages to patients with hemophilia B: less frequent administration, prolonged protection from bleeding and improved compliance--increasing the likelihood of a positive clinical outcome. These examples of current research endeavors are intended to enhance the treatment experience as well as provide new and improved therapies for patients with bleeding disorders.

  5. Jejunogastric intussusception presenting as tumor bleed

    PubMed Central

    Rather, Shiraz Ahmad; Dar, Tanveer Iqbal; Wani, Rauf A; Khan, Asima

    2010-01-01

    Jejunogastric intussusception (JGI) is a rare but serious complication of previous gastrectomy or gastrojejunostomy, and a delayed diagnosis can lead to catastrophe. It can present as hematemesis, and an endoscopist aware of the condition can diagnose it early. We present a case of JGI presenting as hematemesis and diagnosed as tumor bleed on endoscopy. Diagnosis of JGI was confirmed on laparotomy, gangrenous efferent limb was resected and a fresh gastrojejunostomy performed. PMID:21063568

  6. Interhospital Air Transport of a Blind Patient on Extracorporeal Life Support with Consecutive and Successful Left Ventricular Assist Device Implantation

    PubMed Central

    Bauer, Adrian; Schaarschmidt, Jan; Grosse, F. Oliver; Al Alam, Nidal; Hausmann, Harald; Krämer, Klaus; Strüber, Martin; Mohr, Friedrich W.

    2014-01-01

    Abstract: The use of extracorporeal life support systems (ECLS) in patients with postcardiotomy low cardiac output syndrome (LCO) as a bridge to recovery and bridge to implantation of ventricular assist device (VAD) is common nowadays. A 59-year-old patient with acute myocardial infarction received a percutaneous transluminal angioplasty and stenting of the circumflex artery. During catheterization of the left coronary artery (LAD), the patient showed ventricular fibrillation and required defibrillation and cardiopulmonary resuscitation. After implantation of an intra-aortic balloon pump, the patient immediately was transmitted to the operating room. He received emergency coronary artery bypass grafting in a beating heart technique using pump-assisted minimal extracorporeal circulation circuit (MECC). Two bypass grafts were performed to the LAD and the right posterior descending artery. Despite initial successful weaning off cardiopulmonary bypass with high-dose inotropic support, the patient presented postcardiotomy LCO and an ECLS was implanted. The primary setup of the heparin-coated MECC system was modified and used postoperatively. As a result of the absence of an in-house VAD program, the patient was switched to a transportable ECLS the next day and was transferred by helicopter to the nearest VAD center where the patient received a successful insertion of a left VAD 3 days later. PMID:25208435

  7. Single session treatment for bleeding hemorrhoids

    SciTech Connect

    Weinstein, S.J.; Rypins, E.B.; Houck, J.; Thrower, S.

    1987-12-01

    Fifty consecutive outpatients with bleeding internal hemorrhoids were prospectively treated with a single application of rubber band ligation or infrared coagulation. Complete follow-up observation was obtained in 48 patients (23 underwent rubber band ligation and 25 underwent infrared coagulation). At one month after treatment, 22 patients who underwent rubber band ligation and 16 who underwent infrared coagulation, were symptomatically improved (p less than 0.05). At six months, 15 patients who had undergone rubber band ligation and ten who had infrared coagulation treatment, remained improved (p less than 0.05). There was no statistical difference in the discomfort experienced by either group during or after the procedure as determined by a self-assessment scale. Two patients who underwent rubber band ligation experienced complications--a thrombosed external hemorrhoid developed in one patient and another had delayed rectal bleeding. Although associated with occasional complications after treatment, rubber band ligation is more effective than in infrared coagulation for single session treatment of bleeding internal hemorrhoids.

  8. Treatment and prognosis in peptic ulcer bleeding.

    PubMed

    Laursen, Stig Borbjerg

    2014-01-01

    Peptic ulcer bleeding is a frequent cause of admission. Despite several advances in treatment the 30-day mortality seems unchanged at a level around 11%. Use of risk scoring systems is shown to be advantageous in the primary assessment of patients presenting with symptoms of peptic ulcer bleeding. Studies performed outside Denmark have demonstrated that use of risk scoring systems facilitates identification of low-risk patients suitable for outpatient management. Nevertheless, these systems have not been implemented for routine use in Denmark. This is mainly explained by concerns about the external validity due to considerable inter-country variation in patients' characteristics. In recent years, transcatheter arterial embolization (TAE) has become increasingly used for achievement of hemostasis in patients with peptic ulcer bleeding not responding to endoscopic therapy. As rebleeding is associated with poor outcome TAE could, in theory, also be beneficial as a supplementary treatment in patients with ulcer bleeding responding to endoscopic therapy. This has not been examined previously. Several studies have concluded that peptic ulcer bleeding is associated with excess long-term mortality. These findings are, however, questioned as the studies were based on life-table analysis, unmatched control groups, or did not perform adequate adjustment for comorbidity. Treatment with blood transfusion is, among patients undergoing cardiac bypass surgery, shown to increase the long-term mortality. Despite frequent use of blood transfusion in treatment of peptic ulcer bleeding a possible adverse effect of on long-term survival has not been examined in these patients. The aims of the present thesis were: 1. To examine which risk scoring system is best at predicting need of hospital-based intervention, rebleeding, and mortality in patients presenting with upper gastrointestinal bleeding (Study I) 2. To evaluate if supplementary transcatheter arterial embolization (STAE) after

  9. Investigation of Tractor Base Bleeding for Heavy Vehicle Aerodynamic Drag Reduction

    SciTech Connect

    Ortega, J; Salari, K; Storms, B

    2007-10-25

    One of the main contributors to the aerodynamic drag of a heavy vehicle is tractor-trailer gap drag, which arises when the vehicle operates within a crosswind. Under this operating condition, freestream flow is entrained into the tractor-trailer gap, imparting a momentum exchange to the vehicle and subsequently increasing the aerodynamic drag. While a number of add-on devices, including side extenders, splitter plates, vortex stabilizers, and gap sealers, have been previously tested to alleviate this source of drag, side extenders remain the primary add-on device of choice for reducing tractor-trailer gap drag. However, side extenders are not without maintenance and operational issues. When a heavy vehicle pivots sharply with respect to the trailer, as can occur during loading or unloading operations, the side extenders can become crushed against the trailer. Consequently, fleet operators are forced to incur additional costs to cover the repair or replacement of the damaged side extenders. This issue can be overcome by either shortening the side extenders or by devising an alternative drag reduction concept that can perform just as effectively as side extenders. To explore such a concept, we investigate tractor base bleeding as a means of reducing gap drag. Wind tunnel measurements are made on a 1:20 scale heavy vehicle model at a vehicle width-based Reynolds number of 420,000. The tractor bleeding flow, which is delivered through a porous material embedded within the tractor base, is introduced into the tractor-trailer gap at bleeding coefficients ranging from 0.0-0.018. To determine the performance of tractor base bleeding under more realistic operating conditions, computational fluid dynamics simulations are performed on a full-scale heavy vehicle within a crosswind for bleeding coefficients ranging from 0.0-0.13.

  10. Patterns of bleeding in adolescents with severe haemophilia A.

    PubMed Central

    Aronstam, A; Rainsford, S G; Painter, M J

    1979-01-01

    Eighty-two boys with severe haemophilia A who spent some time at Lord Mayor Treloar College during 1973-7 were studied. All episodes of bleeding that occurred during term time were recorded, along with the number of transfusions. The bleeding frequency among these boys, most of them aged 10-17 years, increased steadily from 8,31 episodes/100 days in 1973 to 12,63 episodes/100 days in 1977. At the same time there was a steady fall in bleeding frequency with age. Altogether 24% of bleeding episodes were into the elbow joint, 22% into the knee, and 15% into the ankle. As the boys grew older the proportion of bleeding episodes in the legs declined and that in the arms increased. The overall results reflect the fact that special schools now see only the severest cases of haemophilia. The pattern of bleeding during adolescence suggests that concepts of management of arm bleeding need modifying. PMID:427411

  11. Effects of bleed-hole geometry and plenum pressure on three-dimensional shock-wave/boundary-layer/bleed interactions

    NASA Technical Reports Server (NTRS)

    Chyu, Wei J.; Rimlinger, Mark J.; Shih, Tom I.-P.

    1993-01-01

    A numerical study was performed to investigate 3D shock-wave/boundary-layer interactions on a flat plate with bleed through one or more circular holes that vent into a plenum. This study was focused on how bleed-hole geometry and pressure ratio across bleed holes affect the bleed rate and the physics of the flow in the vicinity of the holes. The aspects of the bleed-hole geometry investigated include angle of bleed hole and the number of bleed holes. The plenum/freestream pressure ratios investigated range from 0.3 to 1.7. This study is based on the ensemble-averaged, 'full compressible' Navier-Stokes (N-S) equations closed by the Baldwin-Lomax algebraic turbulence model. Solutions to the ensemble-averaged N-S equations were obtained by an implicit finite-volume method using the partially-split, two-factored algorithm of Steger on an overlapping Chimera grid.

  12. Evaluations of the Combat Ready Clamp to Control Bleeding in Human Cadavers, Manikins, Swine Femoral Artery Hemorrhage Model and Swine Carcasses

    DTIC Science & Technology

    2012-06-01

    Fayetteville, NC) received FDA 510(k) clearance for prehospital hemorrhage control of pelvic , groin or buttock bleeding in warfare. Although 500 units... pelvic , groin or buttock bleeding in warfare. Although 500 units have been sold and 125-200 deployed, there is but one anecdotal report of its...Clamp (CRC), a device developed by Combat Medical Systems for controlling abdominal or pelvic hemorrhage. METHODS: The Wake Forest University human

  13. Testing Percutaneous Arterial Closure Devices: An Animal Model

    SciTech Connect

    Ni Ruifang; Kranokpiraksa, Pawanrat; Pavcnik, Dusan Kakizawa, Hideaki; Uchida, Barry T.; Keller, Frederick S.; Roesch, Josef

    2009-03-15

    The ovine superficial femoral artery was used for testing the efficacy of percutaneous arterial closure devices (PACDs) in their developmental stage. Two topical devices containing chitostan, one staple-mediated PACD and a porcine small intestinal submucosa plug, were tested by follow-up angiography in 37 sheep. Absence or presence of bleeding and time to bleeding cessation were the main criteria for evaluation of PAVD efficacy. The results of these tests directed modification of individual PACDs and improved their efficacy.

  14. Endoscopic hemostasis state of the art - Nonvariceal bleeding

    PubMed Central

    Goelder, Stefan Karl; Brueckner, Juliane; Messmann, Helmut

    2016-01-01

    New endoscopic techniques for hemostasis in nonvariceal bleeding were introduced and known methods further improved. Hemospray and Endoclot are two new compounds for topical treatment of bleeding. Initial studies in this area have shown a good hemostatic effect, especially in active large scale oozing bleeding, e.g., tumor bleedings. For further evaluation larger prospective studies comparing the substanced with other methods of endoscopic hemostasis are needed. For localized active arterial bleeding primary injection therapy in the area of ​​bleeding as well as in the four adjacent quadrants offers a good method to reduce bleeding activity. The injection is technically easy to learn and practicable. After bleeding activity is reduced the bleeding source can be localized more clearly for clip application. Today many different through-the-scope (TTS) clips are available. The ability to close and reopen a clip can aid towards good positioning at the bleeding site. Even more important is the rotatability of a clip before application. Often multiple TTS clips are required for secure closure of a bleeding vessel. One model has the ability to use three clips in series without changing the applicator. Severe arterial bleeding from vessels larger than 2 mm is often unmanageable with these conventional methods. Here is the over-the-scope-clip system another newly available method. It is similar to the ligation of esophageal varices and involves aspiration of tissue into a transparent cap before closure of the clip. Thus a greater vascular occlusion pressure can be achieved and larger vessels can be treated endoscopically. Patients with severe arterial bleeding from the upper gastrointestinal tract have a very high rate of recurrence after initial endoscopic treatment. These patients should always be managed in an interdisciplinary team of interventional radiologist and surgeons. PMID:26962402

  15. Management of Patients with Acute Lower Gastrointestinal Bleeding

    PubMed Central

    Strate, Lisa L.; Gralnek, Ian M.

    2016-01-01

    This guideline provides recommendations for the management of patients with acute overt lower gastrointestinal hemorrhage. Hemodynamic status should be initially assessed with intravascular volume resuscitation started as needed. Risk stratification based upon clinical parameters should be performed to help distinguish patients at high and low-risk of adverse outcomes. Hematochezia associated with hemodynamic instability may be indicative of an upper GI bleeding source and thus warrants an upper endoscopy. In the majority of patients, colonoscopy should be the initial diagnostic procedure and should be performed within 24 hours of patient presentation after adequate colon preparation. Endoscopic hemostasis therapy should be provided to patients with high risk endoscopic stigmata of bleeding including active bleeding, non-bleeding visible vessel, or adherent clot. The endoscopic hemostasis modality used (mechanical, thermal, injection or combination) is most often guided by the etiology of bleeding, access to the bleeding site, and endoscopist experience with the various hemostasis modalities. Repeat colonoscopy, with endoscopic hemostasis performed if indicated, should be considered for patients with evidence of recurrent bleeding. Radiographic interventions (tagged red blood cell scintigraphy, CT angiography, angiography) should be considered in high-risk patients with ongoing bleeding who do not respond adequately to resuscitation, and who are unlikely to tolerate bowel preparation and colonoscopy. Strategies to prevent recurrent bleeding should be considered. NSAID use should be avoided in patients with a history of acute lower GI bleeding particularly if secondary to diverticulosis or angioectasia. In patients with established cardiovascular disease who require aspirin (secondary prophylaxis), aspirin should not be discontinued. The exact timing depends on the severity of bleeding, perceived adequacy of hemostasis and the risk of a thromboembolic event. Surgery

  16. Intra-abdominal bleeding in appendicitis.

    PubMed

    Thongprayoon, C; Pasa-Arj, S

    1991-08-01

    A 34-year-old woman, gravida 6 with 10 weeks of gestation was admitted because of abdominal pain and fainting. On physical examination she had hypotension, was pale with abdominal tenderness and guarding. Culdocentesis yielded unclotted blood. Immediate laparotomy was performed, because a diagnosis of ectopic pregnancy was made. About 2,500 ml of fresh blood was found in the abdominal cavity. Appendicular artery tear caused active arterial bleeding. The torn appendicular artery was observed to be the consequence of perforated appendicitis, which, in turn, was caused by a faecalith. Appendectomy was performed and she made a good recovery.

  17. Enteral alimentation and gastrointestinal bleeding in mechanically ventilated patients.

    PubMed

    Pingleton, S K; Hadzima, S K

    1983-01-01

    The incidence of upper gastrointestinal (GI) bleeding in mechanically ventilated ICU patients receiving enteral alimentation was reviewed and compared to bleeding occurring in ventilated patients receiving prophylactic antacids or cimetidine. Of 250 patients admitted to our ICU during a 1-yr time period, 43 ventilated patients were studied. Patients in each group were comparable with respect to age, respiratory diagnosis, number of GI hemorrhage risk factors, and number of ventilator, ICU, and hospital days. Twenty-one patients had evidence of GI bleeding. Fourteen of 20 patients receiving antacids and 7 of 9 patients receiving cimetidine had evidence of GI bleeding. No bleeding occurred in 14 patients receiving enteral alimentation. Complications of enteral alimentation were few and none required discontinuation of enteral alimentation. Our preliminary data suggest the role of enteral alimentation in critically ill patients may include not only protection against malnutrition but also protection against GI bleeding.

  18. Multiple Polypoid Angiodysplasia with Obscure Overt Bleeding

    PubMed Central

    Lee, Jooyoung; Hwang, Sung Wook; Kim, Jihye; Kang, Jinwoo; Kang, Gyeong Hoon; Park, Kyu Joo; Im, Jong Pil; Kim, Joo Sung

    2016-01-01

    Angiodysplasia (AD) is increasingly being recognized as a major cause of gastrointestinal bleeding. Morphologically flat lesions are common types of AD, whereas the polypoid types are rare. We report a case of multiple polypoid AD in the small bowel causing severe anemia and requiring surgical treatment. A 60-year-old male patient visited our hospital with dyspnea and hematochezia. He had a history of myocardial infarction and was taking both aspirin and clopidogrel. Capsule endoscopy, enteroscopy, computed tomography, and angiography revealed multifocal vascular lesions with a polypoid shape in the jejunum. Surgical resection was performed because endoscopic treatment was considered impossible with the number and the location of lesions. The risk of recurrent bleeding related to the use of antiplatelet agents also contributed to the decision to perform surgery. AD was histologically diagnosed from the surgical specimen. He resumed taking both aspirin and clopidogrel after surgery. He fully recovered and has been doing well during the several months of follow-up. PMID:26855931

  19. Endovascular Management of Acute Enteric Bleeding from Pancreas Transplant

    SciTech Connect

    Semiz-Oysu, Aslihan; Cwikiel, Wojciech

    2007-04-15

    Arterioenteric fistula is a rare but serious complication of enteric drained pancreas transplant, which may lead to massive gastrointestinal bleeding. We present 3 patients with failed enteric drained pancreas transplants and massive gastrointestinal bleeding secondary to arterioenteric fistula. One patient was treated by embolization and the 2 others by stent graft placement. Bleeding was successfully controlled in all cases, at follow up of 5 days, 8 months, and 12 months, respectively. One patient died 24 days after embolization, of unknown causes.

  20. Gastrointestinal Bleeding from Metastatic Prostate Adenocarcinoma to the Stomach

    PubMed Central

    Koop, Andree; Brauhmbhatt, Bhaumik; Lewis, Jason

    2017-01-01

    We present a rare case of gastrointestinal (GI) bleeding associated with metastatic prostate adenocarcinoma to the stomach. Prostate cancer, which is the most common noncutaneous malignancy among men, rarely spreads to the stomach, with only 7 cases reported in the English literature. Symptoms may include abdominal pain, nausea, vomiting, and GI bleeding. Our patient was treated with epinephrine injection and bipolar cautery, but GI bleeding recurred 7 months later when he had worsening of his thrombocytopenia while using ibuprofen. PMID:28377935

  1. Rare bleeding disorders in children: identification and primary care management.

    PubMed

    Acharya, Suchitra S

    2013-11-01

    Bleeding symptoms are common in healthy children but occasionally may indicate an underlying congenital or acquired bleeding diathesis. The rare bleeding disorders (RBDs) comprise inherited deficiencies of coagulation factors I (congenital fibrinogen deficiencies), II, V, VII, X, XI, and XIII and combined factor deficiencies, most notably of factors V and VIII and of vitamin K-dependent factors. These disorders often manifest during childhood and may present with recurrent or even serious or life-threatening bleeding episodes, particularly during the neonatal period. Accordingly, primary care and other nonhematologist pediatric providers should be familiar with the clinical presentation and initial evaluation of these rare disorders. Bleeding manifestations generally vary within the same RBD and may be indistinguishable from 1 RBD to another or from other more common bleeding disorders. Serious bleeding events such as intracranial hemorrhage may be heralded by less serious bleeding symptoms. The results of initial coagulation studies, especially prothrombin time and activated partial thromboplastin time, are often helpful in narrowing down the potential factor deficiency, with factor XIII deficiency being an exception. Consultation with a hematologist is advised to facilitate accurate diagnosis and to ensure proper management and follow-up. The approach to bleeding episodes and invasive procedures is individualized and depends on the severity, frequency, and, in the case of procedures, likelihood of bleeding. Prophylaxis may be appropriate in children with recurrent serious bleeding and specifically after life-threatening bleeding episodes. When available, specific purified plasma-derived or recombinant factor concentrates, rather than fresh frozen plasma or cryoprecipitate, are the treatment of choice.

  2. Management of acute variceal bleeding: emphasis on endoscopic therapy.

    PubMed

    Cárdenas, Andrés

    2010-05-01

    Acute variceal bleeding is one of the most serious and feared complications of patients with portal hypertension. The most common cause of portal hypertension is advanced liver disease. Patients with esophageal and gastric varices may bleed because of a progressive increase in portal pressure that causes them to grow and finally rupture. This article will review the current management strategies for acute variceal bleeding with emphasis on endoscopic therapy for the acute episode.

  3. New Trends in Acute Management of Colonic Diverticular Bleeding

    PubMed Central

    Cirocchi, Roberto; Grassi, Veronica; Cavaliere, Davide; Renzi, Claudio; Tabola, Renata; Poli, Giulia; Avenia, Stefano; Farinella, Eleonora; Arezzo, Alberto; Vettoretto, Nereo; D’Andrea, Vito; Binda, Gian Andrea; Fingerhut, Abe

    2015-01-01

    Abstract Colonic diverticular disease is the most common cause of lower gastrointestinal bleeding. In the past, this condition was usually managed with urgent colectomy. Recently, the development of endoscopy and interventional radiology has led to a change in the management of colonic diverticular bleeding. The aim of this systematic review is to define the best treatment for colonic diverticular bleeding. A systematic bibliographic research was performed on the online databases for studies (randomized controlled trials [RCTs], observational trials, case series, and case reports) published between 2005 and 2014, concerning patients admitted with a diagnosis of diverticular bleeding according to the PRISMA methodology. The outcomes of interest were: diagnosis of diverticulosis as source of bleeding; incidence of self-limiting diverticular bleeding; management of non self-limiting bleeding (endoscopy, angiography, surgery); and recurrent diverticular bleeding. Fourteen studies were retrieved for analysis. No RCTs were found. Eleven non-randomized clinical controlled trials (NRCCTs) were included in this systematic review. In all studies, the definitive diagnosis of diverticular bleeding was always made by urgent colonoscopy. The colonic diverticular bleeding stopped spontaneously in over 80% of the patients, but a re-bleeding was not rare. Recently, interventional endoscopy and angiography became the first-line approach, thus relegating emergency colectomy to patients presenting with hemodynamic instability or as a second-line treatment after failure or complications of hemostasis with less invasive treatments. Colonoscopy is effective to diagnose diverticular bleeding. Nowadays, interventional endoscopy and angiographic treatment have gained a leading role and colectomy should only be entertained in case of failure of the former. PMID:26554768

  4. Recent medical devices for tonsillectomy.

    PubMed

    Sayin, I; Cingi, C

    2012-01-01

    The most frequent and probably the earliest described surgical intervention of ENT field is tonsillectomy. Various methods were described and devices were invented up to now in order to increase safety and decrease time consumption and complications. All new created devices promises lower intraoperative blood loss, intraoperative time, postoperative pain and bleeding. But with their widely use it is seen that they cannot fulfill what they promise. Debate also continues as to which technique yields the best outcome. This study reports a summary for common medical devices which were previously used in tonsillectomy.

  5. Improvements in Modeling 90 degree Bleed Holes for Supersonic Inlets

    NASA Technical Reports Server (NTRS)

    Slater, John W.

    2009-01-01

    The modeling of porous bleed regions as boundary conditions in computational fluid dynamics (CFD) simulations of supersonic inlet flows has been improved through a scaling of sonic flow coefficient data for 90deg bleed holes. The scaling removed the Mach number as a factor in computing the sonic flow coefficient and allowed the data to be fitted with a quadratic equation, with the only factor being the ratio of the plenum static pressure to the surface static pressure. The implementation of the bleed model into the Wind-US CFD flow solver was simplified by no longer requiring the evaluation of the flow properties at the boundary-layer edge. The quadratic equation can be extrapolated to allow the modeling of small amounts of blowing, which can exist when recirculation of the bleed flow occurs within the bleed region. The improved accuracy of the bleed model was demonstrated through CFD simulations of bleed regions on a flat plate in supersonic flow with and without an impinging oblique shock. The bleed model demonstrated good agreement with experimental data and three-dimensional CFD simulations of bleed holes.

  6. Endometrial bleeding in postmenopausal women: with and without hormone therapy.

    PubMed

    Archer, David F

    2011-04-01

    The aim of this study was to present a review of the potential mechanisms involved in the occurrence of endometrial bleeding in postmenopausal women using hormone therapy. Selected literature on the incidence of bleeding in postmenopausal women using estrogen progestogen therapy was reviewed. The incidence of spotting and bleeding in women using continuous-combined hormone therapy was presented. Relevant articles related to the role of angiogenic factors and vasculogenesis in the endometrium, endometrial leukocytes, and endometrial metalloproteinases were used for the review. The cause or etiology of endometrial bleeding with hormone therapy is unknown. Several options are known to alter angiogenesis or be involved in tissue remodeling during normal menstruation. Vascular endothelial growth factor and thrombospondin-1 are proangiogenic and antiangiogenic factors that could cause dysfunction in vasculogenesis that could result in blood vessel fragility and bleeding. The role of pericytes in maintaining vessel morphology and integrity is discussed. Endometrial leukocytes and metalloproteinases are involved in normal menstruation, but their role in postmenopausal bleeding is not clear suggesting involvement of mechanisms in the bleeding. There is limited information on clinical investigation into the etiology of postmenopausal bleeding associated with hormone therapy. The major cause of hormone therapy-related bleeding is unknown. Alterations in angiogenic factors that could result in vascular dysfunction and vessel breakdown provide a working hypothesis as to the potential cause of vessel breakdown.

  7. Photocoagulation in the treatment of bleeding peptic ulcer

    NASA Astrophysics Data System (ADS)

    Otto, Wlodzimierz; Paczkowski, Pawel M.

    1996-03-01

    The authors present their experience in the endoscopic laser photocoagulation of bleeding peptic ulcer. From 1991 to June 1995, 203 patients admitted for UGI bleeding from peptic ulcer have been treated by this method. The source of bleeding was confirmed by endoscopy. The patients were divided into two groups: actively bleeding peptic ulcer (group IA and IB according to Forrest's classification) and ulcer with stigmata of recent bleeding (group IIA/IIB). The former group consisted of 106 patients, among whom over 40 percent (45 patients) presented signs of hypovolemic shock on admission. Nd:YAG laser (Surgical Laser Technologies) was used in a continuous mode with a contact (8 - 20 watts) or non-contact (over 50 watts) method of coagulation. In actively bleeding patients photocoagulation resulted in stopping the hemorrhage in 95 (90%). Recurrent bleeding occurred in 16 cases; in 9 of them it was stopped by repeated photocoagulation. In this group 18 patients required surgical intervention. The mortality was of 10.3% (11 patients). In 97 patients with recent bleeding stigmata photocoagulation provoked heavy hemorrhage in 3 (in 2 cases stopped by prolonged coagulation). In 9 of the remaining 94 patients recurrent bleeding occurred. Nine patients required surgical intervention. Mortality in this group was of 6%.

  8. Modeling of Fixed-Exit Porous Bleed Systems

    NASA Technical Reports Server (NTRS)

    Slater, John W.; Saunders, John D.

    2008-01-01

    A model has been developed to simulate a fixed-exit porous bleed system for supersonic inlets. The fixed-exit model allows the amount of bleed flow to vary according to local flow conditions and fixed-exit characteristics of the bleed system. This variation is important for the control of shock-wave/boundary-layer interactions within the inlet. The model computes the bleed plenum static pressure rather than requiring its specification. The model was implemented in the Wind-US computational fluid dynamics code. The model was then verified and validated against experimental data for bleed on a flat plate with and without an impinging oblique shock and for bleed in a Mach 3.0 axisymmetric, mixed-compression inlet. The model was able to accurately correlate the plenum pressures with bleed rates and simulate the effect of the bleed on the downstream boundary layer. Further, the model provided a realistic simulation of the initiation of inlet unstart. The results provide the most in-depth examination to date of bleed models for use in the simulation of supersonic inlets. The results also highlight the limitations of the models and aspects that require further research.

  9. Upper gastrointestinal bleeding in cirrhosis: clinical and endoscopic correlations.

    PubMed Central

    Terés, J; Bordas, J M; Bru, C; Diaz, F; Bruguera, M; Rodes, J

    1976-01-01

    The clinical data of 180 episodes of upper gastrointestinal bleeding in 168 patients with cirrhosis of the liver are examined. The source of bleeding had been determined by early endoscopy in all cases. In men under the age of 50 years, and without symptoms of liver failure, bleeding was due to ruptured gastro-oesophageal varices in 84% of cases. Severe liver failure was associated with acute lesions of gastric mucosa in many cases. No presumptive diagnosis of the source of haemorrhage could be based on the examination of other clinical data (presence of ascites, mode of presentation and pattern of bleeding, history of ulcer disease, alcoholism, and previous medication. PMID:1083824

  10. The Safety of Thoracentesis in Patients with Uncorrected Bleeding Risk

    PubMed Central

    Argento, A. Christine; Murphy, Terrence E.; Araujo, Katy L. B.; Pisani, Margaret A.

    2013-01-01

    Background: Thoracentesis is commonly performed to evaluate pleural effusions. Many medications (warfarin, heparin, clopidogrel) or physiological factors (elevated International Normalized Ratio [INR], thrombocytopenia, uremia) increase the risk for bleeding. Frequently these medications are withheld or transfusions are performed to normalize physiological parameters before a procedure. The safety of performing thoracentesis without correction of these bleeding risks has not been prospectively evaluated. Methods: This prospective observational cohort study enrolled 312 patients who underwent thoracentesis. All patients were evaluated for the presence of risk factors for bleeding. Hematocrit levels were obtained pre- and postprocedure, and the occurrence of postprocedural hemothorax was evaluated. Measurements and Main Results: Thoracenteses were performed in 312 patients, 42% of whom had a risk for bleeding. Elevated INR, secondary to liver disease or warfarin, and renal disease were the two most common etiologies for bleeding risk, although many patients had multiple potential bleeding risks. There was no significant difference in pre- and postprocedural hematocrit levels in patients with a bleeding risk when compared with patients with no bleeding risk. No patient developed a hemothorax as a result of the thoracentesis. Conclusions: This single-center, observational study suggests that thoracentesis may be safely performed without prior correction of coagulopathy, thrombocytopenia, or medication-induced bleeding risk. This may reduce the morbidity associated with transfusions or withholding of medications. PMID:23952852

  11. Impact on postoperative bleeding and cost of recombinant activated factor VII in patients undergoing heart transplantation

    PubMed Central

    Hollis, Allison L.; Lowery, Ashleigh V.; Pajoumand, Mehrnaz; Pham, Si M.; Slejko, Julia F.; Tanaka, Kenichi A.; Mazzeffi, Michael

    2016-01-01

    Background: Cardiac transplantation can be complicated by refractory hemorrhage particularly in cases where explantation of a ventricular assist device is necessary. Recombinant activated factor VII (rFVIIa) has been used to treat refractory bleeding in cardiac surgery patients, but little information is available on its efficacy or cost in heart transplant patients. Methods: Patients who had orthotopic heart transplantation between January 2009 and December 2014 at a single center were reviewed. Postoperative bleeding and the total costs of hemostatic therapies were compared between patients who received rFVIIa and those who did not. Propensity scores were created and used to control for the likelihood of receiving rFVIIa in order to reduce bias in our risk estimates. Results: Seventy-six patients underwent heart transplantation during the study period. Twenty-one patients (27.6%) received rFVIIa for refractory intraoperative bleeding. There was no difference in postoperative red blood cell transfusion, chest tube output, or surgical re-exploration between patients who received rFVIIa and those who did not, even after adjusting with the propensity score (P = 0.94, P = 0.60, and P = 0.10, respectively). The total cost for hemostatic therapies was significantly higher in the rFVIIa group (median $10,819 vs. $1,985; P < 0.0001). Subgroup analysis of patients who underwent redo-sternotomy with left ventricular assist device explantation did not show any benefit for rFVIIa either. Conclusions: In this relatively small cohort, rFVIIa use was not associated with decreased postoperative bleeding in patients undergoing heart transplantation; however, it led to significantly higher cost. PMID:27397445

  12. Arteriovenous malformation in chronic gastrointestinal bleeding.

    PubMed Central

    Cavett, C M; Selby, J H; Hamilton, J L; Williamson, J W

    1977-01-01

    Arteriovenous malformations of the gastrointestinal tract are uncommon and treatment is problematic because routine barium contrast studies and endoscopy fail to demonstrate the lesion. Diagnosis is by selective mesenteric arteriography, demonstrating a characteristic vascular tuft and very early venous phase. Two cases of arteriovenous malformation are presented and 47 other reported cases are reviewed. Forty-five per cent were found in the cecum; 37, or 80%, involved the distal ileum, cecum ascending colon, or hepatic flexure. Seventy-five per cent of all patients fall into the 50--80 year age range. The literature reveals a recurring pattern of chronic gastrointestinal blood loss, anemia, and delay (even negative abdominal explorations) before the diagnosis is finally made. A more aggressive approach to chronic gastrointestinal bleeding is suggested through the use of selective mesenteric arteriography. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5. PMID:299801

  13. Medical management of heavy menstrual bleeding

    PubMed Central

    Maybin, Jacqueline A; Critchley, Hilary OD

    2016-01-01

    Women with benign heavy menstrual bleeding have the choice of a number of medical treatment options to reduce their blood loss and improve quality of life. The role of the clinician is to provide information to facilitate women in making an appropriate choice. Unfortunately, many options can be associated with hormonal side effects, prevention of fertility and lack of efficacy, leading to discontinuation and progression to surgical interventions. Herein, we discuss the various options currently available to women, including antifibrinolytics, nonsteroidal anti-inflammatory preparations, oral contraceptive pills and oral, injectable and intrauterine progestogens. In addition, we describe the more novel option of selective progesterone receptor modulators and their current benefits and limitations. PMID:26695687

  14. Tooth extraction, bleeding and pain control.

    PubMed

    Al-Bahlani, S; Sherriff, A; Crawford, P J

    2001-10-01

    Local anaesthesia is used routinely in dental surgery; it is effective in both pain control and--through the vasoconstrictors often contained within it--the reduction of bleeding. The extraction of deciduous teeth under general anaesthesia is often carried out without these local effects. There are no previous studies to investigate the combined effect of local anaesthesia with general anaesthesia on blood loss and pain control. A randomised, controlled clinical trial was carried out with one hundred children aged 3-5 years. Ethical approval and informed consent were obtained. Surface anaesthetic cream (EMLA) was placed on the hand into which the intravenous access was to be placed. One to two ml of blood was taken at the time of induction as a baseline of the patient's level of haematin pigment. Children in the experimental group were given one quarter of a cartridge (0.5 ml) of local anaesthetic containing epinephrine (1:80,000) in each quadrant before tooth extraction; all blood in swabs, suction equipment and disposables was collected and digested with NaOH. The children were observed for 11 minutes post-operatively for any signs of distress. Total blood loss was calculated by comparison of the baseline sample and the shed blood digests. This study showed that using local anaesthesia for dental extractions under general anaesthesia was associated with decreased blood loss (p = 0.001). The second finding--which has not been reported before--was that this use of local anaesthesia was shown to cause distress to this age group of children upon recovery from the general anaesthetic (p <0.0001). The use of local anaesthetic in this situation provided a useful reduction in post-operative bleeding. However, its use was associated with greater post-operative distress.

  15. Platelet Function Tests in Bleeding Disorders.

    PubMed

    Lassila, Riitta

    2016-04-01

    Functional disorders of platelets can involve any aspect of platelet physiology, with many different effects or outcomes. These include platelet numbers (thrombocytosis or thrombocytopenia); changes in platelet production or destruction, or capture to the liver (Ashwell receptor); altered adhesion to vascular injury sites and/or influence on hemostasis and wound healing; and altered activation or receptor functions, shape change, spreading and release reactions, procoagulant and antifibrinolytic activity. Procoagulant membrane alterations, and generation of thrombin and fibrin, also affect platelet aggregation. The above parameters can all be studied, but standardization and quality control of assay methods have been limited despite several efforts. Only after a comprehensive clinical bleeding assessment, including family history, information on drug use affecting platelets, and exclusion of coagulation factor, and tissue deficits, should platelet function testing be undertaken to confirm an abnormality. Current diagnostic tools include blood cell counts, platelet characteristics according to the cell counter parameters, peripheral blood smear, exclusion of pseudothrombocytopenia, whole blood aggregometry (WBA) or light transmission aggregometry (LTA) in platelet-rich plasma, luminescence, platelet function analysis (PFA-100) for platelet adhesion and deposition to collagen cartridges under blood flow, and finally transmission electron microscopy to exclude rare structural defects leading to functional deficits. The most validated test panels are included in WBA, LTA, and PFA. Because platelets are isolated from their natural environment, many simplifications occur, as circulating blood and interaction with vascular wall are omitted in these assays. The target to reach a highly specific platelet disorder diagnosis in routine clinical management can be exhaustive, unless needed for genetic counseling. The elective overall assessment of platelet function disorder

  16. Forced-Air Warmers and Surgical Site Infections in Patients Undergoing Knee or Hip Arthroplasty.

    PubMed

    Austin, Paul N

    2017-01-01

    The majority of the evidence indicates preventing inadvertent perioperative hypothermia reduces the incidence of many perioperative complications. Among the results of inadvertent perioperative hypothermia are increased bleeding, myocardial events, impaired wound healing, and diminished renal function. Most researchers agree there is an increased incidence of surgical site infections in patients who experience inadvertent perioperative hypothermia. Forced-air warming is effective in preventing inadvertent perioperative hypothermia. Paradoxically, forced-air warmers have been implicated in causing surgical site infections in patients undergoing total knee or hip arthroplasty. The results of investigations suggest these devices harbor pathogens and cause unwanted airflow disturbances. However, no significant increases in bacterial counts were found when forced-air warmers were used according to the manufacturer's directions. The results of one study suggested the incidence of surgical site infections in patients undergoing total joint arthroplasty was increased when using a forced-air warmer. However these researchers did not control for other factors affecting the incidence of surgical site infections in these patients. Current evidence does not support forced-air warmers causing surgical site infections in patients undergoing total knee or hip arthroplasty. Clinicians must use and maintain these devices as per the manufacturer's directions. They may consider using alternative warming methods. Well-conducted studies are needed to help determine the role of forced-air warmers in causing infections in these patients.

  17. Close antiplatelet therapy monitoring and adjustment based upon thrombelastography may reduce late-onset bleeding in HeartMate II ecipients

    PubMed Central

    Karimi, Ashkan; Beaver, Thomas M.; Hess, Philip J.; Martin, Tomas D.; Staples, Edward D.; Schofield, Richard S.; Hill, James A.; Aranda, Juan M.; Klodell, Charles T.

    2014-01-01

    OBJECTIVES Bleeding is the most common complication of HeartMate II and is partially attributable to platelet dysfunction; however, antiplatelet therapy is arbitrary in most centres. We investigated how antiplatelet therapy adjustment with thrombelastography affects late-onset bleeding. METHODS Thrombelastography was used to adjust antiplatelet therapy in 57 HeartMate II recipients. Kaplan–Meier survival curves and Cox proportional hazard ratio model were used to identify predictors of late-onset bleeding in univariate and multivariate analysis. Finally, late-onset bleeding rate in our study was compared with the reported rates in other studies in the literature, all of which did not use any test to monitor or adjust antiplatelet therapy. RESULTS Mean follow-up was 347 days. Eighteen late-onset bleeding events occurred in 12 patients, a late-onset bleeding rate of 12/57 (21%) or 0.21 events/patient-year. The Kaplan–Meier survival curves demonstrated that late-onset bleeding was more common in the destination therapy cohort (P = 0.02), in patients older than 60 years (P = 0.04) and in females (P = 0.01), none of which was significant in multivariate analysis at a significance level of 0.05. To further investigate the higher bleeding rate in elderly patients, thrombelastography parameters were compared between younger and older patients at the age cut-off of 60 years which demonstrated a prothrombotic change the day after device implantation in younger patients that was absent in the elderly. There was also a trend towards higher requirement for antiplatelet therapy in younger patients while on device support, but the difference did not reach statistical significance. The average late-onset or gastrointestinal bleeding rate among seven comparable studies in the literature that did not use any monitoring test to adjust antiplatelet therapy was 0.49 events/patient-year. CONCLUSIONS Our study implicates that antiplatelet therapy adjustment with thrombelastography

  18. Thrombocytosis in a patient with upper gastrointestinal bleeding

    PubMed Central

    Qi, Xingshun; De Stefano, Valerio; Shao, Xiaodong; Guo, Xiaozhong

    2017-01-01

    Summary Reported here is a case of upper gastrointestinal bleeding secondary to a peptic ulcer involving an extremely high platelet count of 989 × 109/L. Myeloproliferative neoplasms were ruled out on the basis of gene mutation testing and a bone marrow biopsy. After the cessation of index bleeding, the platelet count decreased markedly. Thus, reactive thrombocytosis was considered as a possibility. PMID:28357187

  19. ANNULAR IMPACTOR SAMPLING DEVICE

    DOEpatents

    Tait, G.W.C.

    1959-03-31

    A high-rate air sampler capable of sampling alphaemitting particles as small as 0.5 microns is described. The device is a cylindrical shaped cup that fits in front of a suction tube and which has sticky grease coating along its base. Suction forces contaminated air against the periodically monitored particle absorbing grease.

  20. On Supersonic-Inlet Boundary-Layer Bleed Flow

    NASA Technical Reports Server (NTRS)

    Harloff, Gary J.; Smith, Gregory E.

    1995-01-01

    Boundary-layer bleed in supersonic inlets is typically used to avoid separation from adverse shock-wave/boundary-layer interactions and subsequent total pressure losses in the subsonic diffuser and to improve normal shock stability. Methodologies used to determine bleed requirements are reviewed. Empirical sonic flow coefficients are currently used to determine the bleed hole pattern. These coefficients depend on local Mach number, pressure ratio, hole geometry, etc. A new analytical bleed method is presented to compute sonic flow coefficients for holes and narrow slots and predictions are compared with published data to illustrate the accuracy of the model. The model can be used by inlet designers and as a bleed boundary condition for computational fluid dynamic studies.

  1. New insights to occult gastrointestinal bleeding: From pathophysiology to therapeutics

    PubMed Central

    Sánchez-Capilla, Antonio Damián; De La Torre-Rubio, Paloma; Redondo-Cerezo, Eduardo

    2014-01-01

    Obscure gastrointestinal bleeding is still a clinical challenge for gastroenterologists. The recent development of novel technologies for the diagnosis and treatment of different bleeding causes has allowed a better management of patients, but it also determines the need of a deeper comprehension of pathophysiology and the analysis of local expertise in order to develop a rational management algorithm. Obscure gastrointestinal bleeding can be divided in occult, when a positive occult blood fecal test is the main manifestation, and overt, when external sings of bleeding are visible. In this paper we are going to focus on overt gastrointestinal bleeding, describing the physiopathology of the most usual causes, analyzing the diagnostic procedures available, from the most classical to the novel ones, and establishing a standard algorithm which can be adapted depending on the local expertise or availability. Finally, we will review the main therapeutic options for this complex and not so uncommon clinical problem. PMID:25133028

  2. Evaluating for suspected child abuse: conditions that predispose to bleeding.

    PubMed

    Carpenter, Shannon L; Abshire, Thomas C; Anderst, James D

    2013-04-01

    Child abuse might be suspected when children present with cutaneous bruising, intracranial hemorrhage, or other manifestations of bleeding. In these cases, it is necessary to consider medical conditions that predispose to easy bleeding/bruising. When evaluating for the possibility of bleeding disorders and other conditions that predispose to hemorrhage, the pediatrician must consider the child's presenting history, medical history, and physical examination findings before initiating a laboratory investigation. Many medical conditions can predispose to easy bleeding. Before ordering laboratory tests for a disease, it is useful to understand the biochemical basis and clinical presentation of the disorder, condition prevalence, and test characteristics. This technical report reviews the major medical conditions that predispose to bruising/bleeding and should be considered when evaluating for abusive injury.

  3. Impact Of Standing Bleed Water On Saltstone Placement

    SciTech Connect

    Cozzi, A. D.; Pickenheim, B. R.

    2012-09-28

    The amount of water present during placement and subsequent curing of saltstone has the potential to impact several properties important for grout quality. An active drain water system can remove residual standing water and expose the surface of the placed saltstone to air. Oxidation of the saltstone may result in an increase in the leachability of redox sensitive elements. A dry surface can lead to cracking, causing an increase in hydraulic conductivity. An inactive drain water system can allow standing water that generates unnecessary hydrostatic head on the vault walls. Standing water that cannot be removed via the drain system will be available for potential incorporation into subsequent grout placements. The objective of this work is to study the impact of standing water on grout quality pertaining to disposal units. A series of saltstone mixes were prepared, and cured at ambient temperature to evaluate the impact of standing water on saltstone placement. The samples were managed to control drying effects on leachability by either exposing or capping the samples. The water to premix ratio was varied to represent a range of processing conditions. Samples were analyzed for density, leachability, and hydraulic conductivity. A monolith of each composition was cut into four sections to analyze the homogeneity of the sample with respect to vertical position within the sample. The density of each section was measured by two methods, helium pycnometry and by ASTM 642-06. The results show a trend of increasing density with increasing depth in the samples. This effect is more pronounced with the inclusion of excess bleed water and indicative of increased settling. The leachability of the eight different samples was analyzed by ANS/ANSI 16.1 method. These results indicate that drying of the saltstone during curing leads to decreased Leachability Indices (indicative of more release) for potassium, sodium, rhenium, nitrite, and nitrate. This may be caused by shrinkage

  4. Bleeding disorders in the tribe: result of consanguineous in breeding

    PubMed Central

    2010-01-01

    Objective To determine the frequency and clinical features of bleeding disorders in the tribe as a result of consanguineous marriages. Design Cross Sectional Study Introduction Countries in which consanguinity is a normal practice, these rare autosomal recessive disorders run in close families and tribes. Here we describe a family, living in village Ali Murad Chandio, District Badin, labeled as haemophilia. Patients & Methods Our team visited the village & developed the pedigree of the whole extended family, up to seven generations. Performa was filled by incorporating patients, family history of bleeding, signs & symptoms, and bleeding from any site. From them 144 individuals were screened with CBC, bleeding time, platelet aggregation studies & RiCoF. While for PT, APTT, VWF assay and Factor VIII assay, samples were kept frozen at -70 degrees C until tested. Results The family tree of the seven generations comprises of 533 individuals, 63 subjects died over a period of 20 years and 470 were alive. Out of all those 144 subjects were selected on the basis of the bleeding history. Among them 98(68.1%) were diagnosed to have a bleeding disorder; 44.9% patients were male and 55.1% patients were female. Median age of all the patients was 20.81, range (4 months- 80 yrs). The results of bleeding have shown that majority had gum bleeding, epistaxis and menorrhagia. Most common bleeding disorder was Von Willebrand disease and Platelet functional disorders. Conclusion Consanguineous marriages keep all the beneficial and adversely affecting recessive genes within the family; in homozygous states. These genes express themselves and result in life threatening diseases. Awareness, education & genetic counseling will be needed to prevent the spread of such common occurrence of these bleeding disorders in the community. PMID:20822539

  5. Design and application of an inertial impactor in combination with an ATP bioluminescence detector for in situ rapid estimation of the efficacies of air controlling devices on removal of bioaerosols.

    PubMed

    Yoon, Ki Young; Park, Chul Woo; Byeon, Jeong Hoon; Hwang, Jungho

    2010-03-01

    We proposed a rapid method to estimate the efficacies of air controlling devices in situ using ATP bioluminescence in combination with an inertial impactor. The inertial impactor was designed to have 1 mum of cutoff diameter, and its performance was estimated analytically, numerically, and experimentally. The proposed method was characterized using Staphylococcus epidermidis, which was aerosolized with a nebulizer. The bioaerosol concentrations were estimated within 25 min using the proposed method without a culturing process, which requires several days for colony formation. A linear relationship was obtained between the results of the proposed ATP method (RLU/m(3)) and the conventional culture-based method (CFU/m(3)), with R(2) 0.9283. The proposed method was applied to estimate the concentration of indoor bioaerosols, which were identified as a mixture of various microbial species including bacteria, fungi, and actinomycetes, in an occupational indoor environment, controlled by mechanical ventilation and an air cleaner. Consequently, the proposed method showed a linearity with the culture-based method for indoor bioaerosols with R(2) 0.8189, even though various kinds of microorganisms existed in the indoor air. The proposed method may be effective in monitoring the changes of relative concentration of indoor bioaerosols and estimating the effectiveness of air control devices in indoor environments.

  6. Bleeding spectrum in children with moderate or severe von Willebrand disease: Relevance of pediatric-specific bleeding.

    PubMed

    Sanders, Yvonne V; Fijnvandraat, Karin; Boender, Johan; Mauser-Bunschoten, Evelien P; van der Bom, Johanna G; de Meris, Joke; Smiers, Frans J; Granzen, Bernd; Brons, Paul; Tamminga, Rienk Y J; Cnossen, Marjon H; Leebeek, Frank W G

    2015-12-01

    The bleeding phenotype of children with von Willebrand disease (VWD) needs to be characterized in detail to facilitate diagnosis during childhood and aid in the planning and assessment of treatment strategies. The objective was to evaluate the occurrence, type, and severity of bleeding in a large cohort of children with moderate and severe VWD. We included 113 children (aged 0-16 years) with Type 1 (n = 60), 2 (n = 44), and 3 (n = 9) VWD with von Willebrand factor (VWF) antigen and/or VWF ristocetin cofactor levels ≤ 30 U/dL from a nation-wide cross-sectional study ("Willebrand in the Netherlands" study). Bleeding severity and frequency were determined using the International Society on Thrombosis and Hemostasis-Bleeding Assessment Tool (ISTH-BAT) with supplementary pediatric-specific bleeding symptoms (umbilical stump bleeding, cephalohematoma, cheek hematoma, conjunctival bleeding, postcircumcision and postvenipuncture bleeding). We found that all 26 postmenarche girls experienced menorrhagia. Other common bleedings were cutaneous (81%), oropharyngeal (64%), prolonged bleeding from minor wounds (58%), and epistaxis (56%). Pediatric-specific bleeding symptoms were present in 44% of patients. ISTH-BAT bleeding score was higher in index cases than in affected family members (median, 12.0 vs. 6.5, P < 0.001), higher in Type 3 VWD than in Type 2 or 1 (17.0 vs. 10.5 or 6.5, P < 0.001) and higher in children with severe (<10 U/dL) than moderate VWD (10-30 U/dL) (11.0 vs. 7.0, P < 0.001). Frequency of any bleeding, epistaxis, and oral cavity was higher in types 2 and 3 than in Type 1 VWD and was associated with VWF levels. We conclude that pediatric-specific bleeding symptoms occurred in a large proportion of children with moderate or severe VWD and should be included when evaluating children for VWD.

  7. Assessment of an Electronic Intervention in Young Women with Heavy Menstrual Bleeding.

    PubMed

    Dietrich, Jennifer E; Yee, Donald L; Santos, Xiomara M; Bercaw-Pratt, Jennifer L; Kurkowski, Jennifer; Soni, Heather; Lee-Kim, Youngna J; Shah, Mona D; Mahoney, Donald; Srivaths, Lakshmi V

    2016-10-15

    STUDY OBJECTIVE, DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Bleeding disorders (BD) occur in up to 50% of adolescents with heavy menstrual bleeding (HMB). This presents unique challenges to health care providers because of the complexity of treating the condition and such complexity can result in difficulty with patients understanding basic information about their condition, limit communication with medical providers, and patient compliance. The aim of the study was to use an electronic approach to enhance patient compliance with medications used to treat their HMB, and to provide educational access to adolescents with BD. This was a prospective cohort study involving patients in a Young Women's Bleeding Disorder Clinic at a single children's hospital. Subjects were given an iPod Touch (Apple Inc, Cupertino, CA) device (ITD), preloaded with the iPeriod (Winkpass Creations) application. Participants recorded information about their BD that they learned about on BD Web sites, and menses, and medications. Electronic and charted data were collected to monitor compliance with prescribed treatment regimens. All ITD allowed Wi-Fi access to allow teens to explore BD Web sites and knowledge was assessed.

  8. Reference values and repeatability of buccal mucosal bleeding time in healthy sedated cats.

    PubMed

    Alatzas, Dimitrios G; Mylonakis, Mathios E; Kazakos, Giorgos M; Kostoulas, Polychronis; Kritsepi-Konstantinou, Maria; Polizopoulou, Zoe S

    2014-02-01

    Bleeding time is a screening test for the evaluation of primary haemostasis. As there is currently limited information on the reference interval (RI) and repeatability of the test in the cat compared with the dog, the purpose of the study was to establish the RI of buccal mucosa bleeding time (BMBT) in healthy cats and to investigate the intra-observer repeatability of the test. Fifty-six cats were prospectively enrolled in the study. The animals were deemed to be healthy based on history, physical examination, complete blood count, serum biochemistry, and negative serological testing for feline leukaemia and immunodeficiency viruses. All cats were sedated with ketamine, dexmedetomidine and morphine, and the BMBT was sequentially measured in the left and right exposed buccal mucosa following a standardised incision made by a commercially available, disposable, bleeding time device. The mean BMBT was 58.6 s and the RIs ranged from 34 to 105 s (Bootstrap estimation). The intra-observer repeatability was up to 87 s (Bland-Altman plot). The results of this study imply that the combination of ketamine, dexmedetomidine and morphine is a safe and useful sedative protocol allowing for the reliable measurement of BMBT in the cat. The RI of feline BMBT may range from 34 to 105 s and the BMBT may differ by up to 87 s for any two consecutive readings for an individual cat.

  9. Major Bleeding after Percutaneous Image-Guided Biopsies: Frequency, Predictors, and Periprocedural Management

    PubMed Central

    Kennedy, Sean A.; Milovanovic, Lazar; Midia, Mehran

    2015-01-01

    Major bleeding remains an uncommon yet potentially devastating complication following percutaneous image-guided biopsy. This article reviews two cases of major bleeding after percutaneous biopsy and discusses the frequency, predictors, and periprocedural management of major postprocedural bleeding. PMID:25762845

  10. Protect Your Baby from Bleeds: Talk to Your Healthcare Provider about Vitamin K

    MedlinePlus

    ... your baby from VKDB. Protect Your Baby from Vitamin K Deficiency Bleeding Before having a baby, most parents don’ ... she gets the shot after birth. What is vitamin K deficiency bleeding (VKDB)? Vitamin K deficiency bleeding or VKDB, ...

  11. Flow Coefficient Behavior for Boundary Layer Bleed Holes and Slots

    NASA Technical Reports Server (NTRS)

    Willis, B. P.; Davis, D. O.; Hingst, W. R.

    1995-01-01

    An experimental investigation into the flow coefficient behavior for nine boundary layer bleed orifice configurations is reported. This test was conducted for the purposes of exploring boundary layer control through mass flow removal and does not address issues of stability bleed. Parametric data consist of bleed region flow coefficient as a function of Mach number, bleed plenum pressure, and bleed orifice geometry. Seven multiple hole configurations and two single slot configurations were tested over a supersonic Mach number range of 1.3 to 2.5 (nominal). Advantages gained by using multiple holes in a bleed region instead of a single spanwise slot are discussed and the issue of modeling an entire array of bleed orifices based on the performance of a single orifice is addressed. Preconditioning the flow approaching a 90 degree inclined (normal) hole configuration resulted in a significant improvement in the performance of the configuration. The same preconditioning caused only subtle changes in performance for a 20 degree inclined (slanted) configuration.

  12. Multidetector CT angiography for acute gastrointestinal bleeding: technique and findings.

    PubMed

    Artigas, José M; Martí, Milagros; Soto, Jorge A; Esteban, Helena; Pinilla, Inmaculada; Guillén, Eugenia

    2013-01-01

    Acute gastrointestinal bleeding is a common reason for emergency department admissions and an important cause of morbidity and mortality. Factors that complicate its clinical management include patient debility due to comorbidities; intermittence of hemorrhage; and multiple sites of simultaneous bleeding. Its management, therefore, must be multidisciplinary and include emergency physicians, gastroenterologists, and surgeons, as well as radiologists for diagnostic imaging and interventional therapy. Upper gastrointestinal tract bleeding is usually managed endoscopically, with radiologic intervention reserved as an alternative to be used if endoscopic therapy fails. Endoscopy is often less successful in the management of acute lower gastrointestinal tract bleeding, where colonoscopy may be more effective. The merits of performing bowel cleansing before colonoscopy in such cases might be offset by the resultant increase in response time and should be weighed carefully against the deficits in visualization and diagnostic accuracy that would result from performing colonoscopy without bowel preparation. In recent years, multidetector computed tomographic (CT) angiography has gained acceptance as a first-line option for the diagnosis and management of lower gastrointestinal tract bleeding. In selected cases of upper gastrointestinal tract bleeding, CT angiography also provides accurate information about the presence or absence of active bleeding, its source, and its cause. This information helps shorten the total diagnostic time and minimizes or eliminates the need for more expensive and more invasive procedures.

  13. Intraoperative bleeding control by uniportal video-assisted thoracoscopic surgery†.

    PubMed

    Gonzalez-Rivas, Diego; Stupnik, Tomaz; Fernandez, Ricardo; de la Torre, Mercedes; Velasco, Carlos; Yang, Yang; Lee, Wentao; Jiang, Gening

    2016-01-01

    Owing to advances in video-assisted thoracic surgery (VATS), the majority of pulmonary resections can currently be performed by VATS in a safe manner with a low level of morbidity and mortality. The majority of the complications that occur during VATS can be minimized with correct preoperative planning of the case as well as careful pulmonary dissection. Coordination of the whole surgical team is essential when confronting an emergency such as major bleeding. This is particularly important during the VATS learning curve, where the occurrence of intraoperative complications, particularly significant bleeding, usually ends in a conversion to open surgery. However, conversion should not be considered as a failure of the VATS approach, but as a resource to maintain the patient's safety. The correct assessment of any bleeding is of paramount importance during major thoracoscopic procedures. Inadequate management of the source of bleeding may result in major vessel injury and massive bleeding. If bleeding occurs, a sponge stick should be readily available to apply pressure immediately to control the haemorrhage. It is always important to remain calm and not to panic. With the bleeding temporarily controlled, a decision must be made promptly as to whether a thoracotomy is needed or if the bleeding can be solved through the VATS approach. This will depend primarily on the surgeon's experience. The operative vision provided with high-definition cameras, specially designed or adapted instruments and the new sealants are factors that facilitate the surgeon's control. After experience has been acquired with conventional or uniportal VATS, the rate of complications diminishes and the majority of bleeding events are controlled without the need for conversion to thoracotomy.

  14. Embolization of Bleeding Stomal Varices by Direct Percutaneous Approach

    SciTech Connect

    Arulraj, Ramakrishnan; Mangat, Kamarjit S.; Tripathi, Dhiraj

    2011-02-15

    Stomal varices can occur in patients with stoma in the presence of portal hypertension. Suture ligation, sclerotherapy, angiographic embolization, stoma revision, beta blockade, portosystemic shunt, and liver transplantation have been described as therapeutic options for bleeding stomal varices. We report the case of a 21-year-old patient with primary sclerosing cholangitis and colectomy with ileostomy for ulcerative colitis, where stomal variceal bleeding was successfully treated by direct percutaneous embolization. We consider percutaneous embolization to be an effective way of treating acute stomal bleeding in decompensated patients while awaiting decisions regarding shunt procedures or liver transplantation.

  15. Is tranexamic acid effective for acute upper gastrointestinal bleeding?

    PubMed

    Flores, Sebastián; Avilés, Carolina; Rada, Gabriel

    2015-12-07

    Upper gastrointestinal bleeding constitutes a medical-surgical emergency given its important associated morbidity and mortality. The antifibrinolytic tranexamic acid might help stopping bleeding, but controversy remains about its role in this setting. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified five systematic reviews including eight randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded tranexamic acid probably decreases rebleeding and mortality, without increasing thromboembolic adverse effects in patients with upper gastrointestinal bleeding.

  16. Transvaginal Ultrasound for the Diagnosis of Abnormal Uterine Bleeding.

    PubMed

    Wheeler, Karen C; Goldstein, Steven R

    2017-03-01

    Transvaginal ultrasound is the first-line imaging test for the evaluation of abnormal uterine bleeding in both premenopausal and postmenopausal women. Transvaginal ultrasound can be used to diagnose structural causes of abnormal bleeding such as polyps, adenomyosis, leiomyomas, hyperplasia, and malignancy, and can also be beneficial in making the diagnosis of ovulatory dysfunction. Traditional 2-dimensional imaging is often enhanced by the addition of 3-dimension imaging with coronal reconstruction and saline infusion sonohysterography. In this article we discuss specific ultrasound findings and technical considerations useful in the diagnosis of abnormal uterine bleeding.

  17. Scintigraphic demonstration of gastrointestinal bleeding due to mesenteric varices

    SciTech Connect

    Hansen, M.E.; Coleman, R.E. )

    1990-07-01

    Mesenteric varices can appear as massive, acute lower gastrointestinal bleeding. The small bowel or colon may be involved, varices usually developing at sites of previous surgery or inflammation in patients with portal hypertension. Two patients with alcoholic cirrhosis and protal hypertension presented with rectal bleeding. Tc-99m RBC studies demonstrated varices and extravasation into the adjacent bowel. The varices were documented by mesenteric angiography. Characteristic features of Tc-99m labeled RBC studies can identify mesenteric varices as the cause of intestinal bleeding and localize the abnormal vessels.

  18. Bleeding following deep hypothermia and circulatory arrest in children.

    PubMed

    Mossad, Emad B; Machado, Sandra; Apostolakis, John

    2007-03-01

    Deep hypothermic circulatory arrest (DHCA) is a technique of extracorporeal circulation commonly used in children with complex congenital heart defects undergoing surgical repairs. The use of profound cooling (20 degrees C) and complete cessation of circulation allow adequate exposure and correction of these complex lesions, with enhanced cerebral protection. However, the profound physiologic state of DHCA results in significant derangement of the coagulation system and a high incidence of postoperative bleeding. This review examines the impact of DHCA on bleeding and transfusion requirements in children and the pathophysiology of DHCA-induced platelet dysfunction. It also focuses on possible pharmacologic interventions to decrease bleeding following DHCA in children.

  19. Bevacizumab and gastrointestinal bleeding in hereditary hemorrhagic telangiectasia

    PubMed Central

    Ou, George; Galorport, Cherry; Enns, Robert

    2016-01-01

    We report a case of severe, refractory gastrointestinal (GI) bleeding in a patient with hereditary hemorrhagic telangiectasia (HHT) whose massive transfusion dependence was lifted shortly after treatment with bevacizumab, an anti-vascular endothelial growth factor. The patient’s bleeding had been refractory to repeated endoscopic interventions, tranexamic acid, and tamoxifen. However, following treatment with bevacizumab at 5 mg/kg every other week, nearly 300 units of packed red blood cell transfusions were avoided in one year’s time. Despite its relatively high cost, bevacizumab may have a more active role in the management of severe GI bleeding in HHT if such remarkable response can be consistently demonstrated. PMID:28070235

  20. Remote possibly hazardous content container sampling device

    DOEpatents

    Volz, David L.

    1998-01-01

    The present invention relates to an apparatus capable of sampling enclosed containers, where the contents of the container is unknown. The invention includes a compressed air device capable of supplying air pressure, device for controlling the amount of air pressure applied, a pneumatic valve, a sampling device having a hollow, sampling insertion needle suspended therein and device to communicate fluid flow between the container and a containment vessel, pump or direct reading instrument.

  1. Assessment of bleeding disorders in Sheehan's syndrome: are bleeding disorders the underlying cause of Sheehan's syndrome?

    PubMed

    Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Ayyildiz, Orhan; Erdemoglu, Mahmut; Alpagat, Gulistan

    2011-01-01

    Sheehan's syndrome (SS) is an adenopituitary insufficiency caused by hypovolemia secondary to excessive blood loss during or after childbirth. However, the mechanism of postpartum hemorrhage and ischemia is not clear. We aimed to evaluate the bleeding disorders among patients with SS, in comparison with healthy controls. In addition, we investigated underlying causes in postpartum hemorrhage that begin the event. The present study was conducted at the Dicle University School of Medicine. Forty-eight patients with SS and 50 age-matched female healthy controls were included. Biochemical and hormonal variables were measured, as was platelet function by means of closure times (PFA-100 testing using collagen plus epinephrine and collagen plus ADP), von Willebrand factor (vWF) level, prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR), and coagulation factors. Although PT and INR were significantly higher in patients with SS (both P<0.01), aPTT and levels of fibrinogen, vWF, and factors II, V, VII, VIII, IX, X, XI, and XII did not differ significantly. Closure times with collagen/epinephrine and collagen/ADP also did not differ significantly between patients with SS and control patients. The nonspecific etiology and presence of excessive postpartum hemorrhage in patients with SS suggest that coagulation disorders may play a role in their predisposition to bleeding. The increased PT and INR noted might implicate bleeding diathesis as the underlying etiology, although no significant decreases were noted in factor levels. Further studies are needed to elucidate this complex mechanism of this disorder.

  2. Intra-uterine contraceptive devices.

    PubMed

    Elias, J

    1985-05-01

    Among the advantages of IUDs are the device's high continuation rate, the lack of systemic side effects, and the absence of a need for continual motivation to practice contraception. The effectiveness of plastic IUDs is directly proportional to their surface area, but the degree of excessive bleeding experienced is inversely related to device size. Thus, devices represent a compromise between large size for effectiveness and small size for acceptability. The optimum time to fit an IUD is during the 1st hald of the menstrual cycle. Absolute contraindications to IUD use include the presence of active pelvic inflammatory disease, undiagnosed irregular bleeding, a history of ectopic pregnancy or tubal surgery, and a distorted uteine cavity. Failure rates associated with IUD use range from 2-3% in the 1st year and then decrease. Since the main mechanism of action appears to be production of a sterile inflammatory reaction in the uterine cavity, the IUD prevents intrauterine pregnancy more effectively than ectopic pregnancy. Nonetheless, there is little evidence to suggest that IUD use actually increases the incidence of ectopic pregnancy. Resumption of fertility after IUD removal is not delayed. There is not need to change inert plastic IUDs in women who remain symptom free. The copper devices should be changed every 3-4 years. A search is under way for antifertility agents that can be incorporated into the device to reduce side effects. In general, the IUD is most suitable for older, parous women.

  3. 21 CFR 868.2025 - Ultrasonic air embolism monitor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ultrasonic air embolism monitor. 868.2025 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Monitoring Devices § 868.2025 Ultrasonic air embolism monitor. (a) Identification. An ultrasonic air embolism monitor is a device used to detect air bubbles...

  4. Study of Ram-air Heat Exchangers for Reducing Turbine Cooling-air Temperature of a Supersonic Aircraft Turbojet Engine

    NASA Technical Reports Server (NTRS)

    Diaguila, Anthony J; Livingood, John N B; Eckert, Ernst R G

    1956-01-01

    The sizes and weights of the cores of heat exchangers were determined analytically for possible application for reducing turbine cooling-air temperatures of an engine designed for a Mach number of 2.5 and an altitude The sizes and weights of the cores of heat exchangers were determined analytically for possible application for reducing turbine cooling-air temperatures of an engine designed for a Mach number of 2.5 and an altitude of 70,000 feet. A compressor-bleed-air weight flow of 2.7 pounds per second was assumed for the coolant; ram air was considered as the other fluid. Pressure drops and inlet states of both fluids were prescribed, and ranges of compressor-bleed-air temperature reductions and of the ratio of compressor-bleed to ram-air weight flows were considered.

  5. Do statins protect against upper gastrointestinal bleeding?

    PubMed Central

    Gulmez, Sinem Ezgi; Lassen, Annmarie Touborg; Aalykke, Claus; Dall, Michael; Andries, Alin; Andersen, Birthe Søgaard; Hansen, Jane Møller; Andersen, Morten; Hallas, Jesper

    2009-01-01

    AIMS Recently, an apparent protective effect of statins against upper gastrointestinal bleeding (UGB) was postulated in a post hoc analysis of a randomized trial. We aimed to evaluate the effect of statin use on acute nonvariceal UGB alone or in combinations with low-dose aspirin and other antithrombotic drugs. METHODS A population-based case–control study was conducted in the County of Funen, Denmark. Cases (n = 3652) were all subjects with a first discharge diagnosis of serious UGB from a hospital during the period 1995 to 2006. Age- and gender-matched controls (10 for each case) (n = 36 502) were selected by a risk set sampling. Data on all subjects' drug exposure and past medical history were retrieved from a prescription database and from the County's patient register. Confounders were controlled by conditional logistic regression. RESULTS The adjusted odds ratios (ORs) associating use of statins with UGB were 0.94 (0.78–1.12) for current use, 1.40 (0.89–2.20) for recent use and 1.42 (0.96–2.10) for past use. The lack of effect was consistent across most patient subgroups, different cumulative or current statin doses and different statin substances. In explorative analyses, a borderline significant protective effect was observed for concurrent users of low-dose aspirin [OR 0.43 (0.18–1.05)]. CONCLUSION Statins do not prevent UGB, except possibly in users of low-dose aspirin. PMID:19371320

  6. Aspirin use and post-operative bleeding from dental extractions.

    PubMed

    Brennan, M T; Valerin, M A; Noll, J L; Napeñas, J J; Kent, M L; Fox, P C; Sasser, H C; Lockhart, P B

    2008-08-01

    Aspirin is a common, chronically administered preventive treatment for cardiovascular disease, but is often discontinued prior to invasive dental procedures because of concern for bleeding complications. We hypothesized that aspirin does not cause increased bleeding following a single tooth extraction. Thirty-six healthy persons requiring a tooth extraction were randomized to receive 325 mg/day aspirin or placebo for 4 days. Cutaneous bleeding time (BT) and platelet aggregation tests were obtained prior to extraction. The primary outcome measure, oral BT, and secondary bleeding outcomes were evaluated during and following extraction. No significant baseline differences, except for diastolic blood pressure, were found between groups. There were no differences in oral BT, cutaneous BT, secondary outcome measures, or compliance. Whole-blood aggregation results were significantly different between the aspirin and placebo groups. These findings suggest that there is no indication to discontinue aspirin for persons requiring single-tooth extraction.

  7. Study Tracks Bleeding Risk from Common Blood Thinners

    MedlinePlus

    ... as vitamin K antagonists (which includes Coumadin/warfarin); clopidogrel (Plavix); or other blood-thinning medications. Low-dose ... risk of the subdural hematoma bleed; use of clopidogrel plus a second blood-thinning pill was associated ...

  8. A rare cause of recurrent gastrointestinal bleeding: mesenteric hemangioma

    PubMed Central

    Kazimi, Mircelal; Ulas, Murat; Ibis, Cem; Unver, Mutlu; Ozsan, Nazan; Yilmaz, Funda; Ersoz, Galip; Zeytunlu, Murat; Kilic, Murat; Coker, Ahmet

    2009-01-01

    Lower gastrointestinal hemorrhage accounts for approximately 20% of gastrointestinal hemorrhage. The most common causes of lower gastrointestinal hemorrhage in adults are diverticular disease, inflammatory bowel disease, benign anorectal diseases, intestinal neoplasias, coagulopathies and arterio-venous malformations. Hemangiomas of gastrointestinal tract are rare. Mesenteric hemangiomas are also extremely rare. We present a 25-year-old female who was admitted to the emergency room with recurrent lower gastrointestinal bleeding. An intraluminal bleeding mass inside the small intestinal segment was detected during explorative laparotomy as the cause of the recurrent lower gastrointestinal bleeding. After partial resection of small bowel segment, the histopathologic examination revealed a cavernous hemagioma of mesenteric origin. Although rare, gastrointestinal hemangioma should be thought in differential diagnosis as a cause of recurrent lower gastrointestinal bleeding. PMID:19178725

  9. Lag model for turbulent boundary layers over rough bleed surfaces

    NASA Astrophysics Data System (ADS)

    Lee, J.; Sloan, M. L.; Paynter, G. C.

    1994-07-01

    Boundary-layer mass removal (bleed) through spanwise bands of holes on a surface is used to prevent or control separation and to stabilize the normal shock in supersonic inlets. The addition of a transport equation lag relationship for eddy viscosity to the rough wall algebraic turbulence model of Cebeci and Chang was found to improve agreement between predicted and measured mean velocity distributions downstream of a bleed band. The model was demonstrated for a range of bleed configurations, bleed rates, and local freestream Mach numbers. In addition, the model was applied to the boundary-layer development over acoustic lining materials for the inlets and nozzles of commercial aircraft. The model was found to yield accurate results for integral boundary-layer properties unless there was a strong adverse pressure gradient.

  10. Challenges in the management of acute peptic ulcer bleeding.

    PubMed

    Lau, James Y W; Barkun, Alan; Fan, Dai-ming; Kuipers, Ernst J; Yang, Yun-sheng; Chan, Francis K L

    2013-06-08

    Acute upper gastrointestinal bleeding is a common medical emergency worldwide, a major cause of which are bleeding peptic ulcers. Endoscopic treatment and acid suppression with proton-pump inhibitors are cornerstones in the management of the disease, and both treatments have been shown to reduce mortality. The role of emergency surgery continues to diminish. In specialised centres, radiological intervention is increasingly used in patients with severe and recurrent bleeding who do not respond to endoscopic treatment. Despite these advances, mortality from the disorder has remained at around 10%. The disease often occurs in elderly patients with frequent comorbidities who use antiplatelet agents, non-steroidal anti-inflammatory drugs, and anticoagulants. The management of such patients, especially those at high cardiothrombotic risk who are on anticoagulants, is a challenge for clinicians. We summarise the published scientific literature about the management of patients with bleeding peptic ulcers, identify directions for future clinical research, and suggest how mortality can be reduced.

  11. Evaluation and Management of Adolescents with Abnormal Uterine Bleeding.

    PubMed

    Mullins, Tanya L Kowalczyk; Miller, Rachel J; Mullins, Eric S

    2015-09-01

    The International Federation of Gynecology and Obstetrics and the American Congress of Obstetricians and Gynecologists support the use of new terminology for abnormal uterine bleeding (AUB) to consistently categorize AUB by etiology. The term AUB can be further classified as AUB/heavy menstrual bleeding (HMB) (replacing the term "menorrhagia") or AUB/intermenstrual bleeding (replacing the term "metrorrhagia"). Although many cases of AUB in adolescent women are attributable to immaturity of the hypothalamic-pituitary-ovarian axis, underlying bleeding disorders should be considered in women with AUB/HMB. This article reviews the new terminology for AUB, discusses important relevant features of history and examination, presents the laboratory evaluation of HMB, and describes hormonal (oral contraceptive pills, progestin-only methods, long-acting reversible contraceptives including intrauterine systems), hematologic (tranexamic acid and desmopressin), and surgical management options for AUB/HMB.

  12. [Fiberendoscopic injection therapy of bleeding gastrointestinal lesions (author's transl)].

    PubMed

    Liehr, H; Brunswig, D; Gallenkamp, H; Seez, P; Zilly, W

    1979-06-01

    In 28 patients with acute gastrointestinal bleeding emergency fiberendoscopy was combined with aethoxysclerole (1%) injection of the bleeding lesion with purpose to controll haemorrhage. In 61% of 31 proceudres done in patients with oesophageal varices (n = 19) haemorrhage was controlled, and in further 16% deminuation of bleeding intensity was noted. In the remaining cases (n = 7) the procedure was ineffective. Only patients with Child C liver cirrhosis having oesophageal varices stages III and IV finally died because of uncontrolled haemorrhage. In 9 patients with bleeding from other lesions (gastric erosions and ulcers, Mallory-Weiss-Syndrome, erosio simplex Dieulafoy) haemorrhage was controlled in 8 patients. The method is practicable and efficient, but does not determine better the final outcome of patients with livercirrhosis Child C having oesophageal varices stages III and IV. In other cases tube treatment was avoided. The operation lethality within the series was 1,5%.

  13. Bleeding oesophageal varices with long term follow up.

    PubMed Central

    Spence, R A; Johnston, G W; Odling-Smee, G W; Rodgers, H W

    1984-01-01

    Complete long term follow up was obtained in 27 children who had bled from oesophageal varices. Most presented with haematemesis or melaena at an average age of 5.2 years in the portal vein thrombosis group (20 children) and 9.5 years in the intrahepatic group (7 children). All had splenomegaly. Only 6 of 20 children with portal vein thrombosis had a possible precipitating factor. A total of 182 admissions for bleeding are reported, in 68 of which injection sclerotherapy was used to control bleeding. Control rate with injection sclerotherapy was 97%. Shunts performed below age 10 years were associated with a high thrombosis rate. A conservative approach to bleeding varices in children is recommended with transfusion, pitressin, and injection sclerotherapy. Oesophageal transection may have a role in the emergency management of the few children in whom bleeding is not controlled by injection sclerotherapy. PMID:6609683

  14. Clinical approach to the patient with unexpected bleeding.

    PubMed

    Teitel, J M

    2000-10-01

    Bleeding can be considered unexpected if it is disproportionate to the intensity of the haemostatic stress in a patient with no known haemorrhagic disorder or if it occurs in a patient in whom a bleeding disorder has been characterized but is adequately treated. A thorough history usually allows the clinician to predict reasonably accurately whether the patient is likely to have a systemic haemostatic defect (and if so whether it is congenital or acquired), or whether the bleeding likely has a purely anatomical basis. The nature of bleeding is instructive with respect to preliminary categorization. Thus, mucocutaneous bleeding suggests defects of primary haemostasis (disordered platelet-vascular interactions). Bleeding into deeper structures is more suggestive of coagulation defects leading to impaired fibrin clot formation, and delayed bleeding after primary haemostasis is characteristic of hyperfibrinolysis. Localized bleeding suggests an anatomical cause, although an underlying haemostatic defect may coexist. Where bleeding is so acutely threatening as to require urgent intervention, diagnosis and treatment must proceed simultaneously. In the case of minor haemorrhage (not threatening to life or limb) it may be preferable to defer therapy while the nature of the bleeding disorder is methodically investigated. Initial laboratory evaluation is guided by the preliminary clinical impression. The amount of blood loss can be inferred from the haematocrit or haemoglobin concentration, and the platelet count will quickly identify cases in which thrombocytopenia is the likely cause of bleeding. In the latter instance, examination of the red cell morphology, leucocyte differential, and mean platelet volume may allow the aetiological mechanism to be presumptively identified as hypoproliferative or consumptive. With regard to coagulation testing, the activated PTT, prothrombin time, and thrombin time usually constitute an adequate battery of screening tests, unless the

  15. Transarterial embolization for management of severe postcoital bleeding

    PubMed Central

    Eskandari, Armen; Mukherjee, Ashis; McHugh, John

    2016-01-01

    Objectives: Postcoital bleeding is an uncommon cause of gynecologic hemorrhage; however, it can be severe in a majority of cases necessitating surgical management. Methods: We report a case of severe postcoital bleeding in a young woman requiring blood transfusion. Results: Hemostasis was achieved using subselective embolization of cervical artery by metallic coils. Conclusion: Our case demonstrates a minimally invasive treatment for control of non-obstetric hemorrhage. PMID:27551425

  16. Severe Epistaxis from an Intracranial Vascular Bleed from Grenade Injury

    DTIC Science & Technology

    2008-09-01

    Severe Epistaxis from an Intracranial Vascular Bleed from Grenade Injury Radiology Corner Case 27 Severe Epistaxis from an Intracranial ...neck injuries. In particular, this case focuses on an intracranial vascular injury generated by a hand grenade with the diagnosis assisted by...4. TITLE AND SUBTITLE Severe Epistaxis from an Intracranial Vascular Bleed from Grenade Injury 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM

  17. Amphetamine-related ischemic colitis causing gastrointestinal bleeding

    PubMed Central

    Panikkath, Deepa

    2016-01-01

    A 43-year-old woman presented with acute lower intestinal bleeding requiring blood transfusion. Multiple initial investigations did not reveal the cause of the bleeding. Colonoscopy performed 2 days later showed features suggestive of ischemic colitis. On detailed history, the patient admitted to using amphetamines, and her urine drug screen was positive for them. She was managed conservatively and advised not to use amphetamines again. She did not have any recurrence on 2-year follow-up. PMID:27365888

  18. ENDOSCOPIC DIAGNOSIS AND THERAPY IN GASTRO-ESOPAGEAL VARICEAL BLEEDING

    PubMed Central

    Sanyal, Arun J.

    2016-01-01

    Gastroesophageal variceal hemorrhage is a medical emergency with high morbidity and mortality. Endoscopic therapy is the mainstay of management of bleeding varices. It requires attention to technique and the appropriate choice of therapy for a given patient at a given point in time. Subjects must be monitored continuously after initiation of therapy for control of bleeding and second line definitive therapies introduced quickly if endoscopic and pharmacologic treatment fails. PMID:26142034

  19. A pediatric case of factitious disorder with unexplained bleeding symptoms.

    PubMed

    Uzuner, Selcuk; Bahali, Kayhan; Kurban, Sema; Erenberk, Ufuk; Cakir, Erkan

    2013-01-01

    Factitious disorder is characterized by deliberate production or imitation of physical or psychological symptoms in order to adopt the sick role. The disorder can be seen as factitious bleeding. Factitious bleeding is a rare disorder in pediatric population. The concomitant appearance of hemoptysis and hematuria in the same patient has not been previously reported. In this case report, we present a pediatric case of factitious disorder with both hemoptysis and hematuria.

  20. Surgical Removal of an Extrauterine Device Migrating to Appendix

    PubMed Central

    Tanridan Okçu, Nefise; Seyfettinoglu, Sevtap; Kazgan, Halil

    2016-01-01

    Intrauterine devices (IUDs) remain highly effective reversible family planning methods in developing countries. We aimed to report one of the complications of extrauterine and intrauterine devices. A 44-year-old woman was admitted to our hospital with mislocated intrauterine device and abnormal uterine bleeding. Extrauterine IUD device was proven by ultrasound and X-ray. She had normal blood test count with a negative pregnancy test. There are several cases of complications with intrauterine devices, but this is the first case report about an extrauterine IUD embedded by inflame enlarged appendix presenting with abnormal uterine bleeding. Although intrauterine devices are a common safe method for contraception, there is no risk-free insertion even with advanced ultrasounds. A regular self-examination should be taught to the patients and ultrasonography should be performed in the follow-up of the patients especially for inserted devices during lactation period. Extrauterine IUDs can be successfully removed by laparotomy. PMID:27885327

  1. 21 CFR 874.1800 - Air or water caloric stimulator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Diagnostic Devices § 874.1800 Air or water caloric stimulator. (a) Identification. An air or water caloric stimulator is a device that delivers a stream of air...) Classification. Class I (general controls). The device is exempt from the premarket notification procedures...

  2. Approach to a child with upper gastrointestinal bleeding.

    PubMed

    Singhi, Sunit; Jain, Puneet; Jayashree, M; Lal, Sadhna

    2013-04-01

    Upper gastrointestinal bleeding (UGIB) is a potentially life threatening medical emergency requiring an appropriate diagnostic and therapeutic approach. Therefore, the primary focus in a child with UGIB is resuscitation and stabilization followed by a diagnostic evaluation. The differential diagnosis of UGIB in children is determined by age and severity of bleed. In infants and toddlers mucosal bleed (gastritis and stress ulcers) is a common cause. In children above 2 y variceal bleeding due to Extra-Hepatic Portal Venous Obstruction (EHPVO) is the commonest cause of significant UGIB in developing countries as against peptic ulcer in the developed countries. Upper gastrointestinal endoscopy is the most accurate and useful diagnostic tool to evaluate UGIB in children. Parenteral vitamin K (infants, 1-2 mg/dose; children, 5-10 mg) and parenteral Proton Pump Inhibitors (PPI's), should be administered empirically in case of a major UGIB. Octreotide infusion is useful in control of significant UGIB due to variceal hemorrhage. A temporarily placed, Sengstaken-Blakemore tube can be life saving if pharmacologic/ endoscopic methods fail to control variceal bleeding. Therapy in patients having mucosal bleed is directed at neutralization and/or prevention of gastric acid release; High dose Proton Pump Inhibitors (PPIs, Pantoprazole) are more efficacious than H2 receptor antagonists for this purpose.

  3. Diagnosis and therapy of non-variceal upper gastrointestinal bleeding

    PubMed Central

    Biecker, Erwin

    2015-01-01

    Non-variceal upper gastrointestinal bleeding (UGIB) is defined as bleeding proximal to the ligament of Treitz in the absence of oesophageal, gastric or duodenal varices. The clinical presentation varies according to the intensity of bleeding from occult bleeding to melena or haematemesis and haemorrhagic shock. Causes of UGIB are peptic ulcers, Mallory-Weiss lesions, erosive gastritis, reflux oesophagitis, Dieulafoy lesions or angiodysplasia. After admission to the hospital a structured approach to the patient with acute UGIB that includes haemodynamic resuscitation and stabilization as well as pre-endoscopic risk stratification has to be done. Endoscopy offers not only the localisation of the bleeding site but also a variety of therapeutic measures like injection therapy, thermocoagulation or endoclips. Endoscopic therapy is facilitated by acid suppression with proton pump inhibitor (PPI) therapy. These drugs are highly effective but the best route of application (oral vs intravenous) and the adequate dosage are still subjects of discussion. Patients with ulcer disease are tested for Helicobacter pylori and eradication therapy should be given if it is present. Non-steroidal anti-inflammatory drugs have to be discontinued if possible. If discontinuation is not possible, cyclooxygenase-2 inhibitors in combination with PPI have the lowest bleeding risk but the incidence of cardiovascular events is increased. PMID:26558151

  4. Bleeding after endoscopic submucosal dissection: Risk factors and preventive methods

    PubMed Central

    Kataoka, Yosuke; Tsuji, Yosuke; Sakaguchi, Yoshiki; Minatsuki, Chihiro; Asada-Hirayama, Itsuko; Niimi, Keiko; Ono, Satoshi; Kodashima, Shinya; Yamamichi, Nobutake; Fujishiro, Mitsuhiro; Koike, Kazuhiko

    2016-01-01

    Endoscopic submucosal dissection (ESD) has become widely accepted as a standard method of treatment for superficial gastrointestinal neoplasms because it enables en block resection even for large lesions or fibrotic lesions with minimal invasiveness, and decreases the local recurrence rate. Moreover, specimens resected in an en block fashion enable accurate histological assessment. Taking these factors into consideration, ESD seems to be more advantageous than conventional endoscopic mucosal resection (EMR), but the associated risks of perioperative adverse events are higher than in EMR. Bleeding after ESD is the most frequent among these adverse events. Although post-ESD bleeding can be controlled by endoscopic hemostasis in most cases, it may lead to serious conditions including hemorrhagic shock. Even with preventive methods including administration of acid secretion inhibitors and preventive hemostasis, post-ESD bleeding cannot be completely prevented. In addition high-risk cases for post-ESD bleeding, which include cases with the use of antithrombotic agents or which require large resection, are increasing. Although there have been many reports about associated risk factors and methods of preventing post-ESD bleeding, many issues remain unsolved. Therefore, in this review, we have overviewed risk factors and methods of preventing post-ESD bleeding from previous studies. Endoscopists should have sufficient knowledge of these risk factors and preventive methods when performing ESD. PMID:27468187

  5. Upper gastrointestinal ectopic variceal bleeding treated with various endoscopic modalities

    PubMed Central

    Park, Sang Woo; Cho, Eunae; Jun, Chung Hwan; Choi, Sung Kyu; Kim, Hyun Soo; Park, Chang Hwan; Rew, Jong Sun; Cho, Sung Bum; Kim, Hee Joon; Han, Mingui; Cho, Kyu Man

    2017-01-01

    Abstract Rationale: Ectopic variceal bleeding is a rare (2–5%) but fatal gastrointestinal bleed in patients with portal hypertension. Patients with ectopic variceal bleeding manifest melena, hematochezia, or hematemesis, which require urgent managements. Definitive therapeutic modalities of ectopic varices are not yet standardized because of low incidence. Various therapeutic modalities have been applied on the basis of the experiences of experts or availability of facilities, with varying results. Patient concerns: We have encountered eight cases of gastrointestinal ectopic variceal bleeding in five patients in the last five years. Diagnoses: All patients were diagnosed with liver cirrhosis presenting melena or hematemesis. Interventions: All patients were treated with various endoscopic modalities (endoscopic variceal obturation [EVO] with cyanoacrylate in five cases, endoscopic variceal band ligation (EVL) in two cases, hemoclipping in one case). Outcomes: Satisfactory hemostasis was achieved without radiologic interventions in all cases. EVO and EVL each caused one case of portal biliopathy, and EVL induced ulcer bleeding in one case. Lessons: EVO generally accomplished better results of variceal obturations than EVL or hemoclipping, without serious adverse events. EVO may be an effective modality for control of ectopic variceal bleeding without radiologic intervention or surgery. PMID:28072750

  6. Experimental research in the use of electrets in measuring effluents from rocket exhaust and a review of standard air quality measuring devices

    NASA Technical Reports Server (NTRS)

    Susko, M.

    1976-01-01

    Seven standard types of measuring devices used to obtain the chemical composition of rocket exhaust effluents were discussed. The electrets, a new measuring device, are investigated and compared with established measuring techniques. The preliminary results obtained show that electrets have multipollutant measuring capabilities, simplicity of deployment, speed of assessment or analysis, and may be an important and valuable tool in measuring pollutants from space vehicle rocket exhaust.

  7. Pressure, velocity, and temperature sensitivities of a bleed-type pressure sensor

    NASA Astrophysics Data System (ADS)

    Giovanangeli, J. P.; Chambaud, P.

    1987-07-01

    This paper presents the results of a complete series of tests and calibrations of a bleed-type pressure sensor used in order to determine in-stream static pressure fluctuations in a turbulent boundary layer just above a pure laboratory wind-wave field. The static calibrations show that for air flow mean velocities lower than 15 m/s, the sensor response depends not only upon the pressure but also upon the velocity and the temperature of the air flow. Dynamic calibrations prove that the temperature and velocity sensitivities depend strongly upon the frequency. They are important for low frequencies and equal to zero only for frequencies greater than 0.1 Hz if the sensor is operated in an isothermal turbulent flow and greater than 1 Hz for a nonisothermal flow. Pressure sensitivity does not depend upon frequency for a range from dc to 600 Hz.

  8. 21 CFR 880.6500 - Medical ultraviolet air purifier.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Miscellaneous Devices § 880.6500 Medical ultraviolet air purifier. (a) Identification. A medical ultraviolet air purifier is a device intended for medical purposes that is used to destroy bacteria in the air by...

  9. 21 CFR 880.6500 - Medical ultraviolet air purifier.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Miscellaneous Devices § 880.6500 Medical ultraviolet air purifier. (a) Identification. A medical ultraviolet air purifier is a device intended for medical purposes that is used to destroy bacteria in the air by...

  10. 21 CFR 880.6500 - Medical ultraviolet air purifier.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Miscellaneous Devices § 880.6500 Medical ultraviolet air purifier. (a) Identification. A medical ultraviolet air purifier is a device intended for medical purposes that is used to destroy bacteria in the air by...

  11. 21 CFR 880.6500 - Medical ultraviolet air purifier.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Miscellaneous Devices § 880.6500 Medical ultraviolet air purifier. (a) Identification. A medical ultraviolet air purifier is a device intended for medical purposes that is used to destroy bacteria in the air by...

  12. 49 CFR 173.166 - Air bag inflators, air bag modules and seat-belt pretensioners.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... suitable material, or other dedicated handling devices are authorized for shipment of air bag inflators... handling devices are authorized for shipment of air bag inflators, air bag modules, and seat-belt... 49 Transportation 2 2014-10-01 2014-10-01 false Air bag inflators, air bag modules and...

  13. 49 CFR 173.166 - Air bag inflators, air bag modules and seat-belt pretensioners.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... suitable material, or other dedicated handling devices are authorized for shipment of air bag inflators... handling devices are authorized for shipment of air bag inflators, air bag modules, and seat-belt... 49 Transportation 2 2013-10-01 2013-10-01 false Air bag inflators, air bag modules and...

  14. A novel semi-quantitative method for measuring tissue bleeding.

    PubMed

    Vukcevic, G; Volarevic, V; Raicevic, S; Tanaskovic, I; Milicic, B; Vulovic, T; Arsenijevic, S

    2014-03-01

    In this study, we describe a new semi-quantitative method for measuring the extent of bleeding in pathohistological tissue samples. To test our novel method, we recruited 120 female patients in their first trimester of pregnancy and divided them into three groups of 40. Group I was the control group, in which no dilation was applied. Group II was an experimental group, in which dilation was performed using classical mechanical dilators. Group III was also an experimental group, in which dilation was performed using a hydraulic dilator. Tissue samples were taken from the patients' cervical canals using a Novak's probe via energetic single-step curettage prior to any dilation in Group I and after dilation in Groups II and III. After the tissue samples were prepared, light microscopy was used to obtain microphotographs at 100x magnification. The surfaces affected by bleeding were measured in the microphotographs using the Autodesk AutoCAD 2009 program and its "polylines" function. The lines were used to mark the area around the entire sample (marked A) and to create "polyline" areas around each bleeding area on the sample (marked B). The percentage of the total area affected by bleeding was calculated using the formula: N = Bt x 100 / At where N is the percentage (%) of the tissue sample surface affected by bleeding, At (A total) is the sum of the surfaces of all of the tissue samples and Bt (B total) is the sum of all the surfaces affected by bleeding in all of the tissue samples. This novel semi-quantitative method utilizes the Autodesk AutoCAD 2009 program, which is simple to use and widely available, thereby offering a new, objective and precise approach to estimate the extent of bleeding in tissue samples.

  15. Hemostatic powder spray: a new method for managing gastrointestinal bleeding

    PubMed Central

    Papafragkakis, Haris; Ofori, Emmanuel; Ona, Mel A.; Krishnaiah, Mahesh; Duddempudi, Sushil; Anand, Sury

    2015-01-01

    Gastrointestinal bleeding is a leading cause of morbidity and mortality in the United States. The management of gastrointestinal bleeding is often challenging, depending on its location and severity. To date, widely accepted hemostatic treatment options include injection of epinephrine and tissue adhesives such as cyanoacrylate, ablative therapy with contact modalities such as thermal coagulation with heater probe and bipolar hemostatic forceps, noncontact modalities such as photodynamic therapy and argon plasma coagulation, and mechanical hemostasis with band ligation, endoscopic hemoclips, and over-the-scope clips. These approaches, albeit effective in achieving hemostasis, are associated with a 5–10% rebleeding risk. New simple, effective, universal, and safe methods are needed to address some of the challenges posed by the current endoscopic hemostatic techniques. The use of a novel hemostatic powder spray appears to be effective and safe in controlling upper and lower gastrointestinal bleeding. Although initial reports of hemostatic powder spray as an innovative approach to manage gastrointestinal bleeding are promising, further studies are needed to support and confirm its efficacy and safety. The aim of this study was to evaluate the technical feasibility, clinical efficacy, and safety of hemostatic powder spray (Hemospray, Cook Medical, Winston-Salem, North Carolina, USA) as a new method for managing gastrointestinal bleeding. In this review article, we performed an extensive literature search summarizing case reports and case series of Hemospray for the management of gastrointestinal bleeding. Indications, features, technique, deployment, success rate, complications, and limitations are discussed. The combined technical and clinical success rate of Hemospray was 88.5% (207/234) among the human subjects and 81.8% (9/11) among the porcine models studied. Rebleeding occurred within 72 hours post-treatment in 38 patients (38/234; 16.2%) and in three porcine

  16. The Clinical Outcomes of Lower Gastrointestinal Bleeding Are Not Better than Those of Upper Gastrointestinal Bleeding

    PubMed Central

    2016-01-01

    The incidence of lower gastrointestinal bleeding (LGIB) is increasing; however, predictors of outcomes for patients with LGIB are not as well defined as those for patients with upper gastrointestinal bleeding (UGIB). The aim of this study was to identify the clinical outcomes and the predictors of poor outcomes for patients with LGIB, compared to outcomes for patients with UGIB. We identified patients with LGIB or UGIB who underwent endoscopic procedures between July 2006 and February 2013. Propensity score matching was used to improve comparability between LGIB and UGIB groups. The clinical outcomes and predictors of 30-day rebleeding and mortality rate were analyzed between the two groups. In total, 601 patients with UGIB (n = 500) or LGIB (n = 101) were included in the study, and 202 patients with UGIB and 101 patients with LGIB were analyzed after 2:1 propensity score matching. The 30-day rebleeding and mortality rates were 9.9% and 4.5% for the UGIB group, and 16.8% and 5.0% for LGIB group, respectively. After logistic regression analysis, the Rockall score (P = 0.013) and C-reactive protein (CRP; P = 0.047) levels were significant predictors of 30-day mortality in patients with LGIB; however, we could not identify any predictors of rebleeding in patients with LGIB. The clinical outcomes for patients with LGIB are not better than clinical outcomes for patients with UGIB. The clinical Rockall score and serum CRP levels may be used to predict 30-day mortality in patients with LGIB. PMID:27550490

  17. Gallbladder bleeding-related severe gastrointestinal bleeding and shock in a case with end-stage renal disease: A case report.

    PubMed

    Tsai, Jun-Li; Tsai, Shang-Feng

    2016-06-01

    Gallbladder (GB) bleeding is very rare and it is caused by cystic artery aneurysm and rupture, or GB wall rupture. For GB rupture, the typical findings are positive Murphy's sign and jaundice. GB bleeding mostly presented as hemobilia. This is the first case presented with severe GI bleeding because of GB rupture-related GB bleeding. After comparing computed tomography, one gallstone spillage was noticed. In addition to gallstones, uremic coagulopathy also worsens the bleeding condition. This is also the first case that patients with GB spillage-related rupture and bleeding were successfully treated by nonsurgical management. Clinicians should bear in mind the rare causes of GI bleeding. Embolization of the bleeding artery should be attempted as soon as possible.

  18. Using intraoperative MRI to assess bleeding

    NASA Astrophysics Data System (ADS)

    Liu, Haiying; Hall, Walter A.; Martin, Alastair J.; Truwit, Charles L.

    2001-05-01

    Immediate detector of any surgically induced hemorrhage prior to the closure is important for minimizing the unnecessary post surgical complications. In the case of hemorrhage, the surgical site of interests often involves hemorrhagic blood in the presence of CSF as well as air pockets. It is known that the hemorrhagic blood or air has a different magnetic susceptibility from its surrounding tissue, and CSF has long T1 and T2. Based on these differences, a set of complimentary imaging techniques (T2, FLAIR, and GE) were optimized to reveal the existence of surgically induced acute hemorrhage. Among 330 neurosurgical cases, one relatively severe hemorrhage has been successfully found intra-operatively using the concept. During the case, a new hyperintense area close to the primary motor cortex was initially noticed on T2 weighted HASTE images. As soon as it was found to increase in size rapidly, the patient was treated immediately via craniotomy for aspiration of the intra-parenchymal blood. Owing to early detection and treatment, the patient was completely free of motor deficits. Besides, there were ten much less severe hemorrhages have been noticed using the method. The proper post-surgical care was planned to closely follow-up the patient for any sign of hemorrhage.

  19. Gastrointestinal Symptoms from Left-Ventricular Assist Device External Compression of the Gastric Lumen

    PubMed Central

    Suarez, Jorge

    2016-01-01

    A 74-year-old man with a left-ventricular assist device (LVAD) as destination therapy for end-stage ischemic cardiomyopathy presented with acute upper gastrointestinal bleeding. Other symptoms included chronic early satiety, intermittent nausea, and non-specific abdominal discomfort since LVAD implantation 3 years ago. An actively bleeding duodenal arteriovenous malformation was successfully treated with endoscopic coagulation. There was also evidence of moderate external compression of the anterior gastric wall from the LVAD pump with luminal narrowing in the antrum. While bleeding may be the most commonly encountered gastrointestinal manifestation in LVAD patients, other potential complications, including luminal compression by the device, should be recognized. PMID:28008413

  20. Providing Young Women with Credible Health Information about Bleeding Disorders

    PubMed Central

    Rhynders, Patricia A.; Sayers, Cynthia A.; Presley, Rodney J.; Thierry, JoAnn M.

    2015-01-01

    Background Approximately 1% of U.S. women may have an undiagnosed bleeding disorder, which can diminish quality of life and lead to life-threatening complications during menstruation, childbirth, and surgery. Purpose To understand young women’s knowledge, attitudes, and perceptions about bleeding disorders and determine the preferred messaging strategy (e.g., gain- versus loss-framed messages) for presenting information. Methods In September 2010, a web-assisted personal interview of women aged 18–25 years was conducted. Preliminary analyses were conducted in 2011 with final analyses in 2013. In total, 1,243 women participated. Knowledge of blood disorders was tabulated for these respondents. Menstrual experiences of women at risk for a bleeding disorder were compared with those not at risk using chi-square analyses. Perceived influence of gain- versus loss-framed messages also was compared. Results Participants knew that a bleeding disorder is a condition in which bleeding takes a long time to stop (77%) or blood does not clot (66%). Of the women, 57% incorrectly thought that a bleeding disorder is characterized by thin blood; many were unsure if bleeding disorders involve blood types, not getting a period, or mother and fetus having a different blood type. Women at risk for a bleeding disorder were significantly more likely to report that menstruation interfered with daily activities (36% vs 9%); physical or sports activities (46% vs 21%); social activities (29% vs 7%); and school or work activities (20% vs 9%) than women not at risk. Gain-framed messages were significantly more likely to influence women’s decisions to seek medical care than parallel loss-framed messages. Findings suggest that the most influential messages focus on knowing effective treatment is available (86% gain-framed vs 77% loss-framed); preventing pregnancy complications (79% gain- vs 71% loss-framed); and maintaining typical daily activities during menstrual periods. Conclusions Lack

  1. Antiplatelet Drugs: Mechanisms and Risks of Bleeding Following Cardiac Operations

    PubMed Central

    Ferraris, Victor A.; Ferraris, Suellen P.; Saha, Sibu P.

    2011-01-01

    Preoperative antiplatelet drug use is common in patients undergoing coronary artery bypass grafting (CABG). The impact of these drugs on bleeding and blood transfusion varies. We hypothesize that review of available evidence regarding drug-related bleeding risk, underlying mechanisms of platelet dysfunction, and variations in patient response to antiplatelet drugs will aid surgeons as they assess preoperative risk and attempt to limit perioperative bleeding. The purpose of this review is to (1) examine the role that antiplatelet drugs play in excessive postoperative blood transfusion, (2) identify possible mechanisms to explain patient response to antiplatelet drugs, and (3) formulate a strategy to limit excessive blood product usage in these patients. We reviewed available published evidence regarding bleeding risk in patients taking preoperative antiplatelet drugs. In addition, we summarized our previous research into mechanisms of antiplatelet drug-related platelet dysfunction. Aspirin users have a slight but significant increase in blood product usage after CABG (0.5 U of nonautologous blood per treated patient). Platelet adenosine diphosphate (ADP) receptor inhibitors are more potent antiplatelet drugs than aspirin but have a half-life similar to aspirin, around 5 to 10 days. The American Heart Association/American College of Cardiology and the Society of Thoracic Surgeons guidelines recommend discontinuation, if possible, of ADP inhibitors 5 to 7 days before operation because of excessive bleeding risk, whereas aspirin should be continued during the entire perioperative period in most patients. Individual variability in response to aspirin and other antiplatelet drugs is common with both hyper- and hyporesponsiveness seen in 5 to 25% of patients. Use of preoperative antiplatelet drugs is a risk factor for increased perioperative bleeding and blood transfusion. Point-of-care tests can identify patients at high risk for perioperative bleeding and blood

  2. Comparative efficacy of the standard flossing procedure and a new floss applicator in reducing interproximal bleeding: a short-term study.

    PubMed

    Kinane, D F; Jenkins, W M; Paterson, A J

    1992-09-01

    This was a parallel stratified study which examined the effect on gingival health of a new floss holder and applicator, designed to deliver a 25 microliters dose of 0.1% chlorhexidine solution to each interdental embrasure during the flossing procedure. Fifty-two patients with simple chronic gingivitis were stratified according to age, sex, and baseline interdental bleeding score and then assigned to one of three treatment groups. One of the following interdental cleaning agents was used once daily during a 2-week period: conventional floss; a flossing device with chlorhexidine; or a flossing device with placebo solution. Gingival health was assessed using the interdental bleeding index (IBI); i.e., the ratio of bleeding sites to the number of sites tested by stimulation with an interdental cleaner. The percentage reduction in bleeding amounted to 38.3% for conventional floss, 51.5% for the flossing device with chlorhexidine, and 51.4% for the flossing device with placebo. The reductions in both flossing device groups were significantly greater than that of the conventional floss group as determined by one-way ANOVA (F = 4.0; P = 0.024) and multiple range tests. There were no statistically significant differences between the two flossing device groups. There was no difference in patients' perception of ease of use of their respective materials; however, 72% of chlorhexidine users and 94% of placebo users, but only 24% of conventional floss users, felt that their interdental cleaning regimens left their mouths feeling fresher. It is therefore postulated that the pleasant tasting spray may have been an important stimulus to extended use of the new device and may explain its greater effectiveness.

  3. Risk of bleeding after dentoalveolar surgery in patients taking anticoagulants.

    PubMed

    Broekema, Ferdinand I; van Minnen, Baucke; Jansma, Johan; Bos, Rudolf R M

    2014-03-01

    To avoid increasing the risk of thromboembolic events, it is recommended that treatment with anticoagulants should be continued during dentoalveolar operations. We have evaluated the incidence of bleeding after dentoalveolar operations in a prospective study of 206 patients, 103 who were, and 103 who were not, taking anticoagulants. Seventy-one were taking thrombocyte aggregation inhibitors and 32 vitamin K antagonists. Patients were treated according to guidelines developed at the Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands. The operations studied included surgical extraction (when the surgeon had to incise the gingiva before extraction), non-surgical extraction, apicectomy, and placement of implants. Patients were given standard postoperative care and those taking vitamin K antagonists used tranexamic acid mouthwash postoperatively. No patient developed a severe bleed that required intervention. Seven patients (7%) taking anticoagulants developed mild postoperative bleeds. Patients taking vitamin K antagonists reported 3 episodes (9%) compared with 4 (6%) in the group taking thrombocyte aggregation inhibitors. Among patients not taking anticoagulants, two (2%) developed mild bleeding. The differences between the groups were not significant. All bleeding was controlled by the patients themselves with compression with gauze. We conclude that dentoalveolar surgery is safe in patients being treated with anticoagulants provided that the conditions described in the ACTA guidelines are met.

  4. Prediction and Reduction of Noise in Pneumatic Bleed Valves

    NASA Astrophysics Data System (ADS)

    Taghavi Nezhad, Shervin

    This study investigates numerically the fluid mechanics and acoustics of pneumatic bleed valves used in turbofan engines. The goal is to characterized the fundamental processes of noise generation and devise strategies for noise reduction. Three different methods are employed for both analysis and redesign of the bleed valve to reduce noise. The bleed valve noise problem is carefully divided into multiple smaller problems. For large separations and tonal noises, the unsteady Reynolds-Averaged Navier-Stokes (URANS) method is utilized. This method is also applied in the re-designing of the bleed valve geometry. For the bleed valve muffler, which is comprised of perforated plates and a honeycomb, a Reynolds-Averaged Navier-Stokes (RANS) method combined with a simplified acoustic analogy is used. The original muffler design is modified to improve noise attenuation. Finally, for sound scattering through perforated plates, a fully implicit linearized Euler solver is developed. The problem of sound interaction with perforated plates is studied from two perspectives. In the first study the effect of high--speed mean flow is considered and it is shown that at Strouhal numbers of around 0.2-0.25 there is an increase in transmitted incident sound. In the second part, the interaction of holes in two--dimensional perforated plates is investigated using three different configurations. The study demonstrates that the hole interaction has a significant impact on sound attenuation, especially at high frequencies.

  5. Endovascular management for significant iatrogenic portal vein bleeding.

    PubMed

    Kim, Jong Woo; Shin, Ji Hoon; Park, Jonathan K; Yoon, Hyun-Ki; Ko, Gi-Young; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu-Bo

    2017-01-01

    Background Despite conservative treatment, hemorrhage from an intrahepatic branch of the portal vein can cause hemodynamic instability requiring urgent intervention. Purpose To retrospectively report the outcomes of hemodynamically significant portal vein bleeding after endovascular management. Material and Methods During a period of 15 years, four patients (2 men, 2 women; median age, 70.5 years) underwent angiography and embolization for iatrogenic portal vein bleeding. Causes of hemorrhage, angiographic findings, endovascular treatment, and complications were reported. Results Portal vein bleeding occurred after percutaneous liver biopsy (n = 2), percutaneous radiofrequency ablation (n = 1), and percutaneous cholecystostomy (n = 1). The median time interval between angiography and percutaneous procedure was 5 h (range, 4-240 h). Common hepatic angiograms including indirect mesenteric portograms showed active portal vein bleeding into the peritoneal cavity with (n = 1) or without (n = 2) an arterioportal (AP) fistula, and portal vein pseudoaneurysm alone with an AP fistula (n = 1). Successful transcatheter arterial embolization (n = 2) or percutaneous transhepatic portal vein embolization (n = 2) was performed. Embolic materials were n-butyl cyanoacrylate alone (n = 2) or in combination with gelatin sponge particles and coils (n = 2). There were no major treatment-related complications or patient mortality within 30 days. Conclusion Patients with symptomatic or life-threatening portal vein bleeding following liver-penetrating procedures can successfully be managed with embolization.

  6. Ameboma: an unusual cause of gastrointestinal bleeding during severe leptospirosis

    PubMed Central

    2014-01-01

    Background Severe leptospirosis occurs mainly in a tropical environment and includes icterus, acute renal failure and hemorrhages. These bleedings, which are mainly a consequence of acute homeostatic disturbances, can also reveal simultaneous diseases. Coinfections with other tropical diseases have been previously reported during leptospirosis. To our knowledge, invasive amebiasis, which can induce gastrointestinal bleedings, has never been described in the course of severe leptospirosis. Case presentation In this report, we describe a case of a 60 year-old man living in Reunion Island (Indian Ocean, France) admitted to our intensive care unit for severe Leptospira interrogans serovar icterohaemorrhagiae infection with neurological, renal, liver and hematological involvement. Two lower gastrointestinal bleedings occurred 7 and 15 days after admission. The first episode was promoted by hemostatic disturbances while the second bleeding occurred during low-dose heparin therapy. Colonoscopy revealed a pseudo-tumoral inflammatory mass of the recto-sigmoid junction. Histological examination found trophozoites inside mucinous exudate suggestive of Entamoeba histolytica. Amoebic serology was strongly positive whereas careful detection of cysts or trophozoites on saline-wet mount was negative in three consecutive samples of stools. Amoxicillin followed by metronidazole therapy, combined with supportive care, led to an improvement in the clinical and biological patient’s condition and endoscopic appearances. Conclusion Clinicians should be aware that gastrointestinal bleeding during severe leptospirosis could not solely be the consequences of hemostatic disturbances. Careful endoscopic evaluation that may reveal curable coinfections should also be considered. PMID:24894109

  7. [Blood transfusion and adjunctive therapy in the bleeding trauma patient].

    PubMed

    Ozier, Y

    2008-11-01

    Uncontrolled hemorrhage is the most common cause of potentially preventable death in massive trauma. In addition to the early identification of potential bleeding sources and angiographic embolisation or surgical bleeding control, in-hospital management will aim at maintain tissue oxygenation with volume replacement using crystalloids, colloids and RBC. In general, RBC transfusion is recommended to maintain hemoglobin between 7-10g/dL. The complex combination of clotting factors and platelets consumption, loss and dilution, shock, hypothermia, acidosis and colloid-induced hemostatic alterations leads to coagulopathic bleeding. Most guidelines recommend the use of FFP in significant bleeding complicated by coagulopathy (PT, aPTT >1.5 times control). Platelets should be administered to maintain a platelet count above 50 x 10(9)/L (100 x 10(9)/L in patients with traumatic brain injury). However, standard laboratory tests have poor correlation with in vivo coagulopathy and the test results are not rapidly available. Empiric guidelines derived from mathematical hemodilution models developed in elective surgery settings may not be appropriate for trauma settings where significant bleeding may have already occurred. Moreover, coagulopathy is frequently present on admission in severely injured patients. Recent litterature suggests that FFP and platelets should be given early and more often to injured patients requiring massive transfusion. The place of adjunctive hemostatic therapy is discussed.

  8. Management of bleeding following major trauma: an updated European guideline

    PubMed Central

    2010-01-01

    Introduction Evidence-based recommendations are needed to guide the acute management of the bleeding trauma patient, which when implemented may improve patient outcomes. Methods The multidisciplinary Task Force for Advanced Bleeding Care in Trauma was formed in 2005 with the aim of developing a guideline for the management of bleeding following severe injury. This document presents an updated version of the guideline published by the group in 2007. Recommendations were formulated using a nominal group process, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) hierarchy of evidence and based on a systematic review of published literature. Results Key changes encompassed in this version of the guideline include new recommendations on coagulation support and monitoring and the appropriate use of local haemostatic measures, tourniquets, calcium and desmopressin in the bleeding trauma patient. The remaining recommendations have been reevaluated and graded based on literature published since the last edition of the guideline. Consideration was also given to changes in clinical practice that have taken place during this time period as a result of both new evidence and changes in the general availability of relevant agents and technologies. Conclusions This guideline provides an evidence-based multidisciplinary approach to the management of critically injured bleeding trauma patients. PMID:20370902

  9. Aerodynamic Control of a Pitching Airfoil using Distributed Active Bleed

    NASA Astrophysics Data System (ADS)

    Kearney, John; Glezer, Ari

    2012-11-01

    Aero-effected flight control using distributed active bleed driven by pressure differences across lifting surface and regulated by integrated louver actuators is investigated in wind tunnel experiments. The interaction between unsteady bleed and the cross flows alters the apparent aerodynamic shape of the lifting surface by regulating the accumulation and shedding of vorticity concentrations, and consequently the distributions of forces and moments. The present experiments are conducted using a 2-D dynamically-pitching VR-7 airfoil model from pre- to post-stall angles of attack. The effects of leading edge bleed at high angles of attack on the formation and evolution of the dynamic stall vorticity concentrations are investigated at high reduced frequencies (k > 0.1) using PIV phase-locked to the airfoil's motion. The time-dependent bleed enables broad-range variation in lift and pitching moment with significant extension of the stall margin. In particular, bleed actuation reduces the extent of ``negative damping'' or pitching moment instability with minimal lift penalty. Supported by NTRC-VLRCOE, monitored by Dr. Mike Rutkowski.

  10. Computed tomography angiography in patients with active gastrointestinal bleeding.

    PubMed

    Reis, Fatima Regina Silva; Cardia, Patricia Prando; D'Ippolito, Giuseppe

    2015-01-01

    Gastrointestinal bleeding represents a common medical emergency, with considerable morbidity and mortality rates, and a prompt diagnosis is essential for a better prognosis. In such a context, endoscopy is the main diagnostic tool; however, in cases where the gastrointestinal hemorrhage is massive, the exact bleeding site might go undetected. In addition, a trained professional is not always present to perform the procedure. In an emergency setting, optical colonoscopy presents limitations connected with the absence of bowel preparation, so most of the small bowel cannot be assessed. Scintigraphy cannot accurately demonstrate the anatomic location of the bleeding and is not available at emergency settings. The use of capsule endoscopy is inappropriate in the acute setting, particularly in the emergency department at night, and is a highly expensive method. Digital angiography, despite its high sensitivity, is invasive, presents catheterization-related risks, in addition to its low availability at emergency settings. On the other hand, computed tomography angiography is fast, widely available and minimally invasive, emerging as a promising method in the diagnostic algorithm of these patients, being capable of determining the location and cause of bleeding with high accuracy. Based on a critical literature review and on their own experience, the authors propose a computed tomography angiography protocol to assess the patient with gastrointestinal bleeding.

  11. Effective treatment of gastrointestinal bleeding with thalidomide - Chances and limitations

    PubMed Central

    Bauditz, Juergen

    2016-01-01

    For more than 50 years bleeding from gastrointestinal angiodysplasias has been treated by hormonal therapy with estrogens and progesterons. After a randomized study finally demonstrated that hormones have no effect on bleeding events and transfusion requirements, therapy has switched to endoscopic coagulation. However, angiodysplasias tend to recur over months to years and endoscopy often has to be repeated for long time periods. Thalidomide, which caused severe deformities in newborn children in the 1960s, is now increasingly used after it was shown to suppress tumor necrosis factor alpha, inhibit angiogenesis and to be also effective for treatment of multiple myeloma. In 2011 thalidomide was proven to be highly effective for treatment of bleeding from gastrointestinal angiodysplasias in a randomized study. Further evidence by uncontrolled studies exists that thalidomide is also useful for treatment of bleeding in hereditary hemorrhagic telangiectasia. In spite of this data, endoscopic therapy remains the treatment of choice in many hospitals, as thalidomide is still notorious for its teratogenicity. However, patients with gastrointestinal bleeding related to angiodysplasias are generally at an age in which women have no child-bearing potential. Teratogenicity is therefore no issue for these elderly patients. Other side-effects of thalidomide like neurotoxicity may limit treatment options but can be monitored safely. PMID:27003992

  12. Clinical Outcomes of Endoscopic Hemostasis in Marginal Ulcer Bleeding.

    PubMed

    Yamasaki, Yasushi; Takenaka, Ryuta; Hori, Keisuke; Takemoto, Koji; Kawano, Seiji; Kawahara, Yoshiro; Fujiki, Shigeatsu; Okada, Hiroyuki

    2016-12-01

    The usefulness of endoscopy in marginal ulcer bleeding has rarely been studied, and the optimal method for preventing rebleeding is unclear. Here we assessed the efficacy of endoscopy in marginal ulcer bleeding and examined the efficacy of proton pump inhibitors (PPIs) in the prevention of rebleeding. A total of 28 patients with marginal ulcer bleeding (21 men, 7 women; median age 58.5 years) were treated by endoscopy. We analyzed the clinical characteristics, results of endoscopic therapy, characteristics of rebleeding patients, and relation between the use of PPIs and the duration of rebleeding. Sixteen patients had active bleeding. Initial hemostasis was achieved in all patients. There were no procedure-related adverse events. Rebleeding occurred in one patient within the first month and in 7 patients thereafter. There was a significant difference in the rebleeding rate between the patients who received a PPI and those who did not. In a multivariate analysis, the non-use of PPIs was a risk factor for rebleeding (hazard ratio, 6.22). Therapeutic endoscopy is effective in achieving hemostasis from marginal ulcer bleeding. PPIs may prevent rebleeding from marginal ulcers.

  13. Endoscopic band ligation for bleeding lesions in the small bowel

    PubMed Central

    Ikeya, Takashi; Ishii, Naoki; Shimamura, Yuto; Nakano, Kaoru; Ego, Mai; Nakamura, Kenji; Takagi, Koichi; Fukuda, Katsuyuki; Fujita, Yoshiyuki

    2014-01-01

    AIM: To investigate the safety and efficacy of endoscopic band ligation (EBL) for bleeding lesions in the small bowel. METHODS: This is a retrospective study evaluating EBL in six consecutive patients (three males, three females, 46-86 years of age) treated between May 2009 and February 2014: duodenal vascular ectasia; 1, jejunal bleeding diverticulum; 1, ileal Dieulafoy’s lesion; 1 and ileal bleeding diverticula; 3. The success of the initial hemostasis was evaluated, and patients were observed for early rebleeding (within 30 d after EBL), and complications such as perforation and abscess formation. Follow-up endoscopies were performed in four patients. RESULTS: Initial hemostasis was successfully achieved with EBL in all six patients. Eversion was not sufficient in four diverticular lesions. Early rebleeding occurred three days after EBL in one ileal diverticulum, and a repeat endoscopy revealed dislodgement of the O-band and ulcer formation at the banded site. This rebleeding was managed conservatively. Late rebleeding occurred in this case (13 and 21 mo after initial EBL), and re-EBL was performed. Follow-up endoscopies revealed scar formation and the disappearance of vascular lesions at the banded site in the case with a duodenal bleeding lesion, and unresolved ileal diverticula in three cases. Surgery or transarterial embolization was not required without any complications during the median follow-up period of 45 (range, 2-83) mo. CONCLUSION: EBL is a safe and effective endoscopic treatment for hemostasis of bleeding lesions in the small bowel. PMID:25324920

  14. Computed tomography angiography in patients with active gastrointestinal bleeding*

    PubMed Central

    Reis, Fatima Regina Silva; Cardia, Patricia Prando; D'Ippolito, Giuseppe

    2015-01-01

    Gastrointestinal bleeding represents a common medical emergency, with considerable morbidity and mortality rates, and a prompt diagnosis is essential for a better prognosis. In such a context, endoscopy is the main diagnostic tool; however, in cases where the gastrointestinal hemorrhage is massive, the exact bleeding site might go undetected. In addition, a trained professional is not always present to perform the procedure. In an emergency setting, optical colonoscopy presents limitations connected with the absence of bowel preparation, so most of the small bowel cannot be assessed. Scintigraphy cannot accurately demonstrate the anatomic location of the bleeding and is not available at emergency settings. The use of capsule endoscopy is inappropriate in the acute setting, particularly in the emergency department at night, and is a highly expensive method. Digital angiography, despite its high sensitivity, is invasive, presents catheterization-related risks, in addition to its low availability at emergency settings. On the other hand, computed tomography angiography is fast, widely available and minimally invasive, emerging as a promising method in the diagnostic algorithm of these patients, being capable of determining the location and cause of bleeding with high accuracy. Based on a critical literature review and on their own experience, the authors propose a computed tomography angiography protocol to assess the patient with gastrointestinal bleeding. PMID:26811556

  15. Ultrasonography of intrauterine devices

    PubMed Central

    Nowitzki, Kristina M.; Hoimes, Matthew L.; Chen, Byron; Zheng, Larry Z.; Kim, Young H.

    2015-01-01

    The intrauterine device (IUD) is gaining popularity as a reversible form of contraception. Ultrasonography serves as first-line imaging for the evaluation of IUD position in patients with pelvic pain, abnormal bleeding, or absent retrieval strings. This review highlights the imaging of both properly positioned and malpositioned IUDs. The problems associated with malpositioned IUDs include expulsion, displacement, embedment, and perforation. Management considerations depend on the severity of the malposition and the presence or absence of symptoms. Three-dimensional ultrasonography has proven to be more sensitive in the evaluation of more subtle findings of malposition, particularly side-arm embedment. Familiarity with the ultrasonographic features of properly positioned and malpositioned IUDs is essential. PMID:25985959

  16. Aircrew Training Devices: Utility and Utilization of Advanced Instructional Features (Phase II-Air Training Command, Military Airlift Command, and Strategic Air Command [and] Phase III-Electronic Warfare Trainers).

    ERIC Educational Resources Information Center

    Polzella, Donald J.; Hubbard, David C.

    This document consists of an interim report and a final report which describe the second and third phases of a project designed to determine the utility and utilization of sophisticated hardware and software capabilities known as advanced instructional features (AIFs). Used with an aircrew training device (ATD), AIFs permit a simulator instructor…

  17. Recurrent Epistaxis and Bleeding as the Initial Manifestation of Brucellosis.

    PubMed

    Kamali Aghdam, Mojtaba; Davari, Kambiz; Eftekhari, Kambiz

    2016-03-01

    Severe thrombocytopenia with bleeding is rarely reported in children with brucellosis, and recurrent epistaxis is extremely rare. Brucellosis with hemorrhage should be differentiated from viral hemorrhagic fever, malignancy, and other blood disorders. Bone marrow aspiration (BMA) is mandatory to differentiate from other blood diseases. An 8-year-old boy was admitted with recurrent epistaxis, petechiae and purpura on face and extremities and bleeding from the gums. During the hospitalization, he was febrile and complained of muscle pain. Leukopenias associated with thrombocytopenia were observed. BMA showed to be normal. Among the multiple tests requested, only serum agglutination test (SAT) and 2-MercaptoEthanol test (2-ME) were positive. He was treated with Intravenous immunoglobulin (IVIG) associated with co-trimoxazole and rifampin. Finally, fever subsided, and he was discharged with good condition and normal platelet count. Brucellosis should be a differential diagnosis in patients with fever and bleeding disorders and a history of consumption of unpasteurized dairy, in endemic areas.

  18. Acquired antiprothrombin antibodies: an unusual cause of bleeding

    PubMed Central

    Carvalho, Cristiana; Viveiro, Carolina; Maia, Paulo; Rezende, Teresa

    2013-01-01

    Acquired inhibitors of coagulation causing bleeding manifestations are rare in children. They emerge, normally in the context of autoimmune diseases or drug ingestion, but transient and self-limiting cases can occur after viral infection. We describe, an otherwise healthy, 7-year-old girl who had gingival bleeding after a tooth extraction. The prothrombin time (PT) and the activated partial thromboplastin time (APTT) were both prolonged with evidence of an immediate acting inhibitor (lupic anticoagulant). Further coagulation studies demonstrated prothrombin (FII) deficiency and prothrombin directed (FII) antibodies. The serological tests to detect an underlying autoimmune disease were all negative. The coagulation studies normalised alongside the disappearance of the antibody. This article presents lupus anticoagulant hypoprothrombinaemia syndrome (LAHS) as a rare case of acquired bleeding diathesis in childhood. PMID:23299692

  19. Acquired antiprothrombin antibodies: an unusual cause of bleeding.

    PubMed

    Carvalho, Cristiana; Viveiro, Carolina; Maia, Paulo; Rezende, Teresa

    2013-01-07

    Acquired inhibitors of coagulation causing bleeding manifestations are rare in children. They emerge, normally in the context of autoimmune diseases or drug ingestion, but transient and self-limiting cases can occur after viral infection. We describe, an otherwise healthy, 7-year-old girl who had gingival bleeding after a tooth extraction. The prothrombin time (PT) and the activated partial thromboplastin time (APTT) were both prolonged with evidence of an immediate acting inhibitor (lupic anticoagulant). Further coagulation studies demonstrated prothrombin (FII) deficiency and prothrombin directed (FII) antibodies. The serological tests to detect an underlying autoimmune disease were all negative. The coagulation studies normalised alongside the disappearance of the antibody. This article presents lupus anticoagulant hypoprothrombinaemia syndrome (LAHS) as a rare case of acquired bleeding diathesis in childhood.

  20. Bedside Bleeding Control, Review Paper and Proposed Algorithm

    PubMed Central

    Simman, Richard; Reynolds, David; Saad, Sharon

    2013-01-01

    Bleeding is a common occurrence in practice, but occasionally it may be challenging issue to overcome. It can come from numerous sources such as, trauma, during or post-surgical intervention, disorders of platelet and coagulation factors and increased fibrinolysis, wounds and cancers. This paper was inspired from our experience with a patient admitted to a local long term acute care facility with a large fungating right breast cancerous wound. During her hospital stay spontaneous bleeding from her breast cancerous mass was encountered and became more frequent and significant over the period of her stay. Different hemostatic technologies were used to control her bleeding. We felt that it was important to share our experience with our colleagues to help with potential similar situation that they may face. PMID:24527382

  1. Dosimetric Analysis of Radiation-Induced Gastric Bleeding

    PubMed Central

    Feng, Mary; Normolle, Daniel; Pan, Charlie C.; Dawson, Laura A.; Amarnath, Sudha; Ensminger, William D.; Lawrence, Theodore S.; Ten Haken, Randall K.

    2012-01-01

    Purpose Radiation-induced gastric bleeding has been poorly understood. In this study, we describe dosimetric predictors for gastric bleeding after fractionated radiotherapy and compare several predictive models. Materials & Methods The records of 139 sequential patients treated with 3-dimensional conformal radiotherapy (3D-CRT) for intrahepatic malignancies between January 1999 and April 2002 were reviewed. Median follow-up was 7.4 months. Logistic regression and Lyman normal tissue complication probability (NTCP) models for the occurrence of ≥ grade 3 gastric bleed were fit to the data. The principle of maximum likelihood was used to estimate parameters for all models. Results Sixteen of 116 evaluable patients (14%) developed gastric bleeds, at a median time of 4.0 months (mean 6.5 months, range 2.1–28.3 months) following completion of RT. The median and mean of the maximum doses to the stomach were 61 and 63 Gy (range 46 Gy–86 Gy), respectively, after bio-correction to equivalent 2 Gy daily fractions. The Lyman NTCP model with parameters adjusted for cirrhosis was most predictive of gastric bleed (AUROC=0.92). Best fit Lyman NTCP model parameters were n =0.10, and m =0.21, with TD50(normal) =56 Gy and TD50(cirrhosis) = 22 Gy. The low n value is consistent with the importance of maximum dose; a lower TD50 value for the cirrhosis patients points out their greater sensitivity. Conclusion This study demonstrates that the Lyman NTCP model has utility for predicting gastric bleeding, and that the presence of cirrhosis greatly increases this risk. These findings should facilitate the design of future clinical trials involving high-dose upper abdominal radiation. PMID:22541965

  2. Dosimetric Analysis of Radiation-induced Gastric Bleeding

    SciTech Connect

    Feng, Mary; Normolle, Daniel; Pan, Charlie C.; Dawson, Laura A.; Amarnath, Sudha; Ensminger, William D.; Lawrence, Theodore S.; Ten Haken, Randall K.

    2012-09-01

    Purpose: Radiation-induced gastric bleeding has been poorly understood. In this study, we described dosimetric predictors for gastric bleeding after fractionated radiation therapy. Methods and Materials: The records of 139 sequential patients treated with 3-dimensional conformal radiation therapy (3D-CRT) for intrahepatic malignancies were reviewed. Median follow-up was 7.4 months. The parameters of a Lyman normal tissue complication probability (NTCP) model for the occurrence of {>=}grade 3 gastric bleed, adjusted for cirrhosis, were fitted to the data. The principle of maximum likelihood was used to estimate parameters for NTCP models. Results: Sixteen of 116 evaluable patients (14%) developed gastric bleeds at a median time of 4.0 months (mean, 6.5 months; range, 2.1-28.3 months) following completion of RT. The median and mean maximum doses to the stomach were 61 and 63 Gy (range, 46-86 Gy), respectively, after biocorrection of each part of the 3D dose distributions to equivalent 2-Gy daily fractions. The Lyman NTCP model with parameters adjusted for cirrhosis predicted gastric bleed. Best-fit Lyman NTCP model parameters were n=0.10 and m=0.21 and with TD{sub 50} (normal) = 56 Gy and TD{sub 50} (cirrhosis) = 22 Gy. The low n value is consistent with the importance of maximum dose; a lower TD{sub 50} value for the cirrhosis patients points out their greater sensitivity. Conclusions: This study demonstrates that the Lyman NTCP model has utility for predicting gastric bleeding and that the presence of cirrhosis greatly increases this risk. These findings should facilitate the design of future clinical trials involving high-dose upper abdominal radiation.

  3. Experimental study of the effects of bleed holes on heat transfer and pressure drop in trapezoidal passages with tapered turbulators

    SciTech Connect

    Taslim, M.E.; Li, T.; Spring, S.D.

    1995-04-01

    Trailing edge cooling cavities in modern gas turbine blades often have trapezoidal cross-sectional areas of relatively low aspect ratio. To enhance cooling effectiveness in these passages, they are roughened with tapered turbulators. Furthermore, to provide additional cooling for the trailing edge, the cooling air may be ejected through trailing edge slots as it moves radially along the cooling passage. The tapered turbulators, in conjunction with the presence of these slots along the smaller base of the trapezoidal cavity, create both spanwise and longitudinal variations in heat transfer coefficient on the turbulated walls. Moreover, the continuous variation of cooling air velocity along these passages causes a continuous change in static pressure, which also requires investigation. Liquid crystals are used in this experimental investigation to study the effects of tapered turbulators on heat transfer coefficients in trailing edge passages with and without bleed holes. The tapered turbulators are configured on two opposite walls of the trapezoidal test section in a staggered arrangement with an angle of attack to the mainstream flow, {alpha}, of 90 deg. Nine different test geometries consisting of two passage aspect ratios, AR, were tested over a range of turbulator aspect ratios, AR{sub t}, blockage ratios, e{sub max}/D{sub h}, pitch-to-height ratios, S/e{sub max}, and Reynolds numbers. Channel pressure losses were also measured and both heat transfer and friction factor results for several geometries are compared. It is concluded that (a) there exists a large spanwise variation in heat transfer coefficient in test sections with no bleed holes, (b) adding bleed holes to the smaller base of the trapezoidal cavity gives a spanwise velocity component to the mainstream flow and reduces this variation, and (c) Nusselt numbers measured in the test sections with bleed holes correlate well with local Reynolds number.

  4. Condensate-removal device for heat exchangers

    NASA Technical Reports Server (NTRS)

    Trusch, R. B.; Oconnor, E. W.

    1973-01-01

    Device comprises array of perforated tubes manifolded together and connected to a vacuum suction device. Vacuum applied to these tubes pulls mixture of condensate and effluent gas through perforations and along length of tubes to discharge device. Discharge device may be a separator which separates water vapor from effluent air and allows recirculation of both of them.

  5. Management of adult Jehovah's Witness patients with acute bleeding.

    PubMed

    Berend, Kenrick; Levi, Marcel

    2009-12-01

    Because of the firm refusal of transfusion of blood and blood components by Jehovah's Witnesses, the management of Jehovah's Witness patients with severe bleeding is often complicated by medical, ethical, and legal concerns. Because of a rapidly growing and worldwide membership, physicians working in hospitals should be prepared to manage these patients. Appropriate management of a Jehovah's Witness patient with severe bleeding entails understanding of the legal and ethical issues involved, and meticulous medical management, including treatment of hypovolemic shock, local hemostatic interventions, and administration of prohemostatic agents, when appropriate. In addition, high-dose recombinant erythropoietin in combination with supplemental iron may enhance the speed of hemoglobin synthesis.

  6. hypertensive intracranial bleed due to mid aortic syndrome.

    PubMed

    Poovazhagi, Varadarajan; Pauline, Leema; Balakrishnan, N

    2014-03-01

    The authors describe an 11-y-old child with intracranial bleed due to malignant hypertension. Child presented with hypertension, right hemiparesis, feeble femoral pulses and lower limb blood pressure less than the upper limb. CT angiogram revealed narrowing of the abdominal aorta with thinned out left renal artery and hypoplasia of the left kidney. A diagnosis of Mid aortic syndrome was arrived at. CT brain revealed left ganglio capsular bleed. Child was treated with antihypertensives and steriods in view of suspected Takayasu arteritis. Child recovered with minimal hemiparesis and is being followed up.

  7. Life-threatening bleeding from gastric mucosal angiokeratomas during anticoagulation

    PubMed Central

    Kang, Eungu; Kim, Yoon-Myung; Kim, Dae-Hee; Yoo, Han-Wook; Lee, Beom Hee

    2017-01-01

    Abstract Rationale: Angiokeratomas are the earliest manifestation of Fabry disease (FD), and the extent of their appearance is related to disease severity. Angiokeratomas are mostly found on cutaneous regions. Patient concerns, diagnoses, interventions, and outcomes: Here we report an FD patient with widespread gastrointestinal angiokeratomas who developed life-threatening bleeding following anticoagulation for atrial fibrillation. Lessons: Careful observation for gastrointestinal bleeding is warranted for patients on anticoagulation with extensive cutaneous angiokeratomas. Furthermore, our experience suggests that surveillance is needed to assess the prevalence and extent of gastrointestinal angiokeratomas in patients with FD. PMID:28178158

  8. [Management of bleeding and coagulopathy following major trauma].

    PubMed

    Etxaniz, A; Pita, E

    2016-05-01

    Bleeding is the most common preventable cause of death in trauma patients. Acute traumatic coagulopathy is a specific condition with a different pathophysiology from other causes of the massive bleeding. An early identification of the coagulopathy is fundamental to implementing rapid treatment. There have been many changes in the management of massive hemorrhage, for example, the administration of the tranexamic acid and the use of balanced transfusion ratio. This review presents these practical points, some of them with scientific evidence, in order to achieve a beneficial effect for patient outcomes.

  9. Metastatic Testicular Choriocarcinoma: A Rare Cause of Upper GI Bleeding

    PubMed Central

    Paterson, Jacqueline; Armstrong, Sharon; Walsh, Shaun; Groome, Max; Mowat, Craig

    2015-01-01

    We present a case of upper gastrointestinal bleeding in an otherwise healthy 18-year-old man who presented with melena. Endoscopy revealed an ulcerated mass in the stomach and pathology confirmed this to be a malignant, poorly differentiated choriocarcinoma. Further imaging showed a left testicular mass with evidence of pulmonary, gastric, and brain metastases, and blood tests revealed an hCG level of 32,219 U/L. He was diagnosed with advanced metastatic testicular choriocarcinoma and underwent intensive induction chemotherapy and an orchidectomy. Metastatic testicular choriocarcinoma is a rare cause of gastrointestinal bleeding. PMID:26504875

  10. An unreported complication of intravenously administered ibuprofen: gastrointestinal bleeding.

    PubMed

    Sarici, S U; Dabak, O; Erdinc, K; Okutan, V; Lenk, M K

    2012-03-01

    Ibuprofen is used for the closure of ductus arteriosus either intravenously or enterally. Although intraventricular hemorrhage, necrotizing enterocolitis, bronchopulmonary dysplasia, transient renal failure, oliguria, hyponatremia and thrombocytopenia are reported complications during or after ibuprofen treatment, gastrointestinal bleeding, to our knowledge, has not been reported previously. We herein report a premature newborn, in whom ibuprofen was used intravenously for the closure of ductus arteriosus and gastrointestinal bleeding developed as a complication, and aim to discuss this rare adverse effect. In conclusion, we emphasize the importance of close follow-up of premature newborns during intravenous ibuprofen treatment considering also the other rare systemic side effects reported in the literature.

  11. Closed-loop air cooling system for a turbine engine

    DOEpatents

    North, William Edward

    2000-01-01

    Method and apparatus are disclosed for providing a closed-loop air cooling system for a turbine engine. The method and apparatus provide for bleeding pressurized air from a gas turbine engine compressor for use in cooling the turbine components. The compressed air is cascaded through the various stages of the turbine. At each stage a portion of the compressed air is returned to the compressor where useful work is recovered.

  12. 21 CFR 880.5045 - Medical recirculating air cleaner.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical recirculating air cleaner. 880.5045... Therapeutic Devices § 880.5045 Medical recirculating air cleaner. (a) Identification. A medical recirculating air cleaner is a device used to remove particles from the air for medical purposes. The device...

  13. 21 CFR 868.6250 - Portable air compressor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Portable air compressor. 868.6250 Section 868.6250...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Miscellaneous § 868.6250 Portable air compressor. (a) Identification. A portable air compressor is a device intended to provide compressed air for medical purposes,...

  14. 21 CFR 868.6250 - Portable air compressor.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Portable air compressor. 868.6250 Section 868.6250...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Miscellaneous § 868.6250 Portable air compressor. (a) Identification. A portable air compressor is a device intended to provide compressed air for medical purposes,...

  15. Control of shock-wave boundary-layer interactions by bleed in supersonic mixed compression inlets

    NASA Technical Reports Server (NTRS)

    Fukuda, M. K.; Reshotko, E.; Hingst, W. R.

    1975-01-01

    An experimental investigation has been conducted to determine the effect of bleed region geometry and bleed rate on shock wave-boundary layer interactions in an axisymmetric, mixed-compression inlet at a Mach number of 2.5. The full realizable reduction in transformed form factor is obtained by bleeding off about half the incident boundary layer mass flow. Bleeding upstream or downstream of the shock-induced pressure rise is preferable to bleeding across the shock-induced pressure rise. Slanted holes are more effective than normal holes. Two different bleed hole sizes were tested without detectable difference in performance.

  16. Physical stability and aerosol properties of liposomes delivered using an air-jet nebulizer and a novel micropump device with large mesh apertures.

    PubMed

    Elhissi, A M A; Faizi, M; Naji, W F; Gill, H S; Taylor, K M G

    2007-04-04

    The aerosol properties of liposomes and their physical stability to aerosolization were evaluated using an air-jet nebulizer (Pari LC Plus) and a customized large aperture vibrating-mesh nebulizer (Aeroneb Pro-8microm). Soya phosphatidylcholine: cholesterol (1:1 mole ratio) multilamellar liposomes (MLVs) entrapping salbutamol sulfate were nebulized directly, or after being reduced in size by extrusion through 1 or 0.4microm polycarbonate membrane filters. MLVs were very unstable to jet nebulization and stability was not markedly enhanced when vesicles were extruded before nebulization, such that drug losses from delivered liposomes using the Pari nebulizer were up to 88% (i.e. only 12% retained in liposomes). The Aeroneb Pro-8microm nebulizer was less disruptive to liposomes, completed nebulization in a much shorter time, and produced greater mass output rate than the Pari nebulizer. However, aerosol droplets were larger, total drug and mass outputs were lower and aerosolization performance was dependent on formulation. Vibrating-mesh nebulization was less disruptive to liposomes extruded through the 1microm membranes compared with the non-extruded MLVs, so that the retained entrapment of the drug in the nebulized vesicles was 56% and 37%, respectively. However, extrusion of liposomes to 0.4microm resulted in reduced stability of liposomes to vibrating-mesh nebulization (retained entrapment=41%) which was attributed to the reduced liposome lamellarity and subsequent reduced resistance to nebulization-induced shearing. This study has shown that vibrating-mesh nebulization using the customized large aperture mesh nebulizer (Aeroneb Pro-8microm) had a less disruptive effect on liposomes and produced a higher output rate compared with the Pari LC Plus air-jet nebulizer. On the other hand, the air-jet nebulizer produced higher total mass and drug outputs and smaller aerosol droplets.

  17. Two cases of vaginal bleeding in pet rats

    PubMed Central

    Sadar, Miranda J.; Parker, Dennilyn L.; Burgess, Hilary; Wojnarowicz, Chris

    2011-01-01

    Two unrelated rats were presented to the Western College of Veterinary Medicine emergency service for vaginal bleeding. Each was taken to surgery due to marked blood loss and suspicion of uterine pathology. Despite similar clinical presentation, gross and histopathologic examination revealed 2 different underlying disease processes, uterine dilatation with mild endometritis and vaginal polyp. PMID:22210942

  18. Bleeding Duodenal: Varices Treatment by TIPS and Transcatheter Embolization

    SciTech Connect

    Lopera, Jorge E. Arthurs, Blain; Scheuerman, Christian; Sandoz, Charles; Petersosn, Scott; Castaneda-Zuniga, Wildriodo

    2008-03-15

    We describe our clinical experience in 4 patients with portal hypertension who presented with bleeding mesenteric varices originating from the superior mesenteric vein with retrograde filling of collaterals draining into the inferior vena cava. The clinical presentation, imaging findings, and potential therapeutic management are discussed.

  19. Massive posttraumatic bleeding: epidemiology, causes, clinical features, and therapeutic management.

    PubMed

    Lippi, Giuseppe; Favaloro, Emmanuel J; Cervellin, Gianfranco

    2013-02-01

    Bleeding typically results as a consequence of derangements of primary hemostasis, secondary hemostasis, or both, and can be dramatically amplified by the presence of other predisposing conditions, especially inherited bleeding disorders. Life-threatening hemorrhages are, however, almost exclusively caused by penetrating wounds, blunt traumas of chest and abdomen, suicide attempts, amputations, bone fractures with concomitant injury to internal organs and blood vessels, and shearing forces from sudden rotation, violent flexion, extension, or deceleration injuries. The pathogenesis of posttraumatic bleeding is complex and multifaceted. The most dramatic phenomenon that always accompanies major hemorrhages is the abrupt and considerable loss of intravascular volume, that further leads to hypovolemic shock, also known as hemorrhagic shock, culminating with peripheral ischemia, especially in those tissues where oxygen delivery is more critical (i.e., central nervous system and myocardium). The mortality rate of severe posttraumatic bleeding can be as high as 50%, especially when an appropriate treatment is not established in a timely manner. The damage control sequence basically entails a four-step approach including damage control surgery, damage control resuscitation with fluid restoration, and hemocomponents administration, as well as correction of the coagulopathy with platelets, antifibrinolytic (e.g., tranexamic acid), and/or procoagulant agents such as fresh frozen plasma, prothrombin complex concentrate, or recombinant-activated Factor VII.

  20. The Effect of Ferric Chloride on Superficial Bleeding

    PubMed Central

    Nouri, Saeed; Sharif, Mohammad Reza; Sahba, Sare

    2015-01-01

    Background: Controlling superficial bleeding, despite all the progress in surgical science, is still a challenge in some settings. Objectives: This study assesses the hemostatic effects of ferric chloride and compares it with the standard method (suturing technique) to control superficial bleeding. Materials and Methods: In this animal model study, 60 male Wistar rats were used. An incision, 2 cm long and 0.5 cm deep was made on rat skin and the hemostasis time was recorded using ferric chloride at different concentrations (5%, 10%, 15%, 25%, and 50%) and then using a control (i.e. control of bleeding by suturing). The skin tissue was examined for pathological changes. Finally, the obtained data were entered into SPSS (ver. 16) and analyzed using Kruskal-Wallis test, Mann-Whitney, Kolmogorov-Smirnov, and Wilcoxon signed ranks test. Results: The hemostasis time for the ferric chloride concentration group was significantly less than for the control group (P < 0.001). Conclusions: Ferric chloride may be an effective hemostatic agent to control superficial bleeding in rats. PMID:25825694

  1. Management of anticoagulation in patients with acute gastrointestinal bleeding.

    PubMed

    Radaelli, Franco; Dentali, Francesco; Repici, Alessandro; Amato, Arnaldo; Paggi, Silvia; Rondonotti, Emanuele; Dumonceau, Jean Marc

    2015-08-01

    Acute gastrointestinal bleeding represents the most common adverse event associated with the use of oral anticoagulant therapy. Due to increasing prescription of anticoagulants worldwide, gastroenterologists are more and more called to deal with bleeding patients taking these medications. Their management is challenging because several issues have to be taken into account, such as the severity of bleeding, the intensity of anticoagulation, the patient's thrombotic risk and endoscopy findings. The recent introduction into the marketplace of new direct oral anticoagulants, for whom specific reversal agents are still lacking, further contributes to make the decision-making process even more demanding. Available evidence on this topic is limited and practice guidelines by gastroenterology societies only marginally address key issues for clinicians, including when and how to reverse coagulopathy, the optimal timing of endoscopy and when and how to resume anticoagulation thereafter. The present paper reviews the evidence in the literature and provides practical algorithms to support clinicians in the management of patients on anticoagulants who present with acute gastrointestinal bleeding.

  2. Inherited bleeding disorders: a 14-year retrospective study.

    PubMed

    Eid, Suhair S; Kamal, Nazmi R; Shubeilat, Taisir S; Wael, Abu-Ghoush Mohammed

    2008-01-01

    Congenital bleeding disorders comprise a heterogeneous group of diseases that reflect abnormalities of blood vessels, coagulation proteins, and platelets. A 14-year retrospective study (1991-2005) was conducted for patients referred to the coagulation section of the Hematology Department (King Hussein Medical Center, Amman, Jordan), who had suffered from bleeding tendencies to assess the prevalence of bleeding disorders among Jordanians and to describe their clinical manifestations. Four hundred and three patients matched our criteria. All patients were screened with routine coagulation assays and a complete blood cell count; a factor assay was performed if indicated by the results of the screening assays. A total of 168 patients (41.6%) were diagnosed with a bleeding disorder caused by a factor deficiency, of which 17.1% were described as hemophilia A (n=69), 6.2% were described as vWD (n=25), and 4.2% were described as hemophilia B (n=17). A subset of the total patient population comprising 14.1% of the patients were diagnosed with a Rare Inherited Coagulation Deficiency (RICD), where 4.0% were FX deficient (n=16), 3.7% were FVII deficient (n=15), 3.7% were FV deficient (n=15), 2.5% were FXI deficient (n=10), and 0.2% were diagnosed with afibrinogenemia (n=1).

  3. Hemoperitoneum secondary to intercostal arterial bleeding in a trauma patient

    PubMed Central

    Laeeq, K.; Cheung, S.; Phillips, B.

    2017-01-01

    Blunt trauma resulting in rib fractures can be associated with hemothorax, pneumothorax, pulmonary contusions or less frequently chest and abdominal wall hematomas. Our case describes the first report of hemoperitoneum secondary to intercostal arterial bleeding from blunt trauma in a patient on anticoagulation. PMID:28108633

  4. Next Generation Air Monitoring

    EPA Science Inventory

    Abstract. Air pollution measurement technology is advancing rapidly towards smaller-scale and wireless devices, with a potential to significantly change the landscape of air pollution monitoring. The U.S. EPA Office of Research and Development is evaluating and developing a rang...

  5. Nasal packing in sphenopalatine artery bleeding: therapeutic or harmful?

    PubMed

    Sireci, F; Speciale, R; Sorrentino, R; Turri-Zanoni, M; Nicolotti, M; Canevari, F R

    2017-03-01

    The aim of this study is to present our management protocol of sphenopalatine artery bleeding, demonstrating that nasoendoscopic cautery (NC) was a more effective method than the nasal packing, in terms of shorter inpatient stay and reduced complications rate. We present ten posterior epistaxis not resolved by nasal packing. Tabotamp(®) was placed in the area of sphenopalatine foramen and/or in those parts of the posterior nasal cavity, where it was suspected that bleeding origins. In two cases, the bleeding was resolved in this way, instead eight cases needed of subperiosteal cauterization of sphenopalatine artery by Dessi bipolar forceps (MicroFrance(®)). 4 of these 8 patients evidenced a remarkable bleeding removing nasal packing (Hb before-nasal packing = 15 ± 0.69 versus Hb after-nasal packing = 13.3 ± 0.81; t student = 2.94; p value = 0.025). These four patients showed a deviation of the nasal septum ipsilateral to epistaxis, and according our experience, a traumatism of sphenopalatine area can be caused by Merocel(®) nasal packing in this condition. During follow-up, no recurrences of nasal bleeding have been observed in such patients. Nasal packing must be considered if posterior epistaxis is severe, but always taking into account the specific anatomy of patient and in particular septal spurs that can further compromise sphenopalatine artery. In our experience, the endoscopic endonasal cauterization of the sphenopalatine branches represented a safe and effective procedure.

  6. Assessment of multi-modality evaluations of obscure gastrointestinal bleeding

    PubMed Central

    Law, Ryan; Varayil, Jithinraj E; WongKeeSong, Louis M; Fidler, Jeff; Fletcher, Joel G; Barlow, John; Alexander, Jeffrey; Rajan, Elizabeth; Hansel, Stephanie; Becker, Brenda; Larson, Joseph J; Enders, Felicity T; Bruining, David H; Coelho-Prabhu, Nayantara

    2017-01-01

    AIM To determine the frequency of bleeding source detection in patients with obscure gastrointestinal bleeding (OGIB) who underwent double balloon enteroscopy (DBE) after pre-procedure imaging [multiphase computed tomography enterography (MPCTE), video capsule endoscopy (VCE), or both] and assess the impact of imaging on DBE diagnostic yield. METHODS Retrospective cohort study using a prospectively maintained database of all adult patients presenting with OGIB who underwent DBE from September 1st, 2002 to June 30th, 2013 at a single tertiary center. RESULTS Four hundred and ninety five patients (52% females; median age 68 years) underwent DBE for OGIB. AVCE and/or MPCTE performed within 1 year prior to DBE (in 441 patients) increased the diagnostic yield of DBE (67.1% with preceding imaging vs 59.5% without). Using DBE as the gold standard, VCE and MPCTE had a diagnostic yield of 72.7% and 32.5% respectively. There were no increased odds of finding a bleeding site at DBE compared to VCE (OR = 1.3, P = 0.150). There were increased odds of finding a bleeding site at DBE compared to MPCTE (OR = 5.9, P < 0.001). In inpatients with overt OGIB, diagnostic yield of DBE was not affected by preceding imaging. CONCLUSION DBE is a safe and well-tolerated procedure for the diagnosis and treatment of OGIB, with a diagnostic yield that may be increased after obtaining a preceding VCE or MPCTE. However, inpatients with active ongoing bleeding may benefit from proceeding directly to antegrade DBE. PMID:28216967

  7. Resuscitation of Polytrauma Patients: The Management of Massive Skeletal Bleeding

    PubMed Central

    Guerado, Enrique; Bertrand, Maria Luisa; Valdes, Luis; Cruz, Encarnacion; Cano, Juan Ramon

    2015-01-01

    The term ‘severely injured patient’ is often synonymous of polytrauma patient, multiply-injured patient or, in some settings, polyfractured patient. Together with brain trauma, copious bleeding is the most severe complication of polytrauma. Consequently hypotension develop. Then, the perfusion of organs may be compromised, with the risk of organ failure. Treatment of chest bleeding after trauma is essential and is mainly addressed via surgical manoeuvres. As in the case of lesions to the pelvis, abdomen or extremities, this approach demonstrates the application of damage control (DC). The introduction of sonography has dramatically changed the diagnosis and prognosis of abdominal bleeding. In stable patients, a contrast CT-scan should be performed before any x-ray projection, because, in an emergency situation, spinal or pelvic fractures be missed by conventional radiological studies. Fractures or dislocation of the pelvis causing enlargement of the pelvic cavity, provoked by an anteroposterior trauma, and in particular cases presenting vertical instability, are the most severe types and require fast stabilisation by closing the pelvic ring diameter to normal dimensions and by stabilising the vertical shear. Controversy still exists about whether angiography or packing should be used as the first choice to address active bleeding after pelvic ring closure. Pelvic angiography plays a significant complementary role to pelvic packing for final haemorrhage control. Apart from pelvic trauma, fracture of the femur is the only fracture provoking acute life-threatening bleeding. If possible, femur fractures should be immobilised immediately, either by external fixation or by a sheet wrap around both extremities. PMID:26312112

  8. Comparison of Bypassing Agents in Bleeding Reduction in Treatment of Bleeding Episodes in Patients With Haemophilia and Inhibitors

    PubMed Central

    Golestani, Mina; Eshghi, Peyman; Rasekh, Hamid Reza; Cheraghali, Abdol Majid; Salamzadeh, Jamshid; Imani, Ali

    2014-01-01

    Context: Mild-to-moderate bleeding disorders in haemophilia are primarily treated via recombinant activated factor VII a (rFVIIa) or activated prothrombin complex concentrate (aPCC). However, the efficacy of each bypassing agents may vary and none of them is universally effective. Evidence Acquisition: After reviewing the databases of PubMed, Scopus, MD Consult, Ovid, Trip database, Google Scholar, ProQuest and the Cochrane Library, finally, 17 papers published from 2000 to 2013 were extracted. We used as a random effect model in meta-analysis. Comprehensive meta-analysis (CMA) software was used for calculating and estimating the mean of bleeding reduction and performing meta-analysis. Results: The mean of bleeding reduction in aPCC and rFVIIa were 71.2% with CI 95% (lower limit 86.8% and upper limit 82%) and 72.3% with CI 95% (lower limit 57.6% and upper limit 83.4%), respectively. Conclusions: Although differences between the two products were very close to each other, they reported similar effects on joint bleeds. Further clinical studies should be performed by incorporating a standardized measurement in comparative efficacy of aPCC and rFVIIa. PMID:25763245

  9. Standardizing the descriptive terminology of abnormal menstrual bleeding: it is time we talk the same talk.

    PubMed

    Bayer, Steven R

    2007-03-01

    The movement towards international standardization of the terminology used to describe abnormal uterine bleeding and of the definition that sets the boundaries of normal menstrual bleeding will greatly benefit clinicians and researchers.

  10. Control of shock wave-boundary layer interactions by bleed in supersonic mixed compression inlets

    NASA Technical Reports Server (NTRS)

    Fukuda, M. K.; Hingst, W. G.; Reshotko, E.

    1975-01-01

    An experimental investigation was conducted to determine the effect of bleed on a shock wave-boundary layer interaction in an axisymmetric mixed-compression supersonic inlet. The inlet was designed for a free-stream Mach number of 2.50 with 60-percent supersonic internal area contraction. The experiment was conducted in the NASA Lewis Research Center 10-Foot Supersonic Wind Tunnel. The effects of bleed amount and bleed geometry on the boundary layer after a shock wave-boundary layer interaction were studied. The effect of bleed on the transformed form factor is such that the full realizable reduction is obtained by bleeding of a mass flow equal to about one-half of the incident boundary layer mass flow. More bleeding does not yield further reduction. Bleeding upstream or downstream of the shock-induced pressure rise is preferable to bleeding across the shock-induced pressure rise.

  11. Von Willebrand factor in patients on mechanical circulatory support - a double-edged sword between bleeding and thrombosis.

    PubMed

    Hudzik, Bartosz; Kaczmarski, Jacek; Pacholewicz, Jerzy; Zakliczynski, Michal; Gasior, Mariusz; Zembala, Marian

    2015-09-01

    Mechanical circulatory support (MCS) is an umbrella term describing the various technologies used in both short- and long-term management of patients with either end-stage chronic heart failure (HF) or acute HF. Most often, MCS has emerged as a bridge to transplantation, but more recently it is also used as a destination therapy. Mechanical circulatory support includes left ventricular assist device (LVAD) or bi-ventricular assist device (Bi-VAD). Currently, 2- to 3-year survival in carefully selected patients is much better than with medical therapy. However, MCS therapy is hampered by sometimes life-threatening complications including bleeding and device thrombosis. Von Willebrand factor (vWF) has two major functions in haemostasis. First, it plays a crucial role in platelet-subendothelium adhesion and platelet-platelet interactions (aggregation). Second, it is the carrier of factor VIII (FVIII) in plasma. Von Willebrand factor prolongs FVIII half-time by protecting it from proteolytic degradation. It delivers FVIII to the site of vascular injury thus enhancing haemostatic process. On one hand, high plasma levels of vWF have been associated with an increased risk of thrombosis. On the other, defects or deficiencies of vWF underlie the inherited von Willebrand disease or acquired von Willebrand syndrome. Here we review the pathophysiology of thrombosis and bleeding associated with vWF.

  12. Endoscopic Management of Gastrointestinal Leaks and Bleeding with the Over-the-Scope Clip: A Prospective Study

    PubMed Central

    Goenka, Mahesh Kumar; Rai, Vijay Kumar; Goenka, Usha; Tiwary, Indrajit Kumar

    2017-01-01

    Background/Aims The over-the-scope clip (OTSC) is a device used for endoscopic closure of perforations, leaks and fistulas, and for endoscopic hemostasis. To evaluate the clinical effectiveness and safety of OTSC. Methods Between October 2013 and November 2015, 12 patients underwent OTSC placement by an experienced endoscopist. OTSC was used for the closure of gastrointestinal (GI) leaks and fistula in six patients, three of which were iatrogenic (esophageal, gastric, and duodenal) and three of which were inflammatory. In six patients, OTSC was used for hemostasis of non-variceal upper GI bleeding. Endoscopic tattooing using India ink was used to assist the accurate placement of the clip. Results All subjects except one with a colonic defect experienced immediate technical success as well as long-term clinical success, during a mean follow-up of 6 weeks. Only one clip was required to close each of the GI defects and to achieve hemostasis in all patients. There were no misfirings or complications of clips. The procedure was well tolerated, and patients were hospitalized for an average of 8 days (range, 3 to 10). Antiplatelet therapy was continued in patients with GI bleeding. Conclusions In our experience, OTSC was safe and effective for the closure of GI defect and to achieve hemostasis of non-variceal GI bleeding. PMID:27802375

  13. A needle trap device packed with a sol-gel derived, multi-walled carbon nanotubes/silica composite for sampling and analysis of volatile organohalogen compounds in air.

    PubMed

    Heidari, Mahmoud; Bahrami, Abdolrahman; Ghiasvand, Ali Reza; Shahna, Farshid Ghorbani; Soltanian, Ali Reza

    2013-06-27

    A needle trap device (NTD) packed with silica composite of multi-walled carbon nanotubes (MWCNTs) prepared based on sol-gel technique was utilized for sampling and analysis of volatile organohalogen compounds (HVOCs) in air. The performance of the NTD packed with MWCNTs/silica composite as sorbent was examined in a variety of sampling conditions and was compared with NTDs packed with PDMS as well as SPME with Carboxen/PDMS-coated fibers. The limit of detection of NTDs for the GC/MS detection system was 0.01-0.05 ng mL(-1) and the limit of quantitation was 0.04-0.18 ng mL(-1). The RSD were 1.1-7.8% for intra-NTD comparison intended for repeatability of technique. The NTD-MWCNTs/silica composite showed better analytical performances compared to the NTD-PDMS composite and had the same analytical performances when compared to the SPME-Carboxen/PDMS fibers. The results show that NTD-MWCNTs-GC/MS is a powerful technique for active sampling of occupational/environmental pollutants in air.

  14. CIRSE Vascular Closure Device Registry

    SciTech Connect

    Reekers, Jim A.; Mueller-Huelsbeck, Stefan; Libicher, Martin; Atar, Eli; Trentmann, Jens; Goffette, Pierre; Borggrefe, Jan; Zelenak, Kamil; Hooijboer, Pieter; Belli, Anna-Maria

    2011-02-15

    Purpose: Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. Methods: The CIRSE registry of closure devices with an anchor and a plug started in January 2009 and ended in August 2009. A total of 1,107 patients were included in the registry. Results: Deployment success was 97.2%. Deployment failure specified to access type was 8.8% [95% confidence interval (95% CI) 5.0-14.5] for antegrade access and 1.8% (95% CI 1.1-2.9) for retrograde access (P = 0.001). There was no difference in deployment failure related to local PVD at the access site. Calcification was a reason for deployment failure in only <0.5% of patients. Postdeployment bleeding occurred in 6.4%, and most these (51.5%) could be managed with light manual compression. During follow-up, other device-related complications were reported in 1.3%: seven false aneurysms, three hematoma >5.9 cm, and two vessel occlusions. Conclusion: The conclusion of this registry of closure devices with an anchor and a plug is that the use of this device in interventional radiology procedures is safe, with a low incidence of serious access site complications. There seems to be no difference in complications between antegrade and retrograde access and other parameters.

  15. Comparison of thrombin generation assay with conventional coagulation tests in evaluation of bleeding risk in patients with rare bleeding disorders.

    PubMed

    Zekavat, Omid R; Haghpanah, Sezaneh; Dehghani, Javad; Afrasiabi, Abdolreza; Peyvandi, Flora; Karimi, Mehran

    2014-09-01

    Based on the premise that the capacity of plasma to generate thrombin in vitro is a comprehensive and precise functional test of the clotting system, we designed a cross-sectional, single-center study involving 83 patients with rare bleeding disorders (RBDs) to compare the usefulness of the thrombin generation (TG) assay versus conventional tests including prothrombin time (PT) and activated partial thromboplastin time (aPTT) in predicting bleeding risk in patients with RBD in southern Iran. The TG parameters consisted of endogenous thrombin potential, lag time, peak, time to peak (ttPeak), and start tail. The area under the receiver-operating characteristic (ROC) curve showed statistically significant associations between bleeding risk and lag time, ttPeak, and start tail. We determined cutoff values for these 3 TG parameters and obtained a negative predictive value of 86% to 90% in patients with RBD who had a bleeding score (BS) ≤13. The ROC curves for the association of PT and aPTT with BS did not indicate any significant association. Correlation analysis supported the results of ROC curve analysis, only lag time, ttPeak, and start tail showed significant positive correlations with BS (P < .05). Disease severity based on plasma factor activity was significantly associated with prolonged lag time and ttPeak and with prolonged PT (P <.05). We suggest that TG assay is a potentially more useful tool for predicting the bleeding risk in patients with RBD. However, the small sample size in different RBD subgroups precluded subgroup analysis. Prospective multicenter studies with larger numbers of patients are therefore advisable.

  16. Coagulation is more affected by quick than slow bleeding in patients with massive blood loss.

    PubMed

    Zhao, Juan; Yang, Dejuan; Zheng, Dongyou

    2017-03-01

    Profuse blood loss affects blood coagulation to various degrees. However, whether bleeding speed affects coagulation remains uncertain. This study aimed to evaluate the effect of bleeding speed on coagulation function. A total of 141 patients in the Department of Thoracic Surgery of our hospital were evaluated between January 2007 and February 2014. There are two groups of patients, those who received decortication for chronic encapsulated empyema were called the slow-bleeding group, and those who received thoracoscopic upper lobectomy were called the fast bleeding group; each group was further subdivided into three: group A, 1000 ml ≤ bleeding amount < 1500 ml; group B, 1500 ml ≤ bleeding amount < 1700 ml; group C, 1700 ml ≤ bleeding amount < 2000 ml. Then, coagulation function was assessed in all patients before and during surgery and at 1, 2, and 24 h after surgery, measuring prothrombin time, activated partial thromboplastin time (APTT), fibrinogen, blood pressure, hematocrit, hemoglobin, and platelets. Bleeding duration was overtly longer in the slow-bleeding group than that in quick bleeding individuals (2.3 ± 0.25 h vs. 0.41 ± 0.13 h, P < 0.001). Fibrinogen, hematocrit, hemoglobin, and platelets strikingly decreased, whereas prothrombin time and APTT values significantly increased with bleeding amounts in both quick and slow-bleeding groups. Interestingly, compared with slow-bleeding patients, coagulation indices at each time point and bleeding amounts had significant differences in the quick bleeding group.Increased consumption of coagulation factors in quick bleeding may have greater impact on coagulation function.

  17. Efficacy of eltrombopag in management of bleeding symptoms associated with chronic immune thrombocytopenia.

    PubMed

    Tarantino, Michael D; Fogarty, Patrick; Mayer, Bhabita; Vasey, Sandra Y; Brainsky, Andres

    2013-04-01

    Bleeding is of particular clinical importance in the management of chronic immune thrombocytopenia (ITP), which involves impaired platelet production and accelerated destruction. We report the first comprehensive analysis of the impact of eltrombopag on bleeding in five clinical studies of adult chronic ITP: two 6-week phase 2 (TRA100773A) and phase 3 (TRA100773B) studies; a 6-month phase 3 study (RAISE); a phase 2 repeat-dose study (REPEAT); and a phase 3 extension study (EXTEND). Bleeding was assessed using the World Health Organization Bleeding Scale and categorized as no bleeding (grade 0), any bleeding (grades 1-4), and clinically significant bleeding (grades 2-4). Bleeding was also assessed using National Cancer Institute Common Terminology Criteria for Adverse Events v3.0. Across all studies, bleeding at baseline ranged from 50 to 73% for eltrombopag-treated patients; by week 2, bleeding had decreased, ranging from 26 to 39%. This trend was maintained throughout treatment. Similar results were observed for clinically significant bleeding. No such trend was seen in placebo-treated patients for any bleeding or clinically significant bleeding. For TRA100773B and RAISE, the odds of any bleeding across the entire treatment period were 51 and 76% lower for eltrombopag-treated versus placebo-treated patients (P=0.021, P<0.001). The odds of clinically significant bleeding in RAISE were 65% lower (P<0.001). In conclusion, analysis of prospective data from five clinical studies demonstrates that eltrombopag significantly reduces bleeding in adult patients with chronic ITP.

  18. Pseudoaneurysm of the internal iliac artery resulting in massive per-rectal bleeding

    PubMed Central

    Arthur, T.I.; Gillespie, C.J.; Butcher, W.; Lu, C.T.

    2013-01-01

    Rectal bleeding is a common reason for presentation to hospital, with large bleeds most commonly caused by diverticular disease and angiodysplasia. Here we present an unusual aetiology of massive per-rectal bleeding attributable to pseudoaneurysm of the internal iliac artery leading to an arterial fistula to the distal large bowel. It is hoped the case will serve as a reminder that rectal bleeding can have a less common aetiology. PMID:24964318

  19. Pediatric ventricular assist devices

    PubMed Central

    Burki, Sarah; Zafar, Farhan; Morales, David Luis Simon

    2015-01-01

    The domain of pediatric ventricular assist device (VAD) has recently gained considerable attention. Despite the fact that, historically, the practice of pediatric mechanical circulatory support (MCS) has lagged behind that of adult patients, this gap between the two groups is narrowing. Currently, the Berlin EXCOR VAD is the only pediatric-specific durable VAD approved by the U.S Food and Drug Administration (FDA). The prospective Berlin Heart trial demonstrated a successful outcome, either bridge to transplantation (BTT), or in rare instances, bridge to recovery, in approximately 90% of children. Also noted during the trial was, however, a high incidence of adverse events such as embolic stroke, bleeding and infection. This has incentivized some pediatric centers to utilize adult implantable continuous-flow devices, for instance the HeartMate II and HeartWare HVAD, in children. As a result of this paradigm shift, the outlook of pediatric VAD support has dramatically changed: Treatment options previously unavailable to children, including outpatient management and even destination therapy, have now been becoming a reality. The sustained demand for continued device miniaturization and technological refinements is anticipated to extend the range of options available to children—HeartMate 3 and HeartWare MVAD are two examples of next generation VADs with potential pediatric application, both of which are presently undergoing clinical trials. A pediatric-specific continuous-flow device is also on the horizon: the redesigned Infant Jarvik VAD (Jarvik 2015) is undergoing pre-clinical testing, with a randomized clinical trial anticipated to follow thereafter. The era of pediatric VADs has begun. In this article, we discuss several important aspects of contemporary VAD therapy, with a particular focus on challenges unique to the pediatric population. PMID:26793341

  20. Scintigraphic demonstration of acute gastrointestinal bleeding caused by gallbladder carcinoma eroding the colon

    SciTech Connect

    Czerniak, A.; Zwas, S.T.; Rabau, M.Y.; Avigad, I.; Borag, B.; Wolfstein, I.

    1985-08-01

    Massive lower gastrointestinal (GI) bleeding caused by gallbladder carcinoma eroding into the colonic wall was demonstrated accurately by Tc-99m RBCs. In addition, retrograde bleeding into the gallbladder was also identified while arteriography did not show contrast extravasation. This case supports the use of Tc-99m RBCs over Tc-99m sulfur colloid for more accurate localization of lower GI bleeding.