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Sample records for double balloon endoscopy

  1. Microscopic polyangiitis complicated with ileal involvement detected by double-balloon endoscopy: a case report.

    PubMed

    Fukushima, Masashi; Inoue, Satoko; Ono, Yuichiro; Tamaki, Yoshitaka; Yoshimura, Hajime; Imai, Yukihiro; Inokuma, Tetsuro

    2013-03-02

    Microscopic polyangiitis is characterized by pauci-immune, necrotizing small-vessel vasculitis and an anti-neutrophil cytoplasmic antibody-associated vasculitis. Although gastrointestinal involvement in microscopic polyangiitis is not rare, endoscopic observation of it is extremely rare. To the best of our knowledge, this is the first case report of small intestinal involvement in microscopic polyangiitis detected and followed up by double-balloon endoscopy. A 70-year-old Japanese woman was transferred to our hospital for close examination of suspected small intestinal lymphoma. Retrograde double-balloon endoscopy revealed various forms of ulcers with redness and edema in the ileum. Histological findings suggested ischemic changes. Because mononeuritis multiplex and a fever spike appeared later, vasculitis was suspected. The perinuclear anti-neutrophil cytoplasmic antibody titer was elevated. Nerve biopsy results suggested vasculitis. From these findings, microscopic polyangiitis was diagnosed. It was suggested that microscopic polyangiitis caused the intestinal involvement. Intravenous pulse cyclophosphamide and oral predonisolone were started. After treatment, perinuclear anti-neutrophil cytoplasmic antibodies decreased to the normal range. Retrograde double-balloon endoscopy after treatment showed ulcer scars and no ulcer. The cause of gastrointestinal involvement in microscopic polyangiitis is ischemia due to vasculitis. It is difficult to diagnose small-vessel vasculitis by endoscopic biopsy. Although histological evidence of microscopic polyangiitis is important, the treatment should not be delayed by repeating the biopsy, because such delay can result in adverse sequela.This case report shows that microscopic polyangiitis should be considered as a differential diagnosis when small intestinal changes like those in the present case are observed by endoscopy.

  2. Successful treatment of early-stage jejunum adenocarcinoma by endoscopic mucosal resection using double-balloon endoscopy: a case report.

    PubMed

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

    2012-01-01

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

  3. Multifocal Carcinoid Tumor of Small Intestine: A Rare Cause of Chronic Obscure Gastrointestinal Bleeding, Suspected on Capsule Endoscopy and Diagnosed on Double Balloon Enteroscopy

    PubMed Central

    Hernandez, Jose C.; Rojas, Juan; Gurudu, Suryakanth R.

    2011-01-01

    We reported a case of multifocal carcinoid tumor of small intestine causing chronic obscure gastrointestinal bleeding, suspected on capsule endoscopy and diagnosed on double balloon enteroscopy. PMID:27942327

  4. Route selection for double-balloon endoscopy, based on capsule transit time, in obscure gastrointestinal bleeding.

    PubMed

    Nakamura, Masanao; Ohmiya, Naoki; Shirai, Osamu; Takenaka, Hiroyuki; Morishima, Kenji; Miyahara, Ryoji; Ando, Takafumi; Watanabe, Osamu; Kawashima, Hiroki; Itoh, Akihiro; Hirooka, Yoshiki; Goto, Hidemi

    2010-06-01

    Double-balloon endoscopy (DBE) utilizes both oral and anal routes. The proper selection of the initial route is important for more rapid management of obscure gastrointestinal bleeding (OGIB). The aim of this retrospective study was to clarify the accuracy of the transit time of video capsule endoscopy (VCE) to the lesion as a predictive indicator for the decision on the initial DBE route. Of 172 patients who underwent both DBE and VCE, 65 who were diagnosed with small-intestinal hemorrhagic lesions by both means were enrolled. The relation between VCE transit time to the lesion and the DBE route by which the lesion was discovered was analyzed, distinguishing between 46 complete and 19 incomplete VCEs. Among the 46 patients with a complete VCE, the transit time and position of the lesion were strongly correlated. The best cutoff values for route selection by the VCE transit time from capsule intake and from the duodenal bulb to the lesion, determined using a receiver operating characteristic (ROC) curve, were 60% and 50%, respectively, of the transit time to the cecum. At that point, the accuracy of route selection was 90% and 94%, respectively. Positions shown by VCE for ileal lesions tended to be more proximal than those shown by surgery. In the 19 patients with incomplete VCEs, the best cutoff for transit time was 180 min from the duodenal bulb. The VCE transit time was useful for determining the route for DBE in OGIB. This parameter was most accurate when the cutoff value for the selection was half of the small-bowel transit time in the complete VCE examination.

  5. Metallic stent insertion with double-balloon endoscopy for malignant afferent loop obstruction

    PubMed Central

    Fujii, Masakuni; Ishiyama, Shuhei; Saito, Hiroaki; Ito, Mamoru; Fujiwara, Akiko; Niguma, Takefumi; Yoshioka, Masao; Shiode, Junji

    2015-01-01

    Progress in double-balloon endoscopy (DBE) has allowed for the diagnosis and treatment of disease in the postoperative bowel. For example, a short DBE, which has a 2.8 mm working channel and 152 cm working length, is useful for endoscopic retrograde cholangiopancreatography in bowel disease patients. However, afferent loop and Roux-limb obstruction, though rare, is caused by postoperative recurrence of biliary tract cancer with intractable complications. Most of the clinical findings involving these complications are relatively nonspecific and include abdominal pain, nausea, vomiting, fever, and obstructive jaundice. Treatments by surgery, percutaneous transhepatic biliary drainage, percutaneous enteral stent insertion, and endoscopic therapy have been reported. The general conditions of patients with these complications are poor due to cancer progression; therefore, a less invasive treatment is better. We report on the usefulness of metallic stent insertion using an overtube for afferent loop and Roux-limb obstruction caused by postoperative recurrence of biliary tract cancer under short DBE in two patients with complexly reconstructed intestines. PMID:26078835

  6. Comparison of Capsule Endoscopy Findings to Subsequent Double Balloon Enteroscopy: A Dual Center Experience

    PubMed Central

    Kalra, Amandeep S.; Walker, Andrew J.; Benson, Mark E.; Soni, Anurag; Guda, Nalini M.; Misha, Mehak; Gopal, Deepak V.

    2015-01-01

    Background. There has been a growing use of both capsule endoscopy (CE) and double balloon enteroscopy (DBE) to diagnose and treat patients with obscure gastrointestinal blood loss and suspected small bowel pathology. Aim. To compare and correlate sequential CE and DBE findings in a large series of patients at two tertiary level hospitals in Wisconsin. Methods. An IRB approved retrospective study of patients who underwent sequential CE and DBE, at two separate tertiary care academic centers from May 2007 to December 2011, was performed. Results. 116 patients were included in the study. The mean age ± SD was 66.6 ± 13.2 years. There were 56% males and 43.9% females. Measure of agreement between prior capsule and DBE findings was performed using kappa statistics, which gave kappa value of 0.396 with P < 0.001. Also contingency coefficient was calculated and was found to be 0.732 (P < 0.001). Conclusions. Our study showed good overall agreement between DBE and CE. Findings of angioectasia had maximum agreement of 69%. PMID:26420979

  7. Double-Balloon Endoscopy in Overt and Occult Small Bowel Bleeding: Results, Complications, and Correlation with Prior Videocapsule Endoscopy in a Tertiary Referral Center

    PubMed Central

    Hermans, Carlijn; Stronkhorst, Arnold; Tjhie-Wensing, Annemarie; Kamphuis, Jan; van Balkom, Bas; Dahlmans, Rob; Gilissen, Lennard

    2017-01-01

    Background/Aims Videocapsule endoscopy (VCE) and double-balloon endoscopy (DBE) allow deep exploration in patients with suspected small bowel pathology. VCE is often performed as an initial small bowel examination to explore whether an intervention by DBE is indicated and to determine insertion route. The study aim was to evaluate the correlation between DBE and VCE in patients with obscure or overt bleeding or anemia, as well as intervention frequency, and complications. Methods Retrospective observational study. Results DBE procedures (n=205) showed small bowel lesions in 64% cases. Antegrade DBE showed positive results in 79% cases, mostly angiodysplasias (63%). Retrograde DBE showed positive results in 22% cases. An intervention was performed in 64% of DBE procedures. The major complication rate was 0.5%, which was one case of perforation. Pancreatitis did not occur. The overall diagnostic agreement was 66% among the 134 DBEs with preceded VCE. Conclusions In cases of overt or occult bleeding or anemia, DBE was positive in 64%, with only a few complications. Positive correlation was 66% among initially performed VCEs and DBEs. Owing to the time-consuming and invasive character of DBE, performing VCE before DBE might still be clinically relevant. PMID:28076941

  8. Clinical characteristics of small bowel tumors diagnosed by double-balloon endoscopy: KASID multi-center study.

    PubMed

    Lee, Bo-In; Choi, Hwang; Choi, Kyu-Yong; Byeon, Jeong-Sik; Jang, Hyun-Joo; Eun, Chang-Soo; Cheon, Jae Hee; Shin, Sung Jae; Kim, Jin-Oh; Lee, Moon-Sung; Choi, Jai-Hyun

    2011-10-01

    Small bowel tumors are relatively rare, and their confirmative diagnosis before surgery is not easy. This study was performed to investigate the clinical characteristics of patients with small bowel tumors who received double-balloon enteroscopy (DBE). Secondary end points were to evaluate the usefulness and safety of DBE for the diagnosis of patients with suspected SB tumors derived from other previous procedures. We retrospectively analyzed consecutive DBE examinations to explore the small intestine in eight university hospitals over a 5-year period. A total of 877 DBE examinations (per oral 487, per anal 390) were performed in 645 patients (405 males, mean age 48.2 years). Small bowel tumors were diagnosed in 112 patients (17.4%), of which 38 patients had benign polyps, 29 had gastrointestinal stromal tumors/leiomyomata, 18 had lymphomas, 14 had adenocarcinomas, five had metastatic or invasive cancers, five had lipomas, and three patients had cystic tumors. The main reasons for DBE among patients with small bowel tumors were obscure gastrointestinal bleeding (OGIB, 40.2%) followed by abnormal imaging study (25.2%). The concordance rate of diagnoses based on DBE with diagnoses based on small bowel follow-through, CT, and capsule endoscopy among patients with small bowel tumors was 68.9% (42/61), 75.3% (70/93), and 78.3% (18/23), respectively. Therapeutic plans were changed due to the DBE results in 64.2% of patients with small bowel tumors. Approximately one-sixth of patients who received DBE had small bowel tumors, and the most common reason for DBE among patients with small bowel tumors was OGIB. DBE is a useful method for the confirmative diagnosis of small bowel tumors and has a good clinical impact on therapeutic plans and short-term clinical results.

  9. A case of penetration of the intestinal wall by a soft-shelled turtle bone successfully removed with double-balloon endoscopy.

    PubMed

    Sawada, Mizuho; Sekigawa, Kenichiro; Mitsui, Hiroshi; Kobayashi, Katsuya; Okubo, Masao; Yamaguchi, Hajime; Hashimoto, Naoaki

    2015-10-01

    A 62-year-old male was admitted to our hospital due to left lower abdominal pain. Three days before admission, he ate seafood in a Japanese restaurant. Two days before admission, he suffered from intermittent left lower abdominal pain. One day before admission, he developed a high fever and subsequently visited our hospital the following day. Localized tenderness and rebound pain were observed in the left lower abdomen, and C-reactive protein was elevated. Computed tomography revealed a linear high-density object in the distal portion of the small intestine accompanied by edema of the wall, suggesting penetration by something like a fishbone. On the ninth hospital day, double-balloon endoscopy was performed via the transanal route. Yellow foreign material was found in the ileum and was then successfully removed with biopsy forceps. The removed material measured 3 mm in width, 3 cm in length and was slightly curved. It proved to be a bone of the forefoot of a soft-shelled turtle, which had been included on the menu of the restaurant. The patient was completely cured and discharged on the 14th hospital day.

  10. Percutaneous balloon pericardiotomy: a double-balloon technique.

    PubMed

    Iaffaldano, R A; Jones, P; Lewis, B E; Eleftheriades, E G; Johnson, S A; McKiernan, T L

    1995-09-01

    We describe a double-balloon technique for performing a percutaneous balloon pericardiotomy. This technique was employed when the large, single dilation balloon customarily used for this procedure failed to fully inflate across the parietal pericardium. Two smaller balloons were advanced through the same skin tract and simultaneously inflated, thus producing an adequate pericardial window. This double-balloon technique allowed for the more secure anchoring of the balloons across the pericardium and for the delivery of greater dilation pressures.

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

    PubMed Central

    Akyuz, Umit; Akyuz, Filiz

    2016-01-01

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

  12. [Double balloon enteroscopy. First surgical experience].

    PubMed

    Tonus, C; Neupert, G; Glaser, H-J; Stienecker, K

    2008-05-01

    In Germany double balloon enteroscopy (DBE) has been used for about 4 years in diagnostics of the small intestine. Testing for the first time its value in daily surgical practice, we analyzed retrospectively the results of all DBE examinations from December 2004 to September 2006. During the study period 106 enteroscopies were performed on 75 patients (42 males, 33 females, age 16-84 years). The approach was oral in 75 cases and anal in 31. Most indications were recurrent middle gastrointestinal bleeding. Complete small intestine inspection could be performed completely orally in seven of 106 examinations; and in most cases a combined oral/anal approach was required. Total endoscopy was completed in 21.3% of the patients studied. Pathologies were detected in 41 examinations (54.7%). These included 11 patients with angiodysplasias (14.7%) successfully treated with argon plasma coagulation (APC) and seven patients with small intestinal polyps (9.3%) that could be removed endoscopically. Further findings included diverticulum (6.7%), changes related to Crohn's disease (4.0%), small intestinal tumors (4.0%), extraluminar disorders (2.6%), stenoses (1.3%), and others (8.0%). Secondary diagnoses included colonic/rectal lesions in 5.3% of cases and pathologies of the stomach or esophagus in 4.0%. One patient had severe complications from a perforation following polypectomy. Therapies followed in 40.0% of all patients examined. Surgical interventions were indicated in six of 75 patients (8.0%), specifically five small intestinal resections and one bypass operation due to an infiltrating pancreas carcinoma. Endoscopic interventions were used in 25.3% of patients and medical treatment in 10.7%. With adequate indication, DBE shows very high diagnostic value. Immediate endoscopic therapy is possible in most cases, a considerable advantage over previous methods. Surgery was indicated for 8.0% of those examined in our study group, whereas the literature until now describes

  13. Safety and Efficacy of a New Swallowable Intragastric Balloon Not Needing Endoscopy: Early Italian Experience.

    PubMed

    Genco, A; Ernesti, I; Ienca, R; Casella, G; Mariani, S; Francomano, D; Soricelli, E; Lorenzo, M; Monti, M

    2017-09-04

    The aim of this study was to evaluate the safety and efficacy of a new intragastric balloon (Elipse™ Balloon, Allurion Technologies, Natick, MA USA) not needing endoscopy. The balloon was swallowed under fluoroscopy in 38 consecutive patients (F/M 28/10, mean age 46.4 ± 10.6 years, mean weight 109.7 ± 21.9 kg, and mean body mass index (BMI) 38.6 ± 6.7 kg/m(2)). After 4 months, the balloon spontaneously emptied and it was excreted through the digestive tract without upper endoscopy. There were no complications during balloon passage. After 16 weeks, the mean weight loss was 12.7 kg, mean percent excess weight loss was 26%, and mean BMI reduction was 4.2 kg/m(2). Total body weight loss was 11.6%. There was a significant reduction in major co-morbidities related to metabolic syndrome: blood pressure (p < 0.02), waist circumference (p < 0.002), triglycerides (p < 0.0001), blood glucose (p < 0.001), and HOMA-IR index (p < 0.001). At the end of the treatment, 37 balloons were naturally excreted in the stool, and one balloon was endoscopically removed. The results of this study on 38 consecutive patients demonstrate that the Elipse™ Balloon is safe, effective, and very well accepted by patients.

  14. Tips and tricks of double-balloon endoscopic retrograde cholangiopancreatography (with video).

    PubMed

    Hatanaka, Hisashi; Yano, Tomonori; Tamada, Kiichi

    2015-06-01

    Although endoscopic retrograde cholangiopancreatography (ERCP) is technically difficult in patients with altered gastrointestinal tract, double-balloon endoscopy (DBE) allows endoscopic access to pancreato-biliary system in such patients. Balloon dilation of biliary stricture and extraction of bile duct stones, placement of biliary stent in patients with Roux-en-Y or Billroth-II reconstruction, using DBE have been reported. However, two major technical parts are required for double-balloon ERCP (DB-ERCP). One is insertion of DBE and the other is an ERCP-related procedure. The important point of DBE insertion is a sure approach to the afferent limb with Roux-en-Y reconstruction or Braun anastomosis. Short type DBE with working length 152 cm is beneficial for DB-ERCP because it is short enough for most biliary accessory devices. In this paper, we introduce our tips and tricks for successful DB-ERCP. © 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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

    PubMed Central

    Cooley, D. Matthew; Walker, Andrew J.

    2015-01-01

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

  16. Probe-based confocal laser endomicroscopy in double balloon enteroscopy.

    PubMed

    Miehlke, Stephan; Morgner, A; Aust, D; Baretton, G; Madisch, A

    2011-07-01

    Probe-based confocal laser endomicroscopy (pCLE) allows in-vivo assessment of the gastrointestinal mucosal architecture during ongoing endoscopy. We investigated the feasibility and safety of pCLE during double balloon enteroscopy (DBE). DBE was performed using the Fujinon EN-450P5. pCLE (Cellvizio-GI®, Mauna Kea Technologies) was performed after intravenous injection of 5-10  mL fluorescein 1 % using a 1.8-mm probe (GastroFlex/ColoFlex Z-probe) at the deepest point of DBE insertion and in case of any pathological lesion. Primary outcome measure was technical success, defined as (i) successful advancement of the probe at the deepest DBE insertion and (ii) successful pCLE imaging of the intestinal mucosa. Secondary outcome was safety of the pCLE procedure. 27 DBE procedures (14 antegrade) were performed in 16 patients. The mean depth of small bowel insertion was 255  cm for antegrade and 130  cm for retrograde DBE. Technical success of pCLE was achieved in 96.3 % (antegrade 92.8 %, retrograde 100 %). One technical failure occurred (incomplete probe advancement). There were no adverse events related to the pCLE procedure. pCLE imaging of the small bowel mucosal architecture was possible in all cases. Pathological conditions within the small bowel such as loss of villi, crypt hyperplasia, advanced neoplasia, or increased blood flow due to inflammation tissue could be successful visualized. This study is the first to demonstrate successful and safe application of pCLE in the deep small bowel during double balloon enteroscopy. Further studies are needed to determine the clinical benefit of pCLE in the management of patients with small bowel diseases. © Georg Thieme Verlag KG Stuttgart · New York.

  17. An update on pediatric endoscopy.

    PubMed

    Friedt, Michael; Welsch, Simon

    2013-07-25

    Advances in endoscopy and anesthesia have enabled gastrointestinal endoscopy for children since 1960. Over the past decades, the number of endoscopies has increased rapidly. As specialized teams of pediatric gastroenterologists, pediatric intensive care physicians and pediatric endoscopy nurses are available in many medical centers, safe and effective procedures have been established. Therefore, diagnostic endoscopies in children are routine clinical procedures. The most frequently performed endoscopies are esophagogastroduodenoscopy (EGD), colonoscopy and endoscopic retrograde cholangiopancreaticography (ERCP). Therapeutic interventions include variceal bleeding ligation, foreign body retrieval and percutaneous endoscopic gastrostomy. New advances in pediatric endoscopy have led to more sensitive diagnostics of common pediatric gastrointestinal disorders, such as Crohn's disease, ulcerative colitis and celiac disease; likewise, new diseases, such as eosinophilic esophagitis, have been brought to light.Upcoming modalities, such as capsule endoscopy, double balloon enteroscopy and narrow band imaging, are being established and may contribute to diagnostics in pediatric gastroenterology in the future.

  18. Comparison of magnetic resonance enteroclysis and capsule endoscopy with balloon-assisted enteroscopy in patients with obscure gastrointestinal bleeding.

    PubMed

    Wiarda, B M; Heine, D G N; Mensink, P; Stolk, M; Dees, J; Hazenberg, H J A; Stoker, J; Kuipers, E J

    2012-07-01

    New modalities are available for visualization of the small bowel in patients with possible obscure gastrointestinal bleeding (OGIB), but their performance requires further comparison. This study compared the diagnostic yield of magnetic resonance enteroclysis (MRE) and capsule endoscopy in patients with OGIB, using balloon-assisted enteroscopy (BAE) as the reference standard. Consecutive consenting patients who were referred for evaluation of OGIB were prospectively included. Patients underwent MRE followed by capsule endoscopy and BAE. Patients with high grade stenosis at MRE did not undergo capsule endoscopy. The reference standard was BAE findings in visualized small-bowel segments and expert panel consensus for segments not visualized during BAE. Over a period of 26 months, 38 patients were included (20 female [53 %]; mean age 58 years, range 28 - 75 years). Four patients (11 %) did not undergo capsule endoscopy due to high grade small-bowel stenosis at MRE (n = 3; 8 %) or timing issues (n = 1; 3 %). Capsule endoscopy was non-diagnostic in one patient. The reference standard identified abnormal findings in 20 patients (53 %). MRE had sensitivity, specificity, and positive and negative likelihood ratios of 21 %, 100 %, infinity, and 0.79, respectively. The corresponding values for capsule endoscopy were 61 %, 85 %, 4.1, and 0.46. The reference standard and capsule endoscopy did not differ in percent positive findings (P = 0.34), but MRE differed significantly from the reference BAE (P < 0.001). Capsule endoscopy was superior to MRE for detecting abnormalities (P = 0.0015). Capsule endoscopy performed better than MRE in the detection of small-bowel abnormality in patients with OGIB. MRE may be considered as an alternative for the initial examination in patients with clinical suspicion of small-bowel stenosis. © Georg Thieme Verlag KG Stuttgart · New York.

  19. A case of lymphocytic-plasmacytic jejunitis diagnosed by double-balloon enteroscopy in a dog.

    PubMed

    Ayala, Ignacio; Latorre, Rafael; Soria, Federico; Carballo, Fernando; Lopez-Albors, Octavio; Buendia, Antonio J; Perez-Cuadrado, Enrique

    2011-01-01

    A 3 yr old male English setter dog was presented for evaluation of a 6-wk history of intermittent diarrhea. After standard gastroduodenoscopy and colonoscopy showed normal mucosa, double-balloon endoscopy (DBE) was used via both oral and anal approaches. Gross changes consistent with inflammation in the jejunum were seen, and biopsy specimens were obtained. Histologic analysis confirmed a diagnosis of lymphocytic-plasmacytic jejunitis. Clinical remission of the disease occurred after 3 mo of therapy with prednisone, metronidazole, and a novel protein diet. Use of DBE has not been previously reported in dogs with inflammatory bowel disease, and isolated lymphocytic-plasmacytic jejunitis has not been described. The described cases of intestinal inflammatory disease diagnosed by conventional endoscopy were related to pathologic changes in the duodenum, ileum or colon, but not the jejunum. The main advantage of the DBE technique allowed examination of portions of the small intestine (jejunum) that were not commonly accessible by standard endoscopic techniques, and permitted a minimally invasive collection of biopsy samples compared with surgical biopsy. This case highlights the need to consider using DBE in animals with gastrointestinal disorders, whose symptoms are not readily explained by routine tests, conventional endoscopy, and dietary or therapeutic trials.

  20. ANALYSIS OF DOUBLE BALLOON ENTEROSCOPY: INDICATIONS, FINDINGS, THERAPEUTIC AND COMPLICATIONS

    PubMed Central

    IVANO, Flávio Heuta; VILLELA, Izabela Rodrigues; de MIRANDA, Lívia Fouani; NAKADOMARI, Thaísa Sami

    2017-01-01

    ABSTRACT Background: The double balloon enteroscopy is an important method for the endoscopic approach of the small bowel that provides diagnosis and therapy of this segment’s disorders, with low complication rate. Aim: Analysis of patients undergoing double balloon enteroscopy. The specific objectives were to establish the indications for this method, evaluate the findings by the double balloon enteroscopy, analyze the therapeutic options and the complications of the procedure. Methods: It is a retrospective analysis of 65 patients who underwent double balloon enteroscopy. Results: Sixty-five procedures were performed in 50 patients, 63.1% were women and 36.9% were men. The mean age was 50.94 years. The main indication it was gastrointestinal bleeding, followed by abdominal pain and Crohn’s disease. Most procedures were considered normal. Polyps were the most prevalent finding, followed by angioectasias and duodenitis. In 49.2% of the cases, one or more therapeutic procedures were performed, (biopsy was the most prevalent). There was only one case of acute pancreatitis, which was treated clinically. Conclusion: The enteroscopy is good and safe method for the evaluation of the small bowel, and its main indications are gastrointestinal bleeding and abdominal pain. It has low complications rates and reduces the necessity of surgery.

  1. Double-balloon enteroscopy in small bowel diseases

    PubMed Central

    Chen, Wen-Guo; Shan, Guo-Dong; Zhang, Hong; Yang, Ming; L, Lin; Yue, Min; Chen, Guang-Wu; Gu, Qing; Zhu, Hua-Tuo; Xu, Guo-Qiang; Chen, Li-Hua

    2016-01-01

    Abstract The aim of the study was to evaluate the diagnostic and therapeutic value of double-balloon entoroscopy (DBE) in small bowel diseases (SBDs) in China. A retrospective review of 674 consecutive patients who underwent DBE between January 2007 and November 2015 was conducted. Patients were divided into 3 groups by age, young group (<45 years), middle-aged group (45–65 years), and elderly group (>65 years). Data were collected with regard to demographics, clinical, endoscopic findings, complications, diagnostic yield, and management. A total of 729 DBE procedures were performed successfully in our series. More than 20 types of SBDs were found with the detection rate of 70.9%(517/729). The majority of patients were Crohn's disease (33.4%,225/674), followed by tumor (18.8%,127/674) and angioectasia (7.9%, 53/674). Endoscopic treatment was performed in 60 patients in which hemostasis (17,28.3%) and polypectomy (15,25%) were the predominant form of intervention used. Adverse events occurred in 6 patients (0.96%,6/729) including perforation, hemorrhage, aspiration pneumonia. No acute pancreatitis or other major complications occurred. Adenocarcinoma, GIST, and lymphoma were the most common tumor detected, the majority of tumors located in the jejunum (56.7%), The detection rate of angioectasia was also higher in the jejunum (54.7%),77.8% of Crohn's disease was located in the ileum. The positive rate of DBE in small bowel tumor and Crohn's disease were significantly higher than that of angioectasia (P<0.05). In young cohort, Crohn's disease (48.1%) was the most commonly diseases followed by tumor (10.4%) and nonspecific enteritis (7.1%). Yet in the elderly group, the majority of patients were tumor (27.6%); angioectasia (21.3%) was also detected frequently. The positive rate of capsule endoscopy was 75.44 %(202/268) which was a little high than DBE (67.9%, 182/268) (P > 0.05). The obscure gastrointestinal bleeding (OGIB) was the most common indication, and

  2. Percutaneous Mitral Valve Dilatation: Single Balloon versus Double Balloon - A Finite Element Study

    SciTech Connect

    Schievano, Silvia; Kunzelman, Karyn; Nicosia, Mark; Cochran, R. P.; Einstein, Daniel R.; Khambadkone, Sachin; Bonheoffer, Philipp

    2009-01-01

    Background: Percutaneous mitral valve (MV) dilatation is performed with either a single balloon (SB) or double balloon (DB) technique. The aim of this study was to compare the two balloon system results using the finite element (FE) method. Methods and Results: An established FE model of the MV was modified by fusing the MV leaflet edges at commissure level to simulate a stenotic valve (orifice area=180mm2). A FE model of a 30mm SB (low-pressure, elastomeric balloon) and an 18mm DB system (high-pressure, non-elastic balloon) was created. Both SB and DB simulations resulted in splitting of the commissures and subsequent stenosis dilatation (final MV area=610mm2 and 560mm2 respectively). Stresses induced by the two balloon systems varied across the valve. At the end of inflation, SB showed higher stresses in the central part of the leaflets and at the commissures compared to DB simulation, which demonstrated a more uniform stress distribution. The higher stresses in the SB analysis were due to the mismatch of the round balloon shape with the oval mitral orifice. The commissural split was not easily accomplished with the SB due to its high compliance. The high pressure applied to the DB guaranteed the commissural split even when high forces were required to break the commissure welds. Conclusions: The FE model demonstrated that MV dilatation can be accomplished by both SB and DB techniques. However, the DB method resulted in higher probability of splitting of the fused commissures and less damage caused to the MV leaflets by overstretching.

  3. Submucosal endoscopy with mucosal resection (SEMR): a new hybrid technique of endoscopic submucosal balloon dissection in the porcine rectosigmoid colon.

    PubMed

    Takizawa, Kohei; Knipschield, Mary A; Gostout, Christopher J

    2013-12-01

    We developed a technique, submucosal endoscopy with mucosal resection (SEMR) intended to make endoscopic submucosal dissection easier and safer. With this technique, the submucosal layer is balloon dissected in lieu of electrosurgical knife dissection. The aim of this study was to further evaluate SEMR in the porcine rectum and colon. Targeted sites in the rectum and the distal colon were marked by spot coagulation. Submucosal fluid cushions (SFC) were created followed by a circumferential mucosal incision. After isolation of the targeted mucosa, balloon dissection was initiated. The balloon catheter was inserted deep into SFC and the inflated balloon repeatedly pulled back toward the endoscope tip to disrupt the submucosa. Residual strands of submucosa were cut. Dissection difficulty scores (DDS) were used using a visual analogue scale ranging from 0 to 5 (failed). The entire study period was divided into three periods (first period, pigs 1-10; second period, pigs 11-20; third period, pigs 21-30). Sixty lesions in 30 pigs were resected using SEMR. The en block resection rate was 95%. There were three incomplete resections, two as a result of an errant site location and one as a result of a floppy prototype balloon catheter tip. The median resected size, procedure time, and DDS were 6.0 cm, 25 min, and 1. All three failed cases occurred in first period. The procedure time in third period was significantly shorter than the second period (P = 0.0017). The DDS in first period was significantly higher than the second (P = 0.0024) and third (P = 0.0155) periods. Two perforations, one muscularis propria catheter perforation, and one mucosal perforation were observed (3.3%). Large mucosal target sites in the rectum and distal colon could be safely removed en bloc by means of a hybrid technique, SEMR, with blunt submucosal balloon dissection.

  4. Double-orifice mitral valve treated by percutaneous balloon valvuloplasty.

    PubMed

    Varghese, Thomas George; Revankar, Vinod Raghunath; Papanna, Monica; Srinivasan, Harshini

    2016-07-01

    Double-orifice mitral valve is an rare anomaly characterized by a mitral valve with a single fibrous annulus and 2 orifices that open into the left ventricle. It is often associated with other congenital anomalies, most commonly atrioventricular canal defects, and rarely associated with a stenotic or regurgitant mitral valve. A patient who was diagnosed with congenital double-orifice mitral valve with severe mitral stenosis was treated successfully by percutaneous balloon mitral valvotomy rather than the conventional open surgical approach, demonstrating the utility of percutaneous correction of this anomaly.

  5. Clinical usefulness of single-balloon endoscopy in patients with previously incomplete colonoscopy

    PubMed Central

    Kobayashi, Kiyonori; Mukae, Miyuki; Ogawa, Taishi; Yokoyama, Kaoru; Sada, Miwa; Koizumi, Wasaburo

    2013-01-01

    AIM: To evaluate the clinical usefulness of single-balloon endoscopy (SBE) in patients in whom a colonoscope was technically difficult to insert previously. METHODS: The study group comprised 15 patients (8 men and 7 women) who underwent SBE for colonoscopy (30 sessions). The number of SBE sessions was 1 in 7 patients, 2 in 5 patients, 3 in 1 patient, 4 in 1 patient, and 6 in 1 patient. In all patients, total colonoscopy was previously unsuccessful. The reasons for difficulty in scope passage were an elongated colon in 6 patients, severe intestinal adhesions after open surgery in 4, an elongated colon and severe intestinal adhesions in 2, a left inguinal hernia in 2, and multiple diverticulosis of the sigmoid colon in 1. Three endoscopists were responsible for SBE. The technique for inserting SBE in the colon was basically similar to that in the small intestine. The effectiveness of SBE was assessed on the basis of the success rate of total colonoscopy and the presence or absence of complications. We also evaluated the diagnostic and treatment outcomes of colonoscopic examinations with SBE. RESULTS: Total colonoscopy was successfully accomplished in all sessions. The mean insertion time to the cecum was 22.9 ± 8.9 min (range 9 to 40). Abnormalities were found during 21 sessions of SBE. The most common abnormality was colorectal polyps (20 sessions), followed by radiation colitis (3 sessions) and diverticular disease of the colon (3 sessions). Colorectal polyps were resected endoscopically in 15 sessions. A total of 42 polyps were resected endoscopically, using snare polypectomy in 32 lesions, hot biopsy in 7 lesions, and endoscopic mucosal resection in 3 lesions. Fifty-six colorectal polyps were newly diagnosed on colonoscopic examination with SBE. Histopathologically, these lesions included 2 intramucosal cancers, 42 tubular adenomas, and 2 tubulovillous adenomas. The mean examination time was 48.2 ± 20.0 min (range 25 to 90). Colonoscopic examination or

  6. Management of small-bowel polyps at double-balloon enteroscopy

    PubMed Central

    Nakamura, Masanao; Tahara, Tomomitsu; Nagasaka, Mitsuo; Nakagawa, Yoshihito; Shibata, Tomoyuki; Hirooka, Yoshiki; Goto, Hidemi; Hirata, Ichiro

    2014-01-01

    Small bowel tumors (SBTs) are uncommon, insidious in presentation, and frequently represent a diagnostic challenge. The advent of video capsule endoscopy (VCE) and double-balloon endoscopy (DBE) is a significant breakthrough for visual diagnosis of SBTs throughout the small bowel. Contrast-enhanced computed tomography (CECT) and fluoroscopic enteroclysis had significantly lower diagnostic yields of tumors that were 10 mm or smaller in diameter, but VCE and DBE had high diagnostic yields regardless of tumor size. Regarding SBTs larger than 10 mm in diameter, CECT had a significantly lower diagnostic yield of epithelial tumors compared to subepithelial tumors, whereas fluoroscopic enteroclysis and DBE had high diagnostic yields regardless of the tumor type. VCE had a slightly lower diagnostic yield of subepithelial tumors (78%) compared to epithelial tumors. Therefore, a combined examination method by using CECT and VCE is useful for screening of SBTs. In case suspicious of stenosis, patency capsule should be performed to confirm passage before VCE. DBE is useful for further precise examination including biopsy and ultrasonography by using miniature probe, and enteroscopic treatment. After medical, enteroscopic, and surgical treatment, VCE is helpful for follow-up. DBE is safe and useful in resecting the SBTs deep within the small bowel without laparotomy. Indications of enteroscopic resection may be benign tumors regardless of epithelial or subepithelial type, localizing in the mucosal or submucosal layer, which are symptomatic at present or possibly symptomatic or transforming in the future. Malignant tumors localized in the mucosal layer may be indications although detecting at an early stage is challenging. In this review article, we describe management of SBTs/polyps by various modalities. PMID:25333006

  7. Embolization of direct carotid cavernous fistulas with the novel double-balloon technique

    PubMed Central

    Niu, Yin; Li, Lin; Tang, Jun; Zhu, Gang

    2015-01-01

    Multiple endovascular management of direct carotid cavernous fistula (CCF) has been widely accepted as a treatment option. Embolization of the fistula with detachable balloons or thrombogenic coil-based occlusion has been the main choice to treat direct CCF, with good safety and efficacy. This study investigated the safety and efficacy of embolization of direct CCF with the novel double-balloon technique. A retrospective review of a prospective database on cerebral vascular disease was performed. We identified a total of five patients presenting with high-flow direct CCF. All patients were managed with transarterial embolization with the novel double-balloon technique. Three of the five patients were treated with two detachable balloons, and a completely occluded fistula with preservation of the internal carotid artery was achieved. Of the remaining two patients treated with more detachable balloons, one patient achieved a perfect outcome and the other one suffered from recurrent fistula due to balloon migration 3 weeks after embolization. During a follow-up period of 12–18 months, no symptoms reoccurred in any patient. Thus, the double-balloon treatment may be a promising method for CCF complete occlusion. This novel technique may bring more benefits in the following two cases: 1). A single inflated detachable balloon fails to completely occlude the CCF, which causing the next balloon can not pass into the fistula. 2). A giant CCF needs more balloons for fistula embolization. PMID:26586136

  8. Double Balloon Cervical Ripening Catheter for Control of Massive Hemorrhage in a Cervical Ectopic Pregnancy.

    PubMed

    Zambrano, Nabila; Reilly, James; Moretti, Michael; Lakhi, Nisha

    2017-01-01

    Cervical pregnancy can be complicated by perfuse vaginal bleeding. Mechanical compression directed at tamponing the cervical vessels can control hemostasis. There are several types of balloon catheters that have been described for cervical compression. However use of a double balloon catheter is a novel approach for cervical tamponade, as one balloon is positioned below the external cervical os and the second balloon is situated above in the internal cervical os. This compresses the cervix from internal os to external os between the two balloons, forming a "cervical sandwich." We describe this method of cervical tamponade using a silicone double balloon cervical ripening catheter that rapidly controlled hemorrhage in a patient that failed conservative management with methotrexate.

  9. Double Balloon Cervical Ripening Catheter for Control of Massive Hemorrhage in a Cervical Ectopic Pregnancy

    PubMed Central

    Zambrano, Nabila; Reilly, James; Moretti, Michael

    2017-01-01

    Cervical pregnancy can be complicated by perfuse vaginal bleeding. Mechanical compression directed at tamponing the cervical vessels can control hemostasis. There are several types of balloon catheters that have been described for cervical compression. However use of a double balloon catheter is a novel approach for cervical tamponade, as one balloon is positioned below the external cervical os and the second balloon is situated above in the internal cervical os. This compresses the cervix from internal os to external os between the two balloons, forming a “cervical sandwich.” We describe this method of cervical tamponade using a silicone double balloon cervical ripening catheter that rapidly controlled hemorrhage in a patient that failed conservative management with methotrexate. PMID:28261511

  10. Ileal polypoid lymphangiectasia bleeding diagnosed and treated by double balloon enteroscopy

    PubMed Central

    Park, Min Seon; Lee, Beom Jae; Gu, Dae Hoe; Pyo, Jeung-Hui; Kim, Kyeong Jin; Lee, Yun Ho; Joo, Moon Kyung; Park, Jong-Jae; Kim, Jae Seon; Bak, Young-Tae

    2013-01-01

    Intestinal lymphangiectasia is a rare disease characterized by focal or diffuse dilated enteric lymphatics with impaired lymph drainage. It causes protein-losing enteropathy and may lead to gastrointestinal bleeding. Commonly, lymphangiectasia presents as whitish spots or specks. To our knowledge, small bowel bleeding resulting from polypoid intestinal lymphangiectasia has not been reported. Here, we report a rare case of active bleeding from the small bowel caused by polypoid lymphangiectasia with a review of the relevant literature. An 80-year-old woman was hospitalized for melena. Esophagogastroduodenoscopy could not identify the source of bleeding. Subsequent colonoscopy showed fresh bloody material gushing from the small bowel. An abdominal-pelvic contrast-enhanced computed tomography scan did not reveal any abnormal findings. Video capsule endoscopy showed evidence of active and recent bleeding in the ileum. To localize the bleeding site, we performed double balloon enteroscopy by the anal approach. A small, bleeding, polypoid lesion was found in the distal ileum and was successfully removed using endoscopic snare electrocautery. PMID:24363538

  11. Ileal polypoid lymphangiectasia bleeding diagnosed and treated by double balloon enteroscopy.

    PubMed

    Park, Min Seon; Lee, Beom Jae; Gu, Dae Hoe; Pyo, Jeung-Hui; Kim, Kyeong Jin; Lee, Yun Ho; Joo, Moon Kyung; Park, Jong-Jae; Kim, Jae Seon; Bak, Young-Tae

    2013-12-07

    Intestinal lymphangiectasia is a rare disease characterized by focal or diffuse dilated enteric lymphatics with impaired lymph drainage. It causes protein-losing enteropathy and may lead to gastrointestinal bleeding. Commonly, lymphangiectasia presents as whitish spots or specks. To our knowledge, small bowel bleeding resulting from polypoid intestinal lymphangiectasia has not been reported. Here, we report a rare case of active bleeding from the small bowel caused by polypoid lymphangiectasia with a review of the relevant literature. An 80-year-old woman was hospitalized for melena. Esophagogastroduodenoscopy could not identify the source of bleeding. Subsequent colonoscopy showed fresh bloody material gushing from the small bowel. An abdominal-pelvic contrast-enhanced computed tomography scan did not reveal any abnormal findings. Video capsule endoscopy showed evidence of active and recent bleeding in the ileum. To localize the bleeding site, we performed double balloon enteroscopy by the anal approach. A small, bleeding, polypoid lesion was found in the distal ileum and was successfully removed using endoscopic snare electrocautery.

  12. Double-balloon catheter vs. dinoprostone vaginal insert for induction of labor with an unfavorable cervix.

    PubMed

    Du, Chuying; Liu, Yukun; Liu, Yinglin; Ding, Hong; Zhang, Rui; Tan, Jianping

    2015-06-01

    To compare a double-balloon catheter and dinoprostone vaginal insert for induction of labor with an unfavorable cervix. Patients with a Bishop score of ≤6 requiring labor induction at term received either a double-balloon catheter or a dinoprostone vaginal insert. The primary outcome was vaginal delivery rate within 24 h, and the secondary outcome was cesarean section rate. A total of 155 women were included; 76 received induction with a double-balloon catheter and 79 with the dinoprostone vaginal insert. The groups were similar with respect to maternal age, body mass index, gravidity, parity, baseline Bishop score, and indications for induction. Gestational age at induction was similar between the groups (double balloon 40.52 ± 0.86 weeks; dinoprostone 40.60 ± 0.79 weeks, P = 0.516). There was no difference in the vaginal delivery rate within 24 h (50 vs. 53.2 %, P = 0.694) or the cesarean section rate (39.5 vs. 31.6 %, P = 0.185) between the groups. More patients in the double-balloon catheter group required oxytocin administration than in the dinoprostone group (75 vs. 31.65 %, respectively, P < 0.001), but uterine hyperstimulation was less frequent in the double-balloon catheter group (0 vs. 10.1 %, respectively, P = 0.007). Neonatal outcomes were similar between the groups. Double-balloon catheter and dinoprostone vaginal insert are associated with similar vaginal delivery and cesarean section rates and neonatal outcomes.

  13. First description of a double-wall balloon breach during cryoballoon ablation for atrial fibrillation.

    PubMed

    Suarez, Keith; Banchs, Javier E; Lim, Hae W; Black, James N

    2017-08-01

    To date, this is the first published report of a double-wall breach while using the cryoballoon ablation catheter during the treatment of a patient with atrial fibrillation; however, there have been previous balloon breaches in both the second and third-generation cryoballoon ablation catheter usage. In this report, we describe the case of a double-wall balloon breach and the intraoperative care that was necessary to stabilize the patient. Additionally, we review other known cases of double-wall balloon breaches, and we examine the safety systems of the cryoballoon catheter that mitigate some of the potential patient complications. © 2017 Wiley Periodicals, Inc.

  14. Carbon dioxide insufflation compared with air insufflation in double-balloon enteroscopy: a prospective, randomized, double-blind trial.

    PubMed

    Hirai, Fumihito; Beppu, Takahiro; Nishimura, Taku; Takatsu, Noritaka; Ashizuka, Shinya; Seki, Takehiko; Hisabe, Takashi; Nagahama, Takashi; Yao, Kenshi; Matsui, Toshiyuki; Beppu, Tsuyoshi; Nakashima, Rikiya; Inada, Naomi; Tajiri, Eriko; Mitsuru, Hideko; Shigematsu, Hideko

    2011-04-01

    Few studies have evaluated the degree of pain, the amount of retained gas, and the safety of carbon dioxide (CO(2)) insufflation in patients undergoing double-balloon enteroscopy (DBE). To clarify the usefulness and safety of CO(2) insufflation during DBE. Single-center, prospective, randomized, double-blind, controlled trial. University hospital. Forty eligible patients with small-bowel disease for whom DBE was indicated were randomized to a CO(2) insufflation (CO(2)) group or an air insufflation (air) group by means of sealed envelopes. DBE with insufflation of CO(2) or air. Efficacy evaluation was based on the degree of pain as assessed by use of a visual analog scale (VAS) and the amount of residual gas retention within the small and large bowels on radiography. The safety of CO(2) insufflation was evaluated by arterial blood gas analysis. Significantly fewer patients in the CO(2) group had severe pain of ≥ 50 mm on the VAS during DBE than in the air group (P = .02). Significantly less gas was retained in the small bowel just after and at 3 hours after DBE in the CO(2) group than in the air group (P = .003, P = .01, respectively). There was significantly less residual gas retention in the large bowel at 3 hours after DBE in the CO(2) group than in the air group (P = .02). There was no significant difference in pre-DBE and post-DBE partial pressure of oxygen in the blood (PaO(2)) and partial pressure of carbon dioxide in the blood (PaCO(2)) between groups. Small sample size. CO(2) insufflation is a safe and useful procedure when performed during DBE. Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  15. Double balloon enteroscopy in the old: Experience from China

    PubMed Central

    He, Qiong; Zhang, Qiang; Li, Jian-Dong; Wang, Ya-Dong; Wan, Tian-Mo; Chen, Zhen-Yu; Pan, De-Shou; Cai, Jian-Qun; Liu, Si-De; Xiao, Bing; Zhang, Ya-Li; Jiang, Bo; Bai, Yang; Zhi, Fa-Chao

    2012-01-01

    AIM: To evaluate the safety, efficacy and management of double balloon enteroscopy (DBE) carried out in those aged individuals with suspicious small intestine diseases. METHODS: DBE is a wonderful invention of the past decade and is widely used as an examination tool for the gastrointestinal tract. From January 2003 to July 2011, data from patients who were ≥ 65 years old and underwent DBE examination in the Nanfang Hospital were included in a retrospective analysis. RESULTS: Fifty-nine individuals were found and subsequently analyzed. The mean age was 69.63 ± 3.89 years (range 65-84), 34 were males. Indications for DBE were melena/hematochezia (36 cases), abdominal pain (15 cases), diarrhea (3 cases), stool change (1 case), weight loss (1 case), vomiting (2 cases), and debilitation (1 case). The average duration of symptoms was 33.34 ± 64.24 mo. Twenty-seven patients suffered from age-related diseases. Severe complications were not found during and after DBE. Comparison between systolic and diastolic blood pressure before and after DBE was statistically significant (mean ± SD, P < 0.01, P < 0.05, respectively). Small bowel pathologies were found by DBE in 35 patients, definite diagnoses were made in 31 cases, and detection rate and diagnostic yield for DBE were 68.6% and 60.8%, respectively. CONCLUSION: DBE is a safe and effective method for gastrointestinal examination in the aged population. Aging alone is not a risk factor for elderly patients with suspicious gastrointestinal diseases and thorough preparation prior to the DBE procedure should be made for individuals with multiple diseases especially cardiopulmonary disorders. PMID:22719197

  16. Reduced late rectal mucosal changes after prostate three-dimensional conformal radiotherapy with endorectal balloon as observed in repeated endoscopy

    SciTech Connect

    Lin, Emile van . E-mail: E.vanLin@rther.umcn.nl; Kristinsson, Jon; Philippens, Marielle E.P.; Jong, Dirk J. de; Vight, Lisette P. van der; Kaanders, Johannes; Leer, Jan Willem; Visser, Andries G.

    2007-03-01

    Purpose: The aim of this study was to investigate prospectively the rectal wall (Rwall) spatial dose distribution, toxicity, and mucosal changes after prostate cancer radiotherapy with or without an endorectal balloon (ERB). Methods and Materials: A total of 24 patients with ERB and 24 without ERB (No-ERB) were treated with three-dimensional conformal radiotherapy (3D-CRT) to a dose of 67.5 Gy. The Rwall was divided into 16 mucosal areas and Rwall dose surface maps were constructed. After 3 months, 6 months, 1 year, and 2 years a rectosigmoidoscopy was performed, and each mucosal area was scored on telangiectasia, congestion, ulceration, stricture, and necrosis. Late rectal toxicity was correlated with the endoscopic findings. Results: The ERB significantly reduced the Rwall volume exposed to doses >40 Gy. Late rectal toxicity (grade {>=}1, including excess of bowel movements and slight rectal discharge) was reduced significantly in the ERB group. A total of 146 endoscopies and 2,336 mucosal areas were analyzed. Telangiectases were most frequently seen and appeared after 6 months. At 1 and 2 years, significantly less high-grade telangiectasia (T 2-3) was observed in the ERB group at the lateral and posterior part of the Rwall. In mucosal areas exposed to doses >40 Gy, less high-grade telangiectases (T 2-3) were seen in the ERB group compared with the No-ERB group. Conclusions: An ERB reduced the Rwall volume exposed to doses >40 Gy, resulting in reduction of late rectal mucosal changes and reduced late rectal toxicity. Although further analysis is needed, these data suggest an ERB-induced increased tolerance for late Rwall damage.

  17. Effect of double-balloon enteroscopy on pancreas: An experimental porcine model

    PubMed Central

    Latorre, Rafael; Soria, Federico; López-Albors, Octavio; Sarriá, Ricardo; Sánchez-Margallo, Francisco; Esteban, Pilar; Carballo, Fernando; Pérez-Cuadrado, Enrique

    2012-01-01

    AIM: To evaluate the effect of double-balloon enteroscopy (DBE) on pancreas histology and levels of pancreatic enzymes. METHODS: Conventional upper gastrointestinal endoscopy was performed on five control pigs. Oral DBE was performed with an EN-450T5 enteroscope on 20 pigs. Two experimental groups (10 pigs each) were defined according to DBE duration: 90 min for Group 1 and 140 min for Group 2. During oral insertion, the balloons were not inflated in the descending part of the duodenum to avoid the minor duodenal papilla. Serum amylase, lipase and C-reactive protein (CRP) levels were monitored before the procedure and repeated every 30 min until the exploration was finished, as well as 24 h and 7 d after. After the procedure and for a total of 7 d, the pigs were observed twice a day for signs of decreased activity, irritability, vomiting or anorexia. Gross and microscopic examination of the pancreas was performed on day 7. RESULTS: All animals tolerated DBE without clinical manifestations of acute pancreatitis. Experimental groups had higher levels of enzymes than the control group at 24 h. Throughout the exploration, the amylase levels increased significantly above the baseline 24 h after DBE, although the increase was not statistically significant and did not reach 20% of the baseline. An increase in lipase and CRP was observed at 24 h after the procedure, although by day 7, all enzymatic levels had returned to baseline. No differences between Groups 1 and 2 were found for any enzyme and sampling site during and after the procedure. Similarly, no correlation between insertion depth and enzyme levels was observed. Direct in situ and post-removal inspection of the pancreas did not show any evidence of fluid collection, abscesses or hemorrhage. Histological examination of the pancreas from Groups 1 and 2 revealed the existence of focal areas (0.14-0.26 mm2) of ischemic necrosis in 47.4% of the animals. In the pigs with damaged pancreas, the left lobe (tail) was

  18. Double-Balloon Catheter for Isolated Liver Perfusion: An Experimental Study

    SciTech Connect

    Cwikiel, Wojciech; Bergqvist, Lennart; Harnek, Jan

    2001-05-15

    Purpose: Further development of a previously described interventional method for isolated liver perfusion (ILP) with a new double-lumen balloon catheter, and evaluation of the side-effects of such isolation.Methods: In six pigs a double-balloon occlusion catheter was placed via the transjugular approach with its tip in the portal vein. One of the balloons was positioned in the inferior vena cava (IVC), cranial to the origin of the hepatic veins and the other balloon in the portal vein. By the transfemoral approach, a single-balloon occlusion catheter was placed in the IVC caudal to the origin of the hepatic veins. A third catheter was placed by the transfemoral route with the occlusion balloon in the proper hepatic artery. After inflation of all balloons {sup 99}Tc{sup m}-labelled human serum albumin was recirculated through the liver. The isolation was evaluated by repeated measurement of radioactivity levels in peripheral blood. Laboratory tests of liver and pancreas function, and hemoglobin, were taken before, at the end of, and 3 days after the procedure. Blood gases were tested at the beginning and end of the procedure.Results: One pig died during the procedure due to technical failure and was excluded from the study. In the other pigs leakage from the isolated liver to the systemic circulation increased slowly, up to 9.7% (mean) during 30 min of recirculation of the perfusate through the liver. Laboratory tests were normal in all pigs except insignificant acidosis directly after the procedure and the slight elevation of s-ALAT after 3 days.Conclusions: Only minor leakage from the liver to the systemic circulation was noted during ILP performed with a new, double-balloon catheter. There were no serious side effects.

  19. Nonlinear optical endoscopy based on a double-clad photonic crystal fiber and a MEMS mirror

    NASA Astrophysics Data System (ADS)

    Fu, Ling; Jain, Ankur; Xie, Huikai; Cranfield, Charles; Gu, Min

    2006-02-01

    Two-photon fluorescence and second harmonic generation microscopy have enabled functional and morphological in vivo imaging. However, in vivo applications of those techniques to living animals are limited by bulk optics on a bench top. Fortunately, growing functionality of fiber-optic devices and miniaturization of scanning mirrors stimulate the race to develop nonlinear optical endoscopy. In this paper, we report on a prototype of a nonlinear optical endoscope based on a double-clad photonic crystal fiber to improve the detection efficiency and a MEMS mirror to steer the light at the fiber tip. The miniaturized fiber-optic nonlinear microscope is characterized by rat esophagus imaging. Line profiles from the rat tail tendon and esophagus prove the potential of the technology in in vivo applications.

  20. One-Step Transpapillary Balloon Dilation under Cap-Fitted Endoscopy without a Preceding Sphincterotomy for the Removal of Bile Duct Stones in Billroth II Gastrectomy.

    PubMed

    Lee, Tae Hoon; Hwang, Jae Chul; Choi, Hyun Jong; Moon, Jong Ho; Cho, Young Deok; Yoo, Byung Moo; Park, Sang-Heum; Kim, Jin Hong; Kim, Sun-Joo

    2012-01-01

    Endoscopic sphincterotomy may be limited in Billroth II gastrectomy because of difficulty in orientating the duodenoscope and sphincterotome as a result of altered anatomy. This study was planned to investigate the efficacy and safety of endoscopic transpapillary large balloon dilation (EPBD) without preceding sphincterotomy for removal of large CBD stones in Billroth II gastrectomy. Between March 2010 and February 2011, one-step EPBD under cap-fitted forward-viewing endoscopy was performed in patients who had undergone Billroth II gastrectomy at two tertiary referral centers. Main outcome measurements were successful duct clearance and EPBD-related complications. Successful access to major duodenal papilla was performed in 13 patients, but successful selective CBD cannulation was achieved in 12 patients (92.3%). Median maximum transverse stone size was 11.5 mm (10 to 14 mm). The mean number of stones was 2 (1-5). The median CBD diameter was 15 mm (12 to 19 mm). Mean procedure time from successful biliary access to complete stone removal was 17.8 min. Complete duct clearance was achieved in all patients. Four patients (33.3%) needed one more session of ERCP for removal of remnant stones. Asymptomatic hyperamylasemia in two patients and minor bleeding in another occurred. Without preceding sphincterotomy, one-step EPBD (≥10 mm) under cap-fitted forward-viewing endoscopy may be safe and effective for the removal of large stones (≥10 mm) with CBD dilatation in Billroth II gastrectomy.

  1. Percutaneous management of acutely thrombosed hemodialysis grafts: the double balloon occlusion technique.

    PubMed

    Lai, Chi-Cheng; Kang, Pei-Leun; Tsai, Han-Lin; Mar, Guang-Yuan; Liu, Chun-Peng

    2009-01-01

    The aim of this article is to introduce a new technique, named the "double balloon occlusion technique" (DBOT), for the salvage of acutely thrombosed grafts and to demonstrate its safety and efficacy. Acute thrombosis is recognized as the most common factor of acute graft failures. A suitably percutaneous technique should be devised to remove thrombi safely and effectively. Care should also be taken to prevent possible thromboembolic complications during procedures. Mainly composed of two balloons, the percutaneous DBOT has been developed to meet the clinical needs. Thirty-two patients with graft failures undergoing the DBOT were recruited between May 2007 and May 2008. The DBOT is itemized in the text and a practical case undergoing successful DBOT is also demonstrated. Of the 32 DBOT treatments, the procedural success rate was 100% (32/32). The clinical success rate was 94% (30/32). One complicated case with severe hematoma resulting from a balloon-induced graft rupture received surgery, although the graft outflow restored. The mean procedure time was 92 minutes. Three patients died and two patients were lost within the 3-month follow-up. The 3-month graft patency rate was 70% (19/27). The DBOT has the potential to be operated safely and effectively. Preliminary results had high success rates and patency rates. With basic devices, it may serve as an option to rescue thrombosed grafts. More data are needed to identify its clinical role. (c) 2008 Wiley-Liss, Inc.

  2. ERCP using double-balloon enteroscopy in patients with Roux-en-Y anatomy.

    PubMed

    Kuga, Rogério; Furuya, Carlos Kiyoshi; Hondo, Fábio Yuji; Ide, Edson; Ishioka, Shinichi; Sakai, Paulo

    2008-01-01

    Double-balloon enteroscopy (DBE) is a useful method for endoscopic retrograde cholangiopancreatography (ERCP) in patients with Roux-en-Y anatomy. Depending on the distorted anatomy, endoscopic therapies with conventional scopes were very difficult or impossible before the advent of DBE and patients had to be submitted to a percutaneous or surgical approach. The case of 6 patients with different types of Roux-en-Y-altered anatomy in which DBE-ERCP was performed with 83.3% successful rate (5/6) is reported confirming recent data in the literature on the feasibility of this method. 2009 S. Karger AG, Basel

  3. Successful treatment of double-orifice mitral stenosis with percutaneous balloon mitral commissurotomy.

    PubMed

    Patted, Suresh V; Halkati, Prabhu C; Ambar, Sameer S; Sattur, Ameet G

    2012-01-01

    Double-orifice mitral valve (DOMV) is an uncommon congenital anomaly, being present in 0.05% of the general population. The isolated occurrence of this anomaly is very rare and, to our knowledge, no data are currently available on the incidence of an isolated DOMV. A DOMV is characterized by a mitral valve with a single fibrous annulus with 2 orifices opening into the left ventricle (LV). Subvalvular structures, especially the tensor apparatus, invariably show various degrees of abnormality. It can substantially obstruct mitral valve inflow or cause mitral valve incompetence. We present a rare case of nineteen-year-old male who underwent percutaneous mitral balloon commissurotomy in stenotic DOMV.

  4. Small bowel capsule endoscopy in 2007: indications, risks and limitations.

    PubMed

    Rondonotti, Emanuele; Villa, Federica; Mulder, Chris J J; Jacobs, Maarten A J M; de Franchis, Roberto

    2007-12-14

    Capsule endoscopy has revoluzionized the study of the small bowel by providing a reliable method to evaluate, endoscopically, the entire small bowel. In the last six years several papers have been published exploring the possible role of this examination in different clinical conditions. At the present time capsule endoscopy is generally recommended as a third examination, after negative bidirectional endoscopy, in patients with obscure gastrointestinal bleeding. A growing body of evidence suggests also an important role for this examination in other clinical conditions such as Crohn's disease, celiac disease, small bowel polyposis syndromes or small bowel tumors. The main complication of this examination is the retention of the device at the site of a previously unknown small bowel stricture. However there are also some other open issues mainly due to technical limitations of this tool (which is not driven from remote control, is unable to take biopsies, to insufflate air, to suck fluids or debris and sometimes to correctly size and locate lesions). The recently developed double balloon enteroscope, owing to its capability to explore a large part of the small bowel and to take targeted biopsies, although being invasive and time consuming, can overcome some limitations of capsule endoscopy. At the present time, in the majority of clinical conditions (i.e. obscure GI bleeding), the winning strategy seems to be to couple these two techniques to explore the small bowel in a painless, safe and complete way (with capsule endoscopy) and to define and treat the lesions identified (with double balloon enteroscopy).

  5. Effects of transforaminal balloon treatment in patients with lumbar foraminal stenosis: a randomized, controlled, double-blind trial.

    PubMed

    Kim, Sung Hoon; Choi, Woo-Jong; Suh, Jeong Hun; Jeon, Sang-Ryong; Hwang, Chang Ju; Koh, Won Uk; Lee, Chung; Leem, Jeong Gil; Lee, Sang Chul; Shin, Jin-Woo

    2013-01-01

    Lumbar spinal stenosis is a common condition in the elderly. Although balloon treatment is a well-known therapeutic method in specific pain conditions, applying the balloon treatment in patients with lumbar spinal stenosis is not yet well established. We tested the therapeutic effect of transforaminal balloon treatment with a Fogarty balloon catheter on body pain and functional performance in patients with severe lumbar spinal stenosis. Prospective, randomized, double-blinded, active control trial. A tertiary, interventional pain management practice, specialty referral center. Sixty-two patients with refractory unilateral radiculopathy aggravated by walking were enrolled and randomly assigned to receive transforaminal steroid injection after transforaminal balloon treatment using a 3 Fr balloon catheter (n = 32) or the same procedure without balloon treatment (n = 30). The patients were prohibited from making any alterations to their medications during the 12 weeks of their follow-up period. After the first 12 weeks, the patients who had persistent symptoms or unbearable pain were allowed to increase the dose of analgesics or to receive additional interventional treatment. Visual analogue scale (VAS) pain scores for the leg and lower back, Oswestry disability index (ODI), and claudication distance were measured at 2, 4, 8, and 12 weeks post procedure. During the 52 weeks of the overall follow-up period, the patients achieving ≥ 50% leg pain relief without additional treatment or increasing the dose of analgesics were evaluated. Significant improvement occurred compared to baseline in VAS (P < 0.001), ODI (P < 0.001), and claudication distance (P < 0.001) in the balloon group during the overall follow-up period, whereas the improvement in ODI (P < 0.05) and claudication distance (P < 0.05) in the control group persisted for 8 weeks. The balloon group showed better improvement in leg VAS (P < 0.05), ODI (P < 0.05), and claudication distance (P < 0.05) than the

  6. Effectiveness of Endoscopic Ultrasonography during Double Balloon Enteroscopy for characterization and management of small bowel submucosal tumours.

    PubMed

    Murino, Alberto; Nakamura, Masanao; Watanabe, Osamu; Yamamura, Takeshi; Nagura, Asuka; Yoshimura, Toru; Nakano, Arihiro; Goto, Hidemi; Hirooka, Yoshiki

    2016-10-01

    Characterization of small bowel submucosal tumours is challenging, requiring additional investigations. Endoscopic Ultrasonography performed during Double Balloon Enteroscopy, appeared a promising technique although it has not been fully evaluated. The aim was to determine the effectiveness of this technique for characterization and management of sub mucosal tumours in a large cohort of patients. Patients with suspected small bowel tumours, who underwent Endoscopic Ultrasonography performed during Double Balloon Enteroscopy in our Institution between 2005 and 2013, were reviewed. Demographic data, clinical, endoscopic and radiological findings, therapeutic management, final diagnosis and follow-up were analyzed. 30 patients (19 male; median age 61.5) affected by submucosal tumours were included in the study. Endoscopic Ultrasonography performed during Double Balloon Enteroscopy was successfully performed in all cases providing a correct characterization of 19 submucosal tumours (63%). Based on the ultrasonographic characteristics 8 patients were treated endoscopically, 16 were referred to surgery, and 6 were managed conservatively. Our results suggest that Endoscopic Ultrasonography performed during Double Balloon Enteroscopy is a safe and useful technique for submucosal tumours characterization. This procedure may be applied in clinical practice when small bowel tumours are encountered, to confirm the diagnosis and provide the most appropriate management. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  7. Successful Treatment of Double-Orifice Mitral Stenosis with Percutaneous Balloon Mitral Commissurotomy

    PubMed Central

    Patted, Suresh V.; Halkati, Prabhu C.; Ambar, Sameer S.; Sattur, Ameet G.

    2012-01-01

    Double-orifice mitral valve (DOMV) is an uncommon congenital anomaly, being present in 0.05% of the general population. The isolated occurrence of this anomaly is very rare and, to our knowledge, no data are currently available on the incidence of an isolated DOMV. A DOMV is characterized by a mitral valve with a single fibrous annulus with 2 orifices opening into the left ventricle (LV). Subvalvular structures, especially the tensor apparatus, invariably show various degrees of abnormality. It can substantially obstruct mitral valve inflow or cause mitral valve incompetence. We present a rare case of nineteen-year-old male who underwent percutaneous mitral balloon commissurotomy in stenotic DOMV. PMID:24826244

  8. Role of double-balloon enteroscopy in malignant small bowel tumors

    PubMed Central

    Robles, Enrique Pérez-Cuadrado; Delgado, Pilar Esteban; Conesa, Paloma Bebia; Andrés, Blanca Martínez; Guggiana, Milivoj Franulic; Mateos, Eduardo Alcaraz; Caballero, Mariana Fernández; Agudo, José Luis Rodrigo; Martínez, Silvia Chacón; Latorre, Rafael; Soria, Federico; Gutiérrez, Juan Manuel Herrerías; Martínez, Enrique Pérez-Cuadrado

    2015-01-01

    AIM: To assess the double-balloon enteroscopy (DBE) role in malignant small bowel tumors (MSBT). METHODS: This is a retrospective descriptive study performed in a single center. All consecutive patients who underwent a DBE with final diagnosis of a malignant neoplasm from 2004 to 2014 in our referral center were included. Patient demographic and clinical pathological characteristics were recorded and reviewed. MSBT diagnosis was achieved either by DBE directed biopsy with multiple tissue sampling, endoscopic findings or histological analysis of surgical specimen. We have analyzed double-balloon enteroscopy impact in outcome and clinical course of these patients. RESULTS: Of 627 patients, 28 (4.5%) (mean age = 60 ± 17.3 years) underwent 30 procedures (25 anterograde, 5 retrograde) and were diagnosed of a malignant tumor. Patients presented with obscure gastrointestinal bleeding (n = 19, 67.9%), occlusion syndrome (n = 7, 25%) and diarrhea (n = 1, 3.6%). They were diagnosed by DBE biopsy (n = 18, 64.3%), histological analysis of surgical specimen (n = 7, 25%) and unequivocal endoscopic findings (n = 2, 7.1%). Gastrointestinal stromal tumor (n = 8, 28.6%), adenocarcinoma (n = 7, 25%), lymphoma (n = 4, 14.3%), neuroendocrine tumor (n = 4, 14.3%), metastatic (n = 3, 10.7%) and Kaposi sarcoma (n = 1, 3.6%) were identified. DBE modified outcome in 7 cases (25%), delaying or avoiding emergency surgery (n = 3), modifying surgery approach (n = 2) and indicating emergency SB partial resection instead of elective approach (n = 2). CONCLUSION: DBE may be critical in the management of MSBT providing additional information that may be decisive in the clinical course of these patients. PMID:26078833

  9. Role of double-balloon enteroscopy in malignant small bowel tumors.

    PubMed

    Robles, Enrique Pérez-Cuadrado; Delgado, Pilar Esteban; Conesa, Paloma Bebia; Andrés, Blanca Martínez; Guggiana, Milivoj Franulic; Mateos, Eduardo Alcaraz; Caballero, Mariana Fernández; Agudo, José Luis Rodrigo; Martínez, Silvia Chacón; Latorre, Rafael; Soria, Federico; Gutiérrez, Juan Manuel Herrerías; Martínez, Enrique Pérez-Cuadrado

    2015-06-10

    To assess the double-balloon enteroscopy (DBE) role in malignant small bowel tumors (MSBT). This is a retrospective descriptive study performed in a single center. All consecutive patients who underwent a DBE with final diagnosis of a malignant neoplasm from 2004 to 2014 in our referral center were included. Patient demographic and clinical pathological characteristics were recorded and reviewed. MSBT diagnosis was achieved either by DBE directed biopsy with multiple tissue sampling, endoscopic findings or histological analysis of surgical specimen. We have analyzed double-balloon enteroscopy impact in outcome and clinical course of these patients. Of 627 patients, 28 (4.5%) (mean age = 60 ± 17.3 years) underwent 30 procedures (25 anterograde, 5 retrograde) and were diagnosed of a malignant tumor. Patients presented with obscure gastrointestinal bleeding (n = 19, 67.9%), occlusion syndrome (n = 7, 25%) and diarrhea (n = 1, 3.6%). They were diagnosed by DBE biopsy (n = 18, 64.3%), histological analysis of surgical specimen (n = 7, 25%) and unequivocal endoscopic findings (n = 2, 7.1%). Gastrointestinal stromal tumor (n = 8, 28.6%), adenocarcinoma (n = 7, 25%), lymphoma (n = 4, 14.3%), neuroendocrine tumor (n = 4, 14.3%), metastatic (n = 3, 10.7%) and Kaposi sarcoma (n = 1, 3.6%) were identified. DBE modified outcome in 7 cases (25%), delaying or avoiding emergency surgery (n = 3), modifying surgery approach (n = 2) and indicating emergency SB partial resection instead of elective approach (n = 2). DBE may be critical in the management of MSBT providing additional information that may be decisive in the clinical course of these patients.

  10. Comparison of double-balloon and single-balloon enteroscope for therapeutic endoscopic retrograde cholangiography after Roux-en-Y small bowel surgery.

    PubMed

    De Koning, Michael; Moreels, Tom G

    2016-08-22

    Roux-en-Y reconstructive surgery excludes the biliopancreatic system from conventional endoscopic access. Balloon-assisted enteroscopy allows therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in these patients, avoiding rescue surgery. The objective of the current study is to compare success and complication rate of double-balloon (DBE) and single-balloon enteroscope (SBE) to perform ERCP in Roux-en-Y patients. Seventy three Roux-en-Y patients with suspected biliary tract pathology underwent balloon-assisted enteroscopy in a tertiary-care center. Retrospective analysis of 95 consecutive therapeutic ERCP procedures was performed to define and compare success and complication rate of DBE and SBE. Male-female ratio was 28/45 with a mean age of 58 ± 2 years. 30 (32 %) procedures were performed with DBE and 65 (68 %) with SBE. Overall ERCP success rate was 73 % for DBE and 75 % for SBE (P = 0.831). Failure was due to inability to reach or cannulate the intact papilla or bilioenteric anastomosis. Success rate was significantly higher when performed at the bilioenteric anastomosis (80 % success in 56 procedures) or at the intact papilla in short-limb Roux-en-Y (80 % in 15 procedures) as compared to the intact papilla in long-limb (58 % in 24 procedures; P = 0.040). Adverse event rates were 10 % (DBE) and 8 % (SBE) (P = 0.707) and mostly dealt with conservatively. ERCP after Roux-en-Y altered small bowel anatomy is feasible and safe using both DBE and SBE. Both techniques are equally competent with high success rates and acceptable adverse events rates. ERCP at the level of the intact papilla in long limb Roux-en-Y is less successful as compared to short-limb or bilioenteric anastomosis.

  11. Efficacy, safety, and tolerance of two types of intragastric balloons placed in obese subjects: a double-blind comparative study.

    PubMed

    De Castro, Maria Luisa; Morales, María José; Del Campo, Víctor; Pineda, Juan R; Pena, Eduardo; Sierra, José M; Arbones, María José; Prada, Ignacio R

    2010-12-01

    The intragastric balloon is a temporary treatment for obese patients. Fluid-filled devices have shown efficacy and safety, and are widely used. Recently, although there are no comparative studies between them, an air-filled balloon, Heliosphere® bag, has been proposed. Prospective, double-blind study in 33 patients with morbid and type 2 obesity: 23 female, 43.9±10 years, 120.3±17 kg, and body mass index (BMI) of 44.2±5 kg/m2, placing 18 gastric balloons filled with 960 cm3 of air (Heliosphere® bag) or 15 balloons filled with 700 ml of saline (Bioenterics-BIB®). Both balloons were placed with conscious sedation and removed under general anesthesia 6 months later. Intravenous drugs were given to control symptoms for 48 h. Patients were sent home on a 1000-kcal diet, multivitamin supplements, and oral proton pump inhibitors, and were followed monthly. Complications, symptoms, weight, and quality of life evaluated by the Gastrointestinal Quality of Life Index (GIQLI) scale were recorded. At 6 months, mean weight loss (12.8±8 vs 14.1±8 kg), BMI loss (4.6±3 vs 5.5±3 kg/m2) and percent excess weight loss (27±16 vs.30.2±17) showed no significant differences between both groups. At removal, two Heliosphere® bags were not found in the stomach, and four patients required extraction of the balloon by rigid esophagoscopy or surgery (p=0.02). Tolerance was good in both groups, but early removal occurred in three BIB® (20%) due to vomits and dehydration. The GIQLI total scores remained unchanged. Both balloons achieve a significant weight loss with good tolerance in obese patients. Nevertheless, Heliosphere® bag has severe technical problems that need to be solved before recommending it.

  12. Use of Double-Occlusion Balloon Catheter: Preoperative Portal Vein Embolization for Induction of Future Remnant Liver Hypertrophy

    SciTech Connect

    Kim, Min Joo; Choo, Sung Wook Do, Young Soo; Park, Kwang Bo; Han, Yoon Hee; Choo, In Wook; Cho, Jae Min; Cho, Jae Won; Kim, Sung Joo; Sohn, Tae Sung

    2004-01-15

    Purpose: To evaluate the efficacy and safety of using double-occlusion balloon catheters in preoperative portal vein embolization (PVE) to induce future remnant liver hypertrophy. Materials and Methods: PVE was achieved with gelatin sponges by using double-occlusion balloon catheter in seventeen patients with hepatobiliary malignant tumors. The ipsilateral approach was used in thirteen patients and the contralateral approach in four patients due to large size of tumor in the right hepatic lobe.Surgery was performed in 15 patients, 14-27 days (mean, 21.9 days)after PVE. Computed tomographic liver volumetric studies were performed before embolization and before surgery. The changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), prothrombintime (PT), and total bilirubin levels before and after the PVE were evaluated. Complications were evaluated after PVE. Results: PVE using double-occlusion balloon catheter was successful in all cases, irrespective of approach technique. The future remnant liver (FRL) volumes were 251-920 cm{sup 3} (mean, 437cm{sup 3}) before PVE and 281-1042 cm{sup 3} (mean, 555cm{sup 3}) after PVE. The mean increase in the volume of the FRL was 28.6%; this represented 37% of the pre resection volume of the liver. Clinical and biologic tolerance of PVE was mandatory. There were no complications. Conclusions: PVE using the double-occlusion balloon catheter is safe and well-tolerated and can be performed technically with ease. This hypertrophy allows hepatectomy to be performed safely when the FRL volume is initially insufficient inpatients with hepatobiliary tumors.

  13. [Double-balloon enteroscopy for the diagnosis and treatment of patients with unexplained gastrointestinal blood loss].

    PubMed

    van der Veer, W M; Hekmat, H; Mulder, C J J; Jacobs, M A J M

    2007-09-22

    In 3 patients, 2 women aged 56 and 57 and a 65-year-old man, who presented with overt and occult gastrointestinal bleeding, no focus of the bleeding could be found during gastroscopy and colonoscopy. The patients were then examined and treated by double-balloon enteroscopy (DBE). DBE is a relatively new endoscopic technique that allows high-resolution visualisation of the entire small intestine with full endoscopic instrumentation. The 56-year-old woman had coeliac disease and an enteropathy-associated T-cell lymphoma with stenoses over approximately 150 cm of bowel length. She was given chemotherapy and responded well. The 57-year-old woman suffered from Rendu-Osler-Weber syndrome with multiple angiodysplasias in the small intestine. She was treated 5 times with argon plasma coagulation during DBE, for more than 40 angiodysplasias, and thereafter no longer needed blood transfusions. The 65-year-old man had a history of recurrent melanoma. During DBE, multiple metastases of a melanoma in the small intestine were found and tattooed. The tumours were later surgically excised, with no further metastases in the following 2 years. DBE has proven to be a good diagnostic and therapeutic tool in the management of small intestinal diseases.

  14. Clinical usefulness of double balloon enteroscopy in suspected Crohn's disease: the KASID multi-center trial.

    PubMed

    Jang, Hyun Joo; Choi, Min Ho; Eun, Chang Soo; Choi, Hwang; Choi, Kyu Yong; Park, Dong Il; Park, Jung Ho; Chang, Dong Kyung; Kim, Jin Oh; Ko, Bong Min; Huh, Kyu Chan; Byeon, Jeong Sik; Choi, Ki don; Choi, Jae Hyun; Shin, Sung Jae; Kae, Sea Hyub; Lee, Moon Sung

    2014-01-01

    The recently developed double balloon enteroscopy (DBE) may be useful to evaluate small bowel lesions in patients with suspected Crohn’s disease (CD). We investigated the findings of DBE, small bowel follow-through and abdominal CT in patients with suspected CD who could not be diagnosed with CD using conventional colonoscopy. Thirty patients (27 males, mean age 32.7±9.27 years) with suspected CD were consecutively enrolled in this study. The main symptoms were abdominal pain, chronic diarrhea, weight loss, obscure bleeding, or anemia. These patients were enrolled from May 2006 to January 2007 at 10 tertiary medical centers participating in the Korean Association for the Study of Intestinal Diseases. The DBE demonstrated definite CD in 24 patients (80.0%) and suspected findings of CD in six patients. The pathology results obtained by endoscopic biopsies revealed a granuloma in six patients (23.1%). The DBE identified additional findings not detected by radiology studies in 24 patients (80%) although the small bowel followthrough and the abdominal CT revealed the abnormal findings (73.1% and 64%). DBE may be a promising alternative and useful technique for patients with suspected CD. DBE provides biopsy sampling and more detailed information than radiology studies.

  15. Improved techniques for double-balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography

    PubMed Central

    Osoegawa, Takashi; Motomura, Yasuaki; Akahoshi, Kazuya; Higuchi, Naomi; Tanaka, Yoshimasa; Hisano, Terumasa; Itaba, Souichi; Gibo, Junya; Yamada, Mariko; Kubokawa, Masaru; Sumida, Yorinobu; Akiho, Hirotada; Ihara, Eikichi; Nakamura, Kazuhiko

    2012-01-01

    AIM: To investigate the clinical outcome of double balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (DB-ERCP) in patients with altered gastrointestinal anatomy. METHODS: Between September 2006 and April 2011, 47 procedures of DB-ERCP were performed in 28 patients with a Roux-en-Y total gastrectomy (n = 11), Billroth II gastrectomy (n = 15), or Roux-en-Y anastomosis with hepaticojejunostomy (n = 2). DB-ERCP was performed using a short-type DBE combined with several technical innovations such as using an endoscope attachment, marking by submucosal tattooing, selectively applying contrast medium, and CO2 insufflations. RESULTS: The papilla of Vater or hepaticojejunostomy site was reached in its entirety with a 96% success rate (45/47 procedures). There were no significant differences in the success rate of reaching the blind end with a DBE among Roux-en-Y total gastrectomy (96%), Billroth II reconstruction (94%), or pancreatoduodenectomy (100%), respectively (P = 0.91). The total successful rate of cannulation and contrast enhancement of the target bile duct in patients whom the blind end was reached with a DBE was 40/45 procedures (89%). Again, there were no significant differences in the success rate of cannulation and contrast enhancement of the target bile duct with a DBE among Roux-en-Y total gastrectomy (88 %), Billroth II reconstruction (89%), or pancreatoduodenectomy (100%), respectively (P = 0.67). Treatment was achieved in all 40 procedures (100%) in patients whom the contrast enhancement of the bile duct was successful. Common endoscopic treatments were endoscopic biliary drainage (24 procedures) and extraction of stones (14 procedures). Biliary drainage was done by placement of plastic stents. Stones extraction was done by lithotomy with the mechanical lithotripter followed by extraction with a basket or by the balloon pull-through method. Endoscopic sphincterotomy was performed in 14 procedures with a needle precutting

  16. Double-balloon Enteroscopy: The results of a new experience in Iran

    PubMed Central

    Roushan, Nader; Froutan, Hossein; Taslimi, Reza; Kalani, Mohammad; Ganji, Azita; Darvish Moghaddam, Sodaif; Farahvash, Mohammad Jafar; Khazaeipour, Zahra

    2014-01-01

    Background: Approach to the small intestine has been difficult even with newer methods. Double-balloon enteroscopy (DBE) has been created for diagnostic and therapeutic interventions in diseases of the small intestine. Small intestinal diseases have different etiologies in each country. The DBE has been introduced in recent years in Iran. Our aim was to study the indications and results of DBE in some academic centers in Iran. Methods: Fifty-five patients with symptoms and signs related to small intestine without definitive diagnosis but with previous workup were enrolled in the study. The DBE was performed in three different medical universities in Iran. Results: The mean age of the patients that underwent the DBE was 47.2 ± 17.3 years. Abdominal pain (54.5%) and occult gastrointestinal bleeding (23.6%) were the most common presentations. Small bowel lesions were detected in 26 patients (47.3%); the most common lesions were ulcer (46.2%) and polyps (19.2%). Crohn’s disease (12.7%) was the commonest diagnosis found in DBE procedure. Patients presenting with abdominal pain orl ower hemoglobin level were more likely to be diagnosed (both p≤ 0.05). Small intestinal diseases were ultimately diagnosed in 47.3% of the patients. Twenty percent of the patients had another disease outside the small bowel. Conclusions: DBE is an effective and relatively safe diagnostic and therapeutic option for small bowel evaluations. Accurate selection of patients and more experience technicians and physicians will improve the efficacy of this procedure in Iran. PMID:25250264

  17. Is double-balloon enteroscopy an accurate method to diagnose small-bowel disorders?

    PubMed

    Safatle-Ribeiro, Adriana Vaz; Kuga, Rogério; Ishida, Robson; Furuya, Carlos; Ribeiro, Ulysses; Cecconello, Ivan; Ishioka, Shinichi; Sakai, Paulo

    2007-12-01

    The aim of this study was to analyze the contribution of the double-balloon enteroscopy (DBE) for diagnosis of the small bowel disorders. Forty-four patients (20 women, 24 men; mean age 53.5 years-old, range 21-89 years) with chronic gastrointestinal bleeding, diarrhea, polyposis, weight-loss, Roux-en-Y surgery, and other indications underwent DBE. Twenty patients had occult or obscure gastrointestinal bleeding. The source of bleeding was identified in 15/20 (75%): multiple angiodysplasias in four, arterial-venous malformation beyond the ligament of Treitz in two that could be treated with injection successfully. Other diagnoses included: duodenal adenocarcinoma, jejunal tuberculosis, erosions and ulcer of the jejunum. Of 24 patients with other indications, the diagnosis could be achieved in 18 of them (75%), including: two lymphomas, plasmocytoma, Gardner's syndrome, Peutz-Jeghers' syndrome, familial adenomatous polyposis, Behçet's disease, jejunal submucosal lesion, lymphangiectasia due to blastomycosis and unspecific chronic jejunitis. Of three cases with Roux-en-Y reconstruction, two underwent DBE in order to perform biopsies of the excluded duodenum. Additionally, two patients underwent DBE to exclude Crohn's disease and lymphoma of the small bowel. The mean length of small bowel examination was 240 +/- 50 cm during a single approach. The diagnostic yield was 75% (33/44 cases) and therapeutic yield was 63.6%. No major complications were observed, only minor complication such as sore throat in 4/44 (9.1%). 1. DBE is a safe and and accurate method to diagnose small bowel disorders; 2. this method permits chromoscopy, biopsies and treatment of the lesions.

  18. Baby Shampoo versus Commercial Anti-fogging Solution to Prevent Fogging during Nasal Endoscopy: A Randomized Double-Blinded, Matched-Pair, Equivalent Trial.

    PubMed

    Chainansamit, Seksun; Piromchai, Patorn; Anantpinijwatna, Intira; Kasemsiri, Pornthep; Thanaviratananich, Sanguansak

    2015-08-01

    To compare the minimization of the fog condensation during nasal endoscopy between a commercial anti-fogging agent and baby shampoo. This randomized double-blinded matched pair study was conducted at the Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University during February 4, 2013 to March 14, 2013. The commercial anti-fogging solution (Ultrastop®) and baby shampoo solution (Johnson's® no more tear®) were compared. A computer generated randomization was performed to select the solution applying on the lens for nasal endoscopy of the right nasal cavity. The other solution was then used for the left one. Three passes of endoscopy were performed to examine the floor of the nose, the sphenoethmoidal recess and the middle meatus area which spent about 30 seconds for each time of endoscopy. The time to become foggy on the lens and the preferred solution assessed by the endoscopists were recorded. There were 71 eligible patients recruited in the study, 37 males (52.1%) and 34 females (47.9%). There was no fogging during a 30-second nasal endoscopy either by baby shampoo or commercial anti-fogging solution. However, 9.86% (95% C12.75-16.97) of endoscopists preferred commercial anti-fogging agent, 7.04% (95% CI 0.94-13.14) preferred baby shampoo and 83.10% (95% CI 74.16-92.03) had equal satisfaction. Both agents had no statistically significant difference for preventing foggy on the lens. Baby shampoo is an effective agent to prevent fogging during nasal endoscopy and comparable with the commercial anti-fogging agent.

  19. Endoscopy in inflammatory bowel disease.

    PubMed

    Carter, D; Lang, A; Eliakim, R

    2013-09-01

    Small bowel imaging and endoscopy in inflammatory bowel disease (IBD) underwent a lot of change and advancement in the recent years. Modalities have shifted from gastroscopy, colonoscopy and small bowel follow through, to ileo-colonoscopy, computed tomography (CT) or magnetic resonance (MR), enteroscopy, wireless video capsule endoscopy and balloon assisted enteroscopy. Nowadays endoscopy has a major role in the diagnosis of IBD, assessing its extent, treating some of its complications (stricture, bleeding), assessing the success of various treatments (mucosal healing), and as a predictor of disease course. Wireless capsule endoscopy (WCE) is a relatively new "toy" allowing direct, patient friendly, visualization of the entire small bowel mucosa. It has gained a substantial role in the evaluation of patients with suspected Chron's Disease (CD) and indeterminate colitis. WCE has a high positive predictive value in patients with suspected CD, when one uses more than two of the International Conference on Capsule Endoscopy (ICCE) criteria, and not less important, a very high negative predictive value in patients with suspected CD. Its role in patients with known CD, assessing their disease activity and extent, its role in assessing postsurgical small bowel recurrence and its role in the evaluation of mucosal healing are still unclear. Balloon assisted enteroscopy has established its role as a complementary tool in cases where there is need of biopsies or treatment (dilatation of strictures). The present review will summarize the role of endoscopy in the diagnosis of IBD, in assessing its activity, its management, interventional endoscopy and cancer surveillance.

  20. Double-balloon enteroscopy: Indications, approaches, diagnostic and therapeutic yield, and safety. Early experience at a single center.

    PubMed

    García-Correa, J J E; Ramírez-García, J J; García-Contreras, L F; Fuentes-Orozco, C; Irusteta-Jiménez, L; Michel-Espinoza, L R; Carballo Uribe, A S; Torres Chávez, J A; González-Ojeda, A

    2017-05-12

    Double-balloon enteroscopy has been improving the visualization of the entire intestine for more than a decade. It is a complementary method in the study of intestinal diseases that enables biopsies to be taken and treatments to be administered. Our aim was to describe its main indications, insertion routes, diagnostic/therapeutic yield, and complications. All patients referred to our unit with suspected small bowel pathology were included. The insertion route (oral/anal) was determined through diagnostic suspicion. The variables measured were: insertion route, small bowel examination extent, endoscopic diagnosis/treatment, biopsy/histopathology report, complications, and surgical findings. The study included 28 double-balloon enteroscopies performed on 23 patients, of which 10 were women and 13 were men (mean age of 52.95 years). The oral approach was the most widely used (n=21), the main indication was overt small bowel bleeding (n=16), and the general diagnostic yield was 65.21%. The therapeutic intervention rate was 39.1% and the procedure was effective in all the cases. The most widely used treatment was argon plasma therapy (n=7). The complication rate was 8.6%; one patient presented with low blood pressure due to active bleeding and another had deep mucosal laceration caused by the argon plasma. Double-balloon enteroscopy is a safe and efficacious method for the study and management of small bowel diseases, with an elevated diagnostic and therapeutic yield. Copyright © 2017 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  1. Lubiprostone improves visualization of small bowel for capsule endoscopy: a double-blind, placebo-controlled 2-way crossover study

    PubMed Central

    Matsuura, Mizue; Inamori, Masahiko; Inou, Yumi; Kanoshima, Kenji; Higurashi, Takuma; Ohkubo, Hidenori; Iida, Hiroshi; Endo, Hiroki; Nonaka, Takashi; Kusakabe, Akihiko; Maeda, Shin; Nakajima, Atsushi

    2017-01-01

    Background and study aims  Lubiprostone has been reported to be an anti-constipation drug. The aim of the study was to investigate the usefulness of lubiprostone both for bowel preparation and as a propulsive agent in small bowel endoscopy. Patients and methods  This was a double-blind, placebo-controlled, 2-way crossover study of subjects who volunteered to undergo capsule endoscopy (CE). A total of 20 subjects (16 male and 4 female volunteers) were randomly assigned to receive a 24-μg tablet of lubiprostone 120 minutes prior to capsule ingestion for CE (L regimen), or a placebo tablet 120 minutes prior to capsule ingestion for CE (P regimen). Main outcome was gastric transit time (GTT) and small-bowel transit time (SBTT). Secondary outcome was adequacy of small-bowel cleansing and the fluid score in the small bowel. The quality of the capsule endoscopic images and fluid in the small bowel were assessed on 5-point scale. Results  The capsule passed into the small bowel in all cases. Median GTT was 57.3 (3 – 221) minutes for the P regimen and 61.3 (10 – 218) minutes for the L regimen ( P  = 0.836). Median SBTT was 245.0 (164 – 353) minutes for the P regimen and 228.05 (116 – 502) minutes for the L regimen ( P  = 0.501). The image quality score in the small bowel was 3.05 ± 1.08 for the P regimen and 3.80 ± 0.49 for the L regimen ( P  < 0.001). The fluid score in the small bowel was 2.04 ± 1.58 for the P regimen and 2.72 ± 1.43 for the L regimen ( P  < 0.001). There was a significant difference between the 2 regimens with regard to image quality. The fluid score was more plentiful for the L regimen than for the P regimen. There were no cases of capsule retention or serious adverse events in this study. Conclusion  Our study showed that use of lubiprostone prior to CE significantly improved visualization of the small bowel during CE as a result of inducing fluid secretion into the small bowel. PMID

  2. [Double-balloon angioplasty of pulmonary venous drainage obstruction after the Senning procedure in transposition of the great vessels].

    PubMed

    Benito Bartolomé, F; Sánchez Fernández-Bernal, C

    1999-10-01

    A six and half-year old boy with Senning operation for transposition of the great arteries, showed recurrent atrial flutter and obstruction of the pulmonary venous atrium from the early postoperative period. By Doppler examination a peak gradient of 13 mmHg at the isthmus level was recorded in the pulmonary venous atrium. A successful double-balloon dilatation of stenotic area was performed via a retrograde, transaortic, approach through angioplasty. Six months after the procedure the enlargement of the stenosis persists, and the patient is clinically asymptomatic and arrhythmia-free without medication.

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

    PubMed Central

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

    2015-01-01

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

  4. Endoscopy in inflammatory bowel disease when and why

    PubMed Central

    Rameshshanker, Rajaratnam; Arebi, Naila

    2012-01-01

    Endoscopy plays an important role in the diagnosis and management of inflammatory bowel disease (IBD). It is useful to exclude other aetiologies, differentiate between ulcerative colitis (UC) and Crohn’s disease (CD), and define the extent and activity of inflammation. Ileocolonoscopy is used for monitoring of the disease, which in turn helps to optimize the management. It plays a key role in the surveillance of UC for dysplasia or neoplasia and assessment of post operative CD. Capsule endoscopy and double balloon enteroscopy are increasingly used in patients with CD. Therapeutic applications relate to stricture dilatation and dysplasia resection. The endoscopist’s role is vital in the overall management of IBD. PMID:22720120

  5. Double-balloon catheter and sequential vaginal prostaglandin E2 versus vaginal prostaglandin E2 alone for induction of labor after previous cesarean section.

    PubMed

    Kehl, Sven; Weiss, Christel; Wamsler, Michael; Beyer, Jana; Dammer, Ulf; Heimrich, Jutta; Faschingbauer, Florian; Sütterlin, Marc; Beckmann, Matthias W; Schleussner, Ekkehard

    2016-04-01

    To evaluate the efficacy of inducing labor using a double-balloon catheter and vaginal prostaglandin E2 (PGE2) sequentially, in comparison with vaginal PGE2 alone after previous cesarean section. A total of 264 pregnant women with previous cesarean section undergoing labor induction at term were included in this prospective multicentre cohort study. Induction of labor was performed either by vaginal PGE2 gel or double-balloon catheter followed by vaginal PGE2. The primary outcome measure was the cesarean section rate. The cesarean section rate was 37 % without any statistically significant difference between the two groups (PGE2: n = 41, 37 % vs. balloon catheter/PGE2: n = 41, 42 %; P = 0.438). The median (range) number of applications of PGE2 [2 (1-10) versus 1 (0-8), P < 0.001] and the total amount of PGE2 used in median (range) mg [2 (1-15) vs. 1 (0-14), P = 0.001] was less in the balloon catheter/PGE2 group. Factors significantly increasing risk for cesarean section were "no previous vaginal delivery" (OR 5.391; CI 2.671-10.882) and "no oxytocin augmentation during childbirth" (OR 2.119; CI 1.215-3.695). The sequential application of double-balloon catheter and vaginal PGE2 is as effective as the sole use of vaginal PGE2 with less applications and total amount of PGE2.

  6. Utility of the Anterior Oblique-Viewing Endoscope and the Double-Balloon Enteroscope for Endoscopic Retrograde Cholangiopancreatography in Patients with Billroth II Gastrectomy

    PubMed Central

    Sen-yo, Manabu; Kaino, Seiji; Suenaga, Shigeyuki; Uekitani, Toshiyuki; Yoshida, Kanako; Harano, Megumi; Sakaida, Isao

    2012-01-01

    Background/Purpose. The difficulties of endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrectomy have been reported. We evaluated the usefulness of an anterior oblique-viewing endoscope and a double-balloon enteroscope for endoscopic retrograde cholangiopancreatography in such patients. Methods. From January 2003 to December 2011, 65 patients with Billroth II gastrectomy were enrolled in this study. An anterior oblique-viewing endoscope was used for all patients. From February 2007, a double-balloon enteroscope was used for the failed cases. The success rate of procedures was compared with those in 20 patients with Billroth II gastrectomy using forward-viewing endoscope or side-viewing endoscope from March 1996 to July 2002 as historical controls. Results. In all patients in whom the papilla was reached (60/65), selective cannulation was achieved. The success rate of selective cannulation and accomplishment of planned procedures in the anterior oblique-viewing endoscope group were both significantly higher than that in the control group (100% versus 70.1%, 100 versus 58.8%, resp.). A double-balloon enteroscope was used in 2 patients, and the papilla could be reached and the planned procedures completed. Conclusions. An anterior oblique-viewing endoscope and double-balloon enteroscope appear to be useful in performing endoscopic retrograde cholangiopancreatography in patients with Billroth II gastrectomy. PMID:23056039

  7. Double-balloon catheter versus prostaglandin E2 for cervical ripening and labour induction: a systematic review and meta-analysis of randomised controlled trials.

    PubMed

    Du, Y M; Zhu, L Y; Cui, L N; Jin, B H; Ou, J L

    2017-05-01

    Induction of labour has become an increasingly common procedure. Ripening methods, including mechanical devices and pharmacological agents, improve the success rate of labour induction. To compare the efficacy and safety of the double-balloon catheter with prostaglandin E2 agents used for labour induction. We searched electronic sources from MEDLINE, Embase and Web of Science, the Cochrane Library Database of Systematic Reviews, and ClinicalTrials.gov website. Only randomised controlled trials comparing the PGE2 agents with the double-balloon catheter for cervical ripening and labour induction in women with unfavourable cervices were included in the analysis. The main outcomes included the vaginal delivery rate within 24 hours and risk of caesarean section. We calculated relative risks and mean differences using fixed- and random-effects models. Nine studies (1866 patients) were included in this systematic review. Both the double-balloon catheter and PGE2 agents were comparable with regard to rate of caesarean section (RR 0.92; 95% CI 0.79, 1.07), vaginal delivery within 24 hours (RR 0.95; 95% CI 0.78, 1.16) and maternal adverse events, but the risk of excessive uterine activity (RR 10.02; 95% CI 3.99, 25.17) and need for neonatal intensive care unit admissions (RR 1.31; 95% CI 1.01, 1.69) were significantly increased in women who received PGE2 agents. The double-balloon catheter demonstrated greater safety and cost-effectiveness than PGE2 agents for cervical ripening and labour induction. The efficacy profiles of both methods were similar. Double-balloon catheter versus prostaglandin E2 for cervical ripening and labour induction. © 2016 Royal College of Obstetricians and Gynaecologists.

  8. Impact of a Newly Developed Short Double-Balloon Enteroscope on Stent Placement in Patients with Surgically Altered Anatomies

    PubMed Central

    Tsutsumi, Koichiro; Kato, Hironari; Okada, Hiroyuki

    2017-01-01

    A newly developed short double-balloon enteroscope with a working channel enlarged to a diameter of 3.2 mm is a novel innovation in stent placement for patients with surgically altered anatomies. Herein, we report three patients in whom this new scope contributed to an efficient technique and ideal treatment. In the first case, the double guidewire technique was efficient and effective for multiple stent placements. In the second case, covered self-expandable metal stent (SEMS) placement, which is the standard treatment for malignant biliary obstruction, could be performed in a technologically sound and safe manner. In the third case, SEMS placement was performed as palliative treatment for malignant afferent-loop obstruction; this procedure could be performed soundly and safely using the through-the-scope technique. The wider working channel of this new scope also facilitates a smoother accessory insertion and high suction performance, which reduces procedure time and stress on endoscopists. Furthermore, this new scope, which has advanced force transmission, adaptive bending, and a smaller turning radius, is expected to be highly successful in both diagnosis and therapy for various digestive diseases in patients with surgically altered anatomies. PMID:28208009

  9. Advances in balloon endoscopes.

    PubMed

    Araki, Akihiro; Tsuchiya, Kiichiro; Watanabe, Mamoru

    2014-06-01

    In September 2003, a double-balloon endoscope (DBE) composed of balloons attached to a scope and an overtube was released in Japan prior to becoming available in other parts of the world. The DBE was developed by Dr. Yamamoto (1), and 5 different types of scopes with different uses have already been marketed. In April 2007, a single-balloon small intestinal endoscope was released with a balloon attached only to the overtube as a subsequent model. This article presents a detailed account of the development of these scopes up to the present time.

  10. Evaluation of “top-down” treatment of early Crohn’s disease by double balloon enteroscopy

    PubMed Central

    Fan, Rong; Zhong, Jie; Wang, Zheng-Ting; Li, Shu-Yi; Zhou, Jie; Tang, Yong-Hua

    2014-01-01

    AIM: To assess “top-down” treatment for deep remission of early moderate to severe Crohn’s disease (CD) by double balloon enteroscopy. METHODS: Patients with early active moderate to severe ileocolonic CD received either infusion of infliximab 5 mg/kg at weeks 0, 2, 6, 14, 22 and 30 with azathioprine from week 6 onwards (Group I), or prednisone from week 0 as induction therapy with azathioprine from week 6 onwards (Group II). Endoscopic evaluation was performed at weeks 0, 30, 54 and 102 by double balloon enteroscopy. The primary endpoints were deep remission rates at weeks 30, 54 and 102. Secondary endpoints included the time to achieve clinical remission, clinical remission rates at weeks 2, 6, 14, 22, 30, 54 and 102, and improvement of Crohn’s Disease Endoscopic Index of Severity scores at weeks 30 and 54 relative to baseline. Intention-to-treat analyses of the endpoints were performed. RESULTS: Seventy-seven patients were enrolled, with 38 in Group I and 39 in Group II. By week 30, deep remission rates were 44.7% and 17.9% in Groups I and II, respectively (P = 0.011). The median time to clinical remission was longer for patients in Group II (14.2 wk) than for patients in Group I (6.8 wk, P = 0.009). More patients in Group I were in clinical remission than in Group II at weeks 2, 6, 22 and 30 (2 wk: 26.3% vs 2.6%; 6 wk: 65.8% vs 28.2%; 22 wk: 71.1% vs 46.2%; 30 wk: 68.4% vs 43.6%, P < 0.05). The rates of clinical remission and deep remission were greater at weeks 54 and 102 in Group I, but the differences were insignificant. CONCLUSION: Top-down treatment with infliximab and azathioprine, as compared with corticosteroid and azathioprine, results in higher rates of earlier deep remission in early CD. PMID:25339835

  11. Effect of transurethral split of the prostate using a double-columnar balloon catheter for benign prostatic hyperplasia

    PubMed Central

    Huang, Weiguo; Huang, Zheng; Xiao, Guofeng; Qin, Xiang

    2016-01-01

    Abstract We aimed to evaluate the long-term therapeutic effect of transurethral split of the prostate (TUSP) with a newly improved double-columnar balloon catheter on patients with benign prostatic hyperplasia (BPH). Total 565 BPH patients (mean age 73.6 years, range 46–94 years) who underwent TUSP surgery between January 2006 and January 2015 were included. Patient's baseline characteristics, prostate size, PSA, preoperative and postoperative maximum urinary flow rate (Qmax), postvoid residual (PVR), international prostate symptoms score (IPSS) and quality of life (QOL) score, perioperative data and postoperative complications were recorded. The mean preoperative prostates size was 48.6 ± 8.2 mL (range 33–230 mL), and the PSA level was 0.8 to 18.6 ng/mL. The mean duration of TUSP procedure from the catheter localization to the split of capsula prostatica was ∼10 minutes. After surgery, the mean Qmax increased from 5.2 ± 1.4 to 12.8 ± 2.2 mL/s (P < 0.001). Patients had improved mean PVR, QOL score, and IPSS after TUSP (76 ± 8 vs 20 ± 8.5 mL, 4.6 ± 0.2 vs 1.4 ± 0.3, and 20.2 ± 4.4 vs 6.6 ± 1.1, respectively, all P < 0.001). Until September 2014, 328 patients were successfully followed up for a long-term period of 38 to 99 months. There was no other case of recurrence with dysuria despite 2 recurrent cases. The TUSP with a double-columnar balloons catheter was a safe and long-term efficient treatment for BPH, with minimal invasion, short operative time, few postoperative complications, and low recurrence rate. PMID:27749528

  12. [Double-blind study on the analgesic efficacy of tilidine (valoron) and pethidine (dolantin) in gastro-intestinal endoscopies and liver biopsies (author's transl)].

    PubMed

    Tomatis, H P

    1977-02-01

    In a double-blind trial involving 99 patients, equi-analgesic doses of tilidine and pethidine (100 mg of each i.m.) were compared as to their effectiveness in laparoscopies, gastroscopies, esophagoscopies and liver needle biopsies. The two substances produced equally analgesic effects both during and after the various procedures, with the exception of the liver biopsies, in which tilidine was shown to be significantly more effective than pethidine. Whereas no sedation was noted in connection with tilidine medication, pethidine produced a marked, undesirable sleepiness in 12% of the cases observed. Due to the high analgesic efficacy and tolerance of tilidine found in both this and numerous other clinical trials and to its particular advantages over pethidine and other opiates (no respiratory depression, no effect on intestinal motility) tilidine can be recommended for premedication in gastrointestinal endoscopies and liver needle biopsies. Tilidine (Valoron) is not subject to the restrictions imposed by the West German narcotics laws.

  13. A case of a ruptured submucosal aneurysm of the small intestine identified using double-balloon enteroscopy.

    PubMed

    Chiba, Hirofumi; Endo, Katsuya; Fujishima, Fumiyoshi; Ohtsuka, Hideo; Naitoh, Takeshi; Kuroha, Masatake; Kimura, Tomoya; Shiga, Hisashi; Kakuta, Yoichi; Kinouchi, Yoshitaka; Unno, Michiaki; Shimosegawa, Tooru

    2016-04-01

    A 47-year-old woman was admitted to our hospital urgently with sudden-onset hematochezia. She was temporarily in a state of hemorrhagic shock. As we strongly suspected bleeding from the small intestine, peroral double-balloon enteroscopy was performed, and indicated a 2.0-cm diameter hemispheric elevated lesion in the jejunum. Moreover, a blood clot was observed at the top of the protrusion. The site was marked by injecting India ink, without taking a biopsy specimen, to avoid further hemorrhaging. Subsequently, laparoscopic partial small bowel resection was performed. On histopathological examination, the lesion was found to be a sac-like submucosal arterial aneurysm, with a diameter of 3.5 mm, comprising several small abnormal arteries. The final diagnosis was a ruptured submucosal aneurysm of the small intestine. Ruptured submucosal aneurysms are very rarely observed in the small intestine. Only a few reports have described their endoscopic findings. Our experience indicates that small bowel enteroscopy may be useful for managing ruptured submucosal aneurysms of the small intestine.

  14. Successful removal of an internal pancreatic stent that migrated into the bile duct using double-balloon enteroscopy after pancreaticoduodenectomy.

    PubMed

    Hirono, Seiko; Kawai, Manabu; Yamashita, Yasunobu; Okada, Ken-Ichi; Miyazawa, Motoki; Ueno, Masaki; Maeda, Yoshimasa; Itonaga, Masahiro; Kitano, Masayuki; Yamaue, Hiroki

    2017-07-08

    Internal stents used during pancreaticoduodenectomy (PD) are generally spontaneously passed through the rectum by defecation. However, we encountered six patients with internal stents that migrated into the bile duct after PD. We herein report the outcomes of these six patients and the usefulness of double-balloon enteroscopy (DBE) for removal of such stents from the bile duct. An internal stent was placed across pancreaticojejunostomy in 416 (68.8%) of 605 consecutive patients undergoing PD between 2005 and 2015. This study evaluated the characteristics and outcomes of the six patients whose internal stent migrated into the bile duct. Migration of an internal stent into the bile duct was found during follow-up computed tomography (CT) in 6 (1.4%) of 416 patients who had an internal stent placed during PD. Three patients developed stent-induced cholangitis, and two had bile duct stones. Excluding one patient whose internal stent spontaneously slipped out and disappeared from the bile duct, all patients underwent successful removal of a stent from the bile duct by a single instance of biliary intervention involving DBE. Removal of a stent from the bile duct using DBE is a feasible and useful procedure that should be considered if an internal stent is detected during follow-up CT after PD.

  15. Is it feasible to reach the bypassed stomach after Roux-en-Y gastric bypass for morbid obesity? The use of the double-balloon enteroscope.

    PubMed

    Sakai, P; Kuga, R; Safatle-Ribeiro, A V; Faintuch, J; Gama-Rodrigues, J J; Ishida, R K; Furuya, C K; Yamamoto, H; Ishioka, S

    2005-06-01

    Endoscopic evaluation of the excluded stomach after Roux-en-Y gastric bypass surgery for morbid obesity is a challenge, and the pathological changes that take place in the bypassed stomach are unclear. A new double-balloon method of evaluating the bypassed stomach after Roux-en-Y gastric bypass surgery for morbid obesity is described here. This new enteroscope uses two balloons, one attached to the tip of the endoscope and the other to the distal end of the soft overtube. The procedures were carried out in six patients using the retrograde route, through the end-to-side jejunal anastomosis via the duodenobiliopancreatic limb up to the bypassed stomach. The bypassed stomach was reached in five of six patients (83.3 %). An endoscopic appearance of atrophic gastritis was found in three patients, mild in two cases and severe in one case with intestinal metaplasia. Erosive and hemorrhagic gastritis was found in two patients. Endoscopic evaluation of the bypassed stomach via the retrograde route after Roux-en-Y gastric bypass for morbid obesity is feasible using the double-balloon enteroscope.

  16. The add-on N-acetylcysteine is more effective than dimethicone alone to eliminate mucus during narrow-band imaging endoscopy: a double-blind, randomized controlled trial.

    PubMed

    Chen, Ming-Jen; Wang, Horng-Yuan; Chang, Chen-Wang; Hu, Kuang-Chun; Hung, Chien-Yuan; Chen, Chih-Jen; Shih, Shou-Chuan

    2013-02-01

    Recent studies have shown that pronase can improve mucosal visibility, but this agent is not uniformly available for human use worldwide. This study aimed to assess the efficacy of N-acetylcysteine (NAC), a mucolytic agent, in improving mucus elimination as measured by decreased endoscopic water flushes during narrow-band imaging (NBI) endoscopy. A consecutive series of patients scheduled for upper gastrointestinal endoscopy at outpatient clinics were enrolled in this double-blind, randomized controlled trial. The control group drank a preparation of 100 mg dimethicone (5 ml at 20 mg/ml) plus water up to 100 ml, and the NAC group drank 300 mg NAC plus 100 mg dimethicone and water up to 100 ml. During the endoscopy, the endoscopist used as many flushes of water as deemed necessary to produce a satisfactory NBI view of the entire gastric mucosa. In all, 177 patients with a mean age of 51 years were evaluated in this study. Significantly lesser water was used for flushing during NBI endoscopy for the NAC group than the control group; 40 ml (30-70, 0-120) versus 50 ml (30-100, 0-150) (median (interquartile range, range), p = 0.0095). Considering the safety profile of NAC, decreasing the number of water flushes for optimal vision and unavailability of pronase in some areas, the authors suggest the use of add-on NAC to eliminate mucus during NBI endoscopy.

  17. [Endoscopy 2000].

    PubMed

    Zöpf, T; Riemann, J F

    1999-01-14

    The trends and developments in endoscopy of the coming years are many-sided. Improved fiber-optics and invention of computer technology lead to smaller endoscopes with higher resolution. Electronic image processing makes three dimensional measurement or presentation of objects possible. In endosonography a trend to miniaturization is also obvious. Advances in molecular biology and imaging procedures will strengthen the importance of endoscopy in the future. Moreover a differentiated use of new laser technologies will improve the possibilities of endoscopic diagnosis and therapy. The use of electronic diagnostic documentation systems will contribute to a standardized nomenclature and to a quality-improvement of documentation in the near future. The utilization of modern electronic communication systems will facilitate intra- and interdisciplinary exchange of information.

  18. Lubiprostone neither decreases gastric and small-bowel transit time nor improves visualization of small bowel for capsule endoscopy: a double-blind, placebo-controlled study.

    PubMed

    Hooks, S Bennett; Rutland, Travis J; Di Palma, Jack A

    2009-11-01

    Lubiprostone, a selective activator of type 2 chloride channels, is approved for treatment of chronic idiopathic constipation and recently constipation-predominant irritable bowel syndrome. It has been suggested that lubiprostone has a prokinetic effect. This investigation was designed to evaluate lubiprostone as a preparation and propulsive agent for small-bowel capsule endoscopy. The PillCam Small Bowel capsule endoscopy system with the PillCam SB1 capsule and Rapid 5 software platform were used. The study was designed as a double-blind, placebo-controlled trial. Forty healthy adults. Gastric transit time (GTT), small-bowel transit time (SBTT), and adequacy of small-bowel cleansing preparation. The study subjects received 24 mug lubiprostone or placebo 30 minutes before PillCam capsule ingestion. Capsule endoscopy studies were read by 2 independent investigators unaware of the study medication received, and differences in interpretation were resolved by consensus. Anatomical landmarks were identified, and GTT and SBTT were calculated. Overall preparation quality assessment of the proximal, mid, and distal small bowel was determined by using a 4-step scale. The percentage of visualized bowel was determined by review of 10-minute video segments at 1-hour intervals after the capsule passed through the pylorus. In the lubiprostone group (n = 20), 2 subjects did not pass the capsule through the pylorus in the 8-hour battery life of the capsule. An additional 3 capsules did not pass into the colon. In the placebo group (n = 20), all capsules passed into the small bowel, but 1 did not pass into the colon. The subjects in whom the capsule did not pass into the small bowel were excluded from the small-bowel analysis. In the subjects in whom the capsule did reach the colon, the SBTT could not be calculated and they were excluded from SBTT analysis. The mean GTT in the lubiprostone group was 126 minutes and 43 minutes in the placebo group (P = .0095). The mean SBTT in the

  19. Double-balloon catheter for induction of labour in women with a previous cesarean section, could it be the best choice?

    PubMed

    De Bonrostro Torralba, Carlos; Tejero Cabrejas, Eva Lucía; Marti Gamboa, Sabina; Lapresta Moros, María; Campillos Maza, Jose Manuel; Castán Mateo, Sergio

    2017-05-01

    We analysed the efficacy and safety of double-balloon catheter for cervical ripening in women with a previous cesarean section and which were the most important variables associated with an increased risk of repeated cesarean delivery. We designed an observational retrospective study of 418 women with unfavourable cervices (Bishop Score <5), a prior cesarean delivery, and induction of labour with a double-balloon catheter. Baseline maternal data and perinatal outcomes were recorded for a descriptive, bivariate, and multivariate analysis. A p value <0.05 was considered statistically significant. Most women improved their initial Bishop Score (89.5%) although only a 20.8% of them went into spontaneous active labour. Finally, 51.4% of the women achieved a vaginal delivery. Five cases of intrapartum uterine rupture (1.2%) occurred. After multivariate analysis, main risk factors for repeated cesarean section were dystocia in the previous pregnancy (OR 1.744; CI 95% 1.066-2.846), the absence of previous vaginal delivery (OR 2.590; CI 95% 1.066-6.290), suspected fetal macrosomia (OR 2.410; CI 95% 0.959-6.054), and duration of oxytocin induction period (OR 1.005; CI 95% 1.004-1.006). The area under the curve was 0.789 (p < 0.001). Double-balloon catheter seems to be safe and effective for cervical ripening in women with a previous cesarean delivery and unfavourable cervix. In our study, most women could have a vaginal delivery in spite of their risk factors for cesarean delivery. A multivariate model based on some clinical variables has moderate predictive value for intrapartum cesarean section.

  20. [Double-balloon enteroscopy: experience in the Hospital de Especialidades del Centro Médico Nacional Siglo XXI IMSS, Mexico City].

    PubMed

    Blancas Valencia, Juan Manuel; Paz Flores, Víctor Manuel; Yokota, Alejo Miyamoto; Huerta Fosado, Blanca Rosa; Meneses, Luis Fernando; Piccini Larco, Julio Roberto; Mejía Cuan, Luis Alvaro

    2005-01-01

    The methods used for the study of the small bowel are not ideal. Double-balloon enteroscopy is a new alternative with therapeutic potential. Evaluate the utility, efficacy and safety of double-balloon enteroscopy in Mexico. Adult patients seen in the Hospital de Especialidades Centro Médico Nacional Siglo XXI, Mexico City who were being studied for: chronic diarrhea, obscure gastrointestinal hemorrhage, weight-loss and chronic anemia were included in the study. Anterograde (oral) and retrograde (anal) approaches were used and study time, findings and complications were evaluated. Thirty-one enteroscopies were performed, 15 were anterograde, 8 retrograde and 8 were performed via both routes, in 23 patients studied between February and October, 2004; 10 of them were women and 13 men with ages ranging from 25 to 80 years. Fourteen patients were sedated and 9 patients were anesthetized. Study time varied form 55 to 90 minutes. With the anterograde route the ileum was reached in 56.6% of cases, 39.1% the jejunum and only in one patient (4.3%) the whole intestine was explored. With the retrograde route in 62.5% of cases the jejunum was explored and 37.5% the ileum. Four patients with obscure gastrointestinal bleeding and 1 patient with chronic anemia had vascular ecstasies, and in 40% of patients there was no identifiable cause. In 2 patients with intestinal stenosis biopsies revealed intestinal lymphoma in one and ischemic injury in another one. The adverse effects were mild and transitoru. Double-balloon enteroscopy is a safe diagnostic and therapeutic method that is useful in cases of obscure hemorrhage, chronic anemia; small bowel pathology was found in 64.7% of cases.

  1. Double-balloon catheter and sequential oral misoprostol versus oral misoprostol alone for induction of labour at term: a retrospective cohort study.

    PubMed

    Kehl, Sven; Weiss, Christel; Dammer, Ulf; Heimrich, Jutta; Beckmann, Matthias W; Faschingbauer, Florian; Sütterlin, Marc

    2016-09-01

    To evaluate the efficacy of induction of labour using a double-balloon catheter and, if necessary, sequential oral misoprostol without delay after removal of the catheter, in comparison with oral misoprostol alone. This retrospective cohort study included women undergoing induction of labour with oral misoprostol or double-balloon catheter with sequential oral misoprostol in singleton pregnancies at term. The catheter was placed in the evening and removed when there was no onset of labour within 12h. Then oral misoprostol was started within 3h. Primary outcome measure was the caesarean section rate. There were 13,082 deliveries during the study period with 3466 labour inductions out of which 1032 were eligible and analysed. The caesarean section rate was significantly lower in the double-balloon catheter group (26.1% vs. 17.3, p=0.021). Furthermore, in the combination group, the induction-to-delivery interval was shorter (median values 1144 vs. 1365min, p=0.001) and there were more deliveries within 24h (51.9 vs. 64.7%, p=0.003) and 48h (87.4 vs. 95.8%, p=0.002). When stratifying for parity, there were less caesarean sections in the combination group (37.2% vs. 24.2%, p=0.015) in nulliparous women, too. In both, nulliparous and parous women, the induction-to-delivery interval was shorter (1742 vs. 1400min, 0.005; 1020 vs. 912min, p=0.018). Especially in parous women, the rates of delivery within 24h (62.6% vs. 79.0%, p=0.007) and 48h (88.6% vs. 99.0%, p=0.007) were higher in the combination group. Double-balloon catheter and sequential oral misoprostol without long delay in absent onset of labour after removal of the catheter resulted in less caesarean section and shorter induction-to-delivery interval in comparison with oral misoprostol alone. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Intracranial endoscopy.

    PubMed

    Schroeder, H W; Gaab, M R

    1999-04-15

    The authors' intention is to reduce the invasiveness of intracranial procedures while avoiding traumatization of brain tissue, to decrease the risk of neurological and mental deficits. Intracranial endoscopy is a minimally invasive technique that provides rapid access to the target via small burr holes without the need for brain retraction. Craniotomy as well as microsurgical brain splitting and dissection can often be avoided. Furthermore, because obstructed cerebrospinal fluid pathways can be physiologically restored, the need for shunt placement is eliminated. The ventricular system and subarachnoid spaces provide ideal conditions for the use of an endoscope. Therefore, a variety of disorders, such as hydrocephalus, small intraventricular lesions, and arachnoid and parenchymal cysts can be effectively treated using endoscopic techniques. With the aid of special instruments, laser fibers, and bipolar diathermy, even highly vascularized lesions such as cavernomas may be treated. Moreover, during standard microsurgical procedures, the endoscopic view may provide valuable additional information ("looking around a corner") about the individual anatomy that is not visible with the microscope. In transsphenoidal pituitary surgery, transseptal dissection can be avoided if an endonasal approach is taken. In the depth of the intrasellar space, the extent of tumor removal can be more accurately controlled, especially in larger tumors with para- and suprasellar growth. The combined use of endoscopes and computerized neuronavigation systems increases the accuracy of the approach and provides real-time control of the endoscope tip position and approach trajectory. In the future, the indications for neuroendoscopy will certainly expand with improved technical equipment.

  3. Requirements and standards facilitating quality improvement for reporting systems in gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

    PubMed

    Bretthauer, Michael; Aabakken, Lars; Dekker, Evelien; Kaminski, Michal F; Rösch, Thomas; Hultcrantz, Rolf; Suchanek, Stepan; Jover, Rodrigo; Kuipers, Ernst J; Bisschops, Raf; Spada, Cristiano; Valori, Roland; Domagk, Dirk; Rees, Colin; Rutter, Matthew D

    2016-03-01

    To develop standards for high quality in gastrointestinal (GI) endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all GI endoscopy procedures is state-of-the-art integrated digital reporting systems for standardized documentation of the procedures. The current paper describes the ESGE's viewpoints on the requirements for high-quality endoscopy reporting systems in GI endoscopy. Recommendations 1 Endoscopy reporting systems must be electronic. 2 Endoscopy reporting systems should be integrated into hospitals' patient record systems. 3 Endoscopy reporting systems should include patient identifiers to facilitate data linkage to other data sources. 4 Endoscopy reporting systems shall restrict the use of free-text entry to a minimum, and be based mainly on structured data entry. 5 Separate entry of data for quality or research purposes is discouraged. Automatic data transfer for quality and research purposes must be facilitated. 6 Double entry of data by the endoscopist or associate personnel is discouraged. Available data from outside sources (administrative or medical) must be made available automatically. 7 Endoscopy reporting systems shall facilitate the inclusion of information on histopathology of detected lesions, patient satisfaction, adverse events, and surveillance recommendations. 8 Endoscopy reporting systems must facilitate easy data retrieval at any time in a universally compatible format. 9 Endoscopy reporting systems must include data fields for key performance indicators as defined by quality improvement committees. 10 Endoscopy reporting systems must facilitate changes in indicators and data entry fields as required by professional organizations.

  4. Double-Balloon Enteroscopy-detected Lipid Islets in the Small Bowel are Strong Predictors of Cardiovascular Disease when associated with Angiectasia and Bleeding.

    PubMed

    Albrecht, Heinz; Hagel, Wolfgang H; Hagel, Alexander F; Neurath, Markus F; Raithel, Martin

    2016-03-01

    Double-balloon enteroscopy (DBE) is a sensitive and safe procedure for the detection and treatment of mid-gastrointestinal bleeding (MGIB). It combines the possibility of a panenteroscopy with the immediate chance for intervention. This study evaluates the yield of DBE for the detection and treatment of MGIB in an unselected patient cohort. In a five-year period a total of 119 DBEs were carried out on 62 patients due to MGIB. Inclusion criteria were hematochezia, melena, anemia, positive hemoccult-test and iron deficiency. All pre-existing diseases or comorbidities were evaluated. Two main statistical methodologies were used in data analysis: descriptive statistics to describe the basic features of our data and Fisher's exact test for comparisons of proportions. The diagnostic yield was 69% (pathological findings in 43/62 patients) and the main diagnoses in all DBE-procedures were angiodysplasia (22%, 26/119 DBE), followed by lipid islets (18%, 21/119 DBE). In all patients with lipid islets this diagnosis was significantly connected with cardiovascular diseases. The combination of lipid islets and a relevant bleeding source appeared in 79% of the 19 patients with these findings. Of these, 53% had to be treated due to the bleeding event. The overall therapeutic intervention rate was 58%. Serious complications such as perforation or pancreatitis did not occur. Double-balloon enteroscopy as the gold standard for small bowel investigation in MGIB confirmed its high diagnostic yield in an unselected cohort of patients. A new strong combination of lipid islets with cardiovascular disease was revealed, with a high incidence of angiectasia bleeding. This combination should be evaluated in more detail as a new risk factor for MGIB, and should be regarded in this population when therapeutic anticoagulation is needed.

  5. Balloons for Science.

    ERIC Educational Resources Information Center

    Lally, Vincent E.

    1982-01-01

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

  6. Balloons Revisited

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  7. Reporting systems in gastrointestinal endoscopy: Requirements and standards facilitating quality improvement: European Society of Gastrointestinal Endoscopy position statement.

    PubMed

    Bretthauer, Michael; Aabakken, Lars; Dekker, Evelien; Kaminski, Michal F; Rösch, Thomas; Hultcrantz, Rolf; Suchanek, Stepan; Jover, Rodrigo; Kuipers, Ernst J; Bisschops, Raf; Spada, Cristiano; Valori, Roland; Domagk, Dirk; Rees, Colin; Rutter, Matthew D

    2016-04-01

    To develop standards for high quality of gastrointestinal endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all gastrointestinal endoscopy procedures is state-of-the-art integrated digital reporting systems for standardized documentation of the procedures. The current paper describes the ESGE's viewpoints on requirements for high-quality endoscopy reporting systems. The following recommendations are issued: Endoscopy reporting systems must be electronic.Endoscopy reporting systems should be integrated into hospital patient record systems.Endoscopy reporting systems should include patient identifiers to facilitate data linkage to other data sources.Endoscopy reporting systems shall restrict the use of free text entry to a minimum, and be based mainly on structured data entry.Separate entry of data for quality or research purposes is discouraged. Automatic data transfer for quality and research purposes must be facilitated.Double entry of data by the endoscopist or associate personnel is discouraged. Available data from outside sources (administrative or medical) must be made available automatically.Endoscopy reporting systems shall enable the inclusion of information on histopathology of detected lesions; patient's satisfaction; adverse events; surveillance recommendations.Endoscopy reporting systems must facilitate easy data retrieval at any time in a universally compatible format.Endoscopy reporting systems must include data fields for key performance indicators as defined by quality improvement committees.Endoscopy reporting systems must facilitate changes in indicators and data entry fields as required by professional organizations.

  8. Prospective evaluation of a new high-power argon plasma coagulation system (hp-APC) in therapeutic gastrointestinal endoscopy.

    PubMed

    Manner, Hendrik; May, Andrea; Rabenstein, Thomas; Pech, Oliver; Nachbar, Lars; Enderle, Markus D; Gossner, Liebwin; Ell, Christian

    2007-03-01

    The aim of this study was to prospectively evaluate a new high-power argon plasma coagulation system (hp-APC) in therapeutic gastrointestinal (GI) endoscopy. From February to June 2005, 216 patients (167 M (77.3%), mean age 66 years) underwent treatment with hp-APC in a total of 275 sessions. Main indications were additive ablation therapy in Barrett's esophagus, palliative treatment of esophageal cancer, gastric polyps/carcinomas, angiodysplasias, Zenker's diverticula, and duodenal adenomas. The new hp-APC device (VIO 300 D with APC 2) was used (15-120 W) in upper GI endoscopy, push-enteroscopy, and double-balloon enteroscopy. The mean number of treatment sessions required was 1.7 (1-5). For palliative tumor ablation in the esophagus, the number of sessions was 2.3 (1-5). Minor complications (pain, dysphagia, neuromuscular irritation, asymptomatic gas accumulation in the intestinal wall) were observed in 29/216 patients (13.4%). Major complications (perforation, stenosis occurred) in 2 patients (0.9%). Hp-APC appears to be safe and effective in the treatment of various GI condition using different types of endoscopes including double-balloon enteroscopy. Because of the low number of treatment sessions required, hp-APC could be used as an alternative to Nd:YAG laser treatment in tumor debulking.

  9. Ballooning Interest.

    ERIC Educational Resources Information Center

    Mebane, Robert C.; Rector, Bronwyn

    1991-01-01

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

  10. [Endoscopy simulator for training in digestive endoscopy].

    PubMed

    Bures, Jan; Rejchrt, Stanislav; Tachecí, Ilja; Cyrany, Jirí; Fejfar, Tomás; Douda, Tomás; Kopácová, Marcela

    2012-01-01

    This paper reports on a computer-based simulator (GI Mentor II) used for initial training in digestive endoscopy. The highly sophisticated apparatus employs real endoscopes and virtual accessories. The training programme starts with a group of exercises, specially designed to enhance eye-hand coordination. Interactive computerised simulator contains modules for training in gastroscopy, colonoscopy, endoscopic retrograde cholangio-pancreatography and endoscopic control of gastrointestinal bleeding. Virtual library contains 88 authentic cases of diagnostic and therapeutic procedures. Computer-based endoscopy simulators enable trainees to learn and gain technical endoscopic skills before operating on patients. It has the potential to shorten the learning process to competency in digestive endoscopy.

  11. Comparing omeprazole with fluoxetine for treatment of patients with heartburn and normal endoscopy who failed once daily proton pump inhibitors: double-blind placebo-controlled trial.

    PubMed

    Ostovaneh, M R; Saeidi, B; Hajifathalian, K; Farrokhi-Khajeh-Pasha, Y; Fotouhi, A; Mirbagheri, S S; Emami, H; Barzin, G; Mirbagheri, S A

    2014-05-01

    Patients with heartburn but without esophageal erosion respond less well to proton pump inhibitors (PPIs). There is a growing body of evidence implicating the role of psychological comorbidities in producing reflux symptoms. Pain modulators improve symptoms in patients with other functional gastrointestinal disorders. We aimed to compare the efficacy of fluoxetine with omeprazole and placebo to achieve symptomatic relief in patients with heartburn and normal endoscopy who failed once daily PPIs. Endoscopy-negative patients with heartburn who failed once daily PPIs were randomly allocated to receive 6 weeks treatment of fluoxetine, omeprazole, or placebo. Random allocation was stratified according to ambulatory pH monitoring study. Percentage of heartburn-free days and symptom severity was assessed. Sixty patients with abnormal and 84 patients with normal pH test were randomized. Subjects receiving fluoxetine experienced more improvement in percentage of heartburn-free days (median 35.7, IQR 21.4-57.1) than those on omeprazole (median 7.14, IQR 0-50, p < 0.001) or placebo (median 7.14, IQR 0-33.6, p < 0.001). In normal pH subgroup, fluoxetine was superior to both omeprazole and placebo regarding percentage of heartburn-free days (median improvement, 57.1, IQR 35.7-57.1 vs 13.9, IQR, 0-45.6 and 7.14, 0-23.8, respectively, p < 0.001), but no significant difference was observed between medications in abnormal pH subgroup. Fluoxetine was superior to omeprazole for improving the symptoms of patients with heartburn and normal endoscopy who failed once daily PPIs. The superiority of fluoxetine was mostly attributed to those with normal esophageal pH rather than those with abnormal pH (ClinicalTrials.gov, number NCT01269788). © 2014 John Wiley & Sons Ltd.

  12. Sedation for Pediatric Endoscopy

    PubMed Central

    2014-01-01

    It is more difficult to achieve cooperation when conducting endoscopy in pediatric patients than adults. As a result, the sedation for a comfortable procedure is more important in pediatric patients. The sedation, however, often involves risks and side effects, and their prediction and prevention should be sought in advance. Physicians should familiarize themselves to the relevant guidelines in order to make appropriate decisions and actions regarding the preparation of the sedation, patient monitoring during endoscopy, patient recovery, and hospital discharge. Furthermore, they have to understand the characteristics of the pediatric patients and different types of endoscopy. The purpose of this article is to discuss the details of sedation in pediatric endoscopy. PMID:24749082

  13. Lubiprostone decreases the small bowel transit time by capsule endoscopy: an exploratory, randomised, double-blind, placebo-controlled 3-way crossover study.

    PubMed

    Matsuura, Mizue; Inamori, Masahiko; Endo, Hiroki; Matsuura, Tetsuya; Kanoshima, Kenji; Inoh, Yumi; Fujita, Yuji; Umezawa, Shotaro; Fuyuki, Akiko; Uchiyama, Shiori; Higurashi, Takuma; Ohkubo, Hidenori; Sakai, Eiji; Iida, Hiroshi; Nonaka, Takashi; Futagami, Seiji; Kusakabe, Akihiko; Maeda, Shin; Nakajima, Atsushi

    2014-01-01

    The aim of this study was to investigate the usefulness of lubiprostone for bowel preparation and as a propulsive agent in small bowel endoscopy. Six healthy male volunteers participated in this randomized, 3-way crossover study. The subjects received a 24 μg tablet of lubiprostone 60 minutes prior to the capsule ingestion for capsule endoscopy (CE) and a placebo tablet 30 minutes before the capsule ingestion (L-P regimen), a placebo tablet 60 minutes prior to CE and a 24 μg tablet of lubiprostone 30 minutes prior to CE (P-L regimen), or a placebo tablet 60 minutes prior to r CE and a placebo tablet again 30 minutes prior to CE (P-P regimen). The quality of the capsule endoscopic images and the amount of water in the small bowel were assessed on 5-point scale. The median SBTT was 178.5 (117-407) minutes in the P-P regimen, 122.5 (27-282) minutes in the L-P regimen, and 110.5 (11-331) minutes in the P-L regimen (P = 0.042). This study showed that the use of lubiprostone significantly decreased the SBTT. We also confirmed that lubiprostone was effective for inducing water secretion into the small bowel during CE.

  14. Capsule endoscopy in patients refusing conventional endoscopy

    PubMed Central

    Romero-Vázquez, Javier; Argüelles-Arias, Federico; García-Montes, Josefa Maria; Caunedo-Álvarez, Ángel; Pellicer-Bautista, Francisco Javier; Herrerías-Gutiérrez, Juan Manuel

    2014-01-01

    Capsule endoscopy is nowadays the diagnostic technique of choice in the study of small bowel pathologies, allowing the non-invasive study of the entire mucosa. This has led, together with new technical advances, to the creation of two new models (PillCam ESO and PillCam Colon) for the study of esophageal and colonic diseases. These two new capsules offer an interesting alternative to conventional endoscopy in the study of the upper and lower digestive tracts, because traditional endoscopy is often unpleasant and uncomfortable for the patient, can be painful, often requires moderate or deep sedation and is not without complications (hemorrhage, perforation, etc.). PillCam Colon is particularly important for its usefulness in the diagnosis of colonic polyps, and is a potentially useful tool in cases of incomplete colonoscopy or in colorectal cancer screening, even more when most patients are reluctant to undergo screening programs due to the said disadvantages of conventional colonoscopy. This article discusses the advantages of capsule endoscopy over conventional endoscopy, its current application possibilities and indications in routine clinical practice. In the various sections of the work, we assess the application of endoscopic capsule in different sections of the digestive tract (esophagus, stomach, and colon) and finally the potential role of panendoscopy with PillCam Colon. PMID:24966612

  15. Balloon Sculpture

    ERIC Educational Resources Information Center

    Warwick, James F.

    1976-01-01

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

  16. Cosmic Balloons

    ERIC Educational Resources Information Center

    El Abed, Mohamed

    2014-01-01

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

  17. Cosmic Balloons

    ERIC Educational Resources Information Center

    El Abed, Mohamed

    2014-01-01

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

  18. Balloon Sculpture

    ERIC Educational Resources Information Center

    Warwick, James F.

    1976-01-01

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

  19. Endoscopy in Amphibians.

    PubMed

    Chai, Norin

    2015-09-01

    Despite advances in exotic animal endoscopy, descriptions involving amphibians are scarce. Amphibian endoscopy shares some similarities with reptiles, especially in lizards. Selected procedures are discussed, including stomatoscopy, gastroscopy, coelioscopy, and biopsy of coelomic organs and lesions. This short overview provides the practitioner with pragmatic advice on how to conduct safe and effective endoscopic examinations in amphibians. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. A comparative evaluation of treatment methods for bile duct stones after hepaticojejunostomy between percutaneous transhepatic cholangioscopy and peroral, short double-balloon enteroscopy

    PubMed Central

    Tsutsumi, Koichiro; Kato, Hironari; Yabe, Shuntaro; Mizukawa, Sho; Seki, Hiroyuki; Akimoto, Yutaka; Uchida, Daisuke; Matsumoto, Kazuyuki; Tomoda, Takeshi; Yamamoto, Naoki; Horiguchi, Shigeru; Kawamoto, Hirofumi; Okada, Hiroyuki

    2016-01-01

    Background: Bile duct stones after hepaticojejunostomy are considered a troublesome adverse event. Although percutaneous transhepatic procedures using a cholangioscopy is performed to treat these bile duct stones, a peroral endoscopic procedure using a short, double-balloon enteroscope (sDBE) is an alternative. This study aimed to compare the immediate and long-term outcomes of both treatments for bile duct stones in patients who underwent prior hepaticojejunostomy. Methods: Between October 2001 and May 2013, 40 consecutive patients were treated for bile duct stones after hepaticojejunostomy at a tertiary care hospital. Initial success with biliary access, biliary intervention-related technical success, clinical success, adverse events, hospitalization duration, and stone-free survival were retrospectively evaluated. Results: The initial success rates for biliary access were 100% (8/8) with percutaneous transhepatic cholangioscopy (PTCS) and 91% (29/32) with sDBE. In three patients in whom biliary access during initial sDBE failed, successful access with subsequent PTCS was achieved, and biliary intervention-related technical success and clinical success were eventually achieved in all 40 patients. The rate of adverse events was significantly lower with sDBE than with PTCS (10% versus 45%; p = 0.025). The median hospitalization duration for complete stone clearance was significantly shorter with sDBE than with PTCS (10 versus 35 days; p < 0.001). During the median 7.2 year or 3.1 year follow up, the probabilities of being stone-free at 1, 2, and 3 years were 100%, 73%, and 64% for PTCS and 85%, 65%, and 59% for sDBE, respectively (p = 0.919). Conclusions: sDBE was useful, with few adverse events and short hospitalization; therefore, experienced endoscopists can consider it as first-line treatment for bile duct stones in patients with prior hepaticojejunostomy. PMID:28286559

  1. Rebamipide has the potential to reduce the intensity of NSAID-induced small intestinal injury: a double-blind, randomized, controlled trial evaluated by capsule endoscopy.

    PubMed

    Fujimori, Shunji; Takahashi, Yoko; Gudis, Katya; Seo, Tsuguhiko; Ehara, Akihito; Kobayashi, Tsuyoshi; Mitsui, Keigo; Yonezawa, Masaoki; Tanaka, Shu; Tatsuguchi, Atsushi; Sakamoto, Choitsu

    2011-01-01

    A study reported that rebamipide was effective at reducing short-term nonsteroidal anti-inflammatory drug (NSAID)-induced enteropathy. The purpose of this study was to re-evaluate the effect of the co-administration of rebamipide on small intestinal injuries induced by short-term NSAID treatment. Eighty healthy male volunteers were randomly assigned to two study groups: a control group (N = 40), which received NSAID (diclofenac sodium, 75 mg/day) and omeprazole (20 mg/day) treatment along with a placebo; and a rebamipide group, which received NSAID, omeprazole and rebamipide (300 mg/day). Small intestinal injuries (mucosal breaks plus denuded areas) were evaluated by capsule endoscopy before and after 14 days of treatment. A total of 38 control subjects and 34 rebamipide subjects completed the treatment and were evaluated by capsule endoscopy. NSAID therapy increased the mean number of mucosal injuries per subject from a basal level of 0.1 ± 0.3 to 16 ± 71 and 4.2 ± 7.8 in the control and rebamipide groups, respectively, but the difference was not significant. The difference in the percentage of subjects with at least one mucosal injury post-treatment was also not significant (control 63%; rebamipide 47%). Limiting our analysis to subjects with mucosal injuries, rebamipide co-treatment had the tendency to reduce the mean number of mucosal injuries per subject from 25 in the control group to 8.9 in the rebamipide group (multiple comparisons test; p = 0.088, Mann-Whitney U test; p = 0.038). Rebamipide co-therapy had the potential to reduce the intensity of small intestinal injury induced by 2-week administration of diclofenac.

  2. Multiple angiodysplasia diagnosed by capsule endoscopy

    PubMed Central

    Diamantini, Giulia; Procacciante, Fabio

    2017-01-01

    A 28-year-old Caucasian man was admitted in our unit for acute massive rectal bleeding. Past medical and family history was unremarkable. Hemoglobin was 7.6 g/dL. Blood transfusions were required. Computed tomography and gastrointestinal endoscopy were negative for active bleeding. When patient’s hemoglobin was normalized and stable, a video capsule endoscopy was performed. Video relieved the presence of multiple digiunal and ileal angiodysplastic lesions. A double endoscopic argon plasma coagulation procedure was planned on general anaesthesia. Upper and rectal operative approach were performed. Procedure was uneventful. After 2 years follow-up patient had no recurrence of gastrointestinal bleeding.

  3. Balloons and Science Kit.

    ERIC Educational Resources Information Center

    Balloon Council, Washington, DC.

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

  4. Obscure gastrointestinal bleeding: preliminary comparison of 64-section CT enteroclysis with video capsule endoscopy.

    PubMed

    Khalife, Samer; Soyer, Philippe; Alatawi, Abdullah; Vahedi, Kouroche; Hamzi, Lounis; Dray, Xavier; Placé, Vinciane; Marteau, Philippe; Boudiaf, Mourad

    2011-01-01

    To retrospectively compare the diagnostic capabilities of 64-section CT enteroclysis with those of video capsule endoscopy (VCE) to elucidate the cause of obscure gastrointestinal bleeding. Thirty-two patients who had 64-section CT enteroclysis and VCE because of obscure gastrointestinal bleeding were included. Imaging findings were compared with those obtained at double balloon endoscopy, surgery and histopathological analysis, which were used as a standard of reference. Concordant findings were found in 22 patients (22/32; 69%), including normal findings (n=13), tumours (n=7), lymphangiectasia (n=1) and inflammation (n=1), and discrepancies in 10 patients (10/32; 31%), including ulcers (n=3), angioectasias (n=2), tumours (n=2) and normal findings (n=3). No statistical difference in the proportions of abnormal findings between 64-section CT enteroclysis (11/32; 34%) and VCE (17/32, 53%) (P=0.207) was found. However, 64-section CT enteroclysis helped identify tumours not detected at VCE (n=2) and definitely excluded suspected tumours (n=3) because of bulges at VCE. Conversely, VCE showed ulcers (n=3) and angioectasias (n=2) which were not visible at 64-section CT enteroclysis. Our results suggest that 64-section CT enteroclysis and VCE have similar overall diagnostic yields in patients with obscure gastrointestinal bleeding. However, the two techniques are complementary in this specific population.

  5. Balloon Kyphoplasty

    PubMed Central

    2004-01-01

    Executive Summary Objective To review the evidence on the effectiveness and cost-effectiveness of balloon kyphoplasty for the treatment of vertebral compression fractures (VCFs). Clinical Need Vertebral compression fractures are one of the most common types of osteoporotic fractures. They can lead to chronic pain and spinal deformity. They are caused when the vertebral body (the thick block of bone at the front of each vertebra) is too weak to support the loads of activities of daily living. Spinal deformity due to a collapsed vertebral body can substantially affect the quality of life of elderly people, who are especially at risk for osteoporotic fractures due to decreasing bone mass with age. A population-based study across 12 European centres recently found that VCFs have a negative impact on health-related quality of life. Complications associated with VCFs are pulmonary dysfunction, eating disorders, loss of independence, and mental status change due to pain and the use of medications. Osteoporotic VCFs also are associated with a higher rate of death. VCFs affect an estimated 25% of women over age 50 years and 40% of women over age 80 years. Only about 30% of these fractures are diagnosed in clinical practice. A Canadian multicentre osteoporosis study reported on the prevalence of vertebral deformity in Canada in people over 50 years of age. To define the limit of normality, they plotted a normal distribution, including mean and standard deviations (SDs) derived from a reference population without any deformity. They reported a prevalence rate of 23.5% in women and a rate of 21.5% in men, using 3 SDs from the mean as the limit of normality. When they used 4 SDs, the prevalence was 9.3% and 7.3%, respectively. They also found the prevalence of vertebral deformity increased with age. For people older than 80 years of age, the prevalence for women and men was 45% and 36%, respectively, using 3 SDs as the limit of normality. About 85% of VCFs are due to primary

  6. Reporting systems in gastrointestinal endoscopy: Requirements and standards facilitating quality improvement: European Society of Gastrointestinal Endoscopy position statement

    PubMed Central

    Aabakken, Lars; Dekker, Evelien; Kaminski, Michal F; Rösch, Thomas; Hultcrantz, Rolf; Suchanek, Stepan; Jover, Rodrigo; Kuipers, Ernst J; Bisschops, Raf; Spada, Cristiano; Valori, Roland; Domagk, Dirk; Rees, Colin; Rutter, Matthew D

    2016-01-01

    To develop standards for high quality of gastrointestinal endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all gastrointestinal endoscopy procedures is state-of-the-art integrated digital reporting systems for standardized documentation of the procedures. The current paper describes the ESGE’s viewpoints on requirements for high-quality endoscopy reporting systems. The following recommendations are issued: Endoscopy reporting systems must be electronic.Endoscopy reporting systems should be integrated into hospital patient record systems.Endoscopy reporting systems should include patient identifiers to facilitate data linkage to other data sources.Endoscopy reporting systems shall restrict the use of free text entry to a minimum, and be based mainly on structured data entry.Separate entry of data for quality or research purposes is discouraged. Automatic data transfer for quality and research purposes must be facilitated.Double entry of data by the endoscopist or associate personnel is discouraged. Available data from outside sources (administrative or medical) must be made available automatically.Endoscopy reporting systems shall enable the inclusion of information on histopathology of detected lesions; patient’s satisfaction; adverse events; surveillance recommendations.Endoscopy reporting systems must facilitate easy data retrieval at any time in a universally compatible format.Endoscopy reporting systems must include data fields for key performance indicators as defined by quality improvement committees.Endoscopy reporting systems must facilitate changes in indicators and data entry fields as required by professional organizations. PMID:27087943

  7. What Is Endoscopy?

    MedlinePlus

    ... look inside. Endoscopy Colonoscopy and Sigmoidoscopy Biopsy and Cytology Tests Waiting to hear a possible cancer diagnosis ... best decisions about your treatment. Testing Biopsy and Cytology Specimens for Cancer Breast Biopsy Understanding Your Lab ...

  8. Quality Metrics in Endoscopy

    PubMed Central

    Gurudu, Suryakanth R.

    2013-01-01

    Endoscopy has evolved in the past 4 decades to become an important tool in the diagnosis and management of many digestive diseases. Greater focus on endoscopic quality has highlighted the need to ensure competency among endoscopists. A joint task force of the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy has proposed several quality metrics to establish competence and help define areas of continuous quality improvement. These metrics represent quality in endoscopy pertinent to pre-, intra-, and postprocedural periods. Quality in endoscopy is a dynamic and multidimensional process that requires continuous monitoring of several indicators and benchmarking with local and national standards. Institutions and practices should have a process in place for credentialing endoscopists and for the assessment of competence regarding individual endoscopic procedures. PMID:24711767

  9. Robotics in endoscopy.

    PubMed

    Klibansky, David; Rothstein, Richard I

    2012-09-01

    The increasing complexity of intralumenal and emerging translumenal endoscopic procedures has created an opportunity to apply robotics in endoscopy. Computer-assisted or direct-drive robotic technology allows the triangulation of flexible tools through telemanipulation. The creation of new flexible operative platforms, along with other emerging technology such as nanobots and steerable capsules, can be transformational for endoscopic procedures. In this review, we cover some background information on the use of robotics in surgery and endoscopy, and review the emerging literature on platforms, capsules, and mini-robotic units. The development of techniques in advanced intralumenal endoscopy (endoscopic mucosal resection and endoscopic submucosal dissection) and translumenal endoscopic procedures (NOTES) has generated a number of novel platforms, flexible tools, and devices that can apply robotic principles to endoscopy. The development of a fully flexible endoscopic surgical toolkit will enable increasingly advanced procedures to be performed through natural orifices. The application of platforms and new flexible tools to the areas of advanced endoscopy and NOTES heralds the opportunity to employ useful robotic technology. Following the examples of the utility of robotics from the field of laparoscopic surgery, we can anticipate the emerging role of robotic technology in endoscopy.

  10. Sedation with propofol for interventional endoscopy by trained nurses in high-risk octogenarians: a prospective, randomized, controlled study.

    PubMed

    Schilling, D; Rosenbaum, A; Schweizer, S; Richter, H; Rumstadt, B

    2009-04-01

    Sedation with the short-acting anesthetic agent propofol has shown several advantages, particularly in interventional endoscopy. So far, however, there are no valid data on the safety of nurse-administered propofol sedation (NAPS) during interventional endoscopy in elderly high-risk patients. A total of 150 patients aged > 80 years with high comorbidity were randomized to receive midazolam plus meperidine (n = 75) or propofol alone (n = 76) for sedation during endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound (EUS), or double-balloon endoscopy (DBE). Sedation was supervised by a trained nurse and a trained physician both of whom were not involved in the endoscopic procedure. Vital signs were continuously monitored as well as patient cooperation and tolerance. Mortality and morbidity at 30 days was analyzed. The overall cardiopulmonary complication rate was 16 % in the midazolam group and 23.7 % in the propofol group ( P > 0.05). The mean decline in oxygen saturation (initial vs. lowest O (2) saturation) and the mean decline of blood pressure (initial vs. lowest blood pressure) were significantly greater with propofol (7 % +/- 3 % vs. 4 % +/- 2 % [ P < 0.05] and 10 % +/- 2 % vs. 8 % +/- 2 %, respectively [ P < 0.05]). No procedure had to be interrupted due to serious adverse events. Patient cooperation was statistically significantly better in the propofol group (7 +/- 2 vs. 5 +/- 2 points). Patients sedated with propofol showed a significantly lower oxygen saturation rate during recovery time (8 % vs. 28 %; P < or = 0.01). NAPS during interventional endoscopy is as safe as midazolam/pethidine sedation even in high-risk patients aged > 80 years.

  11. Ballooning Then...and Ballooning Now.

    ERIC Educational Resources Information Center

    Journal of Aerospace Education, 1978

    1978-01-01

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

  12. Usefulness of Small Intestinal Endoscopy in a Case of Adult-onset Familial Mediterranean Fever Associated with Jejunoileitis.

    PubMed

    Kitade, Takashi; Horiki, Noriyuki; Katsurahara, Masaki; Totoki, Toshiaki; Harada, Tetsuro; Tano, Shunsuke; Yamada, Reiko; Hamada, Yasuhiko; Inoue, Hiroyuki; Tanaka, Kyosuke; Gabazza, Esteban C; Hayashi, Hiroyuki; Tanaka, Masanori; Takei, Yoshiyuki

    2015-01-01

    A 66-year-old Japanese man consulted our institution due to paroxysmal and repetitive bouts of fever and abdominal pain that had persisted for more than one week. Capsule and double-balloon endoscopy (DBE) showed petal-shaped mucosal redness with white hemming in the jejunum and ileum, and histopathology of the biopsy specimens revealed villous atrophy and cryptitis with extensive severe neutrophil infiltration. A genetic examination disclosed compound heterozygous MEFV mutations (E84K, P369S), and familial Mediterranean fever was diagnosed. Treatment with colchicine and infliximab was very effective in inducing the complete disappearance of symptoms and normalization of the endoscopic findings. To the best of our knowledge, this is the first report to describe the findings of small intestinal endoscopic images obtained using capsule and DBE.

  13. Capsule endoscopy in non-steroidal anti-inflammatory drugs-enteropathy and miscellaneous, rare intestinal diseases.

    PubMed

    Gay, Gerard; Delvaux, Michel; Frederic, Muriel

    2008-09-14

    Despite significant advances over the last decade, mucosal lesions of the small bowel are poorly detected by imaging studies such as CT scan, MRI-enteroclysis and contrast-enhanced abdominal ultrasound. Capsule endoscopy (CE) has dramatically changed the diagnostic approach to intestinal diseases. Moreover, the use of CE can be extended to include other conditions. However, it is difficult to assess the positive influence of CE on patient outcomes in conditions involving a small number of patients, or in critically ill and difficult to examine patients. CE has the advantage of diagnosing intestinal lesions and of directing the use of double balloon enteroscopy (DBE) in order to obtain biopsy specimens. Moreover, CE allows repeated assessment in chronic conditions, especially to detect relapse of an infectious disease.

  14. Capsule endoscopy in non-steroidal anti-inflammatory drugs-enteropathy and miscellaneous, rare intestinal diseases

    PubMed Central

    Gay, Gerard; Delvaux, Michel; Frederic, Muriel

    2008-01-01

    Despite significant advances over the last decade, mucosal lesions of the small bowel are poorly detected by imaging studies such as CT scan, MRI-enteroclysis and contrast-enhanced abdominal ultrasound. Capsule endoscopy (CE) has dramatically changed the diagnostic approach to intestinal diseases. Moreover, the use of CE can be extended to include other conditions. However, it is difficult to assess the positive influence of CE on patient outcomes in conditions involving a small number of patients, or in critically ill and difficult to examine patients. CE has the advantage of diagnosing intestinal lesions and of directing the use of double balloon enteroscopy (DBE) in order to obtain biopsy specimens. Moreover, CE allows repeated assessment in chronic conditions, especially to detect relapse of an infectious disease. PMID:18785273

  15. Gastrointestinal endoscopy in pregnancy.

    PubMed

    Savas, Nurten

    2014-11-07

    Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions. United States Food and Drug Administration category B drugs may be used in low doses. Endoscopic procedures during pregnancy may include upper gastrointestinal endoscopy, percutaneous endoscopic gastrostomy, sigmoidoscopy, colonoscopy, enteroscopy of the small bowel or video capsule endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. All gastrointestinal endoscopic procedures in pregnant patients should be performed in hospitals by expert endoscopists and an obstetrician should be informed about all endoscopic procedures. The endoscopy and flexible sigmoidoscopy may be safe for the fetus and pregnant patient, and may be performed during pregnancy when strong indications are present. Colonoscopy for pregnant patients may be considered for strong indications during the second trimester. Although therapeutic endoscopic retrograde cholangiopancreatography may be considered during pregnancy, this procedure should be performed only for strong indications and attempts should be made to minimize radiation exposure.

  16. Gastrointestinal endoscopy in pregnancy

    PubMed Central

    Savas, Nurten

    2014-01-01

    Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions. United States Food and Drug Administration category B drugs may be used in low doses. Endoscopic procedures during pregnancy may include upper gastrointestinal endoscopy, percutaneous endoscopic gastrostomy, sigmoidoscopy, colonoscopy, enteroscopy of the small bowel or video capsule endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. All gastrointestinal endoscopic procedures in pregnant patients should be performed in hospitals by expert endoscopists and an obstetrician should be informed about all endoscopic procedures. The endoscopy and flexible sigmoidoscopy may be safe for the fetus and pregnant patient, and may be performed during pregnancy when strong indications are present. Colonoscopy for pregnant patients may be considered for strong indications during the second trimester. Although therapeutic endoscopic retrograde cholangiopancreatography may be considered during pregnancy, this procedure should be performed only for strong indications and attempts should be made to minimize radiation exposure. PMID:25386072

  17. Comparative analysis of upper gastrointestinal endoscopy, double-contrast upper gastrointestinal barium X-ray radiography, and the titer of serum anti-Helicobacter pylori IgG focusing on the diagnosis of atrophic gastritis.

    PubMed

    Yamamichi, Nobutake; Hirano, Chigaya; Takahashi, Yu; Minatsuki, Chihiro; Nakayama, Chiemi; Matsuda, Rie; Shimamoto, Takeshi; Takeuchi, Chihiro; Kodashima, Shinya; Ono, Satoshi; Tsuji, Yosuke; Fujishiro, Mitsuhiro; Wada, Ryoichi; Mitsushima, Toru; Koike, Kazuhiko

    2016-04-01

    Upper gastrointestinal endoscopy (UGI-ES) and double-contrast upper gastrointestinal barium X-ray radiography (UGI-XR) are two major image-based methods to diagnose atrophic gastritis, which is mostly induced by Helicobacter pylori infection. However, there have been few studies directly comparing them. Atrophic gastritis was evaluated using the data of 962 healthy subjects who underwent UGI-ES and UGI-XR within 1 year. Based on UGI-ES and UGI-XR, 602 subjects did not have atrophic gastritis and 254 subjects did have it. Considering UGI-ES-based atrophic gastritis as the standard, sensitivity and specificity of UGI-XR-based atrophic gastritis were 92.0 % (254/276) and 92.8 % (602/649), respectively. The seven-grade Kimura-Takemoto classification of UGI-ES-based atrophic gastritis showed a strong and significant association with the four-grade UGI-XR-based atrophic gastritis. Sensitivity and specificity of serum anti-Helicobacter pylori IgG to detect UGI-ES/UGI-XR-based atrophic gastritis were 89.4 % (227/254) and 99.8 % (601/602), indicating that atrophic gastritis can be overlooked according to serum anti-Helicobacter pylori IgG alone.

  18. Endoscopy in screening for digestive cancer.

    PubMed

    Lambert, René

    2012-12-16

    The aim of this study is to describe the role of endoscopy in detection and treatment of neoplastic lesions of the digestive mucosa in asymptomatic persons. Esophageal squamous cell cancer occurs in relation to nutritional deficiency and alcohol or tobacco consumption. Esophageal adenocarcinoma develops in Barrett's esophagus, and stomach cancer in chronic gastric atrophy with Helicobacter pylori infection. Colorectal cancer is favoured by a high intake in calories, excess weight, low physical activity. In opportunistic or individual screening endoscopy is the primary detection procedure offered to an asymptomatic individual. In organized or mass screening proposed by National Health Authorities to a population, endoscopy is performed only in persons found positive to a filter selection test. The indications of primary upper gastrointestinal endoscopy and colonoscopy in opportunistic screening are increasingly developing over the world. Organized screening trials are proposed in some regions of China at high risk for esophageal cancer; the selection test is cytology of a balloon or sponge scrapping; they are proposed in Japan for stomach cancer with photofluorography as a selection test; and in Europe, America and Japan; for colorectal cancer with the fecal occult blood test as a selection test. Organized screening trials in a country require an evaluation: the benefit of the intervention assessed by its impact on incidence and on the 5 year survival for the concerned tumor site; in addition a number of bias interfering with the evaluation have to be controlled. Drawbacks of screening are in the morbidity of the diagnostic and treatment procedures and in overdetection of none clinically relevant lesions. The strategy of endoscopic screening applies to early cancer and to benign adenomatous precursors of adenocarcinoma. Diagnostic endoscopy is conducted in 2 steps: at first detection of an abnormal area through changes in relief, in color or in the course of

  19. Endoscopy in screening for digestive cancer

    PubMed Central

    Lambert, René

    2012-01-01

    The aim of this study is to describe the role of endoscopy in detection and treatment of neoplastic lesions of the digestive mucosa in asymptomatic persons. Esophageal squamous cell cancer occurs in relation to nutritional deficiency and alcohol or tobacco consumption. Esophageal adenocarcinoma develops in Barrett’s esophagus, and stomach cancer in chronic gastric atrophy with Helicobacter pylori infection. Colorectal cancer is favoured by a high intake in calories, excess weight, low physical activity. In opportunistic or individual screening endoscopy is the primary detection procedure offered to an asymptomatic individual. In organized or mass screening proposed by National Health Authorities to a population, endoscopy is performed only in persons found positive to a filter selection test. The indications of primary upper gastrointestinal endoscopy and colonoscopy in opportunistic screening are increasingly developing over the world. Organized screening trials are proposed in some regions of China at high risk for esophageal cancer; the selection test is cytology of a balloon or sponge scrapping; they are proposed in Japan for stomach cancer with photofluorography as a selection test; and in Europe, America and Japan; for colorectal cancer with the fecal occult blood test as a selection test. Organized screening trials in a country require an evaluation: the benefit of the intervention assessed by its impact on incidence and on the 5 year survival for the concerned tumor site; in addition a number of bias interfering with the evaluation have to be controlled. Drawbacks of screening are in the morbidity of the diagnostic and treatment procedures and in overdetection of none clinically relevant lesions. The strategy of endoscopic screening applies to early cancer and to benign adenomatous precursors of adenocarcinoma. Diagnostic endoscopy is conducted in 2 steps: at first detection of an abnormal area through changes in relief, in color or in the course of

  20. Nurse-Performed Endoscopy.

    PubMed

    Duffield, Christine; Chapman, Susan; Rowbotham, Samantha; Blay, Nicole

    2017-01-01

    Increasing demands for health care globally often lead to discussions about expanding the involvement of nurses in a range of nontraditional roles. Several countries have introduced nurse endoscopists as a means of easing the burden of demand for a range of endoscopic procedures. A shortage of medical staff in Australia combined with increasing demand for endoscopy led to the implementation of nurse endoscopists as a pilot program in the state of Queensland, where a nurse practitioner model was implemented, and Victoria, where an advanced practice model was used. This article will discuss the implementation of and responses from the nursing, medical, and policy community to nurse-performed endoscopy in this country. Regarding health policy, access to cancer screening may be improved by providing nurses with advanced training to safely perform endoscopy procedures. Moreover, issues of nurse credentialing and payment need to be considered appropriate to each country's health system model.

  1. Swallowable Obalon® gastric balloons as an aid for weight loss: a pilot feasibility study.

    PubMed

    Mion, François; Ibrahim, Mostafa; Marjoux, Sophie; Ponchon, Thierry; Dugardeyn, Sonia; Roman, Sabine; Deviere, Jacques

    2013-05-01

    The goal of this study was to evaluate the safety and the impact on weight loss of a new swallowable gastric balloon. In this prospective pilot study, 17 overweight or obese patients were included. Up to three balloons were ingested under fluoroscopic control. All balloons were removed by upper GI endoscopy, 12 weeks after the ingestion of the first balloon. 43 out of 44 attempts (98 %) to swallow a balloon were successful. Nausea and stomach pain were the most frequent side effects. Endoscopic procedures for balloon removal were uneventful. Weight loss was significant at weeks 4, 8, and 12. This pilot study showed no significant side effects induced by up to three balloons, and a significant weight loss.

  2. Energy from solar balloons

    SciTech Connect

    Grena, Roberto

    2010-04-15

    Solar balloons are hot air balloons in which the air is heated directly by the sun, by means of a black absorber. The lift force of a tethered solar balloon can be used to produce energy by activating a generator during the ascending motion of the balloon. The hot air is then discharged when the balloon reaches a predefined maximum height. A preliminary study is presented, along with an efficiency estimation and some considerations on possible realistic configurations. (author)

  3. Gastric balloon to treat obesity: filled with air or fluid?

    PubMed

    Caglar, Erkan; Dobrucali, Ahmet; Bal, Kadir

    2013-09-01

    Our aim was to study the efficacy and safety of different types of intragastric balloon in morbidly obese patients. From 2005 to 2011, intragastric balloons were inserted endoscopically into 32 patients. Intragastric balloons were used in morbidly obese (body mass index [BMI] ≥ 35 kg/m(2) ) individuals who were non-responsive to 6-month medical therapy and diet. Balloons were endoscopically removed after 6 months. Thirty-six balloons were inserted in a total of 32 patients. Mean age of the patients was 37.28 ± 12.08 (17-64) years and mean height was 169.81 ± 8.17 (150-185) cm. Initial mean weight was 128.87 ± 23.31 kg and BMI was 45.26 ± 8.48 kg/m(2) . At month 6, mean bodyweight was 116.93 ± 23.18 and BMI was 40.96 ± 7.96 kg/m(2) (P < 0.001, P < 0.001, respectively). At the end of 6 months, while the excessweight loss (EWL) median was 13.0 kg, [interquartile range IQR: 5.0-16.0] and percent EWL median was 21.92, [IQR: 12.72-28.49] in the Heliosphere BAG patients, the EWL median was 19.0 kg, [IQR: 14.47-26.72] and the percent EWL median was 38.26, [IQR: 19.73-47.79] in the BioEnterics Intragastric Balloon patients (P = 0.006, P = 0.010, respectively for EWL median and percent EWL median). One patient died (3.1%) of cardiac arrest due to aspiration at day 13 after BIB placement. Although not without risk, intragastric balloon placement is an effective method for weight loss. BioEnterics Intragastric Balloon is more effective in helping weight loss than the Heliosphere BAG balloon. © 2012 The Authors. Digestive Endoscopy © 2012 Japan Gastroenterological Endoscopy Society.

  4. Oncologic applications of endoscopy.

    PubMed

    Magne, M L

    1995-01-01

    Endoscopic examinations provide a valuable, noninvasive adjunct in the diagnosis and staging of many neoplastic disorders (Table 1). Additionally, the clinical applications of endoscopic-guided laser or photodynamic therapy have yet to be investigated thoroughly in companion animals. Endoscopy does not eliminate the need for other diagnostics, rather it should be considered complementary to more "traditional" procedures such as radiography, surgery, and ultrasonography.

  5. Present status of endoscopy, therapeutic endoscopy and the endoscopy training system in Indonesia.

    PubMed

    Makmun, Dadang

    2014-04-01

    Recently, Indonesia was ranked as the fourth most populous country in the world. Based on 2012 data, 85000 general practitioners and 25000 specialists are in service around the country. Gastrointestinal (GI) disease remains the most common finding in daily practise, in both outpatient and inpatient settings, and ranks fifth in causing mortality in Indonesia. Management of patients with GI disease involves all health-care levels with the main portion in primary health care. Some are managed by specialists in secondary health care or are referred to tertiary health care. GI endoscopy is one of the main diagnostic and therapeutic modalities in the management of GI disease. Development of GI endoscopy in Indonesia started before World War II and, today, many GI endoscopy procedures are conducted in Indonesia, both diagnostic and therapeutic. Based on August 2013 data, there are 515 GI endoscopists in Indonesia. Most GI endoscopists are competent in carrying out basic endoscopy procedures, whereas only a few carry out advanced endoscopy procedures, including therapeutic endoscopy. Recently, the GI endoscopy training system in Indonesia consists of basic GI endoscopy training of 3-6 months held at 10 GI endoscopy training centers. GI endoscopy training is also eligible as part of a fellowship program of consultant gastroenterologists held at six accredited fellowship centers in Indonesia. Indonesian Society for Digestive Endoscopy in collaboration with GI endoscopy training centers in Indonesia and overseas has been working to increase quality and number of GI endoscopists, covering both basic and advanced GI endoscopy procedures. © 2014 The Author. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

  6. International digestive endoscopy network 2012: a patchwork of networks for the future.

    PubMed

    Kwon, Kwang An; Choi, Il Ju; Kim, Eun Young; Dong, Seok Ho; Hahm, Ki Baik

    2012-09-01

    This special September issue of Clinical Endoscopy will discuss various aspects of diagnostic and therapeutic advancement of gastrointestinal (GI) endoscopy, explaining what is new in digestive endoscopy and why international network should be organized. We proposed an integrated model of international conference based on the putative occurrence of Digestive Endoscopy Networks. In International Digestive Endoscopy Network (IDEN) 2012, role of endoscopy in gastroesophageal reflux disease and Barrett's esophagus, endoscopy beyond submucosa, endoscopic treatment for stricture and leakage in upper GI, how to estimate the invasion depth of early GI cancers, colonoscopy in inflammatory bowel disease (IBD), a look into the bowel beyond colon in IBD, management of complications in therapeutic colonoscopy, revival of endoscopic papllirary balloon dilation, evaluation and tissue acquisition for indeterminate biliopancreatic stricture, updates in the evaluation of pancreatic cystic lesions, issues for tailored endoscopic submucosal dissection (ESD), endoluminal stents, management of upper GI bleeding, endoscopic management of frustrating situations, small bowel exploration, colorectal ESD, valuable tips for frustrating situations in colonoscopy, choosing the right stents for endoscopic stenting of biliary strictures, advanced techniques for pancreaticobiliary visualization, endoscopic ultrasound-guided biliopancreatic drainage, and how we can overcome the obstacles were deeply touched. We hope that IDEN 2012, as the very prestigious endoscopy networks, served as an opportunity to gain some clues for further understanding of endoscopic technologies and to enhance up-and-coming knowledge and their clinical implications from selected 25 peer reviewed articles and 112 invited lectures.

  7. Controlled weather balloon ascents and descents for atmospheric research and climate monitoring

    NASA Astrophysics Data System (ADS)

    Kräuchi, Andreas; Philipona, Rolf; Romanens, Gonzague; Hurst, Dale F.; Hall, Emrys G.; Jordan, Allen F.

    2016-03-01

    In situ upper-air measurements are often made with instruments attached to weather balloons launched at the surface and lifted into the stratosphere. Present-day balloon-borne sensors allow near-continuous measurements from the Earth's surface to about 35 km (3-5 hPa), where the balloons burst and their instrument payloads descend with parachutes. It has been demonstrated that ascending weather balloons can perturb the air measured by very sensitive humidity and temperature sensors trailing behind them, particularly in the upper troposphere and lower stratosphere (UTLS). The use of controlled balloon descent for such measurements has therefore been investigated and is described here. We distinguish between the single balloon technique that uses a simple automatic valve system to release helium from the balloon at a preset ambient pressure, and the double balloon technique that uses a carrier balloon to lift the payload and a parachute balloon to control the descent of instruments after the carrier balloon is released at preset altitude. The automatic valve technique has been used for several decades for water vapor soundings with frost point hygrometers, whereas the double balloon technique has recently been re-established and deployed to measure radiation and temperature profiles through the atmosphere. Double balloon soundings also strongly reduce pendulum motion of the payload, stabilizing radiation instruments during ascent. We present the flight characteristics of these two ballooning techniques and compare the quality of temperature and humidity measurements made during ascent and descent.

  8. Controlled weather balloon ascents and descents for atmospheric research and climate monitoring

    NASA Astrophysics Data System (ADS)

    Kräuchi, A.; Philipona, R.; Romanens, G.; Hurst, D. F.; Hall, E. G.; Jordan, A. F.

    2015-12-01

    In situ upper-air measurements are often made with instruments attached to weather balloons launched at the surface and lifted into the stratosphere. Present day balloon-borne sensors allow near-continuous measurements from the Earth's surface to about 35 km (3-5 hPa), where the balloons burst and their instrument payloads descend with parachutes. It has been demonstrated that ascending weather balloons can perturb the air measured by very sensitive humidity and temperature sensors trailing behind them, particularly in the upper troposphere and lower stratosphere (UTLS). The use of controlled balloon descent for such measurements has therefore been investigated and is described here. We distinguish between the one balloon technique that uses a simple automatic valve system to release helium from the balloon at a pre-set ambient pressure, and the double balloon technique that uses a carrier balloon to lift the payload and a parachute balloon to control the descent of instruments after the carrier balloon is released at pre-set altitude. The automatic valve technique has been used for several decades for water vapor soundings with frost point hygrometers, whereas the double balloon technique has recently been re-established and deployed to measure radiation and temperature profiles through the atmosphere. Double balloon soundings also strongly reduce pendulum motion of the payload, stabilizing radiation instruments during ascent. We present the flight characteristics of these two ballooning techniques and compare the quality of temperature and humidity measurements made during ascent and descent.

  9. NASA Balloon Technology Developments

    NASA Technical Reports Server (NTRS)

    Fairbrother, D. A.

    2004-01-01

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

  10. Scientific ballooning in Japan

    NASA Astrophysics Data System (ADS)

    Makino, Fumiyoshi

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

  11. Venus Altitude Cycling Balloon

    NASA Astrophysics Data System (ADS)

    de Jong, M. L.

    2015-04-01

    A novel balloon concept is demonstrated that uses mechanical compression as altitude control mechanism to sustain long duration balloon probe flight in the cloud level region of Venus’ atmosphere between 45 and 58 km altitude.

  12. Sinuplasty (Balloon Catheter Dilation)

    MedlinePlus

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

  13. [Benchmarking in gastrointestinal endoscopy].

    PubMed

    Rosien, U; Leffmann, C

    2007-12-01

    Quality and costs of endoscopic procedures in gastroenterology have recently come into focus of professionals and patients alike. The project presented here combines benchmarking of indicators of quality and simultaneous assessment of costs in departments of endoscopy. In all 9400 examinations from 14 departments were analysed. First and most obvious results are presented: the machine-readable data sheet was filled out correctly in 95 % (compulsory data fields); endoscopy costs differed by factor two for diagnostic gastroscopy and by factor five for therapeutic ERCP; in some departments a polypectomy was performed in up to every second diagnostic colonoscopy while in others polypectomy occurred only in 10 % in some departments patient monitoring like pulse oxymetry was used only in half of the procedures. Interpretation of the data requires further validation by resumption of the project to obtain more data from possibly more departments.

  14. A balloon strain gage

    NASA Technical Reports Server (NTRS)

    Rand, J. L.

    1981-01-01

    This paper describes the development of a unique strain measuring device which is intended to monitor the state of strain in thin balloon films during flight. The gate is bonded directly to the film without significantly altering the state of strain or stress in the wall of the balloon. Results of a model balloon inflation are presented which indicate the gage to measure strain in a deployed balloon.

  15. Open-access endoscopy.

    PubMed

    Chandrasekhara, Vinay; Eloubeidi, Mohamad A; Bruining, David H; Chathadi, Krishnavel; Faulx, Ashley L; Fonkalsrud, Lisa; Khashab, Mouen A; Lightdale, Jenifer R; Muthusamy, V Raman; Pasha, Shabana; Saltzman, John R; Shaukat, Aasma; Wang, Amy; Cash, Brooks; DeWitt, John M

    2015-01-01

    OAE is commonly used. The majority of patients referred for OAE are considered appropriate for endoscopy according to ASGE guidelines. Most patients undergoing OAE procedures are knowledgeable about the study and are satisfied with the experience. Several potential problems have been identified, including inappropriate referrals, communication errors, and inadequately prepared or informed patients. OAE can be safely used if preprocedure assessment, informed consent, information transfer, patient safety, and satisfaction are addressed in all cases.

  16. Haptic device in endoscopy.

    PubMed

    Sadovnichy, Victor; Gabidullina, Rozaliya; Sokolov, Mikhail; Galatenko, Vladimir; Budanov, Vladimir; Nakashidze, Eldar

    2014-01-01

    Access to organs and tissues is limited during endoscopy. Information about mechanical properties of tissues received during an operation is a key factor for deciding the scale of surgery and further treatment strategy. A new device developed at Lomonosov Moscow State University determines the visco-elastic properties of tissues and presents them in a digital form as a visual image and a tactile sense for the surgeon. This data lets users define pathological change of tissues and if necessary change treatment policy.

  17. Extra-articular hip endoscopy

    PubMed Central

    Verhelst, L.; Guevara, V.; De Schepper, J.; Van Melkebeek, J.; Pattyn, C.; Audenaert, E. A.

    2012-01-01

    The aim of this review is to evaluate the current available literature evidencing on peri-articular hip endoscopy (the third compartment). A comprehensive approach has been set on reports dealing with endoscopic surgery for recalcitrant trochanteric bursitis, snapping hip (or coxa-saltans; external and internal), gluteus medius and minimus tears and endoscopy (or arthroscopy) after total hip arthroplasty. This information can be used to trigger further research, innovation and education in extra-articular hip endoscopy. PMID:23610664

  18. Capsule endoscopy in celiac disease

    PubMed Central

    Spada, Cristiano; Riccioni, Maria Elena; Urgesi, Riccardo; Costamagna, Guido

    2008-01-01

    Video capsule endoscopy is an attractive and patient-friendly tool that provides high quality images of the small bowel. Obscure gastrointestinal bleeding is the primary and most evaluated indication to capsule endoscopy; however, indications are expanding and a small number of preliminary reports have been presented concerning the role of video capsule endoscopy in the diagnosis of celiac disease. The purpose of this review is to update the current knowledge and to hypothesize on future perspectives of the use of video capsule endoscopy in patients with celiac disease. PMID:18636659

  19. NASA balloon technology developments

    NASA Astrophysics Data System (ADS)

    Fairbrother, D. A.

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

  20. Meta-analysis: the use of carbon dioxide insufflation vs. room air insufflation for gastrointestinal endoscopy.

    PubMed

    Wang, W L; Wu, Z H; Sun, Q; Wei, J F; Chen, X F; Zhou, D K; Zhou, L; Xie, H Y; Zheng, S S

    2012-05-01

    Carbon dioxide (CO(2)) insufflation has been proposed as an alternative to air insufflation to distend the lumen in gastrointestinal (GI) endoscopy. To perform a systematic review with meta-analysis of randomised controlled trials (RCTs) in which CO(2) insufflation was compared with room air insufflation in GI endoscopy. Electronic and manual searches were combined to search RCTs. After methodological quality assessment and data extraction, the efficacy and safety of CO(2) insufflation were systematically assessed. Twenty-one RCTs [13 on colonoscopy, four on endoscopic retrograde cholangiopancreatography (ERCP), two on double-balloon enteroscopy (DBE), one on oesophagogastroduodenoscopy, and one on flexible sigmoidoscopy] were identified. For colonoscopy, CO(2) insufflation resulted lower postprocedural pain intensity, and increased the proportion of patient without pain at 1 h (RR: 1.84, 95% CI: 1.37-2.47) and 6 h (RR: 1.28; 95% CI: 1.14-1.44) postprocedure. For ERCP, the pain-releasing effect of CO(2) insufflation was not obvious (SMD: -1.48, 95% CI: -3.56, 0.59). CO(2) insufflation revealed no consistent advantages in the RCTs of DBE, but was shown as safe as air insufflation in oesophagus/stomach endoscopic submucosal dissection in one study. pCO(2) level showed no significant variation during these procedures. Compared with air insufflation, CO(2) insufflation during colonoscopy causes lower postprocedural pain and bowel distension without significant pCO(2) variation. More RCTs are needed to assess its advantages in other GI endoscopic procedures. © 2012 Blackwell Publishing Ltd.

  1. Endoscopy: MedlinePlus Health Topic

    MedlinePlus

    ... What Is Endoscopy? (American Cancer Society) Also in Spanish Related Issues Ensuring the Safety of Your Endoscopic Procedure (American Society for Gastrointestinal Endoscopy) Also in Spanish Sedation for Your Endoscopy (American College of Gastroenterology) ...

  2. [Infectious colitis. Endoscopy].

    PubMed

    Dive, C

    1986-11-01

    Colon and rectum localizations of an disease or a parasitosis depend essentially on the nature of the pathogenous agent and the host resistance. Acute enterocolitis is secondary to enterotoxinogenous germs (such as cholera vibrio), invasive germs (such as shigella), penetrating germs (such as salmonella); viruses are seldom concerned. Parasitic colitis include mostly amibiasis and bilharziosis. Infectious and parasitic enterocolitis may be transmitted sexually. On the other hand, certain venereal diseases have intestinal manifestations. Finally, in AIDS, timely gastro-intestinal infections develop. The diagnosis rests on endoscopy, histological examination and biological and parasitological samplings.

  3. Therapeutic endoscopy in gastroenterology.

    PubMed

    Celiński, K; Cichoz-Lach, H

    2007-08-01

    The role of therapeutic endoscopy in current gastroenterology is very important. Therapuetic endoscopy is useful in treatment of gastrointestinal bleeding. Endoscopic control of gastrointestinal bleeding includes the following procedures of haemostasis techniques: photocoagulation, electrocoagulation, thermocoagulation and injection method. Owing to these procedures mortality has significantly decreased. Endoscopic hemostasis eliminates the risk of surgery, is less expensive and better tolerated by patients. Colonoscopic polypectomy is a widely used technique. By removal of polyps the incidence of colon cancer can be decreased. The "hot biopsy" forceps can be used to excise polyps of up to 6 mm. Larger polyps can be removed safely by snare electrocautery and retrieved for histologic study. Endoscopic retrograde cholangiopancreatography has a therapeutic application designed to cut the sphincter of Oddi fibers of the distal common bile duct, what is indicated currently in choledocholithiasis and papillary stenosis with ascending cholangitis, acute gallstone pancreatitis. Endoscopic sphincterotomy in now an established procedure that is indicated in patients with common bile duct calculi. Endoscopic decompression of the biliary tree - dilatation benign structures of the biliary tree with baloon catheters and placement an internal endoprothesis allows the nonoperative decompression and significant palliation for patients with obstructing tumors.

  4. Lasers in digestive endoscopy

    NASA Astrophysics Data System (ADS)

    Brunetaud, Jean Marc; Maunoury, Vincent; Cochelard, Dominique

    1997-01-01

    Lasers were introduced in digestive endoscopy to stop active gastroduodenal hemorrhages. Their use spread progressively to the treatment of chronic hemorrhages from vascular malformations and sessile tumors. Laser face competition from other endoscopic techniques such as electrocoagulation, injection techniques, dilation, stents, and brachytherapy. Many series have reported the efficacy of lasers in digestive endoscopy used for their thermal or photochemical effects. However, they were gradually abandoned for the treatment of hemorrhages because of competition from nonlaser techniques. Lasers are still used for ablation of sessile tumors, but their true impact is difficult to evaluate. Modern methods of technology assessment did not allow gastroenterologists to clearly define the place of lasers among surgery, radio-chemotherapy, and other endoscopic techniques, and data on the daily use of lasers are not available. Therefore, the conclusion can only be subjective. The best current application of thermal lasers appears to be in the treatment of rectosigmoid villous adenomas in elderly patients. Small superficial rectal cancers may also become a good subject due to the impact of endoscopic ultrasonography. Early lesions with multifocal or diffuse disease such as early esophageal cancers could be the most promising subject of application for photodynamic therapy in the future.

  5. Measures of trainee performance in advanced endoscopy: A systematic review.

    PubMed

    James, P D; Antonova, L; Martel, M; Barkun, A

    2016-06-01

    The diversity, technical skills required, and risk inherent to advanced endoscopy techniques all contribute to complex training curricula and steep learning curves. Since trainees develop endoscopy skills at different rates, there has been a shift towards competency-based training and certification. Validated endoscopy performance measures for trainees are, therefore, necessary. The aim of this systematic review was to describe and critically assess the existing evidence regarding measures of performance for trainees in advanced endoscopy. A systematic review of the literature from January 1980 to January 2016 was carried out using the MEDLINE, EMBASE, CENTRAL, and ISI Web of knowledge databases. MeSH terms related to 'advanced endoscopy' and 'performance' were applied to a highly sensitive search strategy. The main outcomes were face, content, and construct validity, as well as reliability. The literature search yielded 1,662 studies and 77 met the inclusion criteria after abstract and full-text review (endoscopic retrograde cholangiopancreatography (ERCP)=23, endoscopic ultrasound (EUS)=30, colonoscopic polypectomy (CP)=11, balloon-assisted enteroscopy (BAE)=7, luminal stenting=3, radiofrequency ablation (RFA)=2, and endoscopic muscosal resection (EMR)=1). Good validity and reliability were found for measurement tools of overall performance in ERCP, EUS and CP, with applications for both patient-based and simulator training models. A number of specific technical skills were also shown to be valid measures of performance. These include: selective biliary cannulation, sphincterotomy, biliary stent placement, stone extraction and procedure time for ERCP; pancreatic solid mass T-staging, EUS-guided fine needle aspiration (EUS-FNA) procedure time, number of EUS-FNA passes and puncture precision for EUS; procedure time and en bloc resection rate for CP; retrograde fluoroscopy time for BAE; and mean number of endoscopy sessions required to achieve complete eradication

  6. Unmanned powered balloons

    NASA Technical Reports Server (NTRS)

    Korn, A. O.

    1975-01-01

    In the late 1960's several governmental agencies sponsored efforts to develop unmanned, powered balloon systems for scientific experimentation and military operations. Some of the programs resulted in hardware and limited flight tests; others, to date, have not progressed beyond the paper study stage. Balloon system designs, materials, propulsion units and capabilities are briefly described, and critical problem areas are pointed out which require further study in order to achieve operational powered balloon systems capable of long duration flight at high altitudes.

  7. Scientific ballooning in Brazil

    NASA Astrophysics Data System (ADS)

    Corrêa, R.; Rinke, E.; Fernandes, J. O.; Villela, T.

    We present an overview of the scientific ballooning activities that took place in Brazil over the past 30 years as well as the current ongoing efforts in the area. We also briefly describe the balloon launching facility that exists at the Instituto Nacional de Pesquisas Espaciais (National Institute for Space Research) — INPE. Up to now, over 100 scientific balloon experiments, related to Astrophysics, Aeronomy, and Geophysics were launched from Brazil taking advantage of the country's continental dimensions, a well-defined rain season, and a low population density, which offer excellent conditions for scientific ballooning activities. Balloons with volumes up to 500,000 cubic meters can be launched from INPE's balloon launching base (latitude S 22° 4' 2″; longitude W 044° 58' 41″). The availability of good roads and several inland airports in Brazil provides the necessary structure for safe payload retrieval and its rapid return to the balloon base. There are several airports throughout Brazil that can also be used as balloon launching bases, mainly in the country's Eastern region. Overflights of more than 1,000 kilometers are possible and easily attained. Balloon flights ranging from a few hours to long duration flights can be safely verified. The constant climate monitoring through the use of weather satellites information received at INPE provides the necessary data to determine the necessary conditions for a long duration flight. INPE's Center for Weather Forecast and Climate Studies (CPTEC) provides the necessary weather forecast support for launch and payload retrieval.

  8. Weather Balloon Ascent Rate

    NASA Astrophysics Data System (ADS)

    Denny, Mark

    2016-05-01

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

  9. GHOST balloons around Antarctica

    NASA Technical Reports Server (NTRS)

    Stearns, Charles R.

    1988-01-01

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

  10. Kestrel balloon launch system

    SciTech Connect

    Newman, M.J.

    1991-10-01

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

  11. Extra-Articular Endoscopy.

    PubMed

    Doral, Mahmut N; Huri, Gazi; Bohacek, Ivan; Turhan, Egemen; Bojanic, Ivan

    2016-03-01

    With the advent of endoscopy in the last 2 decades, a number of procedures, and modifications to them, have been developed and have advanced exponentially. The list of indications was extended over time because of several reasons: better understanding of the pathophysiology, better diagnostics, and advances in endoscopic technology. In this review article, we summarize the most frequently performed extra-articular endoscopic procedures on the extremities. As there are several methods, some have been described briefly, whereas others have been described in greater detail, such as suprascapular nerve entrapment syndrome and Achilles tendon disorders, as they present our area of interest and subspecialty domain. Recent advances in the treatment of versatile pathologic entities have been described, together with new methods, which currently lack sufficient clinical data but still represent promising techniques for the future.

  12. Endoscopy after bariatric surgery

    PubMed Central

    Malli, Chrysoula P.; Sioulas, Athanasios D.; Emmanouil, Theodoros; Dimitriadis, George D.; Triantafyllou, Konstantinos

    2016-01-01

    Obesity is a global epidemic with significant morbidity and mortality. Weight loss results in reduction of health risks and improvement in quality of life, thus representing a goal of paramount importance. Bariatric surgery is the most efficacious choice compared to conservative alternatives including diet, exercise, drugs and behavioral modification to treat obese patients. Following bariatric operations, patients may present with upper gastrointestinal tract complaints that warrant endoscopic evaluation and the various bariatric surgery types are often linked to complications. A subset of these complications necessitates endoscopic interventions for accurate diagnosis and effective, minimal invasive treatment. This review aims to highlight the role of upper gastrointestinal endoscopy in patients who have undergone bariatric surgery to evaluate and potentially treat surgery-related complications and upper gastrointestinal symptoms. PMID:27366025

  13. Malpractice claims for endoscopy.

    PubMed

    Hernandez, Lyndon V; Klyve, Dominic; Regenbogen, Scott E

    2013-04-16

    To summarize the magnitude and time trends of endoscopy-related claims and to compare total malpractice indemnity according to specialty and procedure. We obtained data from a comprehensive database of closed claims from a trade association of professional liability insurance carriers, representing over 60% of practicing United States physicians. Total payments by procedure and year were calculated, and were adjusted for inflation (using the Consumer Price Index) to 2008 dollars. Time series analysis was performed to assess changes in the total value of claims for each type of procedure over time. There were 1901 endoscopy-related closed claims against all providers from 1985 to 2008. The specialties include: internal medicine (n = 766), gastroenterology (n = 562), general surgery (n = 231), general and family practice (n = 101), colorectal surgery (n = 87), other specialties (n = 132), and unknown (n = 22). Colonoscopy represented the highest frequencies of closed claims (n = 788) and the highest total indemnities ($54 093 000). In terms of mean claims payment, endoscopic retrograde cholangiopancreatography (ERCP) ranked the highest ($374  794) per claim. Internists had the highest number of total claims (n = 766) and total claim payment ($70  730  101). Only total claim payments for colonoscopy and ERCP seem to have increased over time. Indeed, there was an average increase of 15.5% per year for colonoscopy and 21.9% per year for ERCP after adjusting for inflation. There appear to be differences in malpractice coverage costs among specialties and the type of endoscopic procedure. There is also evidence for secular trend in total claim payments, with colonoscopy and ERCP costs rising yearly even after adjusting for inflation.

  14. Clinical Endoscopy as One of Leading Journals in Gastrointestinal Endoscopy

    PubMed Central

    Kwon, Kwang An; Choi, Il Ju; Ryu, Ji Kon; Kim, Eun Young

    2015-01-01

    Clinical Endoscopy (CE) is an official open access journal published bimonthly by the Korean Society of Gastrointestinal Endoscopy (KSGE, http://www.gie.or.kr) and is listed on PMC, PubMed and SCOPUS. The KSGE was established on August 14, 1976, and the journal of the KSGE was published in Korean for the first time in November 1981. The journal was then titled the "Korean Journal of Gastrointestinal Endoscopy" and was published in Korean untill the July 2011 issue. The journal was published in English from the September 2011 issue under the official title of CE. In this review, the past and present of CE are discussed and future perspectives are introduced. In addition, the efforts to progress to a "first come, first served journal" in the field of gastrointestinal endoscopy and to be indexed in Science Citation Index will be described. PMID:26240805

  15. Measuring Quality in Pediatric Endoscopy.

    PubMed

    Lightdale, Jenifer R

    2016-01-01

    Measuring quality in endoscopy includes the assessment of appropriateness of a procedure and the skill with which it is performed. High-quality pediatric endoscopy is safe and efficient, used effectively to make proper diagnoses, is useful for excluding other diagnoses, minimizes adverse events, and is accompanied by appropriate documentation from beginning through end of the procedure. There are no standard quality metrics for pediatric endoscopy, but proposed candidates are both process and outcomes oriented. Both are likely to be used in the near future to increase transparency about patient outcomes, as well as to influence payments for the procedure.

  16. Capsule endoscopy in portal hypertension.

    PubMed

    Rondonotti, Emanuele; Villa, Federica; Dell' Era, Alessandra; Tontini, Gian Eugenio; de Franchis, Roberto

    2010-05-01

    Since the introduction of small bowel capsule endoscopy, and more recently of esophageal capsule endoscopy, these diagnostic tools have become available for the evaluation of the consequences of portal hypertension in the esophagus, stomach, and small intestine. The main advantage of the esophageal and the small bowel capsule is the relatively less invasiveness that could potentially increase patients' adherence to endoscopic screening/surveillance programs. When esophageal capsule endoscopy was compared with traditional gastroscopy, it showed good sensitivity and specificity in recognizing the presence and the size of esophageal varices. However, the results are not consistent among studies, and more data are needed.

  17. Clefting in pumpkin balloons

    NASA Astrophysics Data System (ADS)

    Baginski, F.; Schur, W.

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

  18. Modelling Hot Air Balloons.

    ERIC Educational Resources Information Center

    Brimicombe, M. W.

    1991-01-01

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

  19. Modelling Hot Air Balloons.

    ERIC Educational Resources Information Center

    Brimicombe, M. W.

    1991-01-01

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

  20. Balloon film strain measurement

    NASA Astrophysics Data System (ADS)

    Rand, James L.

    In order to understand the state of stress in scientific balloons, a need exists for the measurement of film deformation in flight. The results of a flight test program are reported where material strain was measured for the first time during the inflation, launch, ascent and float of a typical natural shape, zero pressure scientific balloon.

  1. The Great Balloon Controversy.

    ERIC Educational Resources Information Center

    Chase, Valerie

    1989-01-01

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

  2. Modified Hydrogen Balloon Explosion.

    ERIC Educational Resources Information Center

    Lawrence, Stephen S.

    1995-01-01

    Describes the technique of exploding an oxygen-hydrogen balloon using two balloons and having students observe the formation of water droplets. Suggests that the Socratic Method can be used to start discussions related to stochiometry, states of matter, and gas laws. (DDR)

  3. The Great Balloon Controversy.

    ERIC Educational Resources Information Center

    Chase, Valerie

    1989-01-01

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

  4. Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices: A Feasibility Study

    SciTech Connect

    Sonomura, Tetsuo; Sato, Morio; Kishi, Kazushi; Terada, Masaki; Shioyama, Yasukazu; Kimura, Masashi; Suzuki, Kenzo; Kutsukake, Yasumichi; Ushimi, Takashi; Tanaka, Junji; Hayashi, Seishu; Tanaka, Satoshi

    1998-01-15

    Purpose: To evaluate the clinical feasibility of balloon-occluded retrograde transvenous obliteration (BORTO) for gastric varices. Methods: BORTO was performed in 14 patients with gastric varices due to liver cirrhosis. The gastric varices were confirmed by endoscopy, and their feeding and draining veins were identified by contrast-enhanced computed tomography (CT) and angiography. A 6 Fr Simmons-shaped balloon catheter was inserted into the gastrorenal shunt. The balloon was inflated, and 5% ethanolamine oleate iopamidol was infused slowly through the catheter. Patients were followed up with endoscopy and enhanced CT at 1 week, 1, 3, and 6 months after the procedure and every 6 months thereafter. Results: The gastric varices completely disappeared in 12 of 14 patients and was partially resolved in the remaining 2 patients. Neither a recurrence nor an aggravation of gastric varices were found. No major complications were experienced. Conclusion: BORTO is a safe and effective treatment for gastric varices.

  5. Training the gastrointestinal endoscopy trainer.

    PubMed

    Waschke, Kevin A; Anderson, John; Macintosh, Donald; Valori, Roland M

    2016-06-01

    Endoscopy training has traditionally been accomplished by an informal process in the endoscopy unit that parallels apprenticeship training seen in other areas of professional education. Subsequent to an audit, a series of interventions were implemented in the English National Health Service to support both service delivery and to improve endoscopy training. The resulting training centers deliver a variety of hands-on endoscopy courses, established in parallel with the roll out of a colon cancer screening program that monitors and documents quality outcomes among endoscopists. The program developed a 'training the trainer' module that subsequently became known as the Training the Colonoscopy Trainer course (TCT). Several years after its implementation, colonoscopy quality outcomes in the UK have improved substantially. The core TCT program has spread to other countries with demonstration of a marked impact on endoscopy training and performance. The aim of this chapter is to describe the principles that underlie effective endoscopy training in this program using the TCT as an example. While the review focuses on the specific example of colonoscopy training, the approach is generic to the teaching of any technical skill; it has been successfully transferred to the teaching of laparoscopic surgery as well as other endoscopic techniques.

  6. Preoperative diagnosis of cavernous hemangioma presenting with melena using wireless capsule endoscopy of the small intestine

    PubMed Central

    Akazawa, Yu; Hiramatsu, Katsushi; Nosaka, Takuto; Saito, Yasushi; Ozaki, Yoshihiko; Takahashi, Kazuto; Naito, Tatsushi; Ofuji, Kazuya; Matsuda, Hidetaka; Ohtani, Masahiro; Nemoto, Tomoyuki; Suto, Hiroyuki; Yamaguchi, Akio; Imamura, Yoshiaki; Nakamoto, Yasunari

    2016-01-01

    Background and study aims: Primary neoplasms of the small intestine are relatively rare in all age groups, accounting for about 5 % of all gastrointestinal tumors 1. Cavernous hemangiomas of the small intestine are also rare, can cause gastrointestinal bleeding, and are extremely difficult to diagnose preoperatively 2. We present a patient who presented with melena and iron deficiency anemia, for whom wireless capsule endoscopy and single-balloon enteroscopy facilitated the diagnosis of cavernous hemangioma. PMID:27004239

  7. Advances in Capsule Endoscopy

    PubMed Central

    Scott, Ryan

    2015-01-01

    Wireless video capsule endoscopy (VCE) is a minimally invasive technology that has revolutionized the approach to small intestinal disease investigation and management. Designed primarily to provide diagnostic imaging of the small intestine, VCE is used predominantly for obscure gastrointestinal bleeding and suspected Crohn’s disease; however, numerous other indications have been established, including the assessment of celiac disease, investigation of small bowel tumors, and surveillance of hereditary polyposis syndromes. Since the introduction of small bowel VCE in 2000, more than 1600 articles have been published describing the evolution of this technology. The main adverse outcome is capsule retention, which can potentially be avoided by careful patient selection or by using a patency capsule. Despite the numerous advances in the past 15 years, limitations such as incomplete VCE studies, missed lesions, and time-consuming reporting remain. The inability to control capsule movement for the application of targeted therapy or the acquisition of tissue for histologic analysis remains among the greatest challenges in the further development of capsule technology. This article outlines the recent technological and clinical advances in VCE and the future directions of research in this field. PMID:27482183

  8. [Endonasal skull base endoscopy].

    PubMed

    Simal-Julián, Juan Antonio; Miranda-Lloret, Pablo; Pancucci, Giovanni; Evangelista-Zamora, Rocío; Pérez-Borredá, Pedro; Sanromán-Álvarez, Pablo; Perez-de-Sanromán, Laila; Botella-Asunción, Carlos

    2013-01-01

    The endoscopic endonasal techniques used in skull base surgery have evolved greatly in recent years. Our study objective was to perform a qualitative systematic review of the likewise systematic reviews in published English language literature, to examine the evidence and conclusions reached in these studies comparing transcranial and endoscopic approaches in skull base surgery. We searched the references on the MEDLINE and EMBASE electronic databases selecting the systematic reviews, meta-analyses and evidence based medicine reviews on skull based pathologies published from January 2000 until January 2013. We focused on endoscopic impact and on microsurgical and endoscopic technique comparisons. Full endoscopic endonasal approaches achieved gross total removal rates of craniopharyngiomas and chordomas higher than those for transcranial approaches. In anterior skull base meningiomas, complete resections were more frequently achieved after transcranial approaches, with a trend in favour of endoscopy with respect to visual prognosis. Endoscopic endonasal approaches minimised the postoperative complications after the treatment of cerebrospinal fluid (CSF) leaks, encephaloceles, meningoceles, craniopharyngiomas and chordomas, with the exception of postoperative CSF leaks. Randomized multicenter studies are necessary to resolve the controversy over endoscopic and microsurgical approaches in skull base surgery. Copyright © 2013 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  9. Advances in Capsule Endoscopy.

    PubMed

    Scott, Ryan; Enns, Robert

    2015-09-01

    Wireless video capsule endoscopy (VCE) is a minimally invasive technology that has revolutionized the approach to small intestinal disease investigation and management. Designed primarily to provide diagnostic imaging of the small intestine, VCE is used predominantly for obscure gastrointestinal bleeding and suspected Crohn's disease; however, numerous other indications have been established, including the assessment of celiac disease, investigation of small bowel tumors, and surveillance of hereditary polyposis syndromes. Since the introduction of small bowel VCE in 2000, more than 1600 articles have been published describing the evolution of this technology. The main adverse outcome is capsule retention, which can potentially be avoided by careful patient selection or by using a patency capsule. Despite the numerous advances in the past 15 years, limitations such as incomplete VCE studies, missed lesions, and time-consuming reporting remain. The inability to control capsule movement for the application of targeted therapy or the acquisition of tissue for histologic analysis remains among the greatest challenges in the further development of capsule technology. This article outlines the recent technological and clinical advances in VCE and the future directions of research in this field.

  10. Multicenter study on the safety of bariatric endoscopy.

    PubMed

    Espinet Coll, Eduardo; Nebreda Durán, Javier; López-Nava Breviere, Gontrand; Ducóns García, Julio; Rodríguez-Téllez, Manuel; Crespo García, Javier; Marra-López Valenciano, Carlos

    2017-05-01

    Bariatric endoscopy includes a series of specific techniques focused on the management of obese patients. As a quality criterion, safety as expressed by a minimal incidence of serious complications is required in addition to efficacy. A descriptive, retrospective, multicenter review of the experience recorded at seven hospitals included in the Grupo Español de Endoscopia Bariátrica (GETTEMO) in order to document the incidence, cause, and resolution (including legal consequences) of serious complications reported for each bariatric technique, and according to endoscopist expertise. In all, 6,771 bariatric endoscopic procedures were collected, wherein 57 serious complications (0.84%) were identified. Balloons: Orbera®-Medsil®, 5/5,589; Spatz2® (older model): 44/225; Heliosphere®: 1/70; Obalon®: 0/107. Sutures: POSE®, 5/679; sleeve gastroplasty with Apollo® system: 0/55. Prostheses: Endobarrier®: 2/46. All complications were resolved with medical/endoscopic management except for five cases (0.07%) that required surgery. A single lawsuit occurred (esophageal perforation with Spatz2® balloon), which had a favorable outcome. There was no mortality, and apparently no differences were found according to endoscopist expertise level. In our multicenter experience, bariatric endoscopy may be considered as a safe procedure (0.84% of serious complications in all). However, some devices may induce a higher proportion of complications, such as 19.55% for Spatz2® balloons (already replaced) or 4.34% for Endobarrier® sleeves (at the upper limit of accepted safety), although our experience with the latter is limited. All complications were resolved with conservative medical management, and only exceptionally required surgery (0.07%). No technique-related mortality was seen, and only one lawsuit occurred. Further evolutionary studies are required on the novel endoscopic techniques presently emerging to authenticate our results.

  11. Balloon Design Software

    NASA Technical Reports Server (NTRS)

    Farley, Rodger

    2007-01-01

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

  12. Scientific ballooning in Japan

    NASA Astrophysics Data System (ADS)

    Makino, F.

    Scientific ballooning activity in Japan during 2001 and 2002 is presented. Institute of Space and Astronautical Science (ISAS) launched 10 balloons from Sanriku Balloon Center (SBC) located 500 km north of Tokyo in 2001. Six flights were for scientific observations, observations of high energy cosmic electrons, cryogenic sampling of the air at high altitude, an observation of atmospheric ozone distribution, an observation of hard X-ray spectra of solar flare and a sampling of microorganism in the stratosphere. Two balloons made with 3.4 micron polyethylene film, of 30,000 m^3 without exhaust tube and 1,000 m^3 with exhaust tube were successfully flown and reached at altitudes of 50.7 km and 30.8 km respectively. It has been scheduled to launch 10 balloons in 2002 to observe solar flare, NO_2 and O_3 in the atmosphere, low frequency radiation in the environment, and atmospheric ozone density and to sample the air at high altitude. International collaborative balloon observations of cosmic-rays, Galactic infrared radiation and atmospheric ozone density were successfully conducted in USA, India and Spitzbergen, respectively in 2001. Two balloons will be flown from antarctica for the observations of cosmic-ray electrons and for auroral X-rays, respectively in December of 2002.

  13. Balloon Catheter Prevents Contamination

    NASA Technical Reports Server (NTRS)

    Higginson, Gregory A.; Bouffard, Marc R.; Hoehicke, Beth S.; King, Bradley D.; Peterson, Sandra L.

    1994-01-01

    Balloon catheter similar to that used in such medical procedures as angioplasty and heart surgery protects small orifices against contamination and blockage by chips generated in machining operations. Includes small, inflatable balloon at end of thin, flexible tube. Contains additional features adapting it to anticontamination service: balloon larger to fit wider channel it must block; made of polyurethane (rather than latex), which does not fragment if bursts; material made thicker to resist abrasion better; and kink-resistant axial wire helps catheter negotiate tight bends.

  14. Balloon Catheter Prevents Contamination

    NASA Technical Reports Server (NTRS)

    Higginson, Gregory A.; Bouffard, Marc R.; Hoehicke, Beth S.; King, Bradley D.; Peterson, Sandra L.

    1994-01-01

    Balloon catheter similar to that used in such medical procedures as angioplasty and heart surgery protects small orifices against contamination and blockage by chips generated in machining operations. Includes small, inflatable balloon at end of thin, flexible tube. Contains additional features adapting it to anticontamination service: balloon larger to fit wider channel it must block; made of polyurethane (rather than latex), which does not fragment if bursts; material made thicker to resist abrasion better; and kink-resistant axial wire helps catheter negotiate tight bends.

  15. A Patient Flow Analysis: Identification of Process Inefficiencies and Workflow Metrics at an Ambulatory Endoscopy Unit

    PubMed Central

    Almeida, Rowena; Paterson, William G.; Craig, Nancy; Hookey, Lawrence

    2016-01-01

    Background. The increasing demand for endoscopic procedures coincides with the paradigm shift in health care delivery that emphasizes efficient use of existing resources. However, there is limited literature on the range of endoscopy unit efficiencies. Methods. A time and motion analysis of patient flow through the Hotel-Dieu Hospital (Kingston, Ontario) endoscopy unit was followed by qualitative interviews. Procedures were directly observed in three segments: individual endoscopy room use, preprocedure/recovery room, and overall endoscopy unit utilization. Results. Data were collected for 137 procedures in the endoscopy room, 139 procedures in the preprocedure room, and 143 procedures for overall room utilization. The mean duration spent in the endoscopy room was 31.47 min for an esophagogastroduodenoscopy, 52.93 min for a colonoscopy, 30.47 min for a flexible sigmoidoscopy, and 66.88 min for a double procedure. The procedure itself accounted for 8.11 min, 34.24 min, 9.02 min, and 39.13 min for the above procedures, respectively. The focused interviews identified the scheduling template as a major area of operational inefficiency. Conclusions. Despite reasonable procedure times for all except colonoscopies, the endoscopy room durations exceed the allocated times, reflecting the impact of non-procedure-related factors and the need for a revised scheduling template. Endoscopy units have unique operational characteristics and identification of process inefficiencies can lead to targeted quality improvement initiatives. PMID:27446830

  16. A Patient Flow Analysis: Identification of Process Inefficiencies and Workflow Metrics at an Ambulatory Endoscopy Unit.

    PubMed

    Almeida, Rowena; Paterson, William G; Craig, Nancy; Hookey, Lawrence

    2016-01-01

    Background. The increasing demand for endoscopic procedures coincides with the paradigm shift in health care delivery that emphasizes efficient use of existing resources. However, there is limited literature on the range of endoscopy unit efficiencies. Methods. A time and motion analysis of patient flow through the Hotel-Dieu Hospital (Kingston, Ontario) endoscopy unit was followed by qualitative interviews. Procedures were directly observed in three segments: individual endoscopy room use, preprocedure/recovery room, and overall endoscopy unit utilization. Results. Data were collected for 137 procedures in the endoscopy room, 139 procedures in the preprocedure room, and 143 procedures for overall room utilization. The mean duration spent in the endoscopy room was 31.47 min for an esophagogastroduodenoscopy, 52.93 min for a colonoscopy, 30.47 min for a flexible sigmoidoscopy, and 66.88 min for a double procedure. The procedure itself accounted for 8.11 min, 34.24 min, 9.02 min, and 39.13 min for the above procedures, respectively. The focused interviews identified the scheduling template as a major area of operational inefficiency. Conclusions. Despite reasonable procedure times for all except colonoscopies, the endoscopy room durations exceed the allocated times, reflecting the impact of non-procedure-related factors and the need for a revised scheduling template. Endoscopy units have unique operational characteristics and identification of process inefficiencies can lead to targeted quality improvement initiatives.

  17. Single-balloon push-and-pull enteroscopy system: does it work? A single-center, 3-year experience.

    PubMed

    Riccioni, M E; Urgesi, R; Cianci, R; Spada, C; Nista, E C; Costamagna, G

    2011-09-01

    The last decade has seen significant advances in the evaluation of the small bowel. Several endoscopic techniques have been developed in recent years: capsule endoscopy (CE), double-balloon enteroscopy (DBE), and, more recently, the single-balloon enteroscopy (SBE). The aim of this study was to evaluate diagnostic and therapeutic impact, safety, and feasibility of the SBE procedure after a 3-year experience. A total of 73 SBE procedures were performed from July 2006 to July 2009. The starting insertion route (oral or anal) of SBE was chosen according to the estimated location of the suspected lesions based on the clinical presentation and, in 48 patients, on the findings of CE. A total of 70 patients with obscure gastrointestinal bleeding (31), suspected malabsorption syndrome (12), polyposis syndromes (11), suspected Crohn's disease (9), and suspected gastrointestinal tumors (7) were recruited. The SBE was not carried out in four patients because of technical problems. Multiple angiodysplasias were found and treated in 9 patients; Peutz-Jeghers syndrome, familial adenomatous polyposis (FAP), and multiple polypectomies were carried out in 8 patients; endoscopic tattoos were performed in 2 patients due to the large diameter of the polyps; and multiple biopsies was performed in only one patient. SBE diagnosed Crohn's disease in four patients, malabsorption syndromes in two, lymphangiectasia in two, eosinophilic enteritis in one, melanoma in one, and nonspecific inflammation in eight. A total of seven small-bowel tumors were diagnosed (all were tattooed). In 23/70 patients the exam was negative. No major complications occurred. Single-balloon enteroscopy seems to be safe, useful, and highly effective in the diagnosis and therapy of several small-bowel diseases.

  18. Characteristics of Small Intestinal Diseases on Single-Balloon Enteroscopy

    PubMed Central

    Tao, Zhang; Liu, G.X.; Cai, L.; Yu, H.; Min, X.J.; Gan, H.T.; Yang, K.; SQ, Li; Yan, J.; Chen, L.; Tan, Q.H.; Wu, J.C.; Huang, X.L.

    2015-01-01

    Abstract The small intestine has been considered inaccessible for a long term. The development of single-balloon endoscopy has greatly improved the diagnosis and treatment possibilities for small intestinal diseases. In this study, we aimed to explore the demographic characteristics and small intestinal diseases of patients who underwent single-balloon enteroscopy between 2009 and 2014 at our endoscopy center. We determined the enteroscopic findings for each small intestinal disease and the most susceptible age groups. In total, 186 patients were included in the study. Their mean age was 45.87 ± 15.77 years. Patients who underwent single-balloon enteroscopy were found to have neoplasms (most common age group: 14–45 years, most common lesion location: jejunum), lymphoma (46–59 and 60–74 years, ileum), protuberant lesions (45–59 years, jejunum), inflammation (14–45 and 46–59 years, ileum), benign ulcers (14–45 years, jejunum), diverticulum (14–45 years, ileum), vascular malformations (60–74 years, jejunum), polyps (14–45 years, jejunum), Crohn's disease (14–45 years, jejunum), hookworm infection (14–45 years, jejunum), lipid pigmentation (14–45 and 46–59 years, jejunum), undetermined bleeding (46–59 years, ileum), or undetermined stenosis (31 years, duodenum). Each small intestinal disease had distinct enteroscopic findings. PMID:26496270

  19. Balloon angioplasty - short segment

    MedlinePlus Videos and Cool Tools

    ... narrowed or blocked arteries caused by deposits of plaque. If the blockage is not major, the problem ... inflating the balloon several times to compact the plaque against the arterial wall, widening the passage for ...

  20. NASA Now: Balloon Research

    NASA Image and Video Library

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

  1. The Descending Helium Balloon

    ERIC Educational Resources Information Center

    Helseth, Lars Egil

    2014-01-01

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

  2. Ballooning Interest in Science.

    ERIC Educational Resources Information Center

    Kim, Hy

    1992-01-01

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

  3. Modelling hot air balloons

    NASA Astrophysics Data System (ADS)

    Brimicombe, N. W.

    1991-07-01

    Hot air balloons can be modelled in a number of different ways. The most satisfactory, but least useful model is at a microscopic level. Macroscopic models are easier to use but can be very misleading.

  4. Ballooning Interest in Science.

    ERIC Educational Resources Information Center

    Kim, Hy

    1992-01-01

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

  5. The Descending Helium Balloon

    ERIC Educational Resources Information Center

    Helseth, Lars Egil

    2014-01-01

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

  6. The descending helium balloon

    NASA Astrophysics Data System (ADS)

    Helseth, Lars Egil

    2014-07-01

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

  7. Balloon film strain measurement

    NASA Technical Reports Server (NTRS)

    Rand, J. L.

    1983-01-01

    A discussion is presented of the results of a flight test program in which scientific research balloon material strain was measured in order to determine stress levels. Attention is given to material strain characteristics during the inflation, launch, ascent, and flight of a natural shape, zero-pressure scientific balloon. Measurements were conducted with a simple thin film strain transducer. Thermal, meridional and circumferential strain history data for the test flight are given.

  8. Determination of balloon drag

    NASA Technical Reports Server (NTRS)

    Conrad, George R.; Robbins, Edward J.

    1991-01-01

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

  9. Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.

    PubMed

    Spada, C; Hassan, C; Galmiche, J P; Neuhaus, H; Dumonceau, J M; Adler, S; Epstein, O; Gay, G; Pennazio, M; Rex, D K; Benamouzig, R; de Franchis, R; Delvaux, M; Devière, J; Eliakim, R; Fraser, C; Hagenmuller, F; Herrerias, J M; Keuchel, M; Macrae, F; Munoz-Navas, M; Ponchon, T; Quintero, E; Riccioni, M E; Rondonotti, E; Marmo, R; Sung, J J; Tajiri, H; Toth, E; Triantafyllou, K; Van Gossum, A; Costamagna, G

    2012-05-01

    PillCam colon capsule endoscopy (CCE) is an innovative noninvasive, and painless ingestible capsule technique that allows exploration of the colon without the need for sedation and gas insufflation. Although it is already available in European and other countries, the clinical indications for CCE as well as the reporting and work-up of detected findings have not yet been standardized. The aim of this evidence-based and consensus-based guideline, commissioned by the European Society of Gastrointestinal Endoscopy (ESGE) is to furnish healthcare providers with a comprehensive framework for potential implementation of this technique in a clinical setting.

  10. Upper gastrointestinal endoscopy is safe and feasible in the early postoperative period after Roux-en-Y gastric bypass.

    PubMed

    Sharma, Gautam; Ardila-Gatas, Jessica; Boules, Mena; Davis, Matthew; Villamere, James; Rodriguez, John; Brethauer, Stacy A; Ponsky, Jeffrey; Kroh, Matthew

    2016-10-01

    Surgeons may be reluctant to perform upper gastrointestinal (UGI) endoscopy in the early post-operative period due to concern for anastomotic disruption. The aim of this study was to determine the safety and feasibility of early (≤ 30 days) post-operative UGI endoscopy after roux-en-y gastric bypass (RYGB). A retrospective data analysis of a prospectively maintained database was completed between May 2002 and March 2015 for patients that had undergone UGI endoscopy within 30 days of their RYGB. Data analysis included baseline patient demographics, Charlson Comorbidity Index, perioperative parameters, indications for endoscopy; indications for any further endoscopic evaluation, interventions performed, and post-endoscopy complications. 190 patients underwent early postoperative UGI endoscopy after RYGB during the study period. Nineteen patients (10 %) had undergone revisional surgeries. The median duration to postoperative endoscopy was 22 days [IQR 16-26]. The most common indications included dysphagia (n = 74, 39%), abdominal pain (n = 53, 28%), nausea (n = 55, 29%), and vomiting (n = 47, 25%). Therapeutic interventions were performed in 79 patients (42%). These included balloon dilation (n = 66, 84%), feeding tube placement (n = 7, 9%), evacuation of clot (n = 2, 3%), epinephrine injection (n = 2, 3%) and coagulation of bleeding (n = 1, 1%). There were no post-UGI endoscopy anastomotic disruptions or leaks. Endoscopy is helpful for the diagnosis and management of complications after RYGB. Despite the perceived risks, our study demonstrated no complications for both diagnostic and therapeutic endoscopy when performed in the early postoperative period. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Operative endoscopy of the airway

    PubMed Central

    Walters, Dustin M.

    2016-01-01

    Airway endoscopy has long been an important and useful tool in the management of thoracic diseases. As thoracic specialists have gained experience with both flexible and rigid bronchoscopic techniques, the technology has continued to evolve so that bronchoscopy is currently the foundation for diagnosis and treatment of many thoracic ailments. Airway endoscopy plays a significant role in the biopsy of tumors within the airways, mediastinum, and lung parenchyma. Endoscopic methods have been developed to treat benign and malignant airway stenoses and tracheomalacia. And more recently, techniques have been conceived to treat end-stage emphysema and prolonged air leaks in select patients. This review describes the abundant uses of airway endoscopy, as well as technical considerations and limitations of the current technologies. PMID:26981263

  12. Blood thinners and gastrointestinal endoscopy

    PubMed Central

    Ahmed, Monjur

    2016-01-01

    As the number of diagnostic and therapeutic gastrointestinal endoscopies is increasing, and there is an increase in number of patients taking blood thinners, we are seeing more and more patients on blood thinners prior to endoscopic procedures. Gastrointestinal bleeding or thromboembolism can occur in this category of patients in the periendoscopic period. To better manage these patients, endoscopists should have a clear concept about the various blood thinners in the market. Patients’ risk of thromboembolism off anticoagulation, and the risk of bleeding from endoscopic procedures should be assessed prior to endoscopy. The endoscopic procedure should be done when it is safe to do it. PMID:27668068

  13. Endoscopy imaging intelligent contrast improvement.

    PubMed

    Sheraizin, S; Sheraizin, V

    2005-01-01

    In this paper, we present a medical endoscopy video contrast improvement method that provides intelligent automatic adaptive contrast control. The method fundamentals are video data clustering and video data histogram modification. The video data clustering allows an effective use the low noise two channel contrast enhancement processing. The histogram analysis permitted to determine the video exposure type for simple and complicated contrast distribution. We determined the needed gamma value for automatic local area contrast improvement for the following exposure types: dark, normal, light, dark light, dark normal etc. The experimental results of medical endoscopy video processing allow defining the automatic gamma control range from 0.5 to 2.0.

  14. Chromoendoscopy and magnifying endoscopy for Barrett's esophagus.

    PubMed

    Canto, Marcia Irene

    2005-07-01

    Chromoendoscopy and magnification endoscopy are 2 endoscopic techniques used to improve visualization and diagnosis of gastrointestinal mucosa. This article summarizes the principles behind magnification endoscopy, with and without chromoendoscopy, for the diagnosis of Barrett's esophagus, dysplasia, and adenocarcinoma. Furthermore, this article discusses the possible clinical use of magnification endoscopy and chromoendoscopy in evaluating patients with chronic gastroesophageal reflux disease and Barrett's esophagus.

  15. Recurrent Lower Gastrointestinal Bleeding: Ileal GIST Diagnosed by Video Capsule Endoscopy-A Case Report and Literature Review.

    PubMed

    Ling, Jie; Lamsen, Marie; Coron, Roger; Deliana, Danila; Siddiqui, Sabah; Rangraj, Madhu; Jesmajian, Stephen

    2013-01-01

    Introduction. Gastrointestinal stromal tumor (GIST) in the ileum is an extremely rare cause of recurrent lower gastrointestinal bleeding (GIB). Case Report. An 89-year-old man was admitted with melana. He had extensive PMH of CAD post-CABG/AICD, AAA repair, chronic anemia, myelodysplastic syndrome, lung cancer after resection, and recurrent GIB. Prior EGDs, colonoscopies, and upper device-assisted enteroscopy showed duodenal ulcer, A-V malformation s/p cauterization, and angioectasia. On admission, Hb was 6.0 g/dL. An endoscopic capsule study showed an ulcerated tumor in the ileum. CT showed no distant metastasis. The lesion was resected successfully and confirmed as a high-grade GIST. The patient was discharged with no further bleeding. Discussion. Early diagnosis for patients with ileal GIST is often challenging. Video capsule endoscopy and double balloon enteroscopy could be useful diagnostic tools. Surgical removal is the first line for a resectable GIST. Imatinib has become the standard therapy. Conclusion. This is a unique case of an ileal GIST in a patient with recurrent GIB which was diagnosed by video capsule. Complicated medical comorbidities often lead to a significant delay in diagnosis. Therefore, we recommend that if GIB does not resolve after appropriate treatments for known causes, the alternative diagnosis for occult GIB must be considered, including malignancy such as GIST.

  16. Development of a balloon volume sensor for pulsating balloon catheters.

    PubMed

    Nolan, Timothy D C; Hattler, Brack G; Federspiel, William J

    2004-01-01

    Helium pulsed balloons are integral components of several cardiovascular devices, including intraaortic balloon pumps (IABP) and a novel intravenous respiratory support catheter. Effective use of these devices clinically requires full inflation and deflation of the balloon, and improper operating conditions that lead to balloon under-inflation can potentially reduce respiratory or cardiac support provided to the patient. The goal of the present study was to extend basic spirographic techniques to develop a system to dynamically measure balloon volumes suitable for use in rapidly pulsating balloon catheters. The dynamic balloon volume sensor system (DBVSS) developed here used hot wire anemometry to measure helium flow in the drive line from console to catheter and integrated the flow to determine the volume delivered in each balloon pulsation. An important component of the DBVSS was an algorithm to automatically detect and adjust flow signals and measured balloon volumes in the presence of gas composition changes that arise from helium leaks occurring in these systems. The DBVSS was capable of measuring balloon volumes within 5-10% of actual balloon volumes over a broad range of operating conditions relevant to IABP and the respiratory support catheter. This includes variations in helium concentration from 70-100%, pulsation frequencies from 120-480 beats per minute, and simulated clinical conditions of reduced balloon filling caused by constricted vessels, increased driveline, or catheter resistance.

  17. Universal stratospheric balloon gradiometer

    NASA Astrophysics Data System (ADS)

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

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

  18. Stability of lobed balloons

    NASA Astrophysics Data System (ADS)

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

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

  19. Balloon gondola diagnostics package

    NASA Technical Reports Server (NTRS)

    Cantor, K. M.

    1986-01-01

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

  20. Gradient magnetometer system balloons

    NASA Astrophysics Data System (ADS)

    Korepanov, Valery; Tsvetkov, Yury

    2005-08-01

    Earth's magnetic field study still remains one of the leading edges of experimental geophysics. Thus study is executed on the Earth surface, including ocean bottom, and on satellite heights using component, mostly flux-gate magnetometers. But balloon experiments with component magnetometers are very seldom, first of all because of great complexity of data interpretation. This niche still waits for new experimental ideology, which will allow to get the measurements results with high accuracy, especially in gradient mode. The great importance of precise balloon-borne component magnetic field gradient study is obvious. Its technical realization is based both on the available at the marked high-precision non-magnetic tiltmeters and on recent achievements of flux-gate magnetometry. The scientific goals of balloon-borne magnetic gradiometric experiment are discussed and its practical realization is proposed.

  1. Balloon gondola diagnostics package

    NASA Astrophysics Data System (ADS)

    Cantor, K. M.

    1986-10-01

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

  2. Launching Garbage-Bag Balloons.

    ERIC Educational Resources Information Center

    Kim, Hy

    1997-01-01

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

  3. BARREL Team Launching 20 Balloons

    NASA Image and Video Library

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

  4. Hospital-level balloon tamponade use is associated with increased mortality for all patients presenting with acute variceal haemorrhage.

    PubMed

    Tapper, Elliot B; Ezaz, Ghideon; Patwardhan, Vilas; Mellinger, Jessica; Bonder, Alan; Curry, Michael; Saini, Sameer D

    2017-08-24

    Balloon tamponade (BT) can bridge patients to salvage therapy for uncontrollable acute variceal haemorrhage (AVH). However, data are limited regarding the reasons for, rate of and outcomes associated with Balloon tamponade use. First, we performed an single-centre cohort study of all patients (N = 139) with oesophageal acute variceal haemorrhage from 01/2009 to 10/2015. Associations between Balloon tamponade use and adherence to four quality metrics (endoscopy within 12 hours, band-ligation, pre-endoscopy antibiotics and octreotide) were evaluated. Second, we analysed the National Inpatient Sample (2005-2011) to determine the association between in-hospital mortality for patients and their hospital's Balloon tamponade-utilization to acute variceal haemorrhage volume ratio. In the national cohort, 5.5% of 140 521 acute variceal haemorrhage admissions required Balloon tamponade utilization. Adjusting for patient- and hospital-level confounders, the rate of Balloon tamponade use per acute variceal haemorrhage managed at any given hospital was associated with increased mortality for all-comers with acute variceal haemorrhage. Compared to the lowest tertile, acute variceal haemorrhage admissions in the highest Balloon tamponade utilizers were associated with increased mortality of (OR1.17 95%CI (1.01-1.37). In the single-centre cohort, 14 (10.1%) patients required Balloon tamponade. Balloon tamponade utilization was significantly associated with alcohol abuse (50.4% vs 21.4%, P = .04), hepatocellular carcinoma (35.7% vs 8.8%, P = .01), higher median model for end-stage liver disease (MELD) score (26.3vs15.5, P = .002) and active bleeding during endoscopy (64.3% vs 27.5%, P = .01). Failure to provide all quality metrics was associated with a higher model for end-stage liver disease-adjusted risk of Balloon tamponade use: OR 16.7 95% CI(4.17-100.0, P < .0001). Balloon tamponade use is associated with severity of bleeding but may also implicate deficits in

  5. Transgastral retroperitoneal endoscopy in septic patients with pancreatic necrosis or infected pancreatic pseudocysts.

    PubMed

    Hocke, M; Will, U; Gottschalk, P; Settmacher, U; Stallmach, A

    2008-12-01

    Peripancreatic fluid collections are common complications of acute pancreatitis or acute exacerbations of chronic pancreatitis. Surgery is required when these fluid collections become infected or cause obstruction or pain. However, morbidity and mortality after surgery in these cases are still too high, therefore minimally invasive approaches have been encouraged. The aim of this study was to evaluate the feasibility of endoscopic ultrasound-guided transmural drainage with intracystic endoscopy and necrosectomy. From 2000 to 2006 30 patients (age: 57 +/- 10 years, range: 34 - 74 years) with an infected pancreatic pseudocyst or infected pancreatic necrosis were included in the study. The diagnosis of infection in patients who had fever despite an adequate antibiotic regime was confirmed by endoscopic fine needle aspiration with a positive bacterial or mycological result. The mean C-reactive protein value before treatment was 202 +/- 58 mg/L and the mean leukocyte count was 13.25 +/- 4.75 GPt/L. Transgastric cyst drainage was performed using a therapeutic endoscopic ultrasound probe (Pentax 38 UX or Olympus GF UCT 140) with insertion of an 8-Fr double pigtail prosthesis. After balloon dilatation (12 mm) a normal gastroscope was inserted into the cavity and all the fluid and easy removable necrosis were removed. The prosthesis was removed 4 weeks after the end of the endoscopic treatment. Clinical and ultrasound follow-up were carried out 3 and 6 months after removal of the prosthesis. The mean follow-up was 60 weeks. The technical success of the procedure was 96.7 %, the long-term success was 83.4 %. On average 2.7 (range: 1 - 16) procedures were necessary for complete removal of necrosis and the remaining fluid. Major complications (bleeding, perforation, fistulation) occurred in 10 %. In 10 % a secondary operation was necessary. The overall mortality rate was 6.6 %. Endoscopic treatment of infected pseudocysts and infected postacute pancreatic necrosis using

  6. Balloons of the Civil War

    DTIC Science & Technology

    1994-06-03

    summer. The indirect path involved transporting the Army of the Potomac south, via the water network , to some point nearer Richmond, and thence...using the telegraph. and signal stations near his balloons to communicate with headquarters. Logistic support for the balloons flowed via the water ... network to Aquia Creek Station Landing and then overland to the balloon camps. Two of four balloons available were sent back to Washington for repairs

  7. Balloon borne Infrared Surveys

    NASA Astrophysics Data System (ADS)

    Lubin, Philip M.

    2015-08-01

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

  8. Recent developments in scientific ballooning and launching of stratopause balloon

    NASA Astrophysics Data System (ADS)

    Buduru, Suneel Kumar

    2012-07-01

    The Balloon Facility, Hyderabad has been launching stratospheric zero pressure balloons for scientific, engineering experiments and sounding balloons for getting winds at balloon float altitudes. Sounding balloons of volume 4,000 cubic meters made with thin film of 5.8 microns can reach up to 43 kilometers with a maximum payload of 1 kilogram. To keep pace with growing demand from user scientists in terms of higher payload capability and higher float altitude, developmental work in the area of very thin film continued, resulting in the development of very thin film of 3.8 microns thickness. Using this very thin film, four balloons of volume 60,000 cubic meters each, capable of carrying 10 kilograms payload to stratopause (approximately 47 kilometers) were fabricated for the first time for trial and evaluation. These balloons are precursors to our ultimate aim of developing still thinner film of 2.7 microns, to be used in balloons for reaching mesosphere with 10 kilogram payload. Raw material selection, manufacturing process, test and evaluation of the film in laboratory, new launching techniques for handling the very thin film balloons are described. A summary of the successful balloon flights carried out in last two years for scientific experiments and launching results of very thin film balloon is presented.

  9. Scientific balloons: historical remarks.

    NASA Astrophysics Data System (ADS)

    Ubertini, P.

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

  10. New balloon materials

    NASA Astrophysics Data System (ADS)

    Rand, J. L.; Seely, L. G.; Smith, M. S.

    1993-02-01

    The introduction of StratoFilm® in 1965 solved a number of material related problems that had plagued the balloon community prior to that time. As payloads and float altitudes increased over the years, the balloons also became much larger. Unfortunately, in the late 1970's and early 1980's the catastrophic failure of stratospheric balloons began to reappear which naturally eroded the confidence of the scientific users. At the same time balloon manufacturers intensified their efforts to produce the high quality film so necessary for a reliable, low cost platform operating in the stratosphere. This paper describes the efforts taken by one manufacturer to produce a consistently high quality film for this application. The approach taken was to blend newly developed resins such as linear low density polyethylene with other polymers to achieve the desired properties. The resulting film designated as StratoFilm 372 has enjoyed a 100 percent successful flight record for over three years. In addition, this paper will describe a new resin which has been designed to achieve even superior properties to those now in use.

  11. Particle Astrophysics Using Balloons

    NASA Astrophysics Data System (ADS)

    Seo, E. S.

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

  12. How Is Small Intestine Adenocarcinoma Diagnosed?

    MedlinePlus

    ... normal bowel movement and is flushed away. Double-balloon enteroscopy (endoscopy) Regular upper endoscopy cannot look very ... goes forward a small distance, and then a balloon at its end is inflated to anchor it. ...

  13. Flow Past a Descending Balloon

    NASA Technical Reports Server (NTRS)

    Baginski, Frank

    2001-01-01

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

  14. Advances in upper gastrointestinal endoscopy

    PubMed Central

    Graham, David G.; Banks, Matthew R.

    2015-01-01

    The rapidly moving technological advances in gastrointestinal endoscopy have enhanced an endoscopist’s ability to diagnose and treat lesions within the gastrointestinal tract. The improvement in image quality created by the advent of high-definition and magnification endoscopy, alongside image enhancement, produces images of superb quality and detail that empower the endoscopist to identify important lesions that have previously been undetectable. Additionally, we are now seeing technologies emerge, such as optical coherence tomography and confocal laser endomicroscopy, that allow the endoscopist to visualize individual cells on a microscopic level and provide a real time, in vivo histological assessment. Within this article we discuss these technologies, as well as some of the results from their early use in clinical studies. PMID:26918137

  15. Assessment of explanted PTCA balloons.

    PubMed

    Behrend, D; Zinner, G; Sternberg, K; Schroeder, M; Schmitz, K P; Haubold, A

    2000-10-01

    The data presented here are part of a on-going study to define the surface characteristics and properties of explanted PTCA catheters in a further effort to address some of the ramifications of the re-use issue. PTCA balloon catheter were examined after angioplasty in one hundred and sixty-eight patients (n = 168). This series included six balloon types from three manufacturers. The fresh fixed and dehydrated balloons were examined at first with light microscopy and then in a scanning electron microscope. X-ray semiquantitative microanalysis and FT-IR-ATR analysis were also performed on the balloons. Because most blood proteins are water soluble, we examined unfixed balloons with a protein silver staining kit for detection of adhered proteins described by Heukeshoven. A further method for protein detection is the Lowry-analysis. With this method water insoluble proteins can be observed. Our study has shown convincingly that all deployed angioplasty catheters were coated with adherent protein layers. Plaque particles were found embedded in the surfaces of most of the balloons examined. Fissuring and micro tearing of balloon surfaces was noted. FT-IR-ATR analyses of the blood contacted balloon surfaces did not show any peaks indicative of proteins on the balloon surface. The silver staining method also did not show any evidence of protein adsorption on the balloons. On the other hand, the Lowry-analysis yielded clear evidence that water insoluble proteins were adherent to the balloon surfaces. The average measured protein concentration was 17 microg/ml.

  16. Venus Balloons using Water Vapor

    NASA Astrophysics Data System (ADS)

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

    We propose an inflatable balloon using water vapor for the lifting gas, which is liquid in the transportation stage before entry into the high temperature atmosphere. The envelope of the balloon has an outer layer for gas barrier (a high-temperature resistant film) and an inner layer for liquid water keeping. In the descent stage using a parachute, water widely held just inside the balloon envelope can be quickly vaporized by a lot of heat flux from the surrounding high-temperature atmosphere owing to the large surface area of the balloon. As neither gas containers nor heat exchangers are necessary, we can construct a simple, lightweight and small size Venus balloon probe system. Tentative floating altitude is 35 km below the thick clouds in the Venusian atmosphere. Selection of balloon shape and material for balloon envelope are discussed in consideration of the Venusian environment such as high-temperature, high-pressure, and sulfuric acid. Balloon deployment and inflation sequence is numerically simulated. In case of the total floating mass of 10 kg at the altitude of 35 km, the volume and mass of the balloon is 1.5 cubic meters, and 3.5 kg, respectively. The shape of the balloon is chosen to be cylindrical with a small diameter. The mass of li fting gas can be determined as 4.3 kg and the remaining 2.2 kg becomes the payload mass. The mass of the total balloon system is also just 10 kg excluding the entry capsule.

  17. Integrated flexible endoscopy training during surgical residency.

    PubMed

    Morales, Mario P; Mancini, Gregory J; Miedema, Brent W; Rangnekar, Nitin J; Koivunen, Debra G; Ramshaw, Bruce J; Eubanks, W Stephen; Stephenson, Hugh E

    2008-09-01

    New advances in endoscopic surgery make it imperative that future gastrointestinal surgeons obtain adequate endoscopy skills. An evaluation of the 2001-02 general surgery residency endoscopy experience at the University of Missouri revealed that chief residents were graduating with an average of 43 endoscopic cases. This met American Board of Surgery (ABS) and Accreditation Council for Graduate Medical Education (ACGME) requirements but is inadequate preparation for carrying out advanced endoscopic surgery. Our aim was to determine if endoscopy volume could be improved by dedicating specific staff surgeon time to a gastrointestinal diagnostic center at an affiliated Veterans Administration Hospital. During the academic years 2002-05, two general surgeons who routinely perform endoscopy staffed the gastrointestinal endoscopy center at the Harry S. Truman Hospital two days per week. A minimum of one categorical surgical resident participated during these endoscopy training days while on the Veterans Hospital surgical service. A retrospective observational review of ACGME surgery resident case logs from 2001 to 2005 was conducted to document the changes in resident endoscopy experience. The cases were compiled by postgraduate year (PGY). Resident endoscopy case volume increased 850% from 2001 to 2005. Graduating residents completed an average of 161 endoscopies. Endoscopic experience was attained at all levels of training: 26, 21, 34, 23, and 26 mean endoscopies/year for PGY-1 to PGY-5, respectively. Having specific endoscopy training days at a VA Hospital under the guidance of a dedicated staff surgeon is a successful method to improve surgical resident endoscopy case volume. An integrated endoscopy training curriculum results in early skills acquisition, continued proficiency throughout residency, and is an efficient way to obtain endoscopic skills. In addition, the foundation of flexible endoscopic skill and experience has allowed early integration of surgery

  18. Optimum Designs for Superpressure Balloons

    NASA Astrophysics Data System (ADS)

    Smith, M.; Rainwater, E.

    Natural shape balloons have been employed for minimum stress envelope design in zero pressure scientific balloons since the 1940's. Superpressure balloons, on the other hand, have traditionally been spheres with tangential load attachment points. Application of natural shape design principles to superpressure balloons is relatively new. The resulting natural shape superpressure balloon shape generally fits Euler's Elastica. There are numerous examples of superpressure cylinder balloons which take on the elastica shape when pressurized. Techniques tried for reducing circumferential stresses in the NASA ULDB natural shape superpressure balloons have revealed new challenges both for design and manufacture. This paper will present a thorough background in the development of the current design concept as well as a review of the current challenges associated with manufacturing these envelopes. Approaches for achieving an optimum design will be presented along with ground and flight test data.

  19. New EU regulations in endoscopy.

    PubMed

    Wächter, M; Diekjobst, T

    1995-09-01

    As a result of European unification, new regulations valid within the territory of the European Union (EU) have been negotiated and published. As in other medical fields, the Medical Device Directive (MDD) is the most important new regulation and also effects endoscopy. In a transition period until June 1998, the MDD will be transposed into national law by the member states of the EU. Compliance with the MDD and other European regulations is indicated by the CE mark affixed to the product.

  20. Panoramic views for virtual endoscopy.

    PubMed

    Geiger, Bernhard; Chefd'hotel, Christophe; Sudarsky, Sandra

    2005-01-01

    This paper describes a panoramic projection designed to increase the surface visibility during virtual endoscopies. The proposed projection renders five faces of a cubic viewing space into the plane in a continuous fashion. Using this real-time and interactive visualization technique as a screening method for colon cancer could lead to significantly shorter evaluation time. It avoids having to fly through the colon in both directions and prevents the occlusion of potential polyps behind haustral folds.

  1. Gastrointestinal endoscopy: infection and disinfection.

    PubMed Central

    O'Connor, H J; Axon, A T

    1983-01-01

    The past decade has seen the development of an array of complex flexible fibreoptic instruments for gastrointestinal (GI) endoscopy, and an increasing use of these for diagnostic and therapeutic purposes. It has been recognised more recently that the use of contaminated endoscopic equipment can lead to serious and occasionally fatal infections. Infection with a wide variety of micro-organisms has been reported following oesophago-gastroduodenoscopy (OGD) and endoscopic retrograde cholangio-pancreatography (ERCP). PMID:6414894

  2. Drug-Induced Sleep Endoscopy.

    PubMed

    Charakorn, Natamon; Kezirian, Eric J

    2016-12-01

    Drug-induced sleep endoscopy (DISE) is an upper airway evaluation technique in which fiberoptic examination is performed under conditions of unconscious sedation. Unique information obtained from this 3-dimensional examination of the airway potentially provides additive benefits to other evaluation methods to guide treatment selection. This article presents recommendations regarding DISE technique and the VOTE Classification system for reporting DISE findings and reviews the evidence concerning DISE test characteristics and the association between DISE findings and treatment outcomes.

  3. Wire-guided balloon coloplasty--a new treatment for colorectal strictures?

    PubMed Central

    Banerjee, A K; Walters, T K; Wilkins, R; Burke, M

    1991-01-01

    A new technique for dilatation of colorectal anastomotic strictures--wire-guided balloon coloplasty--is described. It is suitable for high strictures, may be performed without general anaesthetic and is repeatable. It does not require endoscopy and may be used to relieve obstructive symptoms in both benign and malignant strictures so avoiding the need for a defunctioning colostomy. Images Figure 1. Figure 2. Figure 3. PMID:2013892

  4. Capsule endoscopy: The road ahead

    PubMed Central

    Singeap, Ana-Maria; Stanciu, Carol; Trifan, Anca

    2016-01-01

    Since its introduction into clinical practice 15 years ago, capsule endoscopy (CE) has become the first-line investigation procedure in some small bowel pathologies, and more recently, dedicated esophageal and colon CE have expanded the fields of application to include the upper and lower gastrointestinal disorders. During this time, CE has become increasingly popular among gastroenterologists, with more than 2 million capsule examinations performed worldwide, and nearly 3000 PubMed-listed studies on its different aspects published. This huge interest in CE may be explained by its non-invasive nature, patient comfort, safety, and access to anatomical regions unattainable via conventional endoscopy. However, CE has several limitations which impede its wider clinical applications, including the lack of therapeutic capabilities, inability to obtain biopsies and control its locomotion. Several research groups are currently working to overcome these limitations, while novel devices able to control capsule movement, obtain high quality images, insufflate the gut lumen, perform chromoendoscopy, biopsy of suspect lesions, or even deliver targeted drugs directly to specific sites are under development. Overlooking current limitations, especially as some of them have already been successfully surmounted, and based on the tremendous progress in technology, it is expected that, by the end of next 15 years, CE able to perform both diagnostic and therapeutic procedures will remain the major form of digestive endoscopy. This review summarizes the literature that prognosticates about the future developments of CE. PMID:26755883

  5. [Value of endoscopy application in the management of complications after radical gastrectomy for gastric cancer].

    PubMed

    Zhang, Yiqun; Zhou, Pinghong

    2017-02-25

    Endoscopy plays an important role in the diagnosis and treatment of postoperative complications of gastric cancer. Endoscopic intervention can avoid the second operation and has attracted wide attention. Early gastric anastomotic bleeding after gastrectomy is the most common. With the development of technology, emergency endoscopy and endoscopic hemostasis provide a new treatment approach. According to the specific circumstances, endoscopists can choose metal clamp to stop bleeding, electrocoagulation hemostasis, local injection of epinephrine or sclerotherapy agents, and spraying specific hemostatic agents. Anastomotic fistula is a serious postoperative complication. In addition to endoscopically placing the small intestine nutrition tube for early enteral nutrition support treatment, endoscopic treatment, including stent, metal clip, OTSC, and Over-stitch suture system, can be chosen to close fistula. For anastomotic obstruction or stricture, endoscopic balloon or probe expansion and stent placement can be chosen. For esophageal anastomotic intractable obstruction after gastroesophageal surgery, radial incision of obstruction by the hook knife or IT knife, a new method named ERI, is a good choice. Bile leakage caused by bile duct injury can be treated by placing the stent or nasal bile duct. In addition, endoscopic methods are widely used as follows: abdominal abscess can be treated by the direct intervention under endoscopy; adhesive ileus can be treated by placing the catheter under the guidance of endoscopy to attract pressure; alkaline reflux gastritis can be rapidly diagnosed by endoscopy; gastric outlet obstruction mainly caused by cancer recurrence can be relieved by metal stent placement and the combination of endoscopy and X-ray can increase success rate; pyloric dysfunction and spasm caused by the vagus nerve injury during proximal gastrectomy can be treated by endoscopic pyloromyotomy, a new method named G-POEM, and the short-term outcomes are

  6. NASA Balloon Technology Advancements -Balloons, Testing, Analysis, and Systems

    NASA Astrophysics Data System (ADS)

    Fairbrother, Debora; Pierce, David; Cathey, Henry; Said, Magdi; Young, Leyland

    Advancing balloon system technology is at the heart of the National Aeronautics and Space Administration's Balloon Program Office's research and development efforts. These advances span a number of critical areas ranging from new techniques for materials characterization and structural design to flight test vehicles. A thorough understanding of the various balloon materials is key to extending and expanding the use of the current balloon designs. Particular emphasis has been placed on advanced methods for the characterization and analysis of the constituent components of the envelope structure, namely the film and the tendon. These components have been characterized over a broad range of temperatures and conditions that mimics the expected flight exposure conditions and loadings. This understanding is also needed to successfully design and test the next generation of balloon designs. An overview of these advances will be presented. Much of the technology advancements are focused on the NASA Super Pressure Balloon development. Integral parts to balloon development efforts are the analyses of the balloons and flight performance predictions. Overviews of these analyses in the context of balloon design and flight testing will be presented. The Super Pressure Balloon development is aimed at providing extended duration stable float altitude flights to the science community. A number of Super Pressure balloon test flights have been flow in the past two years. These flights have included incremental steps up in balloon volume and payload carrying capability. A very successful test flight of a 200,700 m3 balloon was launch in late 2008 from Antarctica. This balloon flew for over 54 days at a constant altitude and circled the Antarctic continent almost three times. Results of this flight will be presented. Two test flights, one from Sweden and one from Antarctica, of a 420,400 m3 balloon were completed in 2009. The results of these flights will also be presented. This paper

  7. Endoscopy and Endosurgery in Nonhuman Primates.

    PubMed

    Chai, Norin

    2015-09-01

    Endoscopy in nonhuman primates (NHPs) has resulted in improvements in research and clinical care for more than 4 decades. The indications and procedures are the same as in humans and the approach is similar to that in dogs, cats, and humans. Selected procedures are discussed including rhinoscopy, tracheobronchoscopy, upper gastrointestinal endoscopy, laparoscopy, and endoscopic salpingectomy. This short overview provides practitioners with pragmatic elements for safe and effective endoscopy in NHPs.

  8. Endoscopy in the Diagnosis and Management of Complications of Inflammatory Bowel Disease.

    PubMed

    Tharian, Benjamin; George, Nayana; Navaneethan, Udayakumar

    2016-05-01

    The role of endoscopy in inflammatory bowel disease (IBD) has grown over the last decade in both diagnostic and therapeutic realms. It aids in the initial diagnosis of the disease and also in the assessment of the extent and severity of disease. IBD is associated with development of multiple complications such as strictures, fistulae, and colon cancers. Endoscopy plays a pivotal role in the diagnosis of colon cancer in patients with IBD through incorporation of chromoendoscopy for surveillance. In addition, endoscopic resection with surveillance is recommended in the management of polypoid dysplastic lesions without flat dysplasia. IBD-associated benign strictures with obstructive symptoms amenable to endoscopic intervention can be managed with endoscopic balloon dilation both in the colon and small intestine. In addition, endoscopy plays a major role in assessing the neoterminal ileum after surgery to risk-stratify patients after ileocolonic resection and assessment of a patient with ileoanal pouch anastomosis surgery and management of postsurgical complications. Our article summarizes the current evidence in the role of endoscopy in the diagnosis and management of complications of IBD.

  9. Dilatation balloons: polymer selection, balloon design and assembly.

    PubMed

    Crittenden, J F

    1987-01-01

    The current status of coronary dilating instruments is presented from the designer's perspective. Catheter shaft design is considered by important features, common catheter materials and types of catheter construction. Among the seven companies manufacturing balloon dilating instruments, only three types of catheter and four materials are offered. Balloon design is presented by important features and by materials selected. Performance comparisons are made between the three materials used to fabricate dilating balloons: PVC, PE and PET.

  10. NASA Super Pressure Balloon

    NASA Technical Reports Server (NTRS)

    Fairbrother, Debbie

    2017-01-01

    NASA is in the process of qualifying the mid-size Super Pressure Balloon (SPB) to provide constant density altitude flight for science investigations at polar and mid-latitudes. The status of the development of the 18.8 million cubic foot SPB capable of carrying one-tone of science to 110,000 feet, will be given. In addition, the operating considerations such as launch sites, flight safety considerations, and recovery will be discussed.

  11. Space Weather Ballooning

    NASA Astrophysics Data System (ADS)

    Phillips, Tony; Johnson, Sam; Koske-Phillips, Amelia; White, Michael; Yarborough, Amelia; Lamb, Aaron; Herbst, Anna; Molina, Ferris; Gilpin, Justin; Grah, Olivia; Perez, Ginger; Reid, Carson; Harvey, Joey; Schultz, Jamie

    2016-10-01

    We have developed a "Space Weather Buoy" for measuring upper atmospheric radiation from cosmic rays and solar storms. The Buoy, which is carried to the stratosphere by helium balloons, is relatively inexpensive and uses off-the-shelf technology accessible to small colleges and high schools. Using this device, we have measured two Forbush Decreases and a small surge in atmospheric radiation during the St. Patrick's Day geomagnetic storm of March 2015.

  12. Vega balloon meteorological measurements

    NASA Technical Reports Server (NTRS)

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

    1990-01-01

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

  13. NASA Super Pressure Balloon

    NASA Technical Reports Server (NTRS)

    Fairbrother, Debbie

    2016-01-01

    NASA is in the process of qualifying the mid-size Super Pressure Balloon (SPB) to provide constant density altitude flight for science investigations at polar and mid-latitudes. The status of the development of the 18.8 million cubic foot SPB capable of carrying one-tonne of science to 110,000 feet, will be given. In addition, the operating considerations such as launch sites, flight safety considerations, and recovery will be discussed.

  14. Balloon needle for the atraumatic transcortical ventricular approach: technical note.

    PubMed

    Madrazo, I; Franco-Bourland, R; Aguilera, M; Reyes, P; Guízar-Sahagún, G

    1990-03-01

    We have designed a double-lumen inflatable needle for the atraumatic dissection of brain substance. This balloon needle has been successfully used for the ventricular approach in brain grafting procedures to obtain a rounded corticotomy with a diameter of 1.5-2 cm in the treatment of Parkinson's disease.

  15. Optimum designs for superpressure balloons

    NASA Astrophysics Data System (ADS)

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

    2004-01-01

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

  16. Venus balloons at low altitudes

    NASA Astrophysics Data System (ADS)

    Nishimura, J.; Hinada, M.; Yajima, N.; Fujii, M.

    1994-02-01

    The Venus balloons are one of the most important vehicles to explore the dynamics and composition of Venusian atmosphere and several feasibility studies have been reported. We here propose the balloons at low altitude of 10 to 20 km floating below the cloud in the Venus atmosphere, which will make it possible to perform the study of the Venus atmosphere at low altitude together with a direct observation of the Venus surface. The atmospheric pressure is 20 to 40 atm. at this altitude, and the temperature is as high as 300 C to 400 C. The balloons proposed here are of the spherical shape of super pressure type filled by the Helium gas. The balloons are made of thin Ti alloy or reinforced by CFRP, and have capabilities to carry the payloads of weights of several kg. This type of the balloon has several merits on the weight considerations over the normal inflatable balloons with gas containers and its inlet systems.

  17. Photodynamic therapy for Barrett's esophagus using a 20-mm diameter light-delivery balloon

    NASA Astrophysics Data System (ADS)

    Panjehpour, Masoud; Overholt, Bergein F.; Phan, Mary N.; Haydek, John M.; Robinson, Amy R.

    2002-06-01

    Background and Objective: Patients with high grade dysplasia (HGD) in Barrett's esophagus are at a high risk for developing esophageal adenocarcinoma. Esophagectomy is the standard treatment for such patients. The objective of this study was to evaluate the safety and efficacy of photodynamic therapy (PDT) using an improved light delivery balloon for ablation of Barrett's esophagus with high grade dysplasia and/or early cancer. Materials and Methods: 20 patients with HGD or early cancer (19 with HGD, 1 with T1 cancer) received 2 mg/kg of porfimer sodium, intravenously. Two to three days after the injection, laser light was delivered using a cylindrical diffuser inserted inside a 20-mm diameter reflective esophageal PDT balloon. Initially, the balloon was inflated to a pressure of 80 mm Hg. The balloon pressure was gradually reduced to 30 mm Hg. A KTP/dye laser at 630 nm was used as the light source. Light dose of 115 J/cm was delivered at an intensity of 270 mw/cm. Nodules were pre- treated with an extra 50 J/cm using a short diffuser inserted through the scope. Patients were maintained on PPI therapy to keep the gastric pH higher than 4. Eighteen patients required one treatment, while two patients were treated twice. Follow-up consisted of endoscopy with four quadrant biopsies at every 2 cm of the treated area. Thermal ablation was used to treat small residual islands on the follow-ups. The follow-up endoscopies ranged from 6 to 17 months. Results: On follow-up endoscopy, 12 patients had complete replacement of their Barrett's mucosa with neosquamous mucosa. Five patients had residual non-dysplastic Barrett's mucosa, one had indefinite dysplasia, two had low grad dysplasia. There were no residual HGD or cancers. The average length of Barrett's was reduced from 5.4 cm to 1.2 cm. High balloon pressure resulted in wide variation in PDT response among patients. Lower balloon pressures resulted in more consistent destruction of Barrett's mucosa among patients. Five

  18. Cleft formation in pumpkin balloons

    NASA Astrophysics Data System (ADS)

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

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

  19. Breakthrough in Mars balloon technology

    NASA Astrophysics Data System (ADS)

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

    2004-01-01

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

  20. [Endoscopy and face-lift].

    PubMed

    Dardour, J C; Abbou, R

    2017-08-02

    For many years, the face-lift has not been the only intervention for facial rejuvenation. It is necessary today to specify the type of face-lift, cervico-facial lifting, frontal lifting or facelift. We will consider in this article the frontal lift and centro-facial lift and its possible execution assisted by endoscopy with therefore minimal scars, hidden in the scalp. We will consider successively its technique, its indications and its results highlighting a very long hold over time. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  1. Treatment of colonic anastomotic strictures with 'through the scope' balloon dilators.

    PubMed Central

    Dinneen, M D; Motson, R W

    1991-01-01

    Stricture occurs in 1.2-4.2% of colonic anastomoses. Symptomatic strictures have previously been treated by resection and re-anastomosis and more recently by radiographically guided dilatation by a modified Seldinger technique. This paper describes the endoscopic balloon dilatation of five symptomatic cases and three asymptomatic cases. Eight patients underwent balloon dilatation of colonic anastomotic strictures. Four patients had no symptoms post dilatation and the strictures remained patient on follow-up endoscopy. All the remaining patients required re-dilatation at approximately 2 months. One of these patients underwent dilatation but remained symptomatic, the dilatation was repeated and a colonic perforation occurred at this time. Of the other three, two continue to be followed up, and are well and one patient died of disseminated malignancy. Balloon dilatation with 'through the scope' dilators is a simpler technique than radiologically guided dilatation. These early results suggest that endoscopic dilatation may avoid further surgery in some patients with anastomotic stricture. PMID:2041001

  2. Highlights of International Digestive Endoscopy Network 2013

    PubMed Central

    Kwon, Kwang An; Choi, Il Ju; Kim, Eun Young; Dong, Seok Ho

    2013-01-01

    Rapid advances in the technology of gastrointestinal endoscopy as well as the evolution of science have made it necessary for us to continue update in either various endoscopic techniques or state of art lectures relevant to endoscopy. International Digestive Endoscopy Network (IDEN) 2013 was held in conjunction with Korea-Japan Joint Symposium on Gastrointestinal Endoscopy (KJSGE) during June 8 to 9, 2013 at Seoul, Korea. Two days of impressive scientific program dealt with a wide variety of basic concerns from upper gastrointestine (GI), lower GI, pancreaticobiliary endoscopy to advanced knowledge including endoscopic submucosal dissection forum. IDEN seems to be an excellent opportunity to exchange advanced information of the latest issues on endoscopy with experts from around the world. In this special issue of Clinical Endoscopy, we prepared state of art review articles from contributing authors and the current highlights will skillfully deal with very hot spots of each KJSGE, upper GI, lower GI, and pancreaticobiliary sessions by associated editors of Clinical Endoscopy. PMID:24143297

  3. Vibration measurements by pulsed digital holographic endoscopy

    NASA Astrophysics Data System (ADS)

    Schedin, Staffan; Pedrini, Giancarlo; Perez-Lopez, Carlos; Mendoza Santoyo, Fernando

    2005-02-01

    Digital holographic interferometry in combination with a flexible fiber endoscope allows high precision measurements of deformations on hidden objects surfaces, inside cavities and objects with small access apertures. A digital holographic endoscopy system is described with a frequency-doubled, twin oscillator Q-switched pulsed Nd:YAG laser as light source. A sequence of digital hologram pairs are recorded with a maximum repetition rate of 260 ms. Each digital hologram is captured at separate video frames of a CCD-camera. The time separation between the laser pulses from each cavity can be set in the range from 50 to 500 μs. The digital holograms are transferred to a PC via a frame grabber and evaluated quantitatively by the Fourier transform method. The resulting phase fringe pattern has the information needed to evaluate quantitatively the amount of the deformation. Experimental results of vibration measurements of hidden mechanical and biological object surfaces are presented. The quality of the results obtained by mechanical object surfaces is usually higher than for biological surfaces. This can be explained easily by the fact that a biological surface is much more complex than a mechanical surface in the sense that some parts of the surface may reflect the light well whereas other parts may absorb the light. Also, biological surfaces are translucent, which means that part of the light may enter inside the sample where it may be absorbed or reflected.

  4. Design of wormlike automated robotic endoscope: dynamic interaction between endoscopic balloon and surrounding tissues.

    PubMed

    Poon, Carmen C Y; Leung, Billy; Chan, Cecilia K W; Lau, James Y W; Chiu, Philip W Y

    2016-02-01

    The current design of capsule endoscope is limited by the inability to control the motion within gastrointestinal tract. The rising incidence of gastrointestinal cancers urged improvement in the method of screening endoscopy. This preclinical study aimed to design and develop a novel locomotive module for capsule endoscope. We investigated the feasibility and physical properties of this newly designed caterpillar-like capsule endoscope with a view to enhancing screening endoscopy. This study consisted of preclinical design and experimental testing on the feasibility of automated locomotion for a prototype caterpillar endoscope. The movement was examined first in the PVC tube and then in porcine intestine. The image captured was transmitted to handheld device to confirm the control of movement. The balloon pressure and volume as well as the contact force between the balloon and surroundings were measured when the balloon was inflated inside (1) a hard PVC tube, (2) a soft PVC tube, (3) muscular sites of porcine colons and (4) less muscular sites of porcine colons. The prototype caterpillar endoscope was able to move inward and backward within the PVC tubing and porcine intestine. Images were able to be captured from the capsule endoscope attached and being observed with a handheld device. Using the onset of a contact force as indication of the buildup of the gripping force between the balloon and the lumen walls, it is concluded from the results of this study that the rate of change in balloon pressure and volume is two good estimators to optimize the inflation of the balloon. The results of this study will facilitate further refinement in the design of caterpillar robotic endoscope to move inside the GI tract.

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

    ERIC Educational Resources Information Center

    Eckford, Jim

    1983-01-01

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

  6. Telescope Systems for Balloon-Borne Research

    NASA Technical Reports Server (NTRS)

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

    1974-01-01

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

  7. Endoscopy

    MedlinePlus

    ... AJ, Kavoussi LR, Novick AC, et al, eds. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; ... of arthroscopy. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics . 12th ed. Philadelphia, PA: Elsevier Mosby; ...

  8. Medium energy gamma ray astronomy with transpacific balloon flights

    NASA Technical Reports Server (NTRS)

    Zych, A. D.; Jennings, M. C.; White, R. S.; Dayton, B.

    1981-01-01

    Transpacific balloon flights with the University of California, Riverside (UCR) double scatter telescope are discussed. With flight durations from 5 days up to perhaps 15 days the long observation times necessary for medium energy (1-30 MeV) gamma ray astronomy can be obtained. These flights would be made under the auspices of the Joint U.S.-Japan Balloon Flight Program at NASA. It is proposed that flights can provide at least 30 hours of observation time per flight for many discrete source candidates and 120 hours for detecting low intensity cosmic gamma ray bursts.

  9. The Balloon Experimental Twin Telescope for Infrared Interferometry (BETTII)

    NASA Technical Reports Server (NTRS)

    Rinehart, Stephen

    2012-01-01

    The Balloon Experimental Twin Telescope for Infrared Interferometry (BETTII) is an 8-meter baseline far-infrared interferometer to fly on a high altitude balloon. BETTII uses a double-Fourier Michelson interferometer to simultaneously obtain spatial and spectral information on science targets; the long baseline provides subarcsecond angular resolution, a capability unmatched by other far-infrared facilities. Here, we present key aspects of the overall design of the mission and provide an overview of the current status of the project. We also discuss briefly the implications of this experiment for future space-based far-infrared interferometers.

  10. BETTII: The Balloon Experimental Twin Telescope for Infrared Interferometry

    NASA Technical Reports Server (NTRS)

    Rinehart, Stephen

    2011-01-01

    Astronomical studies at infrared wavelengths have dramatically improved our understanding the universe. The relatively low angular resolution of these missions, however, is insufficient to resolve the physical scale on which mid-to far-infrared emission arises. We will build the Balloon Experimental Twin Telescope for Infrared Interferometry (BETTII),8oeight-meter Michelson interferometer to fly on a high-altitude balloon. BETTII's spectral-spatial capability, provided by an instrument using double-Fourier techniques, will address key questions about the nature of disks io young star clusters and active galactic nuclei and the envelopes of evolved stars. BETTII will also lay the technological groundwork for future space interferometers.

  11. The Balloon Experimental Twin Telescope for Infrared Interferometry (BETTII)

    NASA Technical Reports Server (NTRS)

    Rinehart, Stephen A.

    2010-01-01

    Astronomical studies at infrared wavelengths have dramatically improved our understanding of the universe. The relatively low angular resolution of these missions, however, is insufficient to resolve the physical scale on which mid-to far-infrared emission arises. We will build the Balloon Experimental Twin Telescope for Infrared Interferometry (BETTII), an eight-meter Michelson interferometer to fly on a high-altitude balloon. BETTII's spectral-spatial capability, provided by an instrument using double-Fourier techniques, will address key questions about the nature of disks in young star clusters and active galactic nuclei and the envelopes of evolved stars. BETTII will also lay the technological groundwork for future space interferometers.

  12. Medium energy gamma ray astronomy with transpacific balloon flights

    NASA Technical Reports Server (NTRS)

    Zych, A. D.; Jennings, M. C.; White, R. S.; Dayton, B.

    1981-01-01

    Transpacific balloon flights with the University of California, Riverside (UCR) double scatter telescope are discussed. With flight durations from 5 days up to perhaps 15 days the long observation times necessary for medium energy (1-30 MeV) gamma ray astronomy can be obtained. These flights would be made under the auspices of the Joint U.S.-Japan Balloon Flight Program at NASA. It is proposed that flights can provide at least 30 hours of observation time per flight for many discrete source candidates and 120 hours for detecting low intensity cosmic gamma ray bursts.

  13. Balloon borne laser transceiver

    NASA Technical Reports Server (NTRS)

    Wischnia, H. F.

    1974-01-01

    A balloon borne laser transceiver (BBLT) which was carried to an altitude of 80,000 feet, was used to measure the turbulence effect of the atmosphere in daylight on laser beams going both up and down through the intervening atmosphere. The principles of operation of the BBLT are discussed. The instrument must acquire an up-going argon laser beam, lock onto it, and transmit back to the ground observatory a helium-neon laser beam. Questions of system operation for the down-going and the up-going beam are considered along with a servo system analysis.

  14. Balloon Command-Control

    DTIC Science & Technology

    1977-01-07

    system to provide a display at the touch of a button of the one-way slant range to the balloon in statute miles to the nearest tenth mile. System path...the last slant range measured - 145 sm. The parachute winds should have taken the payload perpendicular to the azimuth from the telemetry ground I...station indicating that the slant range measurements again were within ±5 nm. While the automatic system works at the touch of a button after the initial

  15. A Methane Balloon Inflation Chamber

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  16. Aerodynamics of a Party Balloon

    ERIC Educational Resources Information Center

    Cross, Rod

    2007-01-01

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

  17. Aerodynamics of a Party Balloon

    ERIC Educational Resources Information Center

    Cross, Rod

    2007-01-01

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

  18. A Methane Balloon Inflation Chamber

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  19. Scientific Balloons for Venus Exploration

    NASA Astrophysics Data System (ADS)

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

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

  20. Free boundary ballooning mode representation

    SciTech Connect

    Zheng, L. J.

    2012-10-15

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

  1. Nationwide Eclipse Ballooning Project

    NASA Astrophysics Data System (ADS)

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

    2016-05-01

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

  2. Mars Balloon Flight Test Results

    NASA Technical Reports Server (NTRS)

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

    2009-01-01

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

  3. Ketamine Sedation in Gastrointestinal Endoscopy in Children

    PubMed Central

    Eskander, Ayman E.; Baroudy, Nevine R. El; Refay, Amira S. El

    2016-01-01

    BACKGROUND: Moderate sedation for gastrointestinal endoscopy has traditionally been provided by the endoscopist. Controversy has ensued over safe and efficient sedation practice as endoscopy has increased in numbers and complexity. AIM: To evaluate the safety of ketamine sedation given by non-anesthesiologist during gastrointestinal endoscopy in children. METHODS: A prospective study of 100 paediatric patients with gastrointestinal symptoms who were a candidate for upper or lower gastrointestinal endoscopy in paediatric endoscopy unit at Abo El-Reesh Paediatric Hospital, Cairo University. All children were > 2 years old and weighed > 6 kg. The analysis was performed in terms of sedation-related complications. RESULTS: A total 100 paediatric patients including 53 males and 47 females with mean age of 5.04 years were involved in the study. All children were medicated with ketamine with a mean dose of 3.77mg/kg. No complications occurred in 87% of cases. Desaturation occurred in 13% of the cases and was reversible by supplemental nasal oxygen. Desaturation was more frequent during Upper GI Endoscopy and with the intramuscular route (p value=0.049). No apnea, bradycardia, arrest or emergence reactions were recorded. CONCLUSION: Ketamine sedation found to be safe for paediatric gastrointestinal endoscopy in Egyptian children without co-morbidities. Transient Hypoxia (13%) may occur but easily reversed by nasal oxygen therapy. PMID:27703561

  4. Breast ductal endoscopy: how many procedures qualify?

    PubMed Central

    Zagouri, Flora; Sergentanis, Theodoros N; Giannakopoulou, Georgia; Panopoulou, Effrosyni; Chrysikos, Dimosthenis; Bletsa, Garifallia; Flessas, John; Filippakis, George; Papalabros, Alexandros; Bramis, Kostas J; Zografos, George C

    2009-01-01

    Background Breast ductal endoscopy is a relatively new diagnostic method with ever growing importance in the work-up of patients with bloody nipple discharge. The ability to perform ductal endoscopy is very important and useful for breast fellows. Learning curve in breast ductal endoscopy remains a terra incognita, since no systematic studies have addressed this topic. The purpose of this study is to determine the point (number of procedures during training) beyond which ductal endoscopy is successfully performed. Findings Ten breast fellows received training in our Breast Unit. For the training process, an ex vivo model was adopted. Fellows were trained on 20 surgical specimens derived from modified radical mastectomy for breast cancer. The target of the education program was to acquire proficiency in performing ductoscopy. The achievement of four consecutively successful ductal endoscopies was determined as the point beyond which proficiency had been achieved. The number of procedures needed for the achievement of proficiency as defined above ranged between 9 and 17 procedures. The median value was 13 procedures; i.e. 50% of trainees had achieved proficiency at the 13th procedure or earlier. Conclusion These pilot findings point to approximately 13 procedures as a point beyond which ductal endoscopy is successfully performed; studies on a larger number of fellows are nevertheless needed. Further research, focusing on the learning curves of different training models of ductal endoscopy, seems desirable. PMID:19566939

  5. Capsule endoscopy in refractory celiac disease.

    PubMed

    Daum, S; Wahnschaffe, U; Glasenapp, R; Borchert, M; Ullrich, R; Zeitz, M; Faiss, S

    2007-05-01

    Patients with refractory celiac disease (RCD) are at risk of intestinal T-cell lymphoma, which is difficult to diagnose because it often develops in the small bowel. We therefore studied whether wireless capsule endoscopy was able to detect ulcerative jejunitis or intestinal T-cell lymphomas that were missed by standard endoscopic and imaging procedures in patients with RCD. Detection of ulcerative jejunitis and overt T-cell lymphoma by capsule endoscopy or by upper and lower endoscopy, abdominal computed tomography (CT) or abdominal magnetic resonance tomography (MRT) was compared in 14 consecutive patients with RCD: in seven patients who showed loss of T-cell antigens on intraepithelial lymphocytes and/or clonality of the T-cell receptor gene (i. e. type II RCD) and in seven patients who did not have these features (i. e. type I RCD). Complete evaluation of the small bowel by capsule endoscopy was achieved in 9/14 patients. Signs of ulcerative jejunitis or intestinal T-cell lymphoma, affecting further clinical management, were found in two patients with type II RCD: in one patient these signs were found only by capsule endoscopy (ulcerations and stenosis) and in another patient the abnormalities were identified by CT/MRT (mesenteric lymph nodes harboring lymphoma). No clinically relevant abnormalities were found in patients with type I RCD by lower endoscopy or by small-bowel imaging (capsule endoscopy, CT, or MRT). In patients with type II RCD, capsule endoscopy can detect additional cases with ulcerative jejunitis and could be included in the diagnostic armamentarium, subject to confirmation by larger series. In patients with type I RCD, our study confirmed the low diagnostic yield of imaging procedures, including wireless capsule endoscopy.

  6. Leadership and team building in gastrointestinal endoscopy.

    PubMed

    Valori, Roland M; Johnston, Deborah J

    2016-06-01

    A modern endoscopy service delivers high volume procedures that can be daunting, embarrassing and uncomfortable for patients [1]. Endoscopy is hugely beneficial to patients but only if it is performed to high standards [2]. Some consequences of poor quality endoscopy include worse outcomes for cancer and gastrointestinal bleeding, unnecessary repeat procedures, needless damage to patients and even avoidable death [3]. New endoscopy technology and more rigorous decontamination procedures have made endoscopy more effective and safer, but they have placed additional demands on the service. Ever-scarcer resources require more efficient, higher turnover of patients, which can be at odds with a good patient experience, and with quality and safety. It is clear from the demands put upon it, that to deliver a modern endoscopy service requires effective leadership and team working [4]. This chapter explores what constitutes effective leadership and what makes great clinical teams. It makes the point that endoscopy services are not usually isolated, independent units, and as such are dependent for success on the organisations they sit within. It will explain how endoscopy services are affected by the wider policy and governance context. Finally, within the context of the collection of papers in this edition of Best Practice & Research: Clinical Gastroenterology, it explores the potentially conflicting relationship between training of endoscopists and service delivery. The effectiveness of leadership and teams is rarely the subject of classic experimental designs such as randomized controlled trials. Nevertheless there is a substantial literature on this subject within and particularly outside healthcare [5]. The authors draw on this wider, more diffuse literature and on their experience of delivering a Team Leadership Programme (TLP) to the leaders of 70 endoscopy teams during the period 2008-2012. (Team Leadership Programme Link-http://www.qsfh.co.uk/Page.aspx?PageId=Public).

  7. Efficiency of upper gastrointestinal endoscopy in pediatric surgical practice

    PubMed Central

    Temiz, Abdulkerim

    2015-01-01

    After the introduction of flexible fiber optic endoscopy to pediatric gastroenterology in the 1970s, upper gastrointestinal (UGI) endoscopy can be performed for the diagnosis and treatment of all age groups of children. We review indications, contraindications, preparation of patients for the procedure, and details of diagnostic and therapeutic UGI endoscopy used in pediatric surgery. We also discuss potential complications of endoscopy. PMID:26566483

  8. Optoacoustic endoscopy with optical and acoustic resolution

    NASA Astrophysics Data System (ADS)

    He, Hailong; Wissmeyer, Georg; Ovsepian, Saak V.; Buehler, Andreas; Ntziachristos, Vasilis

    2017-03-01

    A hybrid optical and acoustic resolution optoacoustic endoscopy is proposed. Laser light is transmitted to tissue by two types of illumination for optical and acoustic resolution imaging respectively. An unfocused ultrasound detector is used for recording optoacoustic signals. The endoscopy probe attains 3.6 mm diameter and is fully encapsulated into a catheter system. We examine the performance of the hybrid endoscope with phantoms and tissue sample, which shows that the hybrid endoscopy can obtain optical resolution in superficial microscopic imaging and ultrasonic tomography reconstruction resolution when imaging at greater depths.

  9. Endo 2017: WEO's successful first World Congress of GI Endoscopy.

    PubMed

    Rey, Jean-François

    2017-03-24

    For more than 50 years, the World Endoscopy Organization (WEO) has promoted the study and advancement of digestive endoscopy around the globe. Our key efforts have been to promote education and training in digestive endoscopy, and to forge close links with the the WEO zones: Asian Pacific Society of Digestive Endoscopy (A-PSDE), European Society of Gastrointestinal Endoscopy (ESGE), and Inter-American Society of Digestive Endoscopy (SIED). With increased interaction and connectivity between different global regions, our goal to support the advancement of endoscopy in underserved areas of the world has been strengthened. This article is protected by copyright. All rights reserved.

  10. Parastomal hernia incarceration due to migrated intragastric balloon.

    PubMed

    Limani, P; Steinemann, D C; Clavien, P-A; Hahnloser, D

    2013-02-01

    The temporary placement of intragastric balloons is a common method to achieve rapid weight loss before planned metabolic surgery. We report the case of a 48-year-old morbidly obese patient. Ten years ago the patient underwent emergency sigmoidectomy with creation of a double-barreled ileostomy for perforated diverticulitis. Over time he developed a giant parastomal hernia. For preoperative weight reduction before planned restoration of intestinal continuity, an intragastric balloon was inserted 3 years ago. The patient was admitted to our emergency department with peritonism and a septic shock. After computed tomography showing small bowel ileus, laparotomy was performed, revealing marked ischemia of incarcerated small and large intestine. Only postoperatively was the intragastric balloon found in the resected small bowel, causing a mechanical ileus with consecutive incarceration of the bowel. We review the literature on complications due to the migration of intragastric balloons. This clinical case gives a fair warning of the possible deleterious outcome of intragastric balloons, especially in hernia patients.

  11. Air Force Cambridge Research Laboratories balloon operations

    NASA Technical Reports Server (NTRS)

    Danaher, T. J.

    1974-01-01

    The establishment and functions of the AFCRL balloon operations facility are discussed. The types of research work conducted by the facility are defined. The facilities which support the balloon programs are described. The free balloon and tethered balloon capabilities are analyzed.

  12. SAM 2 balloon test (stratospheric aerosol measurement)

    NASA Technical Reports Server (NTRS)

    Pepin, T. J.

    1976-01-01

    As a parallel effort to the LACATE balloon experiment a small optical system was constructed to enable a balloon test of a diode filter system similar to the type planned for the Nimbus-G SAM II experiment. The system was called the SAM II Balloon Test. Results of the balloon flight are summarized.

  13. Calculating Payload for a Tethered Balloon System

    Treesearch

    Charles D. Tangren

    1980-01-01

    A graph method to calculate payload for a tethered balloon system, with the supporting helium lift and payload equations. is described. The balloon system is designed to collect emissions data during the convective-lift and no-convective-lift phases of a forest fire. A description of the balloon system and a list of factors affecting balloon selection are included....

  14. Hot-Air Ballooning in Physics Teaching.

    ERIC Educational Resources Information Center

    Haugland, Ole Anton

    1991-01-01

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

  15. Stability of Lobed Balloons

    NASA Technical Reports Server (NTRS)

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

    2004-01-01

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

  16. Balloon material characterization

    NASA Technical Reports Server (NTRS)

    Wilbeck, J. S.; Rand, J. L.

    1981-01-01

    Experimental data are reviewed to study the state of stress and strain in a typical balloon fabricated from thin polyethylene film. Relaxation tests are conducted over a temperature range of -60 C to 140 C for a constant strain of 1%, and loads measured with the load cell are converted to values of the relaxation modulus. A log-log plot is made of the modulus as a function of time, and the maximum stress is found to occur at times of the order of one-half second. The film behaves as a nonlinear viscoelastic material, and by examining various theoretical relationships of stress and strain with temperature and time histories, a material testing program is developed which yields the necessary data to characterize the film.

  17. Balloon catheter coronary angioplasty

    SciTech Connect

    Angelini, P.

    1987-01-01

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

  18. Structure variations of pumpkin balloon

    NASA Astrophysics Data System (ADS)

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

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

  19. Construction of a virtual bronchus endoscopy system

    NASA Astrophysics Data System (ADS)

    Liu, Xiaofeng; Chang, Xiaogang; Lu, Hanqing

    2001-09-01

    Virtual Endoscopy System is a new aided diagnosis method based on computer processing of 3D image slices to provide simulated visualizations of specific organs similar to those produced by standard endoscopy. Compare with real endoscopy, VES has much advantages and will have more applications in the future. We constructed a Virtual Bronchus Endoscopy System based on the techniques of image analysis, compute graphics, and so on. Based on the characteristic of bronchus, we adopted an improved 3D region-growing algorithm, which we call 3D scanline algorithm to extract the bronchus from the DICOM-formatted medical images, then the 3D polyhedral surface model of bronchus is obtained by triangulation with Marching Cubes Algorithm. Then the user is allowed to navigate freely inside the bronchus along the axis. We adopted surface rendering method in the rendering process. In application this system can meet the requirement of real-time navigation and has pretty good display.

  20. Drinking before endoscopy: milk or water?

    PubMed

    Webster, G J; Bowling, T E; Greenfield, S M; Hallyburton, E; Kuan, A M; Vicary, F R; Beck, E R

    1997-05-01

    The traditional fluid fast prior to endoscopy is unnecessary. We have previously shown that drinking water prior to endoscopy does not affect either the quality of mucosal views or residual gastric fluid volumes when compared to patients undergoing endoscopy after a standard fast. The present study was designed to establish whether milk, which may delay gastric emptying, could also be drunk prior to endoscopy without adverse effect. Forty-eight patients (mean age 48 years, range 20 to 79) undergoing routine upper gastrointestinal endoscopy after overnight fast were randomized to drink 200 ml of either still mineral water or full fat milk. Endoscopy was performed 90 minutes later, when all residual gastric fluid was aspirated via the endoscope. Volume and pH of gastric aspirate were measured and the quality of the mucosal view at endoscopy recorded as poor, adequate, or excellent. No difference was shown between water (n = 27) and milk (n = 21) drinkers in residual gastric volume (mean +/- SEM, water vs milk) (16.0 ml +/- 1.5 vs 18.9 ml +/- 2.9) or pH (2.23 +/- 0.14 vs 2.48 +/- 0.14). Of those patients with poor, adequate, or excellent views, 4 of 4, 11 of 12, and 6 of 32 patients, respectively, were milk drinkers (chi-squared test for trend = 21.7, df = 1, p < 0.001), indicating significantly worse mucosal views in the group drinking milk. Drinking water up to 90 minutes prior to endoscopy is safe, but milk should be discouraged because of suboptimal mucosal views.

  1. Endoscopy - Multiple Languages: MedlinePlus

    MedlinePlus

    ... gov/languages/endoscopy.html Other topics A-Z A B C D E F G H I J K L M N O P Q R S T U V W XYZ List of All Topics All Endoscopy - Multiple Languages To use the sharing features on this page, please enable JavaScript. French (français) Japanese (日本語) Korean (한국어) Russian (Русский) Somali ( ...

  2. Stray energy transfer during endoscopy.

    PubMed

    Jones, Edward L; Madani, Amin; Overbey, Douglas M; Kiourti, Asimina; Bojja-Venkatakrishnan, Satheesh; Mikami, Dean J; Hazey, Jeffrey W; Arcomano, Todd R; Robinson, Thomas N

    2017-02-15

    Endoscopy is the standard tool for the evaluation and treatment of gastrointestinal disorders. While the risk of complication is low, the use of energy devices can increase complications by 100-fold. The mechanism of increased injury and presence of stray energy is unknown. The purpose of the study was to determine if stray energy transfer occurs during endoscopy and if so, to define strategies to minimize the risk of energy complications. A gastroscope was introduced into the stomach of an anesthetized pig. A monopolar generator delivered energy for 5 s to a snare without contacting tissue or the endoscope itself. The endoscope tip orientation, energy device type, power level, energy mode, and generator type were varied to mimic in vivo use. The primary outcome (stray current) was quantified as the change in tissue temperature (°C) from baseline at the tissue closest to the tip of the endoscope. Data were reported as mean ± standard deviation. Using the 60 W coag mode while changing the orientation of the endoscope tip, tissue temperature increased by 12.1 ± 3.5 °C nearest the camera lens (p < 0.001 vs. all others), 2.1 ± 0.8 °C nearest the light lens, and 1.7 ± 0.4 °C nearest the working channel. Measuring temperature at the camera lens, reducing power to 30 W (9.5 ± 0.8 °C) and 15 W (8.0 ± 0.8 °C) decreased stray energy transfer (p = 0.04 and p = 0.002, respectively) as did utilizing the low-voltage cut mode (6.6 ± 0.5 °C, p < 0.001). An impedance-monitoring generator significantly decreased the energy transfer compared to a standard generator (1.5 ± 3.5 °C vs. 9.5 ± 0.8 °C, p < 0.001). Stray energy is transferred within the endoscope during the activation of common energy devices. This could result in post-polypectomy syndrome, bleeding, or perforation outside of the endoscopist's view. Decreasing the power, utilizing low-voltage modes and/or an impedance

  3. Solar research with stratospheric balloons

    NASA Astrophysics Data System (ADS)

    Vázquez, Manuel; Wittmann, Axel D.

    Balloons, driven by hot air or some gas lighter than air, were the first artificial machines able to lift payloads (including humans) from the ground. After some pioneering flights the study of the physical properties of the terrestrial atmosphere constituted the first scientific target. A bit later astronomers realized that the turbulence of the atmospheric layers above their ground-based telescopes deteriorated the image quality, and that balloons were an appropriate means to overcome, total or partially, this problem. Some of the most highly-resolved photographs and spectrograms of the sun during the 20th century were actually obtained by balloon-borne telescopes from the stratosphere. Some more recent projects of solar balloon astronomy will also be described.

  4. Venus balloons at low altitudes.

    NASA Astrophysics Data System (ADS)

    Nishimura, J.; Hinada, M.; Yajima, N.; Fujii, M.

    1994-02-01

    The Venus balloons are one of the most important vehicles to explore the dynamics and composition of Venusian atmosphere. The authors here propose the balloons at low altitude of 10 to 20 km floating below the cloud in the Venus atmosphere, which will make it possible to perform the study of the Venus atmosphere at low altitude together with a direct observation of the Venus surface. The atmospheric pressure is 20 to 40 atm at this altitude, and the temperature is as high as 300°C to 400°C. The balloons proposed here are of the spherical shape of super pressure type filled by the Helium gas. The balloons are made of thin Ti alloy or reinforced by CFRP, and have capabilities to carry the payloads of weights of several kg.

  5. Recent progress in planetary balloons

    NASA Astrophysics Data System (ADS)

    Kerzhanovich, Viktor V.; Cutts, James A.

    2001-08-01

    In the last 15 years several balloon mission cencepts have been proposed for Mars and Venus, one of them - Russian-French Mars Aerostat - was extensively developed in 1988-1995 but was terminated before completion. It became clear that a number of critical technologies still needed to be developed prior to committing a costly space mission. In recent years significant progress has been made in two critical fields: aerial deployment and inflation of thin-film balloons for specific planetary applications, and in the development of envelope design for stratospheric applications. This paper describes requirements, proposed concepts, critical elements and trade-offs in planetary balloon missions as well as current results of some of JPL balloon programs.

  6. Balloon exoplanet nulling interferometer (BENI)

    NASA Astrophysics Data System (ADS)

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

    2009-08-01

    We evaluate the feasibility of a balloon-borne nulling interferometer to detect and characterize an exosolar planet and the surrounding debris disk. The existing instrument consists of a three-telescope Fizeau imaging interferometer with thre fast steering mirrors and three delay lines operating at 800 Hz for closed-loop control of wavefront errors and fine pointing. A compact visible nulling interferometer would be coupled to the imaging interferometer and in principle, allows deep starlight suppression. Atmospheric simulations of the environment above 100,000 feet show that balloonborne payloads are a possible path towards the direct detection and characterization of a limited set of exoplanets and debris disks. Furthermore, rapid development of lower cost balloon payloads provide a path towards advancement of NASA technology readiness levels for future space-based exoplanet missions. Discussed are the BENI mission and instrument, the balloon environment and the feasibility of such a balloon-borne mission.

  7. Ballooning Modes and Sustorm Onset

    NASA Astrophysics Data System (ADS)

    Cheng, C. Z.; Zaharia, S.

    2002-12-01

    Based on the AMPTE/CCE observations [Cheng and Lui, GRL, 1998], a low frequency instability with period on the order of 1 min is observed about 2-3 minutes before the substorm onset and is identified as a kinetic ballooning instability. Kinetic effects such as ion gyroradii, magnetic drift, and trapped electrons can strongly enhance the beta threshold over that of ideal MHD ballooning mode theory prediction. However, the ballooning instability threshold based on the ideal MHD model in realistic magnetospheres is still unresolved. Here, we present the stability property of ideal MHD ballooning modes in numerical 3D magnetospheric equilibria with thin current sheet. The coupling effects between perpendicular and parallel (compressional) perturbed magnetic fields are included. The calculations make use of numerical 3D magnetospheric equilibria including thin current sheet by assuming pressure to be constant along a field line. We then, estimate the stability threshold including kinetic effects and compare with observations.

  8. Cutting-Balloon-Associated Vascular Rupture After Failed Standard Balloon Angioplasty

    SciTech Connect

    Chakraverty, S. Meier, M.A.J.; Aarts, J.C.N.M.; Ross, R.A.; Griffiths, G.D.

    2005-06-15

    The following case reports illustrate a possible complication of vascular rupture when cutting balloon dilatation is performed immediately after failed standard balloon angioplasty to the same diameter. Deferral of the cutting balloon dilatation should be considered in such circumstances.

  9. Contraindications for video capsule endoscopy

    PubMed Central

    Bandorski, Dirk; Kurniawan, Niehls; Baltes, Peter; Hoeltgen, Reinhard; Hecker, Matthias; Stunder, Dominik; Keuchel, Martin

    2016-01-01

    Video capsule endoscopy (VCE) has been applied in the last 15 years in an increasing field of applications. Although many contraindications have been put into perspective, some precautions still have to be considered. Known stenosis of the gastrointestinal tract is a clear contraindication for VCE unless surgery is already scheduled or at least has been considered as an optional treatment modality. In patients with a higher incidence of stenosis, as in an established diagnosis of Crohn’s disease, clinical signs of obstruction, prior radiation or surgical small bowel resection, a preceding test with the self-dissolving patency capsule can override this contraindication. Endoscopic placement of the capsule should be considered in patients with swallowing disorders to avoid aspiration. Esophageal or gastric motility disorders may require endoscopic capsule transport or application of prokinetics if the real-time viewer proofs delayed transit. In pregnant women, VCE should be restricted to urgent cases where diagnosis cannot be postponed after delivery, as data on safety are missing. There is theoretical and clinical evidence that patients with implanted cardiac devices such as a pacemaker, cardioverters or left heart assist devices, can safely undergo VCE in spite of still existing contraindication by manufacturers. Children from the age of 2 years have safely undergone VCE. Although video capsules are not proven safe with magnetic resonance imaging (MRI), first single cases of patients incidentally undergoing MRI with an incorporated capsule have been reported, showing susceptibility artifacts but no signs of clinical harm. PMID:28018097

  10. Cutting thread at flexible endoscopy.

    PubMed

    Gong, F; Swain, P; Kadirkamanathan, S; Hepworth, C; Laufer, J; Shelton, J; Mills, T

    1996-12-01

    New thread-cutting techniques were developed for use at flexible endoscopy. A guillotine was designed to follow and cut thread at the endoscope tip. A new method was developed for guiding suture cutters. Efficacy of Nd: YAG laser cutting of threads was studied. Experimental and clinical experience with thread-cutting methods is presented. A 2.4 mm diameter flexible thread-cutting guillotine was constructed featuring two lateral holes with sharp edges through which sutures to be cut are passed. Standard suture cutters were guided by backloading thread through the cutters extracorporeally. A snare cutter was constructed to retrieve objects sewn to tissue. Efficacy and speed of Nd: YAG laser in cutting twelve different threads were studied. The guillotine cut thread faster (p < 0.05) than standard suture cutters. Backloading thread shortened time taken to cut thread (p < 0.001) compared with free-hand cutting. Nd: YAG laser was ineffective in cutting uncolored threads and slower than mechanical cutters. Results of thread cutting in clinical studies using sewing machine (n = 77 cutting episodes in 21 patients), in-vivo experiments (n = 156), and postsurgical cases (n = 15 over 15 years) are presented. New thread-cutting methods are described and their efficacy demonstrated in experimental and clinical studies.

  11. Recent advances in photoacoustic endoscopy.

    PubMed

    Yoon, Tae-Jong; Cho, Young-Seok

    2013-11-16

    Imaging based on photoacoustic effect relies on illuminating with short light pulses absorbed by tissue absorbers, resulting in thermoelastic expansion, giving rise to ultrasonic waves. The ultrasonic waves are then detected by detectors placed around the sample. Photoacoustic endoscopy (PAE) is one of four major implementations of photoacoustic tomography that have been developed recently. The prototype PAE was based on scanning mirror system that deflected both the light and the ultrasound. A recently developed mini-probe was further miniaturized, and enabled simultaneous photoacoustic and ultrasound imaging. This PAE-endoscopic ultrasound (EUS) system can offer high-resolution vasculature information in the gastrointestinal (GI) tract and display differences between optical and mechanical contrast compared with single-mode EUS. However, PAE for endoscopic GI imaging is still at the preclinical stage. In this commentary, we describe the technological improvements in PAE for possible clinical application in endoscopic GI imaging. In addition, we discuss the technical details of the ultrasonic transducer incorporated into the photoacoustic endoscopic probe.

  12. The Brazilian scientific balloon program

    NASA Astrophysics Data System (ADS)

    Braga, Joao

    The Brazilian scientific balloon program is based almost entirely at the National Institute for Space Research -INPE, which has a facility for research and development of scientific balloon systems such as telemetry, command, power supply, separation and flight train devices, ballast control systems, ATC transponders, shock absorbers and especially different launching tech-niques. The Balloon Launching Center of INPE operates since the early 70s, when the first launches were performed in cooperation with French groups for astronomical gamma-ray obser-vations. Since then, the center was involved in a large numbers of international collaborations with France, Japan, United Kingdom, USA, Italy, Germany and Tasmania. INPEs high-energy astrophysics group developed several X and Gamma-ray experiments that were launched in balloons since the early 80s. The most complex of these payloads is the MASCO experiment, launched in 2004. It consists in a 2-ton experiment with a large gamma-ray imaging coded-mask telescope and an attitude control system developed at INPE. Currently, the high-energy group is developing a prototype balloon experiment for the MIRAX satellite, named protoMIRAX. Others scientists at INPE have also used balloons for cosmic rays, geophysics and atmospheric electricity experiments.

  13. Pioneering Space Research with Balloons

    NASA Astrophysics Data System (ADS)

    Jones, W. V.

    NASA s Scientific Ballooning Planning Team has concluded that ballooning enables significant scientific discoveries while providing test beds for space instruments and training for young scientists Circumpolar flights around Antarctica have been spectacularly successful with fight durations up to 42 days Demand for participation in this Long-Duration Balloon LDB program a partnership with the U S National Science Foundation Office of Polar Programs is greater than the current capacity of two flights per campaign Given appropriate international agreements LDB flights in the Northern Hemisphere would be competitive with Antarctic flights and super-pressure balloons would allow comparable flights at any latitude The Balloon Planning Team made several recommendations for LDB flights provide a reliable funding source for sophisticated payloads extend the Antarctic capability to three flights per year and develop a comparable capability in the Arctic provide aircraft for intact-payload recovery develop a modest trajectory modification capability to enable longer flights and enhance super-pressure balloons to carry 1-ton payloads to 38 km Implementation of these recommendations would facilitate frequent access to near-space for cutting-edge research and technology development for a wide range of investigations

  14. Guidelines for designing a digestive disease endoscopy unit: report of the World Endoscopy Organization.

    PubMed

    Mulder, Chris J J; Jacobs, Maarten A J M; Leicester, Roger J; Nageshwar Reddy, D; Shepherd, Libby E A; Axon, Anthony T; Waye, Jerome D

    2013-07-01

    A dedicated digestive disease endoscopy unit is structurally and functionally differentiating rapidly as a result of increasing diagnostic and therapeutic possibilities in the last 10-20 years. Publications with practical details are scarce, imposing a challenge in the construction of such a unit. The lack of authoritative information about endoscopy unit design means that architects produce their own design with or without consulting endoscopists working in such a unit. A working group of the World Endoscopy Organization discussed and outlined a practical approach fordesign and construction of a modern endoscopy unit. Designing the layout is extremely important, necessitating thoughtful planning to provide comfort to the endoscopy staff and patients, and efficient data archiving and transmission during endoscopic services.

  15. Gastric Cancers Missed During Endoscopy in England.

    PubMed

    Chadwick, Georgina; Groene, Oliver; Riley, Stuart; Hardwick, Richard; Crosby, Tom; Hoare, Jonathan; Hanna, George B; Greenaway, Kimberley; Cromwell, David A

    2015-07-01

    Single-center studies have estimated that 4.6% to 25.8% of gastric cancers are missed at endoscopy. We performed a population-based study to make a more precise estimate of factors associated with missed lesions in England. We performed a retrospective population-based observational cohort study of 2727 patients diagnosed with gastric cancer from April 2011 through March 2012 in England, using linked records from 3 national data sets. The primary outcome was the proportion of patients who had undergone endoscopy in the 3 to 36 months before a diagnosis of gastric cancer. We determined this proportion for the entire cohort and for subgroups. Of the 2727 patients in the cohort, 8.3% (95% confidence interval, 7.2%-9.3%) underwent endoscopic evaluation in the 3 to 36 months before their diagnosis of gastric cancer. An endoscopy within 3 to 36 months of diagnosis was associated with a diagnosis of early stage cancer (stages 0 or 1, 11.5%; stage 2, 7.9%; stages 3 or 4, 6.9%; P = .01 for stage 0 or 1 vs stage 2 or greater), younger age at diagnosis (<55 y, 13.3% vs ≥55 y, 7.8%; P = .03), and female sex (10% of women vs 7.3% of men; P = .01). Gastric ulcers were detected in 15% of endoscopies performed at any time in the 3 years before cancer diagnosis, and in 64% of endoscopies performed 3 to 6 months before a diagnosis of gastric cancer. Based on a retrospective analysis of medical records in England, in 8.3% of patients with gastric cancer, their cancer was missed at endoscopy within the 3 previous years. A previous endoscopy detected benign gastric ulcers more frequently than any other lesion in patients who later were diagnosed with gastric cancer. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  16. New frontiers in capsule endoscopy.

    PubMed

    Fireman, Zvi; Kopelman, Yael

    2007-08-01

    Capsule endoscopy (CE) was launched at the beginning of this millennium and has since become a well-established tool for evaluating the entire small bowel for manifold pathologies. CE far exceeded our early expectations by providing us with a tool to establish the correct diagnosis for elusive gastrointestinal (GI) conditions such as obscure GI bleeding, Crohn's disease, polyposis syndrome, and others. Recent evidence has shown CE to be superior to other imaging modalities, such as small bowel follow-through X-ray, colonoscopy with ileoscopy, computerized tomographic enterography, magnetic resonance enteroclysis, and push enteroscopy, for diagnosing small bowel pathologies. Gastroenterologists would prefer the convenience of a single capsule that can create images of the area from the oral cavity to the anal canal in one 'shot'. Because of anatomic and physiologic differences in the GI tract, however, it may not be possible to use the same capsule and so we would need a different one for each organ. In addition to the pioneer small bowel capsule, there is now an esophageal capsule, and a colonoscopy capsule will soon be available. The ideal CE should be capable of performing a biopsy or carrying out an online analysis (an 'optical' biopsy) and 'stop' bleeding by an epinephrine injection, a heat probe, argon plasma coagulation, etc. The ultimate capsule would include special detectors for white blood cells, and it would check oncological markers (e.g. CEA, CA 19-9), perform serology tests (e.g. antiendomysial, IgE), and measure various cytokines, pH levels, temperature and pressure, as well as deliver drugs. The capsule's motility feature in the small bowel may open a window to study the pathophysiology of relatively elusive medical entities, such as irritable bowel syndrome. The optimal capsule needs to contain an automatic computerized system for automatic detection of pathologies, such as that present in the ECG-Holter recording, in order to overcome the drawback

  17. Capsule endoscopy in neoplastic diseases.

    PubMed

    Pennazio, Marco; Rondonotti, Emanuele; de Franchis, Roberto

    2008-09-14

    Until recently, diagnosis and management of small-bowel tumors were delayed by the difficulty of access to the small bowel and the poor diagnostic capabilities of the available diagnostic techniques. An array of new methods has recently been developed, increasing the possibility of detecting these tumors at an earlier stage. Capsule endoscopy (CE) appears to be an ideal tool to recognize the presence of neoplastic lesions along this organ, since it is non-invasive and enables the entire small bowel to be visualized. High-quality images of the small-bowel mucosa may be captured and small and flat lesions recognized, without exposure to radiation. Recent studies on a large population of patients undergoing CE have reported small-bowel tumor frequency only slightly above that reported in previous surgical series (range, 1.6%-2.4%) and have also confirmed that the main clinical indication to CE in patients with small-bowel tumors is obscure gastrointestinal (GI) bleeding. The majority of tumors identified by CE are malignant; many were unsuspected and not found by other methods. However, it remains difficult to identify pathology and tumor type based on the lesion's endoscopic appearance. Despite its limitations, CE provides crucial information leading in most cases to changes in subsequent patient management. Whether the use of CE in combination with other new diagnostic (MRI or multidetector CT enterography) and therapeutic (Push-and-pull enteroscopy) techniques will lead to earlier diagnosis and treatment of these neoplasms, ultimately resulting in a survival advantage and in cost savings, remains to be determined through carefully-designed studies.

  18. System for clinical photometric stereo endoscopy

    NASA Astrophysics Data System (ADS)

    Durr, Nicholas J.; González, Germán.; Lim, Daryl; Traverso, Giovanni; Nishioka, Norman S.; Vakoc, Benjamin J.; Parot, Vicente

    2014-02-01

    Photometric stereo endoscopy is a technique that captures information about the high-spatial-frequency topography of the field of view simultaneously with a conventional color image. Here we describe a system that will enable photometric stereo endoscopy to be clinically evaluated in the large intestine of human patients. The clinical photometric stereo endoscopy system consists of a commercial gastroscope, a commercial video processor, an image capturing and processing unit, custom synchronization electronics, white light LEDs, a set of four fibers with diffusing tips, and an alignment cap. The custom pieces that come into contact with the patient are composed of biocompatible materials that can be sterilized before use. The components can then be assembled in the endoscopy suite before use. The resulting endoscope has the same outer diameter as a conventional colonoscope (14 mm), plugs into a commercial video processor, captures topography and color images at 15 Hz, and displays the conventional color image to the gastroenterologist in real-time. We show that this system can capture a color and topographical video in a tubular colon phantom, demonstrating robustness to complex geometries and motion. The reported system is suitable for in vivo evaluation of photometric stereo endoscopy in the human large intestine.

  19. Virtual reality simulators for gastrointestinal endoscopy training

    PubMed Central

    Triantafyllou, Konstantinos; Lazaridis, Lazaros Dimitrios; Dimitriadis, George D

    2014-01-01

    The use of simulators as educational tools for medical procedures is spreading rapidly and many efforts have been made for their implementation in gastrointestinal endoscopy training. Endoscopy simulation training has been suggested for ascertaining patient safety while positively influencing the trainees’ learning curve. Virtual simulators are the most promising tool among all available types of simulators. These integrated modalities offer a human-like endoscopy experience by combining virtual images of the gastrointestinal tract and haptic realism with using a customized endoscope. From their first steps in the 1980s until today, research involving virtual endoscopic simulators can be divided in two categories: investigation of the impact of virtual simulator training in acquiring endoscopy skills and measuring competence. Emphasis should also be given to the financial impact of their implementation in endoscopy, including the cost of these state-of-the-art simulators and the potential economic benefits from their usage. Advances in technology will contribute to the upgrade of existing models and the development of new ones; while further research should be carried out to discover new fields of application. PMID:24527175

  20. The CNES Balloon Program : an overview

    NASA Astrophysics Data System (ADS)

    Debouzy, G.; Cazaux, C.

    The CNES (French Space Agency) Balloon Program continues to support the scientific community providing enhanced measurements capabilities across different kind of balloons: zero pressure balloon (80 % of activities), Infra-Red Montgolfiere (MIR) and superpressure balloon. For ENVISAT satellite validation, CNES has set up with ESA an important international balloon program with six dedicated campaigns, in 2002 - 2004 period, from mid-latitude; northern and tropical balloon launch facilities. In the framework of an European program, CNES participates to HIBISCUS project by organizing balloon campaigns (2003 & 2004) in tropical region with the launches of zero-pressure balloon, MIR and superpressure balloon from the same facility. In cooperation with US, CNES is preparing the VORCORE project which consists to study the atmospheric circulation of Antarctica polar vortex, using superpressure balloons launched from the Mac-Murdo station. This paper will present the CNES balloon activities in the 2002-2004 period, mainly focused on atmospheric chemistry, will give an overview of balloon technology development, and will present also the JAXA / CNES cooperation for the HSFD shuttle drop from stratospheric balloons with a first flight realized in 2003.

  1. [Future perspective of gastrointestinal 'intelligent' endoscopy].

    PubMed

    Konishi, Kozo; Hashizume, Makoto

    2010-07-01

    Although the flexible endoscopy has been widely used in the medical field for many years, there is still great potential in improving the endoscopist's capability to perform therapeutic tasks. The application of flexible endoscopy tools for natural orifice translumenal endoscopic surgery (NOTES) is constrained due to limitations in dexterity, instrument insertion, navigation, visualization, and retraction. Miniature endolumenal robots can mitigate these constraints by providing a stable platform for visualization and dexterous manipulation. In this paper, we describe the high-functioned 'intelligent' endoscopic surgery system with navigation. This system has equipped with accurate master-slave manipulation micro arms which can be used in tandem with a conventional flexible endoscope. The system also has an integrated ultrasound probe and high intensity focused ultrasound (HIFU) applicator. With the continued development of the techniques and technology of intelligent endoscopy, innovative minimally invasive personalized therapy may realize.

  2. Capsule endoscopy in 2005: facts and perspectives.

    PubMed

    Delvaux, Michel; Gérard Gay

    2006-02-01

    Capsule endoscopy has recently been introduced to explore endoscopically the whole small intestine, fulfilling a gap between examinations of the upper and lower gastrointestinal tract. The technique consists of a miniaturized endoscope, embedded in a swallowable capsule that is propulsed by peristalsis and achieves the journey to the right colon in five to eight hours. Images captured by the capsule are recorded on a hard drive worn in a belt by the patient. The main indication for capsule examination is the examination of the small bowel to find a bleeding lesion in patients with obscure bleeding. Several studies have shown that the diagnostic yield of capsule endoscopy is superior to that of push enteroscopy in this indication. Other possible indications are patients with suspected intestinal location of Crohn's disease, familial adenomatous polyposis, complicated coeliac disease and lesions due NSAIDs. The review contains information on the technical aspects of capsule endoscopy and discusses the indications. Issues of safety and tolerance are also discussed.

  3. [Dacryolithiasis: diagnosis using nasal endoscopy].

    PubMed

    Piaton, J-M; Keller, P; Sahel, J-A; Nguyen, R; Quesnot, S

    2003-09-01

    The purpose of this study was to assess the value of two new clinical findings for the diagnosis of dacryolithiasis discovered with nasal endoscopy: anatomical abnormalities of the Hasner valve (HV) and mucopurulent discharge visible at this valve. The value of these findings is compared with other clinical and radiological signs of dacryolithiasis. A hypothesis is developed as to the responsibility of the HV in the formation of dacryolithiasis. This study was prospective and based on 797 operations performed for epiphora: 647 endonasal dacryocystorhinostomies and 150 meatotomies of the HV, with systematic preoperative nasal videoendoscopy. Ninety dacryocystographies (DCGs) and 129 lacrimal computed tomographies (LCT) were preoperatively performed. Dacryoliths were found in 55 of 797 patients (6.9%). The HV could be examined in 48 patients in the lithiasis group and in 687 patients in the control group. Mucopurulent discharge was observed in 22 patients with lithiasis (45.8%) and in 40 patients (5.8%) (p<10(-6)) of the control group. Anatomical abnormalities of the HV were found in 40 patients with dacryolithiasis (83.3%) as compared to 82 patients ing the control group (11.4%) (p<10(-6)). In 13 patients, the VH was very small (<2 mm), in 12 patients it was very long (>15 mm), and in 15 patients both abnormalities were observed. Other clinical signs were young age (mean, 48.2 years vs 59.1% in the control group) (p<0.05), a history of acute noninfectious dacryocystic retention (38.2% vs 9.5%) (p<10(-5)), partial obstruction of the lacrimal pathway (LP) (61.8% vs 30.5%) (p<10(-5)). The 28 LCTs that were performed in subjects who had lithiasis made it possible to diagnose 19 cases of dacryolithiasis and confirmed abnormalities of the HV causing narrowing of the LP in 20. Dacryolithiasis is frequent and often misdiagnosed. When dacryolithiasis is suspected, a nasal videoendoscopic exam must be done to seek HV abnormalities and mucopurulent discharge at this valve

  4. [Expansion dilatation balloons for cervical ripening in obstetric practice].

    PubMed

    Ducarme, G; Grange, J; Vital, M

    2016-02-01

    During recent decades, mechanical devices have been substituted by pharmacological methods. Their place in the therapeutic arsenal remains important with a renewed obstetrical interest for these devices. Due to a lack of data they are still not recommended as first-line. This review thus attempted to examine the use of expansion dilatation balloons (Foley catheter and double-balloons) to analyze their effectiveness in case of native uterus and previous cesarean section. Twenty-seven clinical trials had compared balloons catheter and prostaglandins in patients without a history of uterine scar. The risk of cesarean section did not differ. Mechanical methods seemed to be more effective in achieving delivery within 24hours, with fewer episodes of excessive uterine contractions, but they necessitated more oxytocin during labor. Ten clinical trials analyzed dilatation balloons in patients with previous cesarean section. More than 70% women had favorable cervical ripening (Bishop score>6), and vaginal delivery was reported between 35 and 70% of patients. The risk of uterine rupture was low between 0.64 and 0.72%, with neither increased risk of severe neonatal and maternal morbidity nor increased risk of infectious morbidity. Mechanical methods are effective and safe for third trimester cervical ripening, mainly in women with previous cesarean section. Potential advantages may include wide availability and reduction of some of the side effects.

  5. Evolution of the NASA long-duration balloon program

    NASA Technical Reports Server (NTRS)

    Jones, W. Vernon

    1994-01-01

    The development of long-duration ballooning techniques to support flights of 1-2 ton payloads for periods up to 2 weeks, possibly even longer, offers a near-space scientific mission capability with an order of magnitude improvement over traditional balloon flights. This revolution in scientific research ballooning began with the solution of the manufacturing difficulties that plagued the program in the first half of the 1980's, and it has culminated in the early 1990's with three successive circumnavigations of the Antarctic continent in 9 to 14 day flights. A complementary capablity in the Northern hemisphere, which would approximately double the number of flights that could be supported each year, is needed to accommodate the trend for conventional payloads to be modified, or developed, for long-duration flights. Plans are already underway to employ the order-of-magnitude increased flight time for support of multi-flight research programs that will produce results comparable to some space missions. An overview of the current status and near-term plans for ballooning will be presented, along with a discussion of some major science initiatives that have been enabled.

  6. Structure variations of pumpkin balloon

    NASA Astrophysics Data System (ADS)

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

    2004-01-01

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

  7. Balloon Exoplanet Nulling Interferometer (BENI)

    NASA Technical Reports Server (NTRS)

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

    2009-01-01

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

  8. Yellow Balloon in a Briar Patch.

    ERIC Educational Resources Information Center

    Cooper, Frank; Fitzmaurice, Robert W.

    1978-01-01

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

  9. NASA Aeronautics Showcased at Balloon Fiesta

    NASA Image and Video Library

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

  10. Taking the Hot Air Out of Balloons.

    ERIC Educational Resources Information Center

    Brinks, Virgil L.; Brinks, Robyn L.

    1994-01-01

    Describes how a teacher can give their students the challenge of designing and building model balloons or blimps. The project helps students learn the basics of balloon flight and what it really means to be "lighter than air." (PR)

  11. Taking the Hot Air Out of Balloons.

    ERIC Educational Resources Information Center

    Brinks, Virgil L.; Brinks, Robyn L.

    1994-01-01

    Describes how a teacher can give their students the challenge of designing and building model balloons or blimps. The project helps students learn the basics of balloon flight and what it really means to be "lighter than air." (PR)

  12. Yellow Balloon in a Briar Patch.

    ERIC Educational Resources Information Center

    Cooper, Frank; Fitzmaurice, Robert W.

    1978-01-01

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

  13. Utilisation of magnets to enhance gastrointestinal endoscopy

    PubMed Central

    Rahman, Imdadur; Patel, Praful; Boger, Philip; Thomson, Mike; Afzal, Nadeem Ahmad

    2015-01-01

    Methods to assess, access and treat pathology within the gastrointestinal tract continue to evolve with video endoscopy replacing radiology as the gold standard. Whilst endoscope technology develops further with the advent of newer higher resolution chips, an array of adjuncts has been developed to enhance endoscopy in other ways; most notable is the use of magnets. Magnets are utilised in many areas, ranging from endoscopic training, lesion resection, aiding manoeuvrability of capsule endoscopes, to assisting in easy placement of tubes for nutritional feeding. Some of these are still at an experimental stage, whilst others are being increasingly incorporated in our everyday practice. PMID:26722611

  14. Peripheral facial nerve palsy after therapeutic endoscopy.

    PubMed

    Kim, Eun Jeong; Lee, Jun; Lee, Ji Woon; Lee, Jun Hyung; Park, Chol Jin; Kim, Young Dae; Lee, Hyun Jin

    2015-03-01

    Peripheral facial nerve palsy (FNP) is a mononeuropathy that affects the peripheral part of the facial nerve. Primary causes of peripheral FNP remain largely unknown, but detectable causes include systemic infections (viral and others), trauma, ischemia, tumor, and extrinsic compression. Peripheral FNP in relation to extrinsic compression has rarely been described in case reports. Here, we report a case of a 71-year-old man who was diagnosed with peripheral FNP following endoscopic submucosal dissection. This case is the first report of the development of peripheral FNP in a patient undergoing therapeutic endoscopy. We emphasize the fact that physicians should be attentive to the development of peripheral FNP following therapeutic endoscopy.

  15. The EUSO-Balloon pathfinder

    NASA Astrophysics Data System (ADS)

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

    2015-11-01

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

  16. Triple-balloon pulmonary valvuloplasty: an advantageous technique for percutaneous repair of pulmonary valve stenosis in the large pediatric and adult patients.

    PubMed

    Escalera, Robert B; Chase, Thaddeus J; Owada, Carl Y

    2005-11-01

    This report describes a new valvuloplasty procedure for the treatment of pulmonary valve stenosis (PVS) and large pulmonary valve annulus (PVA) diameters using a triple-balloon valvuloplasty (TBV) technique. We sought to demonstrate the safety and efficacy of this new technique. Percutaneous balloon pulmonary valvuloplasty (BPV) is the preferred treatment for PVS. BPV in older patients with large PVA remains a challenge, even when the double-balloon valvuloplasty technique is performed. The technique was first attempted in a case where a large single balloon was unsuccessful and double-balloon valvuloplasty met with technical difficulties. Three subsequent patients underwent the procedure safely and successfully. An algorithm is presented to determine balloon size for TBV. The median PVA diameter was 23.9 mm. Balloon diameters ranged from 12 to 18 mm. The median peak right ventricular-to-pulmonary artery systolic pressure gradient was 43.5 mm Hg before valvuloplasty and was reduced to 12 mm Hg following intervention. No major complications were encountered. Percutaneous valvuloplasty using TBV can be performed safely and provides excellent clinical results. This technique offers advantages over single-balloon and double-balloon valvuloplasty techniques, especially in treatment of PVS in large pediatric or adult patients. Copyright 2005 Wiley-Liss, Inc.

  17. Endoscopy services and training: a national survey of general surgeons.

    PubMed

    Skubleny, Daniel; Switzer, Noah; Karmali, Shahzeer; de Gara, Christopher

    2015-10-01

    Delivering high-quality endoscopy services depends largely on the competence of endoscopists. General surgery residency training in endoscopy and the associated quality of endoscopy services being delivered by general surgeons have been the subject of considerable controversy. In conjunction with the Canadian Association of General Surgeons (CAGS) executive board, we formulated a survey to evaluate the general state of endoscopy practice and training among general surgeons in Canada. The study was designed as a cross-sectional survey. General surgeons who are members of CAGS were selected to participate in the study and were emailed a link to the online questionnaire regarding the importance of endoscopy. They were asked to compare their training to resident training today. Sixty-nine surveys were completed. The majority of general surgeons (95.7%) indicated that endoscopy was an important skill to possess, and more than 85.5% used endoscopy in their own practices. However, nearly half (46.4%) felt that general surgery endoscopy training in Canada is currently inadequate to produce competent endoscopists. The main qualitative themes emerging from the survey were the inadequacy of current postgraduate endoscopy training (37.5%) and the absence of standardization in training (25.0%). Endoscopy is considered integral to academic and community general surgeons' practices; however, the adequacy of training seems to be questioned. Postgraduate training in endoscopy needs to be formalized and standardized, with a greater emphasis placed on teaching endoscopy.

  18. Guidelines for Safety in the Gastrointestinal Endoscopy Unit

    PubMed Central

    Calderwood, Audrey H.; Chapman, Frank J.; Cohen, Jonathan; Cohen, Lawrence B.; Collins, James; Day, Lukejohn W.; Early, Dayna S.

    2014-01-01

    EXECUTIVE SUMMARY Historically, safety in the gastrointestinal (GI) endoscopy unit has focused on infection control, particularly around the reprocessing of endoscopes. Two highly publicized outbreaks where the transmission of infectious agents were related to GI endoscopy have highlighted the need to address potential gaps along the endoscopy care continuum that could impact patient safety. PMID:24485393

  19. Endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy using balloon-assisted enteroscope.

    PubMed

    Katanuma, Akio; Yane, Kei; Osanai, Manabu; Maguchi, Hiroyuki

    2014-08-01

    Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy involves challenging procedures for ERCP endoscopists. In these patients, the anatomical structure of the intestine is substantially altered, and an endoscope needs to be inserted into the long afferent limb. Moreover, the papilla is observed in the opposite view from the normal anatomy. Recently, a balloon-assisted enteroscope (BAE) has been developed and made available for use in daily practice. The two types of BAE are single-balloon enteroscope (SBE), which is inserted with one balloon attached to the overtube using a balloon-assisted method, and double-balloon enteroscope (DBE), which is inserted with two balloons, one attached to the overtube and the other attached to the tip of the enteroscope. In addition, short-type DBE (short-DBE) and short-type SBE (short-SBE) with a working length of approximately 150 cm, which could be used with various ERCP accessories, are commercially available or under development. Notably, the success rate of ERCP through coordinated manipulation with a balloon was remarkably improved with the use of BAE, even in patients with surgically altered anatomy. Here, we report the current status and procedures of ERCP in patients with surgically altered anatomy.

  20. History and perspectives of scientific ballooning

    NASA Astrophysics Data System (ADS)

    Lefevre, Frank

    2001-08-01

    Prehistory: Robertson, Biot and Gay-Lussac; Glaisher and the first studies of the atmosphere; Flammarion. The rebirth of scientific ballooning: polyethylene and mylar vehicles at Minneapolis. Super-pressurized balloons. The CNES and the Nasa programs; meteorology, aeronomy and astronomy, The Eole program. The Venus and Mars balloons in the French-Soviet space program. The future.

  1. 21 CFR 874.4100 - Epistaxis balloon.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4100 Epistaxis balloon. (a) Identification. An epistaxis balloon is a device consisting of an inflatable balloon intended to control...

  2. 21 CFR 874.4100 - Epistaxis balloon.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4100 Epistaxis balloon. (a) Identification. An epistaxis balloon is a device consisting of an inflatable balloon intended to control...

  3. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative.

    PubMed

    Kaminski, Michal F; Thomas-Gibson, Siwan; Bugajski, Marek; Bretthauer, Michael; Rees, Colin J; Dekker, Evelien; Hoff, Geir; Jover, Rodrigo; Suchanek, Stepan; Ferlitsch, Monika; Anderson, John; Roesch, Thomas; Hultcranz, Rolf; Racz, Istvan; Kuipers, Ernst J; Garborg, Kjetil; East, James E; Rupinski, Maciej; Seip, Birgitte; Bennett, Cathy; Senore, Carlo; Minozzi, Silvia; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Spada, Cristiano; Hassan, Cesare; Dinis-Ribeiro, Mario; Rutter, Matthew D

    2017-04-01

    The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for lower gastrointestinal endoscopy. We recommend that endoscopy services across Europe adopt the following seven key performance measures for lower gastrointestinal endoscopy for measurement and evaluation in daily practice at a center and endoscopist level: 1 Rate of adequate bowel preparation (minimum standard 90 %); 2 Cecal intubation rate (minimum standard 90 %); 3 Adenoma detection rate (minimum standard 25 %); 4 Appropriate polypectomy technique (minimum standard 80 %); 5 Complication rate (minimum standard not set); 6 Patient experience (minimum standard not set); 7 Appropriate post-polypectomy surveillance recommendations (minimum standard not set). Other identified performance measures have been listed as less relevant based on an assessment of their importance, scientific acceptability, feasibility, usability, and comparison to competing measures. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Performance measures for lower gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) quality improvement initiative

    PubMed Central

    Thomas-Gibson, Siwan; Bugajski, Marek; Bretthauer, Michael; Rees, Colin J; Dekker, Evelien; Hoff, Geir; Jover, Rodrigo; Suchanek, Stepan; Ferlitsch, Monika; Anderson, John; Roesch, Thomas; Hultcranz, Rolf; Racz, Istvan; Kuipers, Ernst J; Garborg, Kjetil; East, James E; Rupinski, Maciej; Seip, Birgitte; Bennett, Cathy; Senore, Carlo; Minozzi, Silvia; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Spada, Cristiano; Hassan, Cesare; Dinis-Ribeiro, Mario; Rutter, Matthew D

    2017-01-01

    The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for lower gastrointestinal endoscopy. We recommend that endoscopy services across Europe adopt the following seven key performance measures for lower gastrointestinal endoscopy for measurement and evaluation in daily practice at a center and endoscopist level: 1 rate of adequate bowel preparation (minimum standard 90%); 2 cecal intubation rate (minimum standard 90%); 3 adenoma detection rate (minimum standard 25%); 4 appropriate polypectomy technique (minimum standard 80%); 5 complication rate (minimum standard not set); 6 patient experience (minimum standard not set); 7 appropriate post-polypectomy surveillance recommendations (minimum standard not set). Other identified performance measures have been listed as less relevant based on an assessment of their importance, scientific acceptability, feasibility, usability, and comparison to competing measures. PMID:28507745

  5. Virtual endoscopy in neurosurgery: a review.

    PubMed

    Neubauer, André; Wolfsberger, Stefan

    2013-01-01

    Virtual endoscopy is the computerized creation of images depicting the inside of patient anatomy reconstructed in a virtual reality environment. It permits interactive, noninvasive, 3-dimensional visual inspection of anatomical cavities or vessels. This can aid in diagnostics, potentially replacing an actual endoscopic procedure, and help in the preparation of a surgical intervention by bridging the gap between plain 2-dimensional radiologic images and the 3-dimensional depiction of anatomy during actual endoscopy. If not only the endoscopic vision but also endoscopic handling, including realistic haptic feedback, is simulated, virtual endoscopy can be an effective training tool for novice surgeons. In neurosurgery, the main fields of the application of virtual endoscopy are third ventriculostomy, endonasal surgery, and the evaluation of pathologies in cerebral blood vessels. Progress in this very active field of research is achieved through cooperation between the technical and the medical communities. While the technology advances and new methods for modeling, reconstruction, and simulation are being developed, clinicians evaluate existing simulators, steer the development of new ones, and explore new fields of application. This review introduces some of the most interesting virtual reality systems for endoscopic neurosurgery developed in recent years and presents clinical studies conducted either on areas of application or specific systems. In addition, benefits and limitations of single products and simulated neuroendoscopy in general are pointed out.

  6. Narrow band imaging endoscopy of the nasopharynx is not more useful than white light endoscopy for suspected nasopharyngeal carcinoma.

    PubMed

    Vlantis, Alexander C; Woo, John K S; Tong, Michael C F; King, Ann D; Goggins, William; van Hasselt, C Andrew

    2016-10-01

    Endoscopy is often used to screen for nasopharyngeal carcinoma. A normal nasopharynx on white light endoscopy may yet harbor subclinical or occult malignancy. This study assessed whether the vascular pattern seen on narrow band imaging endoscopy could indicate this and thus be useful for detecting suspected nasopharyngeal carcinoma. The nasopharynx of 156 patients who failed serological screening for or presented with symptoms of nasopharyngeal carcinoma was graded under white light and narrow band imaging endoscopy and a biopsy taken. The accuracy of assessing the nasopharynx as being probably or definitely malignant on white light endoscopy was high (area under the curve = 0.924), as it was of being normal on narrow band imaging endoscopy (=0.799). The sensitivity and specificity of white light and narrow band imaging endoscopy for nasopharyngeal carcinoma was 93 and 22 %, and 92 and 98 %, respectively. Significantly associated with nasopharyngeal carcinoma was a high index of suspicion or definitely malignant grade on white light endoscopy (p < 0.0005, odds 58.978) and vascular tufts on narrow band imaging endoscopy (p = 0.020, odds 41.210). Narrow band imaging endoscopy of vasculature alone for suspected nasopharyngeal carcinoma is not more useful than white light endoscopy of nasopharyngeal morphology, nor does it add to or surpass the diagnostic accuracy of white light endoscopy in this regard.

  7. Meteorological Support in Scientific Ballooning

    NASA Technical Reports Server (NTRS)

    Schwantes, Chris; Mullenax, Robert

    2017-01-01

    The weather affects every portion of a scientific balloon mission, from payload integration to launch, float, and impact and recovery. Forecasting for these missions is very specialized and unique in many aspects. CSBF Meteorology incorporates data from NWSNCEP, as well as several international meteorological organizations, and NCAR. This presentation will detail the tools used and specifics on how CSBF Meteorology produces its forecasts.

  8. NASA Scientific Balloon in Antarctica

    NASA Image and Video Library

    2017-09-27

    NASA image captured December 25, 2011 A NASA scientific balloon awaits launch in McMurdo, Antarctica. The balloon, carrying Indiana University's Cosmic Ray Electron Synchrotron Telescope (CREST), was launched on December 25. After a circum-navigational flight around the South Pole, the payload landed on January 5. The CREST payload is one of two scheduled as part of this seasons' annual NASA Antarctic balloon Campaign which is conducted in cooperation with the National Science Foundation's Office of Polar Programs. The campaign's second payload is the University of Arizona's Stratospheric Terahertz Observatory (STO). You can follow the flights at the Columbia Scientific Balloon Facility's web site at www.csbf.nasa.gov/antarctica/ice.htm Credit: NASA NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

  9. Global electrodynamics from superpressure balloons

    NASA Technical Reports Server (NTRS)

    Holzworth, R. H.; Hu, H.

    1995-01-01

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

  10. Simulating clefts in pumpkin balloons

    NASA Astrophysics Data System (ADS)

    Baginski, Frank; Brakke, Kenneth

    2010-02-01

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

  11. Laser welding of balloon catheters

    NASA Astrophysics Data System (ADS)

    Flanagan, Aidan J.

    2003-03-01

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

  12. Meteorological Support in Scientific Ballooning

    NASA Technical Reports Server (NTRS)

    Schwantes, Chris; Mullenax, Robert

    2016-01-01

    The weather affects every portion of a scientific balloon mission, from payload integration to launch, float, and impact and recovery. Forecasting for these missions is very specialized and unique in many aspects. CSBF Meteorology incorporates data from NWSNCEP, as well as several international meteorological organizations, and NCAR. This presentation will detail the tools used and specifics on how CSBF Meteorology produces its forecasts.

  13. Global electrodynamics from superpressure balloons

    NASA Astrophysics Data System (ADS)

    Holzworth, R. H.; Hu, H.

    1995-08-01

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

  14. Stability of the pumpkin balloon

    NASA Astrophysics Data System (ADS)

    Baginski, Frank

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

  15. A challenge to the highest balloon altitude

    NASA Astrophysics Data System (ADS)

    Saito, Y.; Akita, D.; Fuke, H.; Iijima, I.; Izutsu, N.; Kato, Y.; Kawada, J.; Matsuzaka, Y.; Mizuta, E.; Namiki, M.; Nonaka, N.; Ohta, S.; Sato, T.; Seo, M.; Takada, A.; Tamura, K.; Toriumi, M.; Yamagami, T.; Yamada, K.; Yoshida, T.; Matsushima, K.; Tanaka, S.

    2012-02-01

    Development of a balloon to fly at higher altitudes is one of the most attractive challenges for scientific balloon technologies. After reaching the highest balloon altitude of 53.0 km using the 3.4 μm film in 2002, a thinner balloon film with a thickness of 2.8 μm was developed. A 5000 m3 balloon made with this film was launched successfully in 2004. However, three 60,000 m3 balloons with the same film launched in 2005, 2006, and 2007, failed during ascent. The mechanical properties of the 2.8 μm film were investigated intensively to look for degradation of the ultimate strength and its elongation as compared to the other thicker balloon films. The requirement of the balloon film was also studied using an empirical and a physical model assuming an axis-symmetrical balloon shape and the static pressure. It was found that the film was strong enough. A stress due to the dynamic pressure by the wind shear is considered as the possible reason for the unsuccessful flights. A 80,000 m3 balloon with cap films covering 9 m from the balloon top will be launch in 2011 to test the appropriateness of this reinforcement.

  16. Long-Duration Altitude-Controlled Balloons for Venus: A Feasibility Study Informed by Balloon Flights in Remote Environments on Earth

    NASA Astrophysics Data System (ADS)

    Voss, P. B.; Nott, J.; Cutts, J. A.; Hall, J. L.; Beauchamp, P. M.; Limaye, S. S.; Baines, K. H.; Hole, L. R.

    2013-12-01

    In situ exploration of the upper atmosphere of Venus, approximately 65-77 km altitude, could answer many important questions (Limaye 2013, Crisp 2013). This region contains a time-variable UV absorber of unknown composition that controls many aspects of the heat balance on Venus. Understanding the composition and dynamics of this unknown absorber is an important science goal; in situ optical and chemical measurements are needed. However, conventional approaches do not provide access to this altitude range, repeated traverses, and a mission lifetime of several months needed to effectively carry out the science. This paper examines concepts for altitude-controlled balloons not previously flown on planetary missions that could potentially provide the desired measurements. The concepts take advantage of the fact that at 60 km altitude, for example, the atmospheric density on Venus is about 40% of the sea-level density on earth and the temperature is a moderate 230 K. The solar flux is approximately double that on earth, creating some thermal challenges, but making photovoltaic power highly effective. Using a steady-state thermodynamic model and flight data from Earth, we evaluate the suitability of two types of altitude-controlled balloons for a potential mission on Venus. Such balloons could repeatedly measure profiles, avoid diurnal temperature extremes, and navigate using wind shear. The first balloon design uses air ballast (AB) whereby ambient air can be compressed into or released from a constant-volume balloon, causing it to descend or ascend accordingly. The second design uses lift-gas compression (LGC) to change the volume of a zero-pressure balloon, thereby changing its effective density and altitude. For an altitude range of 60-75 km on Venus, we find that the superpressure volume for a LGC balloon is about 5% of that needed for an AB balloon while the maximum pressurization is the same for both systems. The compressor work per km descent of the LGC balloon

  17. The Balloon Experimental Twin Telescope for Infrared Interferometry

    NASA Technical Reports Server (NTRS)

    Rinehart, Stephen A.

    2008-01-01

    Astronomical studies at infrared wavelengths have dramatically improved our understanding of the universe, and observations with Spitzer, the upcoming Herschel mission, and SOFIA will continue to provide exciting new discoveries. The relatively low angular resolution of these missions, however, is insufficient to resolve the physical scales on which mid- to far-infrared emission arises, resulting in source and structure ambiguities that limit our ability to answer key science questions. Interferometry enables high angular resolution at these wavelengths, a powerful tool for scientific discovery, We will build the Balloon Experimental Twin Telescope for Infrared Interferometry (BETII), an eight-meter baseline Michelson stellar interferometer to fly on a high-altitude balloon. BETTII's spectral-spatial capability, provided by an instrument using double-Fourier techniques, will address key questions about the nature of disks in young star clusters and active galactic nuclei and the envelopes of evolved stars. BETTII will also lay the technological groundwork for future space interferometers,

  18. The Balloon Experimental Twin Telescope for Infrared Interferometry

    NASA Technical Reports Server (NTRS)

    Rinehart, Stephen A.

    2008-01-01

    Astronomical studies at infrared wavelengths have dramatically improved our understanding of the universe, and observations with Spitzer, the upcoming Herschel mission, and SOFIA will continue to provide exciting new discoveries. The relatively low angular resolution of these missions, however, is insufficient to resolve the physical scales on which mid- to far-infrared emission arises, resulting in source and structure ambiguities that limit our ability to answer key science questions. Interferometry enables high angular resolution at these wavelengths, a powerful tool for scientific discovery, We will build the Balloon Experimental Twin Telescope for Infrared Interferometry (BETII), an eight-meter baseline Michelson stellar interferometer to fly on a high-altitude balloon. BETTII's spectral-spatial capability, provided by an instrument using double-Fourier techniques, will address key questions about the nature of disks in young star clusters and active galactic nuclei and the envelopes of evolved stars. BETTII will also lay the technological groundwork for future space interferometers,

  19. Sketch of International Digestive Endoscopy Network 2012 Meeting: Overview

    PubMed Central

    2012-01-01

    International Digestive Endoscopy Network (IDEN) is an international meeting covering scientific subjects of diverse topics about upper gastrointestinal (GI) endoscopy, colonoscopy, endoscopic ultrasonography, and PB endoscopy. IDEN is organized by Korean Society of Gastrointestinal Endoscopy and the Korean Gastrointestinal Endoscopy Research Foundation, and took its first step in 2011 in Seoul, Korea. IDEN inaugurated a new era of diagnostic and therapeutic GI endoscopy. IDEN 2012 was designed to offer participants from all over the world with opportunities to share up-to-date knowledge about basic and clinical aspects of GI endoscopy and to engage in in-depth discussion with worldwide well-known experts. During the 2 days of meeting, there were 62 invited lectures, 28 case-based discussions, 20 video lectures, and 6 breakfast with the experts. There were a total of 598 participants registered from 12 countries, including Asian countries, Europe, and USA as well as Korea. PMID:22977804

  20. Microgravity combustion experiment using high altitude balloon.

    NASA Astrophysics Data System (ADS)

    Kan, Yuji

    In JAXA, microgravity experiment system using a high altitude balloon was developed , for good microgravity environment and short turn-around time. In this publication, I give an account of themicrogravity experiment system and a combustion experiment to utilize the system. The balloon operated vehicle (BOV) as a microgravity experiment system was developed from 2004 to 2009. Features of the BOV are (1) BOV has double capsule structure. Outside-capsule and inside-capsule are kept the non-contact state by 3-axis drag-free control. (2) The payload is spherical shape and itsdiameter is about 300 mm. (3) Keep 10-4 G level microgravity environment for about 30 seconds However, BOV’s payload was small, and could not mount large experiment module. In this study, inherits the results of past, we established a new experimental system called “iBOV” in order toaccommodate larger payload. Features of the iBOV are (1) Drag-free control use for only vertical direction. (2) The payload is a cylindrical shape and its size is about 300 mm in diameter and 700 mm in height. (3) Keep 10-3-10-4 G level microgravity environment for about 30 seconds We have "Observation experiment of flame propagation behavior of the droplets column" as experiment using iBOV. This experiment is a theme that was selected first for technical demonstration of iBOV. We are conducting the flame propagation mechanism elucidation study of fuel droplets array was placed at regular intervals. We conducted a microgravity experiments using TEXUS rocket ESA and drop tower. For this microgravity combustion experiment using high altitude balloon, we use the Engineering Model (EM) for TEXUS rocket experiment. The EM (This payload) consists of combustion vessel, droplets supporter, droplets generator, fuel syringe, igniter, digital camera, high-speed camera. And, This payload was improved from the EM as follows. (1) Add a control unit. (2) Add inside batteries for control unit and heater of combustion

  1. Endoscopic papillary large balloon dilation for the management of recurrent difficult bile duct stones after previous endoscopic sphincterotomy.

    PubMed

    Yoon, Hyung Geun; Moon, Jong Ho; Choi, Hyun Jong; Kim, Dong Choon; Kang, Myung Soo; Lee, Tae Hoon; Cha, Sang-Woo; Cho, Young Deok; Park, Sang-Heum; Kim, Sun-Joo

    2014-03-01

    Endoscopic management of recurrent bile duct stones after endoscopic sphincterotomy (EST) is effective and safe. However, repeat EST for extension of a previous EST for recurrent bile duct stones may involve substantial risk. The aim of the present study was to evaluate the safety and efficacy of endoscopic papillary large balloon dilation (EPLBD) without repeat EST for recurrent difficult bile duct stones after previous EST. From January 2006 to October 2010, a total of 52 patients were enrolled; all had undergone EPLBD (balloon diameter: 12-20 mm) to remove recurrent difficult bile duct stones after previous EST. In all patients, stone removal had failed with conventional methods using a basket and/or balloon. The size of the balloon for EPLBD was selected to fit the diameter of the common bile duct or the largest stone. The median interval between initial EST and stone recurrence was 2.2 years (range 1-10). Median diameters of thelargest stone and balloon were 20.1 mm (range 12-40) and 14.7 mm (range 12-20), respectively. Complete stone removal was achieved in all patients (100%). The median number of endoscopic retrograde cholangiopancreatography sessions needed for complete stone removal was 1.6 (range 1-3). Additional lithotripsy was required in 16 patients (30.7%). No procedure-related complications were documented, with the exception of four cases of asymptomatic hyperamylasemia. The recurrence rate of CBD stones after bile duct clearance was 17.3% (9/52) during the follow-up period (mean 27.0 ± 14.1 months). EPLBD without repeat EST is effective and relatively safe for the extraction of recurrent difficult bile duct stones after previous EST. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

  2. Effectiveness of endoscopic balloon dilatation in grade 2a and 2b esophageal burns in children.

    PubMed

    Taşkinlar, Hakan; Bahadir, Gökhan Berktuğ; Yiğit, Doğakan; Erdoğan, Cankat; Avlan, Dinçer; Nayci, Ali

    2017-03-10

    To evaluate the predictability of the initial endoscopic evaluation of the effectiveness of endoscopic balloon dilatation (EBD) in childhood esophageal strictures caused by corrosive ingestion. Medical records of 635 endoscopies caused by corrosive ingestion between January 2000 and December 2015 in children between the ages of 0 and 18 years were retrospectively analyzed. Among them, five children with grade 2a and 15 with grade 2 b who developed esophageal strictures were evaluated for the effectiveness of endoscopic balloon dilatation. The stricture rate was 5/136 (3.6%) in grade 2a and 17/25 (68%) in grade 2 b esophageal burns. Strictures with grade 2a burn had seven (1-10) EBD sessions, and grade 2 b had 8.8 (1-30) EBD sessions. For grade 2a burns, the treatment period was 15 months and 18.8 months for grade 2 b burns. Three patients with grade 2 b and two patients with grade 2a are still on the EBD program. Initial endoscopy for caustic ingestion and esophageal injury grading may help to provide healthcare givers with information about future stricture formation and management.

  3. Comparison of conventional continuous positive airway pressure to continuous positive airway pressure titration performed with sleep endoscopy.

    PubMed

    Civelek, Senol; Emre, Ismet Emrah; Dizdar, Denizhan; Cuhadaroglu, Caglar; Eksioglu, Birsen Karaci; Eraslan, Algın Kayar; Turgut, Suat

    2012-03-01

    To evaluate the effect and obtain a pressure value of continuous positive airway pressure (CPAP) under direct visualization using drug-induced sleep endoscopy (DISE) and compare the pressure values with values obtained using conventional CPAP. Prospective, double-blinded, cohort study. Sixteen patients with obstructive sleep apnea syndrome (OSAS) were included in the study. Each patient underwent polysomnographic evaluation. After diagnosis of OSAS, patients underwent conventional CPAP titration. Patients were then taken to the operating theatre and put under sedation, where CPAP titration with nasendoscopy was performed (DISE CPAP). There were no statistically significant differences between the two techniques regarding pressure levels that decreased apneas in conventional CPAP and provided sufficient opening during DISE CPAP. Results with conventional CPAP titration and endoscopy-assisted CPAP titration showed no statistically significant difference. Endoscopy-assisted CPAP is a cheaper and less time consuming alternative to conventional CPAP and has similar results. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  4. A comparison of propofol and midazolam/meperidine sedation in upper gastrointestinal endoscopy

    PubMed Central

    Gurbulak, Bunyamin; Gurbulak, Esin Kabul; Donmez, Turgut; Hut, Adnan; Yildirim, Dogan

    2016-01-01

    Introduction There is increasing interest in sedation for upper gastrointestinal endoscopy (UGE). Prospective randomized studies comparing sedation properties and complications of propofol and midazolam/meperidine in upper gastrointestinal endoscopy (UGE) are few. Aim To compare propofol and midazolam/meperidine sedation for UGE in terms of cardiopulmonary side effects, patient and endoscopist satisfaction and procedure-related times. Material and methods This was a prospective, randomized, double-blind study of propofol versus midazolam and meperidine in 100 patients scheduled for diagnostic upper gastrointestinal endoscopy. The patients were divided into propofol and midazolam/meperidine groups. Randomization was generated by a computer. Cardiopulmonary side effects (hypotension, bradycardia, hypoxemia), procedure-related times (endoscopy time, awake time, time to hospital discharge), and patient and endoscopist satisfaction were compared between groups. Results There was no significant difference between the groups with respect to the cost, endoscopy time, or demographic and clinical characteristics of the patients. Awake time and time to hospital discharge were significantly shorter in the propofol group (6.58 ±4.72 vs. 9.32 ±4.26 min, p = 0.030 and 27.60 ±7.88 vs. 32.00 ±10.54 min, p = 0.019). Hypotension incidence was significantly higher in the propofol group (12% vs. 0%, p = 0.027). The patient and endoscopist satisfaction was better with propofol. Conclusions Propofol may be preferred to midazolam/meperidine sedation, with a shorter awake and hospital discharge time and better patient and endoscopist satisfaction. However, hypotension risk should be considered with propofol, and careful evaluation is needed, particularly in cardiopulmonary disorders. PMID:27829941

  5. Development of scientific ballooning in Japan

    NASA Astrophysics Data System (ADS)

    Nishimura, Jun

    On the occasion of the 50th Anniversary Celebration of COSPAR of this year of 2008, it is worthwhile to summarize the results of the Scientific ballooning in early days in connection with the recent developments in various countries. Nishina Laboratories, Riken, had started the observations of cosmic rays with rubber balloons as early as 1942. However it was interrupted soon by the war II. After the war, new research group started in collaboration with several universities with nuclear emulsions put on the rubber balloons in 1950, and then soon after the group manufactured by themselves and launched the first plastic balloon in 1953. Based on additional technologies during a few years developed by these group, the Institute of Nuclear Study, INS, the University of Tokyo, organized the large campaign of 14 emulsion chambers and a pellicle stack with 8 plastic balloons in 1956. It is to be noted that the project was one of the largest in the world standard in those days. By the experience of this campaign, the importance of the balloon technologies was more recognized, and INS organized the group to study the balloon technologies, and had established some developments. The systematic study of scientific ballooning has started, when the scientific ballooning laboratory was founded in 1965, in the new Institute of ISAS, the University of Tokyo. The permanent balloon base of "Sanriku Balloon Center" was founded in 1971. This group has expended all efforts for the scientific ballooning, launching 10-20 balloons in each year with new inventions such as the studies of; Technologies to manufacture the reliable plastic balloons, New Balloon materials, New instrumentations for scientific ballooning, Systems of long duration flights including Antarctica flights, International collaboratiom, etc. Up to now almost 600 plastic balloons were launched during past 50 years. Then the scientific balloonings have played important and indispensable roles for the development of space

  6. Investigation of hot air balloon fatalities.

    PubMed

    McConnell, T S; Smialek, J E; Capron, R G

    1985-04-01

    The rising popularity of the sport of hot air ballooning has been accompanied by several recent incidents, both in this country and other parts of the world, where mechanical defects and the improper operation of balloons have resulted in several fatalities. A study was conducted to identify the location and frequency of hot air ballooning accidents. Furthermore, the study attempted to identify those accidents that were the result of improper handling on the part of the balloon operators and those that were related to specific defects in the construction of the balloon. This paper presents a background of the sport of hot air ballooning, together with an analysis of the construction of a typical hot air balloon, pointing out the specific areas where defects may occur that could result in a potential fatal balloon crash. Specific attention is given to the two recent balloon crashes that occurred in Albuquerque, N.M., hot air balloon capital of the world, and that resulted in multiple fatalities.

  7. A method for balloon trajectory control

    NASA Astrophysics Data System (ADS)

    Aaron, K. M.; Heun, M. K.; Nock, K. T.

    A balloon trajectory control system is discussed that is under development for use on NASA's Ultra Long Duration Balloon Project. The trajectory control system exploits the natural wind field variation with altitude to generate passive lateral control forces on a balloon using a tether-deployed aerodynamic surface below the balloon. A lifting device, such as a wing on end, is suspended on a tether well beneath the balloon to take advantage of this variation in wind velocity with altitude. The wing generates a horizontal lift force that can be directed over a wide range of angles. This force, transmitted to the balloon by a tether, alters the balloon's path providing a bias velocity of a few meters per second to the balloon drift rate. The trajectory control system enables the balloon to avoid hazards, reach targets, steer around avoidance countries and select convenient landing zones. No longer will balloons be totally at the mercy of the winds. Tests in April 1999 of a dynamically-scaled model of the trajectory control system were carried out by Global Aerospace Corporation in ground level winds up to 15 m/s. The size of the scale model was designed to simulate the behavior of the full scale trajectory control system operating at 20 km altitude. The model confirmed many aspects of trajectory control system performance and the results will be incorporated into future development.

  8. A Mars 2011 Balloon Mission Trade Study

    NASA Astrophysics Data System (ADS)

    Smith, I.; Lew, T.; Perry, W.

    Mars Scouts are competitively selected PI-led missions to further Mars exploration in ways that satisfy NASA s overall objectives but are not currently in the planned line of missions The current 2006 Announcement of Opportunity AO for Mars Scouts has just closed The goal of this SwRI study was to develop a new balloon mission concept to where it could be credibly proposed for the AO The balloon system was defined in the study as consisting of two parts the balloon flight system BFS and the balloon deployment inflation system DIS The BFS includes the balloon envelope accessory hardware and gondola The balloon includes the envelope seams end fittings load core inflation tube diffusers payload tether shock attenuator and separation hardware The DIS includes the balloon container deployment hardware sequencer tankage gas and control hardware Trade studies were performed to better define the mission design space These studies included 1 effect of varied atmospheric thermal loads 2 effect of varying latitudes 3 effect of payload mass for varying altitudes 4 effect of radiative material properties on balloon size mass 5 effect of material areal densities on balloon size mass and 6 effect of inflation gas on system masses Results of the balloon trade study for the Mars 2011 mission opportunity will be presented

  9. Scientific ballooning in India: recent developments

    NASA Astrophysics Data System (ADS)

    Joshi, M. N.; Damle, S. V.

    The National Scientific Balloon Facility (NBF) of the Tata Institute of Fundamental Research (TIFR) has been conducting regular balloon flights for various experiments in the areas of Space Astronomy and Atmospheric Sciences. A continuous improvement in all aspects of Scientific Ballooning through a sustained R and D programme ensures uptodate services and a better handle on the design specifications for the balloon. Recent developments in balloon grade films, continuous improvements in design specifications, balloon manufacturing methods, flight operational procedures and improved balloon flight capabilities have resulted in a greatly improved flight performance in the last five years. A launch capability upgradation programme in terms of new launch spool and new launch vehicle has been initiated to be able to safely launch balloons with gross lifts upto 3500 kg, balloon volumes upto 450,000 m^3 and payloads upto 1400 kg. A series of steps have been initiated to improve long duration flight capabilities. In this paper, we present details on some of these aspects of Scientific Ballooning in India.

  10. High-altitude balloon experiment

    NASA Astrophysics Data System (ADS)

    Browning, William M.; Olson, David S.; Keenan, Donald E.

    1998-09-01

    The mission of the High Altitude Balloon Experiment (HABE) is to resolve critical acquisition, tracking, and pointing (ATP) and fire control issues, validate enabling technologies, and acquire supporting data for future space- based laser experiments. HABE is integrating components from existing technologies into a payload that can autonomously acquire, track, and point a lower power laser at a ballistic missile in its boost phase of flight. For its primary mission the payload will be flown multiple times to an altitude of 85,000 feet above the White Sands Missile Range. From the near-space environment of the balloon flight, HABE will demonstrate the ATP functions required for a space- based laser in a ballistic missile defense role. The HABE platform includes coarse and fine gimbal pointing, infrared and visible passive tracking, active fine tracking, internal auto-alignment and boresighting, and precision line-of-sight stabilization functions. This paper presents an overview and status of the HABE program.

  11. Terahertz Ballooning: STO And GUSSTO

    NASA Astrophysics Data System (ADS)

    Martin, Christopher L.; Stratospheric TeraHertz Observatory (STO) Team; Gal/Xgal U/LDB Spectroscopic/Stratospheric THz Observatory (GUSSTO) Team

    2012-05-01

    With a long duration balloon launch from Antarctica in January 2012, the Stratospheric TeraHertz Observatory (STO) has completed its maiden science flight. Our team will present some of the first glimpses from this mission to map the interstellar medium (ISM) in [CII], [NII], and [CI] at high spectral and spatial resolution. Additionally, NASA announced this Fall the missions that will begin Phase A studies under the Explorer Program, which included the Gal/Xgal U/LDB Spectroscopic/Stratospheric THz Observatory (GUSSTO). GUSSTO is a balloon-borne, 1 m off-axis telescope that will survey 300 square degrees of the Milky Way and Large Magellanic Cloud (LMC) in 3 important interstellar ines: [CII], [OI], and [NII] at 158, 63, and 205 microns, respectively. With these lines, GUSSTO will map the structure, dynamics, energy balance, pressure, and evolution of the ISM. Our poster will explain the concepts and plans for this exciting mission.

  12. Scientific ballooning payload termination loads

    NASA Technical Reports Server (NTRS)

    Robbins, E.

    1993-01-01

    NASA's high altitude balloon borne scientific payloads are typically suspended from a deployed flat circular parachute. At flight termination, the recovery train is pyrotechnically separated at the parachute apex and balloon nadir interface. The release of elastic energy stored in the parachute at zero initial vertical velocity in the rarefied atmosphere produces high canopy opening forces that subject the gondola to potentially damaging shock loads. Data from terminations occurring at altitudes to 40 km with payloads up to 2500 kg on parachutes up to 40 m in diameter are presented. Measured loads are markedly larger than encountered via packed parachute deployment for similar canopy loadings. Canopy inflation is significantly suppressed in the early stages and then accelerated during final blossoming. Data interpretation and behavioral phenomena are discussed along with proposed shock attenuation techniques.

  13. High Altitude Ozone Research Balloon

    NASA Technical Reports Server (NTRS)

    Cauthen, Timothy A.; Daniel, Leslie A.; Herrick, Sally C.; Rock, Stacey G.; Varias, Michael A.

    1990-01-01

    In order to create a mission model of the high altitude ozone research balloon (HAORB) several options for flight preparation, altitude control, flight termination, and payload recovery were considered. After the optimal launch date and location for two separate HAORB flights were calculated, a method for reducing the heat transfer from solar and infrared radiation was designed and analytically tested. This provided the most important advantage of the HAORB over conventional balloons, i.e., its improved flight duration. Comparisons of different parachute configurations were made, and a design best suited for the HAORB's needs was determined to provide for payload recovery after flight termination. In an effort to avoid possible payload damage, a landing system was also developed.

  14. Clinical multiphoton endoscopy with FLIM capability

    NASA Astrophysics Data System (ADS)

    Weinigel, Martin; Breunig, Hans Georg; Fischer, Peter; Kellner-Höfer, Marcel; Bückle, Rainer; König, Karsten

    2013-02-01

    Multiphoton endoscopy can be applied for intra-corporeal imaging as well as to examine otherwise hard-to-access tissue areas like chronic wounds. Using high-NA (NA = 0.8) gradient-index (GRIN) lens-based endoscopes with a diameter of 1.4 mm and effective lengths of 7 mm and 20 mm, respectively, two-photon excitation of endogenous fluorophores and second-harmonic generation (SHG) is used for multimodal in vivo imaging of human skin. A further imaging modality is fluorescence lifetime imaging (FLIM) which allows functional imaging to investigate the healing mechanism of chronic wounds and the corresponding cell metabolism. We performed first in vivo measurements using FLIM endoscopy with the medically-certified multiphoton tomograph MPTflex® in combination with a computer-controlled motorized scan head and a GRIN-lens endoscope.

  15. Revision Lapidus Arthrodesis by Bone Endoscopy.

    PubMed

    Lui, Tun Hing

    2016-08-01

    Revision arthrodesis is indicated in symptomatic nonunion of the first tarsometatarsal joint. Revision by first tarsometatarsal arthroscopy cannot deal with the dilated screw tract and associated bone cysts. Revision by bone endoscopy is indicated in symptomatic nonunion of the first tarsometatarsal joint, which is previously fixed by transarticular screw along with loosening of the screw and bone cyst formation. The screw tract makes up the portal tract, with the proximal and distal ends of the tract corresponding to the proximal and distal portals, respectively. In this technical note, we describe zonal debridement and bone grafting of the bone cysts, nonunion site, and the screw tract via the bone endoscopy. This can resolve all the co-pathologies of nonunion of the first tarsometatarsal fusion.

  16. Safety of Deep Enteroscopy and Capsule Endoscopy in LVAD Patients: Case Report and Literature Review.

    PubMed

    Kwong, Wilson Tak-Yu; Pearlman, Michelle; Kalmaz, Denise

    2015-12-01

    Patients with a left ventricular assist device (LVAD) have increased risk of gastrointestinal (GI) bleeding. They are prone to develop angiodysplasia of the small intestine, and have a higher risk of bleeding as these patients are all required to be on permanent therapeutic anticoagulation. Here we report a case of a critically ill 55-year-old male on pressors and inotropes with an LVAD, who successfully underwent an antegrade double balloon enteroscopy (DBE).

  17. Gastroenterologic endoscopy in children: past, present, and future.

    PubMed

    Gilger, M A

    2001-10-01

    Perhaps it was the innate human fear of the dark, or the recognition that health was linked in some way to diet. Maybe it was the Hippocratic description of dyspepsia. Whatever the reason, the human desire to peer inside the body was a driving force in the development of endoscopy. The field of gastroenterology began with the Phillip Bozzini's crude, candle-powered lichtleiter in 1805 and blossomed with the introduction of flexible gastrointestinal endoscopy by Basil Hirschowitz in the late 1950s. Pediatric gastroenterology began early 1970s. Fueled by the application of gastrointestinal endoscopy to childhood digestive disease, pediatric gastroenterology has emerged as one of the most diverse medical-surgical practices in modern medicine. Pediatric endoscopists are alerted to prolapse gastropathy, a more accurate description of an old and possibly common cause of upper gastrointestinal bleeding in children. Pediatric endoscopic retrograde cholangiopancreatography continues to evolve, with increasing use in the diagnosis of infant cholestasis and endoscopic treatment of pancreatitis. These developments suggest a need for advanced training in endoscopy for pediatric gastroenterologists. Trends in gastrointestinal endoscopy are moving toward more therapeutic procedures and less diagnostic endoscopy. Therapeutic endoscopy, for example, may soon include antireflux operations. Computer-assisted virtual endoscopy and the wireless pill videoendoscope may replace diagnostic endoscopy eventually. The purpose of this review is to explore the origins of pediatric endoscopy, discuss current innovations, and look at the future of our discipline.

  18. Therapeutic enteroscopy using a new single-balloon enteroscope: a case series

    PubMed Central

    Moreels, Tom G.; Kouinche Madenko, Nathalie; Taha, Alaa; Piessevaux, Hubert; Deprez, Pierre H.

    2016-01-01

    Background and study aims: Balloon-assisted enteroscopy allows therapeutic intervention in the small bowel, and even of the biliopancreatic system in patients with altered anatomy. However, the conventional single-balloon enteroscope (SBE) has limited therapeutic use because of its small-caliber working channel and the lack of an additional water jet channel. The new single-balloon enteroscope prototype XSIF-180JY has been developed to overcome these problems. We present experience with use of the new SBE prototype during 14 therapeutic endoscopy procedures, which illustrates its advantages. Patients and methods: During a 2-month period, 16 SBE procedures were performed (2 antegrade, 2 retrograde and 12 ERCP procedures) using the XSIF-180JY prototype, 14 of which were done with therapeutic intent. Results: The XSIF-180JY SBE allowed deep enteroscopy with balloon dilation and multiple intestinal polypectomies. Moreover, 14 ERCP procedures were successfully performed in 12 patients with Roux-en-Y altered anatomy. Sphincterotomy, balloon dilation, stone extraction and 7 Fr plastic stent placement were performed through the 3.2-mm working channel. The additional water jet was useful for flushing away stone fragments from the intrahepatic bile ducts and the retrieval basket and for flushing away blood from a bleeding sphincterotomy. No complications related to the enteroscope were encountered. Conclusions: The new therapeutic XSIF-180JY SBE permitted therapeutic enteroscopy and ERCP through its 3.2-mm working channel and the additional water jet channel proved useful in flushing away biliary stones and blood without the need to clear the working channel. This newly developed SBE has the advantage of a larger working channel and an additional water jet, improving therapeutic enteroscopy. PMID:27540583

  19. Stratospheric Balloon Gradient Geomagnetic Measurements

    NASA Astrophysics Data System (ADS)

    Filippov, Sergey; Tsvetkov, Yury

    The study of the interior structure of the Earth and laws of its evolution is one of the most difficult problems of natural science. Among the geophysical fields the anomaly magnetic field is one of the most informational in questions of the Earth's crust structure. Many important parameters of an environment are expedient for measuring at lower altitudes, than satellite ones. So, one of the alternatives is stratospheric balloon survey. The balloon flight altitudes cover the range from 20 to 50 km. At such altitudes there are steady zone air flows due to which the balloon flight trajectories can be of any direction, including round-the-world (round-the-pole). One of the examples of such sounding system have been designed, developed and maintained at IZMIRAN during already about 20 years. This system consists of three instrumental con-tainers uniformly placed along a vertical 6 km line. System allows measuring a module and vertical gradient of the geomagnetic field along the whole flight trajectory and so one's name is -stratospheric balloon magnetic gradiometer (SMBG). The GPS-receivers, located in each instrumental container, fix the flight coordinates to within several tens meters. Data trans-mission is carried out by Globalstar satellite link. The obtained data are used in solving the problems of deep sounding of the Earth's crust magnetic structure -an extraction of magnetic anomalies, determination of a depth of bedding of magnetoactive rocks and others. The developed launching technology, deployment in flight, assembly, data processing, transfer and landing the containers with the equipment can be used for other similar problems of monitoring and sounding an environment. Useful flight weights of each instrumental container may be reaching 50 kg. More than ten testing flights (1986-2009) at stratospheric altitudes (20-30 km) have proven the reliability of this system.

  20. Deep enteroscopy with a conventional colonoscope: initial multicenter study by using a through-the-scope balloon catheter system.

    PubMed

    Ali, Rabia; Wild, Daniel; Shieh, Frederick; Diehl, David L; Fischer, Monika; Tamura, Wataru; Rubin, David T; Kumbhari, Vivek; Okolo, Patrick; Storm, Andrew; Halpern, Zamir; Neumann, Helmut; Khara, Harshit S; Pochapin, Mark B; Gross, Seth A

    2015-11-01

    The advent of capsule endoscopy has revolutionized evaluation of the small bowel. Capsule endoscopy has become the criterion standard as the initial examination to diagnose small-bowel abnormalities, but does not allow for tissue sampling or therapeutic intervention. Deep enteroscopy can be performed by using a balloon-assisted device or a spiral overtube for both diagnostic and therapeutic interventions of the small bowel. Deep enteroscopy is time-consuming and requires special endoscopes and accessories to perform the examination. We studied a novel through-the-scope balloon catheter system used for deep enteroscopy that uses a conventional colonoscope and standard accessories. We performed a 9-center, retrospective study using a novel TTS balloon system for small-bowel evaluation. The new through-the-scope device is an on-demand balloon catheter that is inserted through the instrument channel of a standard colonoscope and enables deep advancement into the small bowel in either the anterograde or retrograde approach. It consists of a balloon inflation/deflation system and a single-use balloon catheter designed for anchoring in the small bowel. The balloon is inflated to an anchoring pressure in the small intestine, and a repetitive push-pull technique is performed, with the endoscope sliding over the guiding catheter to the inflated balloon. The catheter may be removed and reinserted to allow for therapeutic intervention while maintaining the endoscope position. A total of 98 patients were included; 52% were male, and the mean age was 55 years old (range 15-94 years). Indications included abdominal pain, iron-deficiency anemia, occult GI bleeding, diarrhea, abnormal capsule endoscopy, weight loss, protein losing enteropathy, retained foreign body, altered anatomy ERCP, and small-bowel strictures. Anterograde enteroscopy was performed in 65 patients. The average depth of insertion was 158 cm (range 50-350 cm) from the pylorus. Retrograde enteroscopy was performed

  1. Aspects of computer vision in surgical endoscopy

    NASA Astrophysics Data System (ADS)

    Rodin, Vincent; Ayache, Alain; Berreni, N.

    1993-09-01

    This work is related to a project of medical robotics applied to surgical endoscopy, led in collaboration with Doctor Berreni from the Saint Roch nursing-home in Perpignan, France). After taking what Doctor Berreni advises, two aspects of endoscopic color image processing have been brought out: (1) The help to the diagnosis by the automatic detection of the sick areas after a learning phase. (2) The 3D reconstruction of the analyzed cavity by using a zoom.

  2. Chromoendoscopy in magnetically guided capsule endoscopy

    PubMed Central

    2013-01-01

    Background Diagnosis of intestinal metaplasia and dysplasia via conventional endoscopy is characterized by low interobserver agreement and poor correlation with histopathologic findings. Chromoendoscopy significantly enhances the visibility of mucosa irregularities, like metaplasia and dysplasia mucosa. Magnetically guided capsule endoscopy (MGCE) offers an alternative technology for upper GI examination. We expect the difficulties of diagnosis of neoplasm in conventional endoscopy to transfer to MGCE. Thus, we aim to chart a path for the application of chromoendoscopy on MGCE via an ex-vivo animal study. Methods We propose a modified preparation protocol which adds a staining step to the existing MGCE preparation protocol. An optimal staining concentration is quantitatively determined for different stain types and pathologies. To that end 190 pig stomach tissue samples with and without lesion imitations were stained with different dye concentrations. Quantitative visual criteria are introduced to measure the quality of the staining with respect to mucosa and lesion visibility. Thusly determined optimal concentrations are tested in an ex-vivo pig stomach experiment under magnetic guidance of an endoscopic capsule with the modified protocol. Results We found that the proposed protocol modification does not impact the visibility in the stomach or steerability of the endoscopy capsule. An average optimal staining concentration for the proposed protocol was found at 0.4% for Methylene blue and Indigo carmine. The lesion visibility is improved using the previously obtained optimal dye concentration. Conclusions We conclude that chromoendoscopy may be applied in MGCE and improves mucosa and lesion visibility. Systematic evaluation provides important information on appropriate staining concentration. However, further animal and human in-vivo studies are necessary. PMID:23758801

  3. Diagnostic Reasoning Model Validation in Digestive Endoscopy

    DTIC Science & Technology

    2007-11-02

    Abstract: The development of a computer -assisted diagnostic system in digestive endoscopy implies to understand the reasoning process of endoscopists. The...that could be used in computer -assisted diagnostic, as referring data. Development of "intelligent" tools, which can retrieve referring images...of the computer -assisted diagnosis system performance was realized with indices, extracted from endoscopist talks. The system responses were compared

  4. Role of endoscopy in early oesophageal cancer.

    PubMed

    Mannath, Jayan; Ragunath, Krish

    2016-12-01

    Incidence of oesophageal adenocarcinoma has increased exponentially in the West over the past few decades. Following detection of advanced cancers, 5-year survival rates remain bleak, making identification of early neoplasia, which has a better outcome, important. Detection of subtle oesophageal lesions during endoscopy can be challenging, and advanced imaging techniques might improve their detection. High-definition endoscopy has become a standard in most endoscopy centres, and this technology probably provides better delineation of mucosal features than standard-definition endoscopy. Various image enhancement techniques are now available with the development of new electronics and software systems. Image enhancement with chromoendoscopy using dyes has been a cost-effective option for many years, yet these techniques have been replaced in some contexts by electronic chromoendoscopy, which can be used with the press of a button. However, Lugol's chromoendoscopy remains the gold standard to identify squamous dysplasia. Identification and characterization of subtle neoplastic lesions could help to target biopsies and perform endoscopic resection for better local staging and definitive therapy. In vivo histology with techniques such as confocal endomicroscopy could make endotherapy feasible within a shorter timescale than when relying on histology on tissue samples. Once early neoplasia is identified, treatments include endoscopic resection, endoscopic submucosal dissection or various ablative techniques. Endotherapy has the advantage of being a less invasive technique than oesophagectomy, and is associated with lower mortality and morbidity. Endoscopic ablation therapies have evolved over the past few years, with radiofrequency ablation showing the best results in terms of success rates and complications in Barrett dysplasia.

  5. Gastrointestinal endoscopy in the pregnant woman

    PubMed Central

    Friedel, David; Stavropoulos, Stavros; Iqbal, Shahzad; Cappell, Mitchell S

    2014-01-01

    About 20000 gastrointestinal endoscopies are performed annually in America in pregnant women. Gastrointestinal endoscopy during pregnancy raises the critical issue of fetal safety in addition to patient safety. Endoscopic medications may be potentially abortifacient or teratogenic. Generally, Food and Drug Administration category B or C drugs should be used for endoscopy. Esophagogastroduodenoscopy (EGD) seems to be relatively safe for both mother and fetus based on two retrospective studies of 83 and 60 pregnant patients. The diagnostic yield is about 95% when EGD is performed for gastrointestinal bleeding. EGD indications during pregnancy include acute gastrointestinal bleeding, dysphagia > 1 wk, or endoscopic therapy. Therapeutic EGD is experimental due to scant data, but should be strongly considered for urgent indications such as active bleeding. One study of 48 sigmoidoscopies performed during pregnancy showed relatively favorable fetal outcomes, rare bad fetal outcomes, and bad outcomes linked to very sick mothers. Sigmoidoscopy should be strongly considered for strong indications, including significant acute lower gastrointestinal bleeding, chronic diarrhea, distal colonic stricture, suspected inflammatory bowel disease flare, and potential colonic malignancy. Data on colonoscopy during pregnancy are limited. One study of 20 pregnant patients showed rare poor fetal outcomes. Colonoscopy is generally experimental during pregnancy, but can be considered for strong indications: known colonic mass/stricture, active lower gastrointestinal bleeding, or colonoscopic therapy. Endoscopic retrograde cholangiopancreatography (ERCP) entails fetal risks from fetal radiation exposure. ERCP risks to mother and fetus appear to be acceptable when performed for ERCP therapy, as demonstrated by analysis of nearly 350 cases during pregnancy. Justifiable indications include symptomatic or complicated choledocholithiasis, manifested by jaundice, cholangitis, gallstone

  6. Viscoelastic behaviour of pumpkin balloons

    NASA Astrophysics Data System (ADS)

    Gerngross, T.; Xu, Y.; Pellegrino, S.

    2008-11-01

    The lobes of the NASA ULDB pumpkin-shaped super-pressure balloons are made of a thin polymeric film that shows considerable time-dependent behaviour. A nonlinear viscoelastic model based on experimental measurements has been recently established for this film. This paper presents a simulation of the viscoelastic behaviour of ULDB balloons with the finite element software ABAQUS. First, the standard viscoelastic modelling capabilities available in ABAQUS are examined, but are found of limited accuracy even for the case of simple uniaxial creep tests on ULDB films. Then, a nonlinear viscoelastic constitutive model is implemented by means of a user-defined subroutine. This approach is verified by means of biaxial creep experiments on pressurized cylinders and is found to be accurate provided that the film anisotropy is also included in the model. A preliminary set of predictions for a single lobe of a ULDB is presented at the end of the paper. It indicates that time-dependent effects in a balloon structure can lead to significant stress redistribution and large increases in the transverse strains in the lobes.

  7. Balloon tracer for atmospheric pollutants

    SciTech Connect

    Lichfield, E.W.; Ivey, M.D.; Zak, B.D.; Church, H.W.

    1985-01-01

    An operational prototype of the Balloon Tracer was developed and described. This prototype was designed to be capable of meeting all of the desired specifications for the Balloon Tracer. Its buoyancy adjustment subsystem is shown. Three Gilian instrument pumps operating in parallel provide a flow of about 12 litres per minute, depending upon backpressure. The miniature Klippard mechanical valves are actuated by a servo mechanism which only requires power when the state of the valves is being changed. The balloon itself for the operational prototype is just under 3 meters in diameter. A block diagram of the operational prototype payload measures ambient pressure, temperature, and humidity obtained from AIR which outputs its data in ASCII format. The vertical anemometer, which has a measured starting speed of under 2 cm/s, makes use of a Gill styrofoam propeller and a Spaulding Instruments rotation sendor. The command decoder is built around a chip developed originally for remote control television tuners. The command receiver operating on 13.8035 MHz was developed and built by Hock Engineering. The Argos transmitter is a Telonics platform transmitter terminal. The heart of the control system is an Intel 8052AH BASIC microcomputer with both random access and read only memory.

  8. Side-wire technique for percutaneous pulmonary balloon valvuloplasty.

    PubMed

    Cay, Serkan; Atak, Ramazan

    2011-07-01

    On occasion during percutaneous pulmonary balloon valvuloplasty, a small balloon may slip into the pulmonary artery when dilating a stenotic pulmonary valve. In order to stabilize the balloon should a larger balloon size not be available, a side wire can be used without changing the original balloon.

  9. 21 CFR 870.1350 - Catheter balloon repair kit.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Catheter balloon repair kit. 870.1350 Section 870... repair kit. (a) Identification. A catheter balloon repair kit is a device used to repair or replace the balloon of a balloon catheter. The kit contains the materials, such as glue and balloons, necessary...

  10. 21 CFR 870.1350 - Catheter balloon repair kit.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Catheter balloon repair kit. 870.1350 Section 870... repair kit. (a) Identification. A catheter balloon repair kit is a device used to repair or replace the balloon of a balloon catheter. The kit contains the materials, such as glue and balloons, necessary...

  11. 21 CFR 870.1350 - Catheter balloon repair kit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Catheter balloon repair kit. 870.1350 Section 870... repair kit. (a) Identification. A catheter balloon repair kit is a device used to repair or replace the balloon of a balloon catheter. The kit contains the materials, such as glue and balloons, necessary...

  12. 21 CFR 870.1350 - Catheter balloon repair kit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Catheter balloon repair kit. 870.1350 Section 870... repair kit. (a) Identification. A catheter balloon repair kit is a device used to repair or replace the balloon of a balloon catheter. The kit contains the materials, such as glue and balloons, necessary...

  13. 21 CFR 870.1350 - Catheter balloon repair kit.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Catheter balloon repair kit. 870.1350 Section 870... repair kit. (a) Identification. A catheter balloon repair kit is a device used to repair or replace the balloon of a balloon catheter. The kit contains the materials, such as glue and balloons, necessary...

  14. Evidence-based indications for hindfoot endoscopy.

    PubMed

    Spennacchio, Pietro; Cucchi, Davide; Randelli, Pietro S; van Dijk, Niek C

    2016-04-01

    The 2-portal hindfoot endoscopic technique with the patient in prone position, first introduced by van Dijk et al. (Arthroscopy 16:871-876, 2000), is currently the most used by foot and ankle surgeons to address endoscopically pathologies located in the hindfoot. This article aims to review the literature to provide a comprehensive description of the level of evidence available to support the use of the 2-portal hindfoot endoscopy technique for the current generally accepted indications. A comprehensive review was performed by use of the PubMed database to isolate literature that described therapeutic studies investigating the results of different hindfoot endoscopy treatment techniques. All articles were reviewed and assigned a classification (I-V) of level of evidence. An analysis of the literature reviewed was used to assign a grade of recommendation for each current generally accepted indication for hindfoot endoscopy. A subscale was used to further describe the evidence base for indications receiving a grade of recommendation indicating poor-quality evidence. On the basis on the available evidence, posterior ankle impingement syndrome, subtalar arthritis and retrocalcaneal bursitis have the strongest recommendation in favour of treatment (grade Cf). Although a low level of evidence of the included studies, the review showed that adequate literature to support the use of the 2-portal endoscopic techniques for most currently accepted indications exists. Future "higher quality" evidence could strengthen current recommendations and further help surgeons in evidence-based practice. Level V, Review of Level III, IV and V studies.

  15. Status of balloon production for KamLAND-Zen 800 kg phase

    NASA Astrophysics Data System (ADS)

    Obara, S.

    2017-02-01

    KamLAND-Zen is an experiment for neutrinoless double beta decay (0 ν 2 β) search with 136Xe, based on the large liquid scintillator detector KamLAND. KamLAND-Zen includes 16.5 m3 xenon loaded liquid scintillator in a 3.16 m diameter nylon balloon (inner-balloon) with 25 μm wall thickness. KamLAND-Zen 400 (383 kg 136Xe used) released a lower limit on the 0 ν 2 β half-life of 136Xe. However, the sensitivity is limited by the contamination of radioactive backgrounds from the inner-balloon. Then, we planned KamLAND-Zen 800, upgrading the detector with a new inner-balloon of 3.84 m diameter with 800 kg 136Xe and 31.4 m3 liquid scintillator. We present the current status of KamLAND-Zen, the new mini-balloon construction and methods to avoid background contaminations. In addition, the development of a scintillating balloon for future upgrades in order to remove the radioactive decay chain daughter nuclei bismuth is also introduced.

  16. Anomalous bulging behaviors of a dielectric elastomer balloon under internal pressure and electric actuation

    NASA Astrophysics Data System (ADS)

    Wang, Fangfang; Yuan, Chao; Lu, Tongqing; Wang, T. J.

    2017-05-01

    When a clamped membrane of elastomer is subject to a lateral pressure, it bulges into a hemispherical balloon. However, for a clamped membrane of dielectric elastomer (DE) under a lateral pressure as well as a voltage through the thickness, it may bulge into a regular hemispherical balloon or an irregular shape. This work focuses on the anomalous bulging behaviors (i.e. the irregular bulging shape) of a DE balloon under electromechanical coupling loading. The full set of the equilibrium configurations of the DE balloon is theoretically derived within the framework of thermodynamics, based on which we find that with the increase of the applied voltage, the pressure-volume relationship changes from the single-N shape for the case of purely mechanical loading to a double-N shape, where five or more equilibrium configurations exist including both regular and irregular bulging shapes. Through stability analysis we find that the anomalous bulging is a common behavior for the DE balloon under electromechanical coupling loading and all types of irregular bulging shapes can be achieved by following carefully designed loading paths. Besides, the irregular bulging region usually has the largest local strain which may initiate the failure of the DE membrane. Guided by the theoretical analysis, we conducted experiments on a DE balloon under the internal pressure and electrical actuation. Typical irregular shapes were successfully observed and the entire evolution of the shape changing agrees very well with theoretical predictions. These findings enrich understandings of highly nonlinear behaviors for soft materials under electromechanical coupling loading.

  17. Biodegradable inflatable balloons for tissue separation.

    PubMed

    Basu, Arijit; Haim-Zada, Moran; Domb, Abraham J

    2016-10-01

    Confining radiation to a specific region (during radiation therapy) minimizes damage to surrounding tissues. Biodegradable inflatable balloons (bio-balloons) were developed. The device protects the normal tissues by increasing the gap between radiation source and critical structures. The radiation fades away while passing through the inflated balloon preventing the surrounding tissues from harmful radiation. These bio-balloons have also found clinical use to treat massive rotator cuff tear. This review summarizes the chemistry, engineering, and clinical development of these biomedical devices. These balloons are made of biodegradable polymers folded into the edge of a trocar and inserted between the tissues to be separated, and inflated by normal saline in the site of the application. The inserted balloon protects the tissues from radiation or mechanical stress. They remain inflated on site for two months and are finally eliminated within 12 months.

  18. Randomized controlled trial comparing submucosal endoscopy with mucosal resection and endoscopic submucosal dissection in the esophagus and stomach: Animal study.

    PubMed

    Takizawa, Kohei; Knipschield, Mary A; Gostout, Christopher J

    2017-06-30

    In Western countries, endoscopic submucosal dissection (ESD) has not prevailed as a result of training problems and a target patient population. We have previously reported a hybrid ESD technique, submucosal endoscopy with mucosal resection (SEMR), in which the submucosal dissection is carried out chiefly by blunt balloon dissection. We have also reported successful application in the porcine colon. In the present study, we compared the safety and efficacy of SEMR with ESD in the porcine esophagus and stomach. SEMR and ESD were carried out in eight domestic pigs under general anesthesia. Resection sites were marked by circumferential coagulation. After circumferential ESD knife mucosal incision, submucosal fluid cushion (SFC) was created. In the SEMR group, the balloon catheter was inserted deep into the SFC. The balloon was then inflated and pulled back toward the endoscope tip repeatedly, altering the direction, to disrupt the submucosa. Residual strands were cut with an IT-knife. En bloc resection rates, procedure times, complications and dissection difficulty scales (DDS) were recorded prospectively. DDS were rated using a visual analog scale. Thirty-two resections (8 SEMR/8 ESD in the esophagus; 8 SEMR/8 ESD in the stomach) were done with no major adverse events. There was no statistical difference between the two techniques in either location in the above categories measured. SEMR and traditional ESD are comparable techniques in safety and effectiveness when carried out in the esophagus and stomach. SEMR may serve as a more appealing technical option for endoscopists who are unable to sustain a traditional ESD practice volume. © 2017 Japan Gastroenterological Endoscopy Society.

  19. Balloon-assisted coil placement in wide-neck bifurcation aneurysms by use of a new, compliant balloon microcatheter.

    PubMed

    Baldi, Sebastian; Mounayer, Charbel; Piotin, Michel; Spelle, Laurent; Moret, Jacques

    2003-01-01

    Two types of balloon are usually employed to perform balloon-assisted coil placement in cerebral aneurysms: oval, guide-dependent balloons for sidewall aneurysms and round balloons for bifurcation aneurysms. We report on the use of a new, more compliant, guide-dependent oval balloon microcatheter to seal wide-neck bifurcation aneurysms with coils during endovascular occlusion.

  20. Endoscopy in Canada: Proceedings of the National Roundtable.

    PubMed

    Switzer, Noah; Dixon, Elijah; Tinmouth, Jill; Bradley, Nori; Vassiliou, Melina; Schwaitzberg, Steve; Gomes, Tony; Ellsmere, James; de Gara, Chris

    2015-01-01

    This 2014 roundtable discussion, hosted by the Canadian Association of General Surgeons, brought together general surgeons and gastroenterologists with expertise in endoscopy from across Canada to discuss the state of endoscopy in Canada. The focus of the roundtable was the evaluation of the competence of general surgeons at endoscopy, reviewing quality assurance parameters for high-quality endoscopy, measuring and assessing surgical resident preparedness for endoscopy practice, evaluating credentialing programs for the endosuite and predicting the future of endoscopic services in Canada. The roundtable noted several important observations. There exist inadequacies in both resident training and the assessment of competency in endoscopy. From these observations, several collaborative recommendations were then stated. These included the need for a formal and standardized system of both accreditation and training endoscopists.

  1. Endoscopy in Canada: Proceedings of the National Roundtable

    PubMed Central

    Switzer, Noah; Dixon, Elijah; Tinmouth, Jill; Bradley, Nori; Vassiliou, Melina; Schwaitzberg, Steve; Gomes, Anthony; Ellsmere, James; de Gara, Chris

    2015-01-01

    This 2014 roundtable discussion, hosted by the Canadian Association of General Surgeons, brought together general surgeons and gastroenterologists with expertise in endoscopy from across Canada to discuss the state of endoscopy in Canada. The focus of the roundtable was the evaluation of the competence of general surgeons at endoscopy, reviewing quality assurance parameters for high-quality endoscopy, measuring and assessing surgical resident preparedness for endoscopy practice, evaluating credentialing programs for the endosuite and predicting the future of endoscopic services in Canada. The roundtable noted several important observations. There exist inadequacies in both resident training and the assessment of competency in endoscopy. From these observations, several collaborative recommendations were then stated. These included the need for a formal and standardized system of both accreditation and training endoscopists. PMID:25886520

  2. Learning curve for endoscopy training: Is it all about numbers?

    PubMed

    Forbes, Nauzer; Mohamed, Rachid; Raman, Maitreyi

    2016-06-01

    Endoscopy training is an important component of postgraduate gastroenterology and general surgery programs. Proficiency in endoscopy requires the development of several tangible and intangible skills. Much attention has traditionally been paid to establishing a threshold, or minimum procedural volume during the training period, which is necessary for a trainee to achieve competence in endoscopy by the conclusion of his or her program. However, despite several attempts to characterize this target, it has become clear in recent years that training programs need to consider other factors rather than relying on this measure as the sole marker of trainee competency. Here, we present a review of general concepts in endoscopy skills acquisition that affect the learning curve, the evolving definition of competency as it relates to procedural volume, the role of simulation in endoscopy training, and the concept of massed versus spaced delivery of endoscopy training.

  3. European Society of Gastrointestinal Endoscopy - Establishing the key unanswered research questions within gastrointestinal endoscopy.

    PubMed

    Rees, Colin J; Ngu, Wee Sing; Regula, Jaroslaw; Bisschops, Raf; Saftoiu, Adrian; Dekker, Evelien; Gralnek, Ian; Ciocirlan, Mihai; Dinis-Ribeiro, Mario; Jover, Rodrigo; Meisner, Søren; Spada, Cristiano; Hassan, Cesare; Valori, Roland; Hucl, Tomas; Le Moine, Olivier; Domagk, Dirk; Kaminski, Michal F; Bretthauer, Michael; Rutter, Matthew D; Aabakken, Lars; Ponchon, Thierry; Fockens, Paul; Siersema, Peter D

    2016-10-01

    Background and study aim: Gastrointestinal endoscopy is a rapidly evolving research field. The European Society of Gastrointestinal Endoscopy (ESGE) plays a key role in shaping opinion and endoscopy activity throughout Europe and further afield. Establishing key unanswered questions within the field of endoscopy and prioritizing those that are important enables researchers and funders to appropriately allocate resources. Methods: Over 2 years, the ESGE Research Committee gathered information on research priorities and refined them through a modified Delphi approach. Consultations were held with the ESGE Governing Board and Quality Improvement Committee to identify important unanswered questions. Research workshops were held at the 21st United European Gastroenterology Week. Research questions were refined by the ESGE Research Committee and Governing Board, compiled into an online survey, and distributed to all ESGE members, who were invited to rank each question by priority. Results: The final questionnaire yielded 291 responses from over 60 countries. The three countries with the highest response rates were Spain, Italy, and United Kingdom. Most responders were from teaching hospitals (62 %) and were specialist endoscopists (51 %). Responses were analyzed with weighted rankings, resulting in prioritization of 26 key unanswered questions. The top ranked generic questions were: 1) How do we define the correct surveillance interval following endoscopic diagnosis? 2) How do we correctly utilize advanced endoscopic imaging? 3) What are the best markers of endoscopy quality? Conclusion: Following this comprehensive process, the ESGE has identified and ranked the key unanswered questions within the field of gastrointestinal endoscopy. Researchers, funders, and journals should prioritize studies that seek to answer these important questions. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Onyx embolization using dual-lumen balloon catheter: initial experience and technical note.

    PubMed

    Paramasivam, Srinivasan; Niimi, Yasunari; Fifi, Johanna; Berenstein, Alejandro

    2013-10-01

    Onyx as an embolization agent for the management of vascular malformation is well established. We report our initial experience with dimethyl-sulphoxide (DMSO) compatible double lumen balloon catheters used for Onyx embolization. Between December 2011 and March 2013, we treated 22 patients aged between 1.5 to 70years with two types of DMSO compatible dual-lumen balloon catheters (Scepter C and Ascent) to treat dural arteriovenous fistulas, brain arteriovenous malformation (AVM) with dural feeders, mandibular, facial, lingual, vertebral and paravertebral AVMs. The catheter has good navigability, compliant balloon on inflation formed a "plug" that has more resistance than Onyx plug enhancing better penetration. During injection, the balloon remained stable without spontaneous deflation or rupture and withstood the pressure build-up well. The retrieval of the catheter in most cases took less than a minute (19/28) while in five, it was less than five minutes and in the remaining four, it was longer that includes a trapped catheter on prolonged attempted retrieval resulted in an epidural hematoma, requiring emergent surgical evacuation. The fluoroscopy time is reduced, as we do not form a proximal onyx plug, the injection time is shorter along with easy and instantaneous removal of the catheter after balloon deflation in most cases. Dual-lumen balloon catheter Onyx embolization is a safe and effective technique. Currently, an important tool to circumvent some of the shortcomings associated with Onyx embolization. The catheter has good navigability, the balloon has stability, tolerance, enhances penetrability. It is easy to retrieve the microcatheter. With the experience gained, and with more compliant balloon catheters available, this technique can be applied to cerebral vessels in near future. Copyright © 2013. Published by Elsevier Masson SAS.

  5. Stability balloon for two-dimensional vortex ripple patterns.

    PubMed

    Hansen, J L; van Hecke, M; Ellegaard, C; Andersen, K H; Bohr, T; Haaning, A; Sams, T

    2001-11-12

    Patterns of vortex ripples form when a sand bed is subjected to an oscillatory fluid flow. Here we describe experiments on the response of regular vortex ripple patterns to sudden changes of the driving amplitude a or frequency f. A sufficient decrease of f leads to a "freezing" of the pattern, while a sufficient increase of f leads to a supercritical secondary "pearling" instability. Sufficient changes in the amplitude a lead to subcritical secondary "doubling" and "bulging" instabilities. Our findings are summarized in a "stability balloon" for vortex ripple pattern formation.

  6. NASA Langley Research Center tethered balloon systems

    NASA Technical Reports Server (NTRS)

    Owens, Thomas L.; Storey, Richard W.; Youngbluth, Otto

    1987-01-01

    The NASA Langley Research Center tethered balloon system operations are covered in this report for the period of 1979 through 1983. Meteorological data, ozone concentrations, and other data were obtained from in situ measurements. The large tethered balloon had a lifting capability of 30 kilograms to 2500 meters. The report includes descriptions of the various components of the balloon systems such as the balloons, the sensors, the electronics, and the hardware. Several photographs of the system are included as well as a list of projects including the types of data gathered.

  7. [Development of all-silicone detachable balloons].

    PubMed

    Machida, T; Aoki, S; Sasaki, Y; Sasaki, Y; Iio, M; Matsuno, A; Yoshida, S; Basugi, N

    1990-11-25

    Treatment of cerebral vascular lesions such as carotid cavernous sinus fistulas and giant aneurysms is now being performed with intravascular detachable balloon embolization techniques. We have developed several types of all-silicone detachable balloons. Our balloons have self-sealing valves (with or without collars) and detach with simple traction. The self-sealing valve is smaller than 0.6 mm and the balloon can easily be placed through a 7-F catheter. We started clinical trials and a representative case was reported.

  8. Absorption spectrometer balloon flight and iodine investigations

    NASA Technical Reports Server (NTRS)

    1970-01-01

    A high altitude balloon flight experiment to determine the technical feasibility of employing absorption spectroscopy to measure SO2 and NO2 gases in the earth's atmosphere from above the atmospheric ozone layer is discussed. In addition to the balloon experiment the contract includes a ground-based survey of natural I emissions from geological sources and studies of the feasibility of mapping I2 from spacecraft. This report is divided into three major sections as follows: (1) the planning engineering and execution of the balloon experiment, (2) data reduction and analysis of the balloon data, and (3) the results of the I2 phase of the contract.

  9. Production of glass balloons for laser targets

    SciTech Connect

    Hendricks, C.D.; Dressler, J.L.

    1982-09-28

    An apparatus for producing small quantities of glass balloons for use as laser fusion targets is described. To produce precise quantities of the ingredients of one glass balloon, a jet of an aqueous solution of the glass constituents and a blowing agent is metered into uniformly sized drops by Rayleigh breakup. A small fraction of these uniform drops is then passed through an oven where the water is evaporated, the remaining solid material is fused into glass, and a blowing agent decomposes or water of hydration evolves as a vapor to blow the drop into a balloon. Photographs of the resulting glass balloons are presented.

  10. Innovative Balloon Buoyancy Techniques for Atmospheric Exploration

    NASA Technical Reports Server (NTRS)

    Jones, J.

    2000-01-01

    Until quite recently, the only practical means to control balloon buoyancy, and thus altitude, required consuming large amounts of fuel or the limited venting of helium balloons and/or dropping of ballast. With recent discoveries at JPL, novel long-life, balloon buoyancy techniques have been discovered that for the first time allow balloons to float in the primarily hydrogen atmospheres of Jupiter, Saturn, Uranus, and Neptune (using ambient fill-gas), and by using renewable energy sources, allow multiple controlled landings on Venus (using atmospheric temperature differences), Mars (solar heat), Titan (RTG heat), and Earth (planet radiant heat).

  11. Design considerations for a Martian Balloon Rover

    NASA Technical Reports Server (NTRS)

    Redd, F.; Levesque, R. J.; Williams, G. E.

    1987-01-01

    The present NASA-sponsored design feasibility study for a balloon-borne sensor platform that is to be used over environmentally dissimilar sites on Mars gives attention to specific environmental and configurational parameters of a baseline balloon design, with a view to day/night altitude variations in response to temperature extremes. It is concluded that a Martian Balloon Rover can be developed using current technology; projected reductions in high-strength fabric density and radiation-resistant coatings will further enhance mission effectiveness, permitting either balloon size reductions or payload capacity increases.

  12. Innovative Balloon Buoyancy Techniques for Atmospheric Exploration

    NASA Technical Reports Server (NTRS)

    Jones, J.

    2000-01-01

    Until quite recently, the only practical means to control balloon buoyancy, and thus altitude, required consuming large amounts of fuel or the limited venting of helium balloons and/or dropping of ballast. With recent discoveries at JPL, novel long-life, balloon buoyancy techniques have been discovered that for the first time allow balloons to float in the primarily hydrogen atmospheres of Jupiter, Saturn, Uranus, and Neptune (using ambient fill-gas), and by using renewable energy sources, allow multiple controlled landings on Venus (using atmospheric temperature differences), Mars (solar heat), Titan (RTG heat), and Earth (planet radiant heat).

  13. Appropriateness and diagnostic yield of upper gastrointestinal endoscopy in an open-access endoscopy system.

    PubMed

    Aljebreen, Abdulrahman M; Alswat, Khalid; Almadi, Majid A

    2013-01-01

    Open access endoscopy (OAE) decreases the waiting time for patients and clinical burden to gastroenterologist; however, the appropriateness of referrals for endoscopy and thus the diagnostic yield of these endoscopies has become an important issue. The aim of this study was to determine the appropriateness of upper gastrointestinal (GI) endoscopy requests in an OAE system. A retrospective chart review of all consecutive patients who underwent an upper gastroscopy in the year 2008 was performed and was defined as appropriate or inappropriate according to the American Society for Gastrointestinal Endoscopy (ASGE) guidelines. Endoscopic findings were recorded and classified as positive or negative. Referrals were categorized as being from a gastroenterologist, internist, surgeon, primary care physicians or others, and on an inpatient or out-patient basis. A total of 505 consecutive patients were included. The mean age was 45.3 (standard deviation 18.1), 259 (51%) of them were males. 31% of the referrals were thought to be inappropriate. Referrals from primary care physicians were inappropriate in 47% of patients while only 19.5% of gastroenterologists referrals were considered inappropriate. Nearly, 37.8% of the out-patient referrals were inappropriate compared to only 7.8% for inpatients. Abnormal findings were found in 78.5% and 78% of patients referred by gastroenterologists and surgeons respectively while in those referred by primary care physicians it was (49.7%). Inpatients referred for endoscopy had abnormal findings in (81.7%) while in out-patients it was (66.6%). The most common appropriate indications in order of frequency were "upper abdominal distress that persisted despite an appropriate trial of therapy "(78.9%),''persistent vomiting of unknown cause "(19.2%), upper GI bleeding or unexplained iron deficiency anemia (7.6%). The sensitivity and specificity of the ASGE guidelines in our study population was 70.3% and 35% respectively. A large proportion of

  14. Scientific Ballooning Activities and Recent Developments in Technology and Instrumentation of the TIFR Balloon Facility, Hyderabad

    NASA Astrophysics Data System (ADS)

    Buduru, Suneel Kumar

    2016-07-01

    The Balloon Facility of Tata Institute of Fundamental Research (TIFR-BF) is a unique center of expertise working throughout the year to design, fabricate and launch scientific balloons mainly for space astronomy, atmospheric science and engineering experiments. Recently TIFR-BF extended its support to new user scientists for conducting balloon launches for biological and middle atmospheric sciences. For the first time two balloon launches conducted for sending live lab rats to upper stratosphere and provided launch support for different balloon campaigns such as Tropical Tropopause Dynamics (TTD) to study water vapour content in upper tropospheric and lower stratospheric regions over Hyderabad and the other balloon campaign to study the Asian Tropopause Aerosol Layer (BATAL) during the Indian summer monsoon season. BATAL is the first campaign to conduct balloon launches during active (South-West) monsoon season using zero pressure balloons of different volumes. TIFR-BF also provided zero pressure and sounding balloon support to various research institutes and organizations in India and for several international space projects. In this paper, we present details on our increased capability of balloon fabrication for carrying heavier payloads, development of high strength balloon load tapes and recent developments of flight control and safety systems. A summary of the various flights conducted in two years will be presented along with the future ballooning plans.

  15. [Radiology and endoscopy in the diagnosis of colorectal cancer].

    PubMed

    Scerpella, E; Penny, E

    1990-01-01

    Over a 5-year period, 64 patients with a primary colorectal carcinoma were studied by means of radiographic or endoscopic diagnostic techniques. The overall accuracy rates of the barium contrast enema and endoscopy were 86% and 93%, respectively. A comparison of diagnostic accuracy between radiology and endoscopy yield a 75% correlation rate. Whenever possible, both radiology and digestive endoscopy should be carried out to assess the diagnosis of colorectal carcinoma.

  16. Jaw Dislocation as an Unusual Complication of Upper Endoscopy

    PubMed Central

    Dellon, Evan S.; Steele, David

    2016-01-01

    This case report presents an unusual complication of upper endoscopy, resulting in jaw dislocation. Temporomandibular joint dislocation is commonly reported in association with anesthesia and intubation, but it is not widely recognized as a complication of gastrointestinal endoscopy. This report also reviews the current literature regarding this complication and discusses the potential causes of dislocation, differential diagnoses for jaw pain following endoscopy, and recommendations for prevention. PMID:27403117

  17. Activities for endoscopy information systems standardization in Japan.

    PubMed

    Yokoi, Hideto; Fujino, Masayuki A

    2006-01-01

    There are two activities for Japanese endoscopy information system. One is for a standard terminology (Minimal Standard Terminology: MST) for endoscopy reporting. Other is Integrating Healthcare Enterprise Japan (IHE-J) for an integration of hospital information system. In IHE-J activity, the members revealed specificities of an endoscopy workflow by making a comparison with a radiology workflow. The authors will propose a scheme for systematic standardization based on our experiences in the standardization activities.

  18. Flexible Gastrointestinal Endoscopy in Ferrets (Mustela putorius furo).

    PubMed

    Pignon, Charly; Huynh, Minh; Husnik, Roman; Jekl, Vladimir

    2015-09-01

    Gastrointestinal disease is a common complaint in ferrets (Mustela putorius furo). Their relatively simple and short gastrointestinal tract makes them good candidates for flexible endoscopy. However, apart from a few references in biomedical research articles, there is little information on the use of flexible endoscopy in ferrets. This review describes patient preparation, equipment, and select gastrointestinal endoscopy techniques in ferrets, including esophagoscopy, gastroscopy, duodenoscopy, percutaneous endoscopic gastrostomy, jejunoileoscopy, colonoscopy, and biopsy. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    PubMed Central

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

    2012-01-01

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

  20. Low-cost balloon missions to Mars and Venus

    NASA Technical Reports Server (NTRS)

    Kerzhanovich, V.; Cutts, J.; Hall, J.

    2003-01-01

    The first successful flight demonstration of aerial deployment of Mars balloon prototypes in June 2002 and, earlier, of Venus balloon prototype deemed to be a turning point in the risk assessment of balloon missions.

  1. Inhaled sevoflurane for lower gastrointestinal endoscopy with possible propofol anaphylaxis

    PubMed Central

    Ye, Ling; Liu, Yun-Fei; Zhu, Tao

    2014-01-01

    Sedation with propofol is widely used for the outpatient examination. Although anaphylaxis to propofol is rare, there were some reports of anaphylaxis following propofol administration. We present a case of female patient under sedation for lower gastrointestinal endoscopy with possible propofol anaphylaxis. Then sevoflurane was successfully used for the examination and the following surgery. We discussed the possible feasibility of sevoflurane for the examination of lower gastrointestinal endoscopy. Propofol is widely used for the sedation of outpatient with lower gastrointestinal endoscopy. But it may cause some allergic reaction. Inhaled sevoflurane may provide a satisfactory and safe alternative for adult outpatients’ endoscopy. PMID:25419408

  2. Cocaine balloon aspiration: successful removal with bronchoscopy.

    PubMed

    Cobaugh, D J; Schneider, S M; Benitez, J G; Donahoe, M P

    1997-09-01

    Ingestion of balloons containing illicit substances along with the potential toxic sequelae associated with these ingestions have been described in the literature. This report describes the successful bronchoscopic retrieval of a cocaine balloon after aspiration. A 39-year-old man was witnessed swallowing several balloons that were thought to contain heroin. Shortly after ingestion, the patient became unconscious and required nasotracheal intubation. Before intubation, several balloons were removed from the oropharynx. Naloxone 4 mg was administered en route to the emergency department (ED). Following naloxone, the patient awoke and became agitated and combative. On arrival in the ED, midazolam, succinylcholine, and vecuronium were required to manage his combativeness. Vital signs were: heart rate, 130 beats/min; blood pressure, 128/86 mm Hg; respirations, 12 breaths/min; temperature, 96.5 degrees F. A balloon and balloon tip were removed during lavage. Whole bowel irrigation with a polyethylene glycol electrolyte solution was initiated. A right upper lobe infiltrate was identified on chest X-ray and aspiration of a balloon was suspected. At bronchoscopy, a small yellow, intact balloon visualized in the basilar segment of the right lower lobe was removed. Toxicologic analysis of the balloon contents found cocaine. The rest of the patient's hospital course was unremarkable and he was discharged 5 days after admission. This case brings to light the potential concerns, such as respiratory compromise, associated with aspiration of small balloons in the body stuffer. Additionally, the potential for the development of toxicity if the balloon ruptures and toxin absorption occurs through through the lungs should be considered. Emergency physicians and toxicologists should be aware of this significant complication of packet ingestion in the body packer or stuffer and be prepared to intervene early during the course of the patient's treatment.

  3. The balloon experimental twin telescope for infrared interferometry (BETTII): interferometry at the edge of the atmosphere

    NASA Astrophysics Data System (ADS)

    Rinehart, S.; Rizzo, M.; Fixsen, D.; Ade, P.; Barclay, R.; Barry, R.; Benford, D.; Dhabal, A.; Juanola-Parramon, R.; Klemencic, Georgina; Griffin, M.; Leisawitz, David T.; Maher, S.; Mentzell, J.; Mundy, Lee G.; Pascale, E.; Savini, G.; Silverberg, Robert F.; Staguhn, J.; Veach, T.

    2014-07-01

    The Balloon Experimental Twin Telescope for Infrared Interferometry (BETTII) is an 8-meter baseline far-infrared interferometer designed to fly on a high altitude balloon. BETTII uses a double-Fourier Michelson interferometer to simultaneously obtain spatial and spectral information on science targets; the long baseline permits subarcsecond angular resolution, a capability unmatched by other far-infrared facilities. This program started in 2011, and is now in the process of building and testing components of the mission, aiming for first flight in fall of 2015. This paper will provide an overview of the BETTII experiment, with a discussion of current progress and of future plans.

  4. Balloon-based interferometric techniques

    NASA Technical Reports Server (NTRS)

    Rees, David

    1985-01-01

    A balloon-borne triple-etalon Fabry-Perot Interferometer, observing the Doppler shifts of absorption lines caused by molecular oxygen and water vapor in the far red/near infrared spectrum of backscattered sunlight, has been used to evaluate a passive spaceborne remote sensing technique for measuring winds in the troposphere and stratosphere. There have been two successful high altitude balloon flights of the prototype UCL instrument from the National Scientific Balloon Facility at Palestine, TE (May 80, Oct. 83). The results from these flights have demonstrated that an interferometer with adequate resolution, stability and sensitivity can be built. The wind data are of comparable quality to those obtained from operational techniques (balloon and rocket sonde, cloud-top drift analysis, and from the gradient wind analysis of satellite radiance measurements). However, the interferometric data can provide a regular global grid, over a height range from 5 to 50 km in regions of clear air. Between the middle troposphere (5 km) and the upper stratosphere (40 to 50 km), an optimized instrument can make wind measurements over the daylit hemisphere with an accuracy of about 3 to 5 m/sec (2 sigma). It is possible to obtain full height profiles between altitudes of 5 and 50 km, with 4 km height resolution, and a spatial resolution of about 200 km, along the orbit track. Below an altitude of about 10 km, Fraunhofer lines of solar origin are possible targets of the Doppler wind analysis. Above an altitude of 50 km, the weakness of the backscattered solar spectrum (decreasing air density) is coupled with the low absorption crosssection of all atmospheric species in the spectral region up to 800 nm (where imaging photon detectors can be used), causing the along-the-track resolution (or error) to increase beyond values useful for operational purposes. Within the region of optimum performance (5 to 50 km), however, the technique is a valuable potential complement to existing wind

  5. Intragastric Balloons in Clinical Practice.

    PubMed

    Papademetriou, Marianna; Popov, Violeta

    2017-04-01

    Cost-effective therapies to address the growing epidemic of obesity are a leading priority in modern medicine. Intragastric balloons (IGBs) are one such option, with increased effectiveness compared with pharmacotherapy and lifestyle and a lower rate of adverse events than bariatric surgery. IGBs are endoscopically placed or swallowed space-occupying devices in the stomach. Three IGB systems were approved in 2015 to 2016 by the Food and Drug Administration for use in the United States, with more devices nearing approval. This paper reviews the adverse events and efficacy of IGBs, and practice setup, management of common complications, and dietary advice for patients.

  6. The development of a pseudo-chamber after balloon pulmonary angioplasty: long-term complications of balloon pulmonary angioplasty.

    PubMed

    Sugiyama, Hisashi; Kise, Hiroaki; Toda, Takako; Hoshiai, Minako

    2016-11-01

    We experienced a rare complication where extravasation developed a pseudo-chamber long after the balloon pulmonary angioplasty for supravalvular pulmonary stenosis. A 3-month-old girl was diagnosed with an anomalous origin of the left coronary artery from the pulmonary artery. She underwent the Takeuchi procedure at 10 months of age. During the follow-up, the supravalvular pulmonary stenosis deteriorated, and was treated by balloon pulmonary angioplasty with the double balloon technique catheter at 6 years of age. Angiography at the main pulmonary artery showed a small amount of extravasation contrast medium after the procedure. Follow-up echocardiography showed a diminished extravasation hemorrhage. Twelve years later, right ventricular enlargement due to pulmonary regurgitation had been observed on echocardiography. In addition, abnormal echo free space was detected at the left posterior of the left atrium. Enhanced computed tomography clearly demonstrated there was an orifice and extent of the pseudo-chamber. Surgical findings revealed a large tear just distal to the coronary tunnel. We speculated that extravasation blood was limited in the perivascular area early after the procedure but eventually reached the non-adhesive oblique pericardial sinus with age. Consequently, pulmonary to oblique pericardial sinus communication was established and looked like a pseudo-chamber long after the procedure. In conclusion, even if extravasation seems to be limited immediately after the balloon pulmonary angioplasty, it could expand for non-adhesive space and could develop a huge blood space like chamber. Long-term careful observation should be necessary for extravasation of pulmonary artery even with surgical adhesion.

  7. Sedation in gastrointestinal endoscopy: Current issues

    PubMed Central

    Triantafillidis, John K; Merikas, Emmanuel; Nikolakis, Dimitrios; Papalois, Apostolos E

    2013-01-01

    Diagnostic and therapeutic endoscopy can successfully be performed by applying moderate (conscious) sedation. Moderate sedation, using midazolam and an opioid, is the standard method of sedation, although propofol is increasingly being used in many countries because the satisfaction of endoscopists with propofol sedation is greater compared with their satisfaction with conventional sedation. Moreover, the use of propofol is currently preferred for the endoscopic sedation of patients with advanced liver disease due to its short biologic half-life and, consequently, its low risk of inducing hepatic encephalopathy. In the future, propofol could become the preferred sedation agent, especially for routine colonoscopy. Midazolam is the benzodiazepine of choice because of its shorter duration of action and better pharmacokinetic profile compared with diazepam. Among opioids, pethidine and fentanyl are the most popular. A number of other substances have been tested in several clinical trials with promising results. Among them, newer opioids, such as remifentanil, enable a faster recovery. The controversy regarding the administration of sedation by an endoscopist or an experienced nurse, as well as the optimal staffing of endoscopy units, continues to be a matter of discussion. Safe sedation in special clinical circumstances, such as in the cases of obese, pregnant, and elderly individuals, as well as patients with chronic lung, renal or liver disease, requires modification of the dose of the drugs used for sedation. In the great majority of patients, sedation under the supervision of a properly trained endoscopist remains the standard practice worldwide. In this review, an overview of the current knowledge concerning sedation during digestive endoscopy will be provided based on the data in the current literature. PMID:23382625

  8. Transnasal endoscopy: no gagging no panic!

    PubMed Central

    Parker, Clare; Alexandridis, Estratios; Plevris, John; O'Hara, James; Panter, Simon

    2016-01-01

    Background Transnasal endoscopy (TNE) is performed with an ultrathin scope via the nasal passages and is increasingly used. This review covers the technical characteristics, tolerability, safety and acceptability of TNE and also diagnostic accuracy, use as a screening tool and therapeutic applications. It includes practical advice from an ear, nose, throat (ENT) specialist to optimise TNE practice, identify ENT pathology and manage complications. Methods A Medline search was performed using the terms “transnasal”, “ultrathin”, “small calibre”, “endoscopy”, “EGD” to identify relevant literature. Results There is increasing evidence that TNE is better tolerated than standard endoscopy as measured using visual analogue scales, and the main area of discomfort is nasal during insertion of the TN endoscope, which seems remediable with adequate topical anaesthesia. The diagnostic yield has been found to be similar for detection of Barrett's oesophagus, gastric cancer and GORD-associated diseases. There are some potential issues regarding the accuracy of TNE in detecting small early gastric malignant lesions, especially those in the proximal stomach. TNE is feasible and safe in a primary care population and is ideal for screening for upper gastrointestinal pathology. It has an advantage as a diagnostic tool in the elderly and those with multiple comorbidities due to fewer adverse effects on the cardiovascular system. It has significant advantages for therapeutic procedures, especially negotiating upper oesophageal strictures and insertion of nasoenteric feeding tubes. Conclusions TNE is well tolerated and a valuable diagnostic tool. Further evidence is required to establish its accuracy for the diagnosis of early and small gastric malignancies. There is an emerging role for TNE in therapeutic endoscopy, which needs further study. PMID:28839865

  9. Finite element analysis of balloon-expandable coronary stent deployment: influence of angioplasty balloon configuration.

    PubMed

    Martin, David; Boyle, Fergal

    2013-11-01

    Today, the majority of coronary stents are balloon-expandable and are deployed using a balloon-tipped catheter. To improve deliverability, the membrane of the angioplasty balloon is typically folded about the catheter in a pleated configuration. As such, the deployment of the angioplasty balloon is governed by the material properties of the balloon membrane, its folded configuration and its attachment to the catheter. Despite this observation, however, an optimum strategy for modelling the configuration of the angioplasty balloon in finite element studies of coronary stent deployment has not been identified, and idealised models of the angioplasty balloon are commonly employed in the literature. These idealised models often neglect complex geometrical features, such as the folded configuration of the balloon membrane and its attachment to the catheter, which may have a significant influence on the deployment of a stent. In this study, three increasingly sophisticated models of a typical semi-compliant angioplasty balloon were employed to determine the influence of angioplasty balloon configuration on the deployment of a stent. The results of this study indicate that angioplasty balloon configuration has a significant influence on both the transient behaviour of the stent and its impact on the mechanical environment of the coronary artery.

  10. Submucosal endoscopy with mucosal resection: a hybrid endoscopic submucosal dissection in the porcine rectum and distal colon.

    PubMed

    Gostout, Christopher J; Knipschield, Mary A

    2012-10-01

    Endoscopic submucosal dissection (ESD) has appeal for en bloc resection of large flat colorectal polyps but carries appreciable risk and demands a high level of expertise and training. Undermining flat and laterally spreading colorectal polyps by using submucosal endoscopy with the mucosal safety valve flap (SEMF) may be combined with ESD to offer a hybrid technique that is easier and safer. To determine the feasibility of combining SEMF and ESD for the removal of progressively larger areas of the mucosa in the porcine rectum and colon. Two-phase ex vivo and in vivo study using domestic pig rectum and distal colon. Developmental endoscopy unit/animal research unit. Progressively larger targeted mucosal dissections were performed by using the basic principles of ESD, which included margination of the targeted area of mucosa, submucosal fluid cushion, and needle-knife dissection. These were combined with the SEMF method of predissection with carbon dioxide (CO(2)) gas and balloon-based blunt dissection of the submucosa undermining the targeted and isolated mucosa. The hybrid technique was first applied to ex vivo porcine rectums and distal colons, then in vivo in an acute animal study. Progressively larger staged dissections were performed with 2-, 4-, and 6-cm diameter targeted mucosal sites. Success with associated difficulty or failure of the hybrid method in the rectum and distal colon to achieve complete resection of a progressively larger targeted area of mucosa. The ex vivo phase of the experiment demonstrated the ability to use the blunt balloon dissection of the SEMF procedure to remove 2-, 4-, and 6-cm areas of rectum and distal colon with a rapid progression to the largest size resection. The colon proximal to 20 cm above the anus was unable to hold a submucosal fluid cushion and allow submucosal dissection. Successful hybrid ESD was performed in vivo with staged progression through to the largest mucosal area (6 cm) within 20 cm of the anus. Dissections

  11. Automatic blood detection in capsule endoscopy video

    NASA Astrophysics Data System (ADS)

    Novozámský, Adam; Flusser, Jan; Tachecí, Ilja; Sulík, Lukáš; Bureš, Jan; Krejcar, Ondřej

    2016-12-01

    We propose two automatic methods for detecting bleeding in wireless capsule endoscopy videos of the small intestine. The first one uses solely the color information, whereas the second one incorporates the assumptions about the blood spot shape and size. The original idea is namely the definition of a new color space that provides good separability of blood pixels and intestinal wall. Both methods can be applied either individually or their results can be fused together for the final decision. We evaluate their individual performance and various fusion rules on real data, manually annotated by an endoscopist.

  12. Optoacoustic endoscopy in curved scanning mode

    NASA Astrophysics Data System (ADS)

    He, Hailong; Buehler, Andreas; Ntziachristos, Vasilis

    2016-03-01

    Optoacoustic technique has been shown to resolve anatomical, functional and molecular features at depths that go beyond the reach of epi-illumination optical microscopy offering new opportunities for endoscopic imaging. Herein, we interrogate the merits of optoacoustic endoscopy implemented by translating a sound detector in linear or curved geometries. The linear and curved detection geometries are achieved by employing an intravascular ultrasound transducer (IVUS) within a plastic guide shaped to a line or a curve. This concept could be used together with optical endoscopes to yield hybrid optical and optoacoustic imaging.

  13. Shared governance in the endoscopy department.

    PubMed

    Metcalf, R; Tate, R

    1995-01-01

    Studies have indicated that active participation by employees improves job satisfaction and performance. There is a sense of pride and accountability that is demonstrated in the work environment when staff are involved in the decision-making process. Recent emergence of a relatively new philosophy for management that promotes employee ownership is shared governance. This type of leadership allows individuals who are at the center of the work place to participate in the decisions that actively reflect their needs. In this article, the authors describe the process of implementing shared governance in an Endoscopy Department. The effectiveness of shared governance is evidenced by the renewed enthusiasm and energy demonstrated by the staff.

  14. Power supplies for long duration balloon flights

    NASA Astrophysics Data System (ADS)

    Lichfield, Ernest W.

    Long duration balloon flights require more electrical power than can be carried in primary batteries. This paper provides design information for selecting rechargeable batteries and charging systems. Solar panels for recharging batteries are discussed, with particular emphasis on cells mounting suitable for balloon flights and panel orientation for maximum power collection. Since efficient utilization of power is so important, modern DC to DC power conversion techniques are presented. On short flights of 1 day or less, system designers have not been greatly concerned with battery weight. But, with the advent of long duration balloon flights using superpressure balloons, anchor balloon systems, and RACOON balloon techniques, power supplies and their weight become of prime importance. The criteria for evaluating power systems for long duration balloon flights is performance per unit weight. Instrumented balloon systems have flown 44 days. For these very long duration flights, batteries recharged from solar cells are the only solution. For intermediate flight duration, say less than 10 days, the system designer should seriously consider using primary cells. The National Center for Atmospheric Research is sponsored by the National Science Foundation. Any opinions, findings and conclusions or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the National Science Foundation.

  15. Montgolfiere balloon missions from Mars and Titan

    NASA Technical Reports Server (NTRS)

    Jones, Jack A.

    2005-01-01

    Montgolfieres, which are balloons that are filled with heated ambient atmospheric gas, appear promising for the exploration of Mars as well as of Saturn's moon, Titan. On Earth, Montgolfieres are also known as 'hot air balloons'. Commercial versions are typically heated by burning propane, although a number of radiant and solar-heated Montgolfieres have been flown on earth by CNES.

  16. The United Kingdom rocket and balloon program

    NASA Astrophysics Data System (ADS)

    Delury, J. T.

    1980-06-01

    The United Kingdom civilian scientific balloon and rocket program for 1979, 1980, 1981 are summarized and the areas of scientific interest for the period 1981 to 1985 are mentioned. Ten balloons up to 40 cu m to be launched from the USA or Australia and launches of up to ten 7.5 in. diameter Petrel rockets are planned.

  17. Reference level winds from balloon platforms

    NASA Technical Reports Server (NTRS)

    Lally, Vincent E.

    1985-01-01

    The superpressure balloon was developed to provide a method of obtaining global winds at all altitudes from 5 to 30 km. If a balloon could be made to fly for several weeks at a constant altitude, and if it could be tracked accurately on its global circuits, the balloon would provide a tag for the air parcel in which it was embedded. The Lagrangian data on the atmospheric circulation would provide a superior data input to the numerical model. The Global Atmospheric Research Program (GARP) was initiated in large part based on the promise of this technique coupled with free-floating ocean buoys and satellite radiometers. The initial name proposed by Charney for GARP was SABABURA 'SAtellite BAlloon BUoy RAdiometric system' (Charney, 1966). However, although the superpressure balloon exceeded its designers' expectations for flight duration in the stratosphere (longest flight duration of 744 days), flight duration below 10 km was limited by icing in super-cooled clouds to a few days. The balloon was relegated to a secondary role during the GARP Special Observing Periods. The several major superpressure balloon programs for global wind measurement are described as well as those new developments which make the balloon once again an attractive vehicle for measurement of global winds as a reference and bench-mark system for future satellite systems.

  18. 21 CFR 874.4100 - Epistaxis balloon.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Epistaxis balloon. 874.4100 Section 874.4100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4100 Epistaxis balloon. (a)...

  19. 21 CFR 874.4100 - Epistaxis balloon.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Epistaxis balloon. 874.4100 Section 874.4100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4100 Epistaxis balloon. (a)...

  20. 21 CFR 874.4100 - Epistaxis balloon.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Epistaxis balloon. 874.4100 Section 874.4100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4100 Epistaxis balloon. (a)...

  1. Early Cosmic Ray Research with Balloons

    NASA Astrophysics Data System (ADS)

    Walter, Michael

    2013-06-01

    The discovery of cosmic rays by Victor Hess during a balloon flight in 1912 at an altitude of 5350 m would not have been possible without the more than one hundred years development of scientific ballooning. The discovery of hot air and hydrogen balloons and their first flights in Europe is shortly described. Scientific ballooning was mainly connected with activities of meteorologists. It was also the geologist and meteorologist Franz Linke, who probably observed first indications of a penetrating radiation whose intensity seemed to increase with the altitude. Karl Bergwitz and Albert Gockel were the first physicists studying the penetrating radiation during balloon flights. The main part of the article deals with the discovery of the extraterrestrial radiation by V. Hess and the confirmation by Werner Kolhörster.

  2. Recent Highlights of Scientific Ballooning in Japan

    NASA Astrophysics Data System (ADS)

    Fuke, H.

    Since 2008, the Japan Aerospace Exploration Agency (JAXA) has carried out annual domestic balloon campaigns from Taiki Aerospace Research Field (TARF). Productive results have been obtained by many projects in academic fields such as atmospheric science, space engineering, cosmic-ray physics, and astronomy. In 2013, an 80,000-m3 balloon made from a 2.8-μm ultra-thin polyethylene film reached an altitude of 53.7 km, equaling the world record for the altitude of an unmanned balloon. In 2015, JAXA carried out a balloon campaign from Alice Springs in Australia as a precursor of future sustainable overseas activities to compliment the domestic ones at TARF. In this paper, we discuss recent highlights of and future prospects for Japanese scientific ballooning.

  3. [Single balloon versus Inoue balloon in percutaneous mitral balloon valvuloplasty. Short-term results and complications].

    PubMed

    Peixoto, E C; de Oliveira, P S; Netto, M S; Borges, I P; Villela, R A; Labrunie, P; Brum, C; Peixoto, R T; Sena, M A; Labrunie, M; Peixoto, R T; Burello, D M

    1998-07-01

    To assess short-term results and complications of percutaneous mitral balloon valvuloplasty (PMBV) performed with Inoue balloon (IB) and single low profile balloon (SB). We performed 390 PMBV procedures, 29 with IB and 337 with SB. There were no differences in age, sex, echocardiographic score distribution and echocardiographic mitral valve area (MVA). We performed 29 complete procedures with IB and 330 of 337 in SB group. Comparing IB and pre and pos-PMBV data we obtained: mean pulmonary artery pressure (MPAP) 36 +/- 15 and 39 +/- 14 mmHg, p = 0.2033, mean mitral gradient 17 +/- 6 and 20 +/- 77 mmHg, p = 0.0396 and MVA 0.9 +/- 0.2 and 0.9 +/- 0.2 cm2, p = 0.8043 and pos-PMBV:MPAP 25 +/- 8 and 28 +/- 10 mmHg, p = 0.2881, gradient 5 +/- 3 and 5 +/- 4 mmHg, p = 0.2778 and MVA 2.2 +/- 0.2 and 2.0 +/- 0.4 cm2, p = 0.0362. Mitral valve (MV) was competent in 26 patients in IB and in 280 in SB group and we had +/4 mitral regurgitation in 3 patients in IB and in 57 in SB group (p = 0.3591) pre-PMBV respectively and pos-PMBV there was also no difference in MV competence (p = 0.7439). Both techniques were effective. Hemodynamic data were also similar although MVA was greater in IB group after PMBV.

  4. Intra-aortic balloon pumps.

    PubMed

    1997-05-01

    Intra-aortic balloon pumps (IABPs) are circulatory assist devices used to treat a number of cardiovascular conditions. IABPs provide temporary circulatory support by reducing the resistance to blood flow out of the heart during systole and by providing added pressure to aid in perfusing the heart during diastole. In this Evaluation, we tested three IABPs from three suppliers. We examined the units' technical performance, safety and monitoring, human factors design, transport operation, and supplier support. Rather than test all the triggering (activation) modes available, we focused our testing on the modes most commonly used on each unit. We also provide information on an IABP currently available only in Japan; although we did not test this unit, we do provide a preliminary judgment based on the information provided to us by the supplier. In the Technology Overview also included in the Evaluation, we describe the basic operation and use of an IABP, as well as review the state of the art of this technology. And in the Selection, Purchasing, and Use Guide at the conclusion of the Evaluation, we discuss such topics as balloon costs and sizing, interfacing IABPs with patient monitors, and the use of IABPs in community hospitals.

  5. Terahertz Ballooning: STO And GUSSTO

    NASA Astrophysics Data System (ADS)

    Martin, Christopher L.; Stratospheric TeraHertz Observatory STO Team; Gal/Xgal U/LDB Spectroscopic/Stratospheric THz Observatory GUSSTO Team

    2012-01-01

    With a long duration balloon launch from Antarctica in December 2011, the Stratospheric TeraHertz Observatory (STO) is expected to have just completed its maiden science flight by the time of the AAS meeting. Our team will present some of the first glimpses from this mission to map the interstellar medium (ISM) in [CII], [NII], and [CI] at high spectral and spatial resolution. Additionally, NASA recently announced the missions that will begin Phase A studies under the Explorer Program, which included the Gal/Xgal U/LDB Spectroscopic/Stratospheric THz Observatory (GUSSTO). GUSSTO is a balloon-borne, 1 m off-axis telescope that will survey 300 square degrees of the Milky Way and Large Magellanic Cloud (LMC) in 3 important interstellar ines: [CII], [OI], and [NII] at 158, 63, and 205 microns, respectively. With these lines, GUSSTO will map the structure, dynamics, energy balance, pressure, and evolution of the ISM. Our poster will explain the concepts and plans for this exciting mission.

  6. Gastrointestinal fiberoptic endoscopy in pediatric patients and juveniles.

    PubMed

    Lux, G; Rösch, W; Phillip, J; Frühmorgen, P

    1978-08-01

    Over a period of 8 years 351 upper gastrointestinal endoscopies and 72 coloscopies were performed in infants, children and juvenile patients. Development of special pediatric instruments provides increasing application even to the youngest patients. Fiberendoscopy is a safe and sensitive diagnostic tool also in the pediatric age group; furthermore the therapeutic possibilities of operative endoscopy can be used without disadvantage.

  7. Electronic Endoscopy in Endoscopic Mucosal Resection (EMR) of Gastric Cancer

    PubMed Central

    Misaka, Ryouichi; Yamada, Michiru; Midorikawa, Shouko; Sanji, Tetuya; Shinohara, Satoshi; Morita, Shigefumi; Handa, Yutaka; Ohno, Hiroyuki; Saitou, Yasuhiko; Yosida, Hajime; Takase, Masahisa; Saitou, Toshihiko

    1995-01-01

    The role in which electronic endoscopy plays is important in EMR. It is useful in diagnosis and treatment of gastric cancer from a clinical viewpoint. EMR with use of electronic endoscopy allows better coordination between the operator and assistants, and thus improves the results further. PMID:18493367

  8. Laser-induced fluorescence spectroscopy at endoscopy

    NASA Astrophysics Data System (ADS)

    Qu, Jianan Y.; MacAulay, Calum E.; Lam, Stephen; Palcic, Branko

    1994-07-01

    A spectrofluorometry system has been developed for the collection of laser induced fluorescense spectra of tissue during endoscopy. In this system, a catheter with seven optical fibers was used to deliver the excitation light and collect the emitted fluorescence. The system enables one to switch from regular endoscopy into fluorescence measurement in 50 ms using a computerized shutter system. The fluorescence spectra can be recorded in 100 ms. This spectrofluorometry system has been used to obtain spectra from bronchial, larynx and nasopharyngeal tissues when employed with the appropriate endoscopes. The results demonstrate that laser induced fluorescence can be used to differentiate abnormal tissue from normal tissue. The illumination and fluorescence collection patterns of this system have been modeled using a Monte Carlo simulation. The Monte Carlo simulation data shows that the spectra recorded by our collection pattern is very close to the intrinsic spectra of tissue. The experimental results and the Monte Carlo simulation suggest that changes in fluorescence intensity are more robust for the detection of early cancers than the differences in spectral characteristics.

  9. Capsule endoscopy of the small bowel

    PubMed Central

    Ching, Hey-Long; Yung, Diana; Sidhu, Reena; Koulaouzidis, Anastasios

    2016-01-01

    Capsule endoscopy (CE) is a first line small bowel investigative modality which provides more sensitive mucosal imaging than comparators. It is a non-invasive, non-irradiating tool well tolerated by patients. The risk of retention of the capsule can be minimised by ensuring luminal patency using the Agile patency device. Research continues into how to minimise missed pathology and variability in the identification of pathology or interpretation of images. The consensus is that bowel preparation using laxatives improves visibility and diagnostic yield. Research includes the development of image recognition software, both to eliminate sequentially identical images to improve viewing speed and to select or enhance images likely to represent pathology. However, careful reading by experienced capsule endoscopists remains the benchmark. This should be performed at a speed comfortable to the viewer, probably at a maximum of 15 frames per second. Some prior experience of endoscopy appears to be helpful for novice capsule endoscopists and formal training on a hands-on training course seems to improve pathology recognition, for novices and for those with CE experience. PMID:27826572

  10. Quality Assurance in Endoscopy: Which Parameters?

    PubMed Central

    Denzer, Ulrike W.

    2016-01-01

    Background The verbalisation of quality standards and parameters by medical societies are relevant for qualitative improvement but may also be an instrument to demand more resources for health care or be a unique characteristic. Within the health care system 3 different quality levels can be defined: structure, process and result quality. Methods The current S2k guideline of the German Society for Gastroenterology (quality requirements for gastrointestinal endoscopy) AWMF registry no. 021-022 provides recommendations based on the available evidence for the structure quality (requirements for equipment, human resources) as well as for the process quality (patient preparation, conduct, documentation) and result quality (follow-up of specific endoscopic procedures). Results Based on these recommendations, measurable quality indicators/parameters for the endoscopy have been selected and formulated. General quality parameters for endoscopic examinations are given as well as quality parameters for specific procedures for the preparation, conduct, and follow-up of specific endoscopic interventions. Conclusion Only the regular review of processes and courses by means of defined measurement parameters builds up the basis for corrections based on facts. In addition, the implementation of recommended standards may be an instrument in demanding more resources from the health care system and, therefore, should be embedded as routine. PMID:27588295

  11. Endoscopy training in Canadian general surgery residency programs.

    PubMed

    Bradley, Nori L; Bazzerelli, Amy; Lim, Jenny; Wu Chao Ying, Valerie; Steigerwald, Sarah; Strickland, Matt

    2015-06-01

    Currently, general surgeons provide about 50% of endoscopy services across Canada and an even greater proportion outside large urban centres. It is essential that endoscopy remain a core component of general surgery practice and a core competency of general surgery residency training. The Canadian Association of General Surgeons Residents Committee supports the position that quality endoscopy training for all Canadian general surgery residents is in the best interest of the Canadian public. However, the means by which quality endoscopy training is achieved has not been defined at a national level. Endoscopy training in Canadian general surgery residency programs requires standardization across the country and improved measurement to ensure that competency and basic credentialing requirements are met.

  12. Endoscopy training in Canadian general surgery residency programs

    PubMed Central

    Bradley, Nori L.; Bazzerelli, Amy; Lim, Jenny; Ying, Valerie Wu Chao; Steigerwald, Sarah; Strickland, Matt

    2015-01-01

    Summary Currently, general surgeons provide about 50% of endoscopy services across Canada and an even greater proportion outside large urban centres. It is essential that endoscopy remain a core component of general surgery practice and a core competency of general surgery residency training. The Canadian Association of General Surgeons Residents Committee supports the position that quality endoscopy training for all Canadian general surgery residents is in the best interest of the Canadian public. However, the means by which quality endoscopy training is achieved has not been defined at a national level. Endoscopy training in Canadian general surgery residency programs requires standardization across the country and improved measurement to ensure that competency and basic credentialing requirements are met. PMID:26011848

  13. Ensuring patient safety and optimizing efficiency during gastrointestinal endoscopy.

    PubMed

    Deas, Tom; Sinsel, Lisa

    2014-03-01

    The volume of outpatient gastrointestinal (GI) endoscopy has grown dramatically in the past three decades, fueled by advancing technologies and evolving payment policies. This magnifies the need to ensure high-quality, safe, and cost-effective endoscopic services. In recent years, publicized breaches in standards of care for GI endoscopy have intensified the focus on patient safety. Because of these patient safety concerns and changes in regulatory policies, some ambulatory surgery center surveyors and inspectors have held GI endoscopy suites to the same standards as hospital ORs. The American Society for Gastrointestinal Endoscopy and other endorsing organizations drafted the Guidelines for Safety in the Gastrointestinal Endoscopy Unit, which published in January 2014. These safety guidelines relevant to sedation, infection control, staffing, training, technical equipment, traffic patterns, and personal protective equipment differ from other published guidelines for the outpatient surgical setting. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  14. Transcrestal sinus lift and implant placement using the sinus balloon technique

    PubMed Central

    Galán-Gil, Sónnica; Carrillo-García, Celia; Peñarrocha-Diago, David; Peñarrocha-Diago, Miguel

    2012-01-01

    Objective: A description is made of transcrestal sinus lift using the sinus balloon technique, evaluating the bone height achieved and implant success one year after prosthetic loading. Material and method: Between January and July 2007, transcrestal sinus lift using the sinus balloon technique for dental implant placement was carried out in 6 patients. A panoramic X-ray study and maxillary computed tomography scan were carried out before the operation, in order to discard possible sinus pathology. During the intervention, the integrity of the sinus membrane was evaluated using a Medi Pack Pal endoscope (Farol Store and Co., Tuttlingen, Germany), and the intraoperative complications were analyzed. The dental implants were placed in the same surgical step in the presence of 3 mm or more of residual bone. Following the operation, panoramic X-rays were used to assess the bone height gained. One year after prosthetic loading, the implant success rate was determined based on the criteria of Buser. Results: One patient was excluded due to Schneider’s membrane perforation as confirmed by endoscopy. Trans-crestal sinus lift was carried out in 5 males with a mean age of 41.6 years (range 27-51), without antecedents of sinus disease. There were no intraoperative complications. In four patients the implants were placed simultaneous to sinus lift, while in another case implant placement was postponed due to insufficient remaining bone height. The mean gain in height after the operation was 8.7 mm. One year after prosthetic loading, the implant success rate was 100%. Conclusions: Transcrestal sinus lift using the sinus balloon technique is a minimally invasive procedure. In 5 patients the bone height gained proved sufficient to allow implant placement even in the presence of 3 mm of residual bone. Key words: Sinus lift, balloon, sinus complications. PMID:22157670

  15. The Renaissance of Transcervical Balloon Catheters for Cervical Ripening and Labour Induction.

    PubMed

    Rath, W; Kehl, S

    2015-11-01

    Due to rising rates of labour induction in industrialised countries, safe and effective methods of induction have once again become a focus of interest and research. Prostaglandins are effective for cervical ripening and induction of uterine contractions. They do, however, cause overstimulation of the uterus in up to 20 % of cases, sometimes causing changes in fetal heart rate. Transcervical balloon catheters provide an alternative to prostaglandins for labour induction and have been used for this purpose for almost 50 years. This induction method has experienced a recent renaissance in clinical practice that is reflected in an annually rising number of publications on its use. Balloon catheters allow gentle ripening of the cervix without causing uterine overstimulation. The two catheters available are the Foley catheter (off-label use) and the double balloon catheter, which is licensed for use in induction of labour. Both are as effective as prostaglandins, and do not increase the risk of infection to mother or child. Catheter induction also requires less monitoring compared to prostaglandins resulting in improved patient satisfaction. Balloon catheters provide a useful and promising option to achieve vaginal delivery despite failed prostaglandin induction. Intravenous oxytocin is nevertheless required in up to 85 % of cases for adequate induction/augmentation of contractions. Balloon catheters, vaginal PGE2 and misoprostol are equally effective in the context of an unripe/unfavourable cervix, the rate of uterine hyperstimulation being significantly lower, and the need for oxytocin significantly higher for catheters. Balloon catheters are increasingly being used in combination or sequentially with oral/vaginal misoprostol, although there is currently inadequate published data on the subject. International guidelines recommend the use of balloon catheters for labour induction with an unripe cervix (also following previous caesarean section) as an alternative to

  16. The Renaissance of Transcervical Balloon Catheters for Cervical Ripening and Labour Induction

    PubMed Central

    Rath, W.; Kehl, S.

    2015-01-01

    Due to rising rates of labour induction in industrialised countries, safe and effective methods of induction have once again become a focus of interest and research. Prostaglandins are effective for cervical ripening and induction of uterine contractions. They do, however, cause overstimulation of the uterus in up to 20 % of cases, sometimes causing changes in fetal heart rate. Transcervical balloon catheters provide an alternative to prostaglandins for labour induction and have been used for this purpose for almost 50 years. This induction method has experienced a recent renaissance in clinical practice that is reflected in an annually rising number of publications on its use. Balloon catheters allow gentle ripening of the cervix without causing uterine overstimulation. The two catheters available are the Foley catheter (off-label use) and the double balloon catheter, which is licensed for use in induction of labour. Both are as effective as prostaglandins, and do not increase the risk of infection to mother or child. Catheter induction also requires less monitoring compared to prostaglandins resulting in improved patient satisfaction. Balloon catheters provide a useful and promising option to achieve vaginal delivery despite failed prostaglandin induction. Intravenous oxytocin is nevertheless required in up to 85 % of cases for adequate induction/augmentation of contractions. Balloon catheters, vaginal PGE2 and misoprostol are equally effective in the context of an unripe/unfavourable cervix, the rate of uterine hyperstimulation being significantly lower, and the need for oxytocin significantly higher for catheters. Balloon catheters are increasingly being used in combination or sequentially with oral/vaginal misoprostol, although there is currently inadequate published data on the subject. International guidelines recommend the use of balloon catheters for labour induction with an unripe cervix (also following previous caesarean section) as an alternative to

  17. Paclitaxel-coated balloon fistuloplasty versus plain balloon fistuloplasty only to preserve the patency of arteriovenous fistulae used for haemodialysis (PAVE): study protocol for a randomised controlled trial.

    PubMed

    Karunanithy, Narayan; Mesa, Irene Rebollo; Dorling, Anthony; Calder, Francis; Katsanos, Konstantinos; Semik, Vikki; Robinson, Emily; Peacock, Janet; Das, Neelanjan; Forman, Colin; Lawman, Sarah; Steiner, Kate; Wilkins, C Jason; Robson, Michael G

    2016-05-12

    The initial therapy for a stenosis in an arteriovenous fistula used for haemodialysis is radiological balloon dilatation or angioplasty. The benefit of angioplasty is often short-lived, intervention-free survival is reported to be 40-50 % at 1 year. Previous small studies and observational data suggest that paclitaxel-coated balloons may be of benefit in improving outcomes after fistuloplasty of stenotic arteriovenous fistulae. We have designed a multicentre, double-blind randomised controlled trial to test the superiority of paclitaxel-coated balloons for preventing restenosis after fistuloplasty in patients with a native arteriovenous fistula. Two hundred and eleven patients will be followed up for a minimum of 1 year. Inclusion criteria include a clinical indication for a fistuloplasty, an access circuit that is free of synthetic graft material or stents, and a residual stenosis of 30 % or less after plain balloon fistuloplasty. Exclusion criteria include a synchronous venous lesion in the same access circuit, location of the stenosis central to the thoracic inlet or a thrombosed access circuit at the time of treatment. The primary endpoint is time to end of target lesion primary patency. This is defined as a clinically-driven radiological or surgical re-intervention at the treatment segment, thrombosis that includes the treatment segment, or abandonment of the access circuit due to an inability to re-treat the treatment segment. Secondary endpoints include angiographic late lumen loss, time to end of access circuit cumulative patency, the total number of interventions, and quality of life. The trial is funded by the National Institute for Health Research. We anticipate that this trial will provide rigorous data that will determine the efficacy of additional paclitaxel-coated balloon fistuloplasty versus plain balloon fistuloplasty only to preserve the patency of arteriovenous fistulae used for haemodialysis. ISRCTN14284759 . Registered on 28 October 2015.

  18. Aldehyde disinfectants and health in endoscopy units. British Society of Gastroenterology Endoscopy Committee.

    PubMed

    Cowan, R E; Manning, A P; Ayliffe, G A; Axon, A T; Causton, J S; Cripps, N F; Hall, R; Hanson, P J; Harrison, J; Leicester, R J

    1993-11-01

    Summary of main recommendations(1) Glutaraldehyde, used in most endoscopy units in the United Kingdom for the disinfection of flexible gastrointestinal endoscopes, is a toxic substance being an irritant and a sensitiser; symptoms associated with glutaraldehyde exposure are common among staff working in endoscopy units.(2) The Control of Substances Hazardous to Health Regulations 1988 (COSHH) obliges the employer to make a systematic assessment of risk to staff of exposure to glutaraldehyde and institute measures to deal effectively with exposure.(3) At present glutaraldehyde remains the first line agent for the disinfection of flexible gastrointestinal endoscopes. Other agents are being developed; a standard means of assessment for flexible endoscope disinfectants should be devised.(4) Equipment and accessories that are heat stable should be sterilised by autoclaving; disposable accessories should be used wherever possible.(5) Flexible gastrointestinal endoscopes should be disinfected within automated washer/disinfectors; trays, bowls or buckets for this purpose are unacceptable.(6) Local exhaust ventilation must be used to control glutaraldehyde vapour. Extracted air may be discharged direct to the atmosphere or passed over special absorbent filters and recirculated. Such control measures must be regularly tested and records retained.(7) Endoscope cleaning and disinfection should be carried out in a room dedicated to the purpose, equipped with control measures to maintain the concentration of glutaraldehyde vapour at a level certainly below the current occupational exposure standard of 0.2 ppm and preferably below the commonly used working limit of 0.1 ppm. Sites other than the endoscopy unit where endoscopy is regularly performed, such as the radiology department, should have their own fully equipped cleaning and disinfection room.(8) COSHH limits the use of personal protective equipment to those situations where other measures cannot adequately control exposure

  19. [Percutaneous balloon mitral valvoplasty. Immediate results, complications and hospital outcome].

    PubMed

    Peixoto, E C; de Oliveira, P S; Netto, M S; Villella, R A; Labrunie, P; Borges, I P; Peixoto, R T

    1995-02-01

    To study the short-term results, complications and in-hospital follow-up of 223 percutaneous mitral balloon valvuloplasty (PMBV) procedures (proc)in 219 patients. It was used a single 20mm balloon diameter in 4 proc, double balloon in 7, Inoue balloon in 4 and low profile balloon in 196. The mean-age group was 37.19 years. One hundred eighty three (82.1%) procedures were performed in women (mean age, 36.99 years) and 40 (17.9%) in men (mean age, 38.10 years) (p = 0.63). Patients were in functional class II, (NYHA) in 25 (11.2%) procedures, class III in 165 (74.0%) and class IV in 33 (14.8%). Patients were in sinus rhythm in 182 procedures (81.6%) and in atrial fibrillation in 41 (18.4%). The echocardiographic score range from 4 to 14 (7.4% +/- 1.7). Among 4 and 11 were 98.2% of patients. We had 203 complete proc and success, mitral valve area (MVA) > or = 1.5cm2 after PMBV in 194 proc. Echocardiographic MVA before PMBV was 0.9 +/- 0.2cm2 and after 1.8 +/- 0.3cm2 (p < 0.01). Hemodynamic measures MVA before PMBV was 0.9 +/- 0.2cm2 and after was 1.9 +/- 0.3cm2 (p < 0.01). Mean pulmonary artery pressure decreased from 39 +/- 14mmHg to 27 +/- 11mmHg (p < 0.01) and mitral mean gradient from 20 +/- 9mmHg to 6 +/- 5mmHg (p < 0.01). In the 203 proc, mitral valve (MV) was competent in 176 and there were 1+ mitral regurgitation (MR) in 27. After PMBV, MV was competent in 126, and there were 1+ MR in 60, 2+ in 10.3+ in 6 and 4+ MR in 1. There was complication in 15 proc, severe MR in 7 (3 or 4+), stroke in 3 and cardiac tamponade in 5. Two patients died during emergency cardiac surgery after left ventricular perforation and one by stroke. PMBV was an effective procedure with a high grade of success and low rate of complication.

  20. Optical Coherence Tomography for Gastrointestinal Endoscopy

    NASA Astrophysics Data System (ADS)

    Kang, Wei; Qi, Xin; Wang, Hui; Rollins, Andrew M.

    Researchers have long been exploring OCT as a diagnostic tool for the early epithelial dysplastic changes in the gastrointestinal tract. One reason is that the subsurface microscopic changes are within the depth-penetrating and detail-resolving capability of OCT. However, endoscopically imaging a large lumen (i.e. esophagus and colon) has been challenging. In this chapter, the key technologies to overcome the obstacles are introduced: 1) Rapid imaging acquisition based on spectral-domain OCT technology; 2) Miniature scanning probe and balloon-based catheter for volumetric imaging; and 3) Image reconstruction and computer-aided diagnosis algorithms. Animal and clinical studies based on these technologies will be presented.

  1. Balloon-borne air traffic management (ATM) as a precursor to space-based ATM

    NASA Astrophysics Data System (ADS)

    Brodsky, Yuval; Rieber, Richard; Nordheim, Tom

    2012-01-01

    The International Space University—Balloon Air traffic control Technology Experiment (I-BATE ) has flown on board two stratospheric balloons and has tracked nearby aircraft by receiving their Automatic Dependent Surveillance-Broadcast (ADS-B) transmissions. Air traffic worldwide is facing increasing congestion. It is predicted that daily European flight volumes will more than double by 2030 compared to 2009 volumes. ADS-B is an air traffic management system being used to mitigate air traffic congestion. Each aircraft is equipped with both a GPS receiver and an ADS-B transponder. The transponder transmits an equipped aircraft's unique identifier, position, heading, and velocity once per second. The ADS-B transmissions can then be received by ground stations for use in traditional air traffic management. Airspace not monitored by these ground stations or other traditional means remains uncontrolled and poorly monitored. A constellation of space-based ADS-B receivers could close these gaps and provide global air traffic monitoring. By flying an ADS-B receiver on a stratospheric balloon, I-BATE has served as a precursor to a constellation of ADS-B-equipped Earth-orbiting satellites. From the ˜30 km balloon altitude, I-BATE tracked aircraft ranging up to 850 km. The experiment has served as a proof of concept for space-based air traffic management and supports a technology readiness level 6 of space-based ADS-B reception. I-BATE: International Space University—Balloon Air traffic control Technology Experiment.

  2. Heat Transfer Model for Hot Air Balloons

    NASA Astrophysics Data System (ADS)

    Llado-Gambin, Adriana

    A heat transfer model and analysis for hot air balloons is presented in this work, backed with a flow simulation using SolidWorks. The objective is to understand the major heat losses in the balloon and to identify the parameters that affect most its flight performance. Results show that more than 70% of the heat losses are due to the emitted radiation from the balloon envelope and that convection losses represent around 20% of the total. A simulated heating source is also included in the modeling based on typical thermal input from a balloon propane burner. The burner duty cycle to keep a constant altitude can vary from 10% to 28% depending on the atmospheric conditions, and the ambient temperature is the parameter that most affects the total thermal input needed. The simulation and analysis also predict that the gas temperature inside the balloon decreases at a rate of -0.25 K/s when there is no burner activity, and it increases at a rate of +1 K/s when the balloon pilot operates the burner. The results were compared to actual flight data and they show very good agreement indicating that the major physical processes responsible for balloon performance aloft are accurately captured in the simulation.

  3. A Low-Cost Sounding Balloon Experiment

    NASA Astrophysics Data System (ADS)

    Saba, Marcelo M. F.; Mirisola, Luiz G. B.; Iguchi, Marcio

    2005-12-01

    Watching the meteorological balloons customarily launched from our city, we wondered how we could develop an experiment to allow our students to effectively gather data about the low atmosphere and at the same time ke6ep our limited financial budget. When you hear about atmospheric balloons, you usually think about balloons with large envelopes of nylon or mylar with payloads between 1 or 10 kg. They ascend to very high altitudes, have a data radio transmitter, and are not recoverable. This setup would be too expensive for us. In order to keep the cost low, the payload containing the data recorded had to be recovered, and therefore, the balloon must not go tens of kilometers away. We ruled out tethered balloons, which would not have recovery problems but can hardly go beyond 100 m high because of the weight of the tether and of lateral winds. Based on some estimates of ascension speed for small balloons and probable horizontal wind intensities, we decided that in order to easily recover the payload we had to limit its ascension to about 2 km high. At this altitude, the payload would have to be released from the balloon by means of a timer.

  4. Investigating Diffusion and Entropy with Carbon Dioxide-Filled Balloons

    ERIC Educational Resources Information Center

    Jadrich, James; Bruxvoort, Crystal

    2010-01-01

    Fill an ordinary latex balloon with helium gas and you know what to expect. Over the next day or two the volume will decrease noticeably as helium escapes from the balloon. So what happens when a latex balloon is filled with carbon dioxide gas? Surprisingly, carbon dioxide balloons deflate at rates as much as an order of magnitude faster than…

  5. Investigating Diffusion and Entropy with Carbon Dioxide-Filled Balloons

    ERIC Educational Resources Information Center

    Jadrich, James; Bruxvoort, Crystal

    2010-01-01

    Fill an ordinary latex balloon with helium gas and you know what to expect. Over the next day or two the volume will decrease noticeably as helium escapes from the balloon. So what happens when a latex balloon is filled with carbon dioxide gas? Surprisingly, carbon dioxide balloons deflate at rates as much as an order of magnitude faster than…

  6. Accurate Determination of the Volume of an Irregular Helium Balloon

    ERIC Educational Resources Information Center

    Blumenthal, Jack; Bradvica, Rafaela; Karl, Katherine

    2013-01-01

    In a recent paper, Zable described an experiment with a near-spherical balloon filled with impure helium. Measuring the temperature and the pressure inside and outside the balloon, the lift of the balloon, and the mass of the balloon materials, he described how to use the ideal gas laws and Archimedes' principal to compute the average molecular…

  7. Accurate Determination of the Volume of an Irregular Helium Balloon

    ERIC Educational Resources Information Center

    Blumenthal, Jack; Bradvica, Rafaela; Karl, Katherine

    2013-01-01

    In a recent paper, Zable described an experiment with a near-spherical balloon filled with impure helium. Measuring the temperature and the pressure inside and outside the balloon, the lift of the balloon, and the mass of the balloon materials, he described how to use the ideal gas laws and Archimedes' principal to compute the average molecular…

  8. Fracture characteristics of balloon films

    NASA Technical Reports Server (NTRS)

    Portanova, Marc A.

    1989-01-01

    An attempt was made to determine the failure modes of high altitude scientific balloons through an investigation of the fracture characteristics of the thin polyethylene films. Two films were the subject of the evaluation, Winzen Int.'s Stratafilm SF-85 and Raven Industries' Astro-E. Research began with an investigation of the film's cold brittleness point and it's effect on the ultimate strength and elasticity of the polyethylene film. A series of preliminary investigations were conducted to develop an understanding of the material characteristics. The primary focus of this investigation was on the notch sensitivity of the films. Simple stress strain tests were also conducted to enable analysis employing fracture toughness parameters. Studies were conducted on both film types at 23 C (room temperature), -60 C, -90 C, and -120 C.

  9. High-altitude balloon experiment

    NASA Astrophysics Data System (ADS)

    Browning, William M.; Olson, David S.; Keenan, Donald E.

    1999-08-01

    The mission of the HABE is to resolve critical acquisition, tracking, and pointing (ATP) and fire control issues, validate enabling technologies, simulations, and models, and acquire supporting data for future space-based lasers experiments. HABE is integrating components from existing technologies into a payload that can autonomously acquire, track, and point a low power laser at a ballistic missile in its boost phase of flight. For its primary mission the payload will be flown multiple times to an altitude of 85,000 feet above the White Sands Missile Range. From the near-space environment of the balloon flight, HABE will demonstrate the ATP functions required for a space-based laser in a ballistic missile defense role. The HABE platform includes coarse and fine gimbal pointing, IR and visible passive tracking, active fine tracking, internal auto- alignment and boresighting,and precision line-of-sight stabilization functions. This paper presents an overview and status of the HABE program.

  10. The testing of balloon fabrics

    NASA Technical Reports Server (NTRS)

    Edwards, Junius David; Moore, Irwin L

    1920-01-01

    Report describes methods and materials used in waterproofing and fireproofing airplane fabrics using dopes. The determination of the probable life of a balloon fabric in service by experimental means is of great value in choosing the most suitable fabrics for a given purpose and in pointing the way to improvements in compounding and construction. The usefulness of exposure to the weather for this purpose has been amply demonstrated. Various attempts have been made to reproduce by artificial means the conditions promoting deterioration in service, but without marked success. Exposure to the weather remains the most satisfactory method for this purpose, and a consideration of the characteristics of such tests is therefore important. This report presents the results of a typical series of exposure tests made in 1917.

  11. Hindfoot endoscopy for posterior ankle impingement.

    PubMed

    Scholten, P E; Sierevelt, I N; van Dijk, C N

    2008-12-01

    The surgical treatment of posterior ankle impingement is associated with a high rate of complications and a substantial time to recover. An endoscopic approach to the posterior ankle (hindfoot endoscopy) may lack these disadvantages. We hypothesized that hindfoot endoscopy causes less morbidity and facilitates a quick recovery compared with open surgery. Fifty-five consecutive patients with posterior ankle impingement were treated with an endoscopic removal of bone fragments and/or scar tissue. The symptoms were caused by trauma (65%) or overuse (35%). All patients were enrolled in a prospective protocol. At baseline, the age, sex, work and sports activities, American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scores, and preinjury Tegner scores were determined for all patients. At the time of follow-up, AOFAS hindfoot scores and Tegner scores were assessed and the time to return to work and sports activities was determined. Complications were recorded. Patients scored the overall result as poor, fair, good, or excellent by means of a 4-point Likert scale. The median duration of follow-up was thirty-six months, and no patient was lost to follow-up. The median AOFAS hindfoot score increased from 75 points preoperatively to 90 points at the time of final follow-up. The median time to return to work and sports activities was two and eight weeks, respectively. At the time of follow-up, patients in the overuse group were more satisfied than those in the posttraumatic group, and the AOFAS hindfoot scores were higher in patients in the overuse group (median, 100 points) compared with patients in the posttraumatic group (median, 90 points). A complication occurred in one patient who had a temporary loss of sensation of the posteromedial aspect of the heel. The outcome after endoscopic treatment of posterior ankle impingement compares favorably with the results of open surgery reported in the literature. Hindfoot endoscopy appears to cause less morbidity than open

  12. The balloon and the airship technological heritage

    NASA Technical Reports Server (NTRS)

    Mayer, N. J.

    1981-01-01

    The balloon and the airship are discussed with emphasis on the identification of commonalities and distinctions. The aerostat technology behind the shape and structure of the vehicles is reviewed, including a discussion of structural weight, internal pressure, buckling, and the development of a stable tethered balloon system. Proper materials for the envelope are considered, taking elongation and stress into account, and flight operation and future developments are reviewed. Airships and tethered balloons which are designed to carry high operating pressure with low gas loss characteristics are found to share similar problems in low speed flight operations, while possessing interchangeable technologies.

  13. Stress analysis of an ascending balloon

    NASA Technical Reports Server (NTRS)

    Rand, James L.; Seely, Loren G.

    1988-01-01

    The effects of various realistic phenomena on the changing stress patterns that occur during the ascent of a typical stratospheric balloon are investigated. The meridional load distribution is shown to be relatively constant during ascent until the material at the base of the balloon begins to deploy, at which time the loads begin to increase. As the balloon assumes its float configuration, the loads are found to increase by as much as 50 percent over the ascent values. The effects of payload changes and thermal strain are also considered.

  14. Stratospheric electric field measurements with transmediterranean balloons

    NASA Astrophysics Data System (ADS)

    de La Morena, B. A.; Alberca, L. F.; Curto, J. J.; Holzworth, R. H.

    1993-01-01

    The horizontal component of the stratospheric electric field was measured using a balloon in the ODISEA Campaign of Transmediterranean Balloon Program. The balloon flew between Trapani (Sicily) and El Arenosillo (Huelva, Spain) along the 39 deg N parallel at a height between 34 and 24 km. The high values found for the field on fair-weather and its quasi-turbulent variation, both in amplitude and direction, are difficult to explain with the classical electric field source. A new source, first described by Holzworth (1989), is considered as possibly causing them.

  15. Balloon cell change in cellular blue nevus.

    PubMed

    Perez, M T; Suster, S

    1999-04-01

    Balloon cells are altered melanocytes with clear vacuolated cytoplasm caused by a defect in the process of melanogenesis. Although rare, balloon cell change has been observed in a variety of melanocytic proliferations, particularly intradermal melanocytic nevi and melanoma. When present, such features may lead to difficulties in diagnosis, particularly with other clear cell neoplasms. We report an unusual case of the development of balloon cell change in a cellular blue nevus, a phenomenon that has not been extensively addressed in the literature. The importance of recognizing this change in cellular blue nevus to avoid misinterpreting the lesion as malignant is discussed.

  16. A balloon-borne integrating nephelometer

    SciTech Connect

    Brown, G.S.; Apple, M.L. ); Weiss, R.E. )

    1990-09-01

    A balloon-borne integrating nephelometer has been successfully developed and flown by Sandia National Laboratories and Radiance Research. This report details instrument design, calibration and data conversion procedure. Free and tethered balloon transport and telemetry systems are described. Data taken during March 1989 South-Central New Mexico free flight ascents are presented as vertical profiles of atmospheric particle scattering coefficient, temperature and balloon heading. Data taken during December 1989 Albuquerque, New Mexico tethered flights are also presented as vertical profiles. Data analysis shows superior instrument performance. 5 refs., 22 figs.

  17. Does magnetically assisted capsule endoscopy improve small bowel capsule endoscopy completion rate? A randomised controlled trial

    PubMed Central

    Hale, Melissa F.; Drew, Kaye; Sidhu, Reena; McAlindon, Mark E.

    2016-01-01

    Background and study aims: Delayed gastric emptying is a significant factor in incomplete small bowel capsule examinations. Gastric transit could be hastened by external magnetic control of the capsule. We studied the feasibility of this approach to improve capsule endoscopy completion rates. Patients and methods: Prospective, single-center, randomized controlled trial involving 122 patients attending for small bowel capsule endoscopy using MiroCam Navi. Patients were randomized to either the control group (mobilisation for 30 minutes after capsule ingestion, followed by intramuscular metoclopramide 10 mg if the capsule failed to enter the small bowel) or the intervention group (1000 mL of water prior to capsule ingestion, followed by positional change and magnetic steering). Outcome measures were capsule endoscopy completion rate, gastric clarity and distention, relationship of body habitus to capsule endoscopy completion rate (CECR), and patient comfort scores. Results: 122 patients were recruited (61 each to the control and intervention groups: mean age 49 years [range 21 – 85], 61 females). There was no significant difference in CECR between the two groups (P = 0.39). Time to first pyloric image was significantly shorter in the intervention group (P = 0.03) but there was no difference in gastric transit times (P = 0.12), suggesting that magnetic control hastens capsular transit to the gastric antrum but does not influence duodenal passage. Gastric clarity and distention were significantly better in the intervention group (P < 0.0001 and P < 0.0001 respectively). Conclusions: Magnetic steering of a small bowel capsule is unable to overcome pyloric contractions to enhance gastric emptying and improve capsule endoscope completion rate. Excellent mucosal visualisation within the gastric cavity suggests this technique could be harnessed for capsule examination of the stomach. PMID:26878053

  18. Live endoscopy events (LEEs): European Society of Gastrointestinal Endoscopy Position Statement - Update 2014.

    PubMed

    Dinis-Ribeiro, Mário; Hassan, Cesare; Meining, Alexander; Aabakken, Lars; Fockens, Paul

    2015-01-01

    The European Society of Gastrointestinal Endoscopy (ESGE) is dedicated to improving the quality of gastrointestinal endoscopy through educational activities such as live endoscopy events (LEEs). The primary utility of LEEs is the educational value for the audience, and patients should not expect additional benefit from being treated during a LEE compared to a routine setting. Although there is no evidence that LEEs entail additional risks for patients, neither can possible unknown risks be excluded as the evidence available is limited. Therefore, necessary measures should be taken to assure patient safety. Patients must be adequately informed that the standard of care will be assured and that their identity will not be revealed. ESGE recommends that an endoscopist not belonging to the hosting unit is named as patient advocate. Clinical indications for the LEE procedures and the educational outputs must be clear and agreed between host and demonstrator teams. ESGE will ensure that in all ESGE-organized LEEs the indications, procedural descriptions, and adverse events will be registered, and that organizers requesting ESGE endorsement can demonstrate such a registry.

  19. In-vivo multispectral video endoscopy towards in-vivo hyperspectral video endoscopy.

    PubMed

    Hohmann, Martin; Kanawade, R; Klämpfl, F; Douplik, A; Mudter, J; Neurath, M F; Albrecht, H

    2017-04-01

    For in-vivo diagnostics of cancer and pre-cancer in the stomach, there is no endoscopic procedure offering both high sensitivity and high specificity. Our data suggest that multispectral or hyperspectral imaging may be helpful to solve this problem. It is successfully applied to the detection and analysis of easily reachable carcinomas, ex-vivo samples of hollow organ mucosal carcinomas and also histological samples. An endoscopy system which allows flexible multispectral videoendoscopy for in-vivo diagnostics has so far been unavailable. To overcome this problem, we modified a standard Olympus endoscopy system to conduct in-vivo multispectral imaging of the upper GI tract. The pilot study is performed on 14 patients with adeno carcinomas in the stomach. For analysis, Support Vector Machine with linear and Gaussian Kernel, AdaBoost, RobustBoost and Random-Forest-walk are used and compared for the data classification with a leave-one-out strategy. The margin of the carcinoma for the training of the classifier is drawn by expert-labeling. The cancer findings are cross-checked by biopsies. We expect that the present study will help to improve the further development of hyperspectral endoscopy and to overcome some of the problems to be faced in this process. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Response of Balloon-Expandable Endoprosthetic Metallic Stents Subjected to Over-Expansion In Vitro

    SciTech Connect

    Montague, B. J.; Kakimoto, W. M.; Arepally, A.; Razavi, M.; Dake, M. D.; Hofmann, L. V.

    2004-03-15

    We attempted to evaluate the in vitro behavior and performance of balloon-expandable endoprosthetic metallic stents subjected to over-expansion (OE). Seventy-two balloon-expandable endoprosthetic stents, representing 22 models from six manufacturers, were over- expanded in vitro. Stents were initially expanded to their maximum manufacturer- recommended diameter and then over-expanded incrementally to their endpoints. Endpoints for OE were either stent disarticulation or an inability to undergo further expansion despite balloon insufflation to maximum burst pressure. Measurements of stent dimensions were recorded at each overexpanded diameter and comparisons were made to manufacturer's specifications. A total of 288 balloon-driven expansions were performed on 72 stents. Sixteen stents were expanded to large diameters ({>=} 16 mm), 20 stents underwent OE of 50% or greater. One model tended to disarticulate after OE greater than 50%. There were five models that had a tendency to disarticulate after minimal OE. Five models were resistant to OE (25% or less OE) but did not disarticulate. Nearly all stents showed some degree of foreshortening with OE, while 36 stents underwent foreshortening of 30% or more. Models that are not recommended for OE include Intrastent, Intrastent DoubleStrut, NIR Royale and Omniflex. Good candidates for OE include Intrastent DoubleStrut LD, Palmaz large, Medtronic Extra Support Biliary Plus and Medtronic Flexible Biliary. Palmaz XL remains the only model available for expansion from 20 to 28 mm in diameter. For the remaining stents, OE is possible, however, caution should be used.

  1. Multilevel wireless capsule endoscopy video segmentation

    NASA Astrophysics Data System (ADS)

    Hwang, Sae; Celebi, M. Emre

    2010-03-01

    Wireless Capsule Endoscopy (WCE) is a relatively new technology (FDA approved in 2002) allowing doctors to view most of the small intestine. WCE transmits more than 50,000 video frames per examination and the visual inspection of the resulting video is a highly time-consuming task even for the experienced gastroenterologist. Typically, a medical clinician spends one or two hours to analyze a WCE video. To reduce the assessment time, it is critical to develop a technique to automatically discriminate digestive organs and shots each of which consists of the same or similar shots. In this paper a multi-level WCE video segmentation methodology is presented to reduce the examination time.

  2. Optimal Bowel Preparation for Video Capsule Endoscopy

    PubMed Central

    Song, Hyun Joo; Moon, Jeong Seop; Shim, Ki-Nam

    2016-01-01

    During video capsule endoscopy (VCE), several factors, such as air bubbles, food material in the small bowel, and delayed gastric and small bowel transit time, influence diagnostic yield, small bowel visualization quality, and cecal completion rate. Therefore, bowel preparation before VCE is as essential as bowel preparation before colonoscopy. To date, there have been many comparative studies, consensus, and guidelines regarding different kinds of bowel cleansing agents in bowel preparation for small bowel VCE. Presently, polyethylene glycol- (PEG-) based regimens are given primary recommendation. Sodium picosulphate-based regimens are secondarily recommended, as their cleansing efficacy is less than that of PEG-based regimens. Sodium phosphate as well as complementary simethicone and prokinetics use are considered. In this paper, we reviewed previous studies regarding bowel preparation for small bowel VCE and suggested optimal bowel preparation of VCE. PMID:26880894

  3. Validation of the Global Rating Scale for endoscopy.

    PubMed

    Williams, T; Ross, A; Stirling, C; Palmer, K; Phull, P S

    2013-02-01

    The Global Rating Scale for endoscopy is a web-based tool that can be used to assess and improve the quality of an endoscopy service. It was developed by asking endoscopy health professionals what they would want from the service for themselves or their relatives if they were undergoing an endoscopic procedure. To date, the Global Rating Scale has not been validated by patients themselves. We used focus groups in order to access the views and opinions of patients who had recently had experience of endoscopy services. Six focus groups were undertaken in five different Health Board areas across Scotland; in total 26 people participated. The results indicated that from the patients' perspective the 12 items of the GRS covered all areas of the endoscopy experience. There were no specific concerns identified that were not already covered within the Global Rating Scale. We conclude that the Global Rating Scale does address quality issues that matter to patients undergoing endoscopy, and validates the use of the GRS as a quality assessment tool for endoscopy services.

  4. Safety of deep sedation in the endoscopy suite.

    PubMed

    Allen, Megan L

    2017-08-01

    As the complexity of endoscopic procedures increases, the use of propofol and the desire for deep sedation are becoming more common in the endoscopy suite. This review explores sedation depth, agents used for sedation, recommended monitoring, and adverse event risks that occur during sedation for endoscopy. The sedation provider for endoscopy varies by practice location and with regulatory requirements. As increasingly deep levels of sedation are used in this setting, the need for all providers to have training in the ability to rescue patients from sedation-related side effects is paramount. Propofol has an important role for prolonged and uncomfortable endoscopic interventions and has a strong safety record in the endoscopy suite. Vital signs monitoring is recommended during all endoscopy sedation, and there is emerging interest in advanced monitoring (e.g., capnography, processed electroencephalogram, respiratory monitoring) in this setting. The reported rate of adverse events during endoscopy sedation varies widely; however, advanced age and increasing American Society of Anesthesiologists physical status score are consistently associated with increased risk. Whether anesthesiologist-administered sedation is safer than non-anesthesiologist-administered sedation remains controversial. This review provides some guidance to providers who administer sedation in the endoscopy suite and is intended to improve the safety of patients. The recommendations are based on best available evidence and expert opinion.

  5. Diagnostic Yield of Microscopic Colitis in Open Access Endoscopy Center.

    PubMed

    Ellingson, Derek; Miick, Ronald; Chang, Faye; Hillard, Robert; Choudhary, Abhishek; Ashraf, Imran; Bechtold, Matthew; Diaz-Arias, Alberto

    2011-08-01

    The diagnostic yield in open access endoscopy has been evaluated which generally support the effectiveness and efficiency of open access endoscopy. With a few exceptions, diagnostic yield studies have not been performed in open access endoscopy for more specific conditions. Therefore, we conducted a study to determine the efficiency of open access endoscopy in the detection of microscopic colitis as compared to traditional referral via a gastroenterologist. A retrospective search of the pathology database at the University of Missouri for specimens from a local open access endoscopy center was conducted via SNOMED code using the terms: "microscopic", "lymphocytic", "collagenous", "spirochetosis", "focal active colitis", "melanosis coli" and "histopathologic" in the diagnosis line for the time period between January 1, 2004 and May 25, 2006. Specimens and colonoscopy reports were reviewed by a single pathologist. Of 266 consecutive patients with chronic diarrhea and normal colonoscopies, the number of patients with microscopic disease are as follows: Lymphocytic colitis (n = 12, 4.5%), collagenous colitis (n = 17, 6.4%), focal active colitis (n = 15, 5.6%), and spirochetosis (n = 2, 0.4%). The diagnostic yield of microscopic colitis in this study of an open access endoscopy center does not differ significantly from that seen in major medical centers. In terms of diagnostic yield, open access endoscopy appears to be as effective in diagnosing microscopic colitis.

  6. Video capsule endoscopy in inflammatory bowel disease

    PubMed Central

    Collins, Paul D

    2016-01-01

    Video capsule endoscopy (VCE) has evolved to become an important tool for the non-invasive examination of the small bowel, which hitherto had been relatively inaccessible to direct visualisation. VCE has been shown to play a role in monitoring the activity of small bowel Crohn’s disease and can be used to assess the response to anti-inflammatory treatment in Crohn’s disease. For those patients with Crohn’s disease who have undergone an intestinal resection, VCE has been assessed as a tool to detect post-operative recurrence. VCE may also aid in the reclassification of patients with a diagnosis of Inflammatory Bowel Disease Unclassified to Crohn’s disease. The evolution of colon capsule endoscopy (CCE) has expanded the application of this technology further. The use of CCE to assess the activity of ulcerative colitis has been described. This advance in capsule technology has also fuelled interest in its potential role as a minimally invasive tool to assess the whole of GI tract opening the possibility of its use for the panenteric assessment of Crohn’s disease. VCE is a safe procedure. However, the risk of a retained capsule is higher in patients with suspected or confirmed Crohn’s disease compared with patients having VCE examination for other indications. A retained video capsule is rare after successful passage of a patency capsule which may be utilised to pre-screen patients undergoing VCE. This paper describes the use of VCE in the assessment of inflammatory bowel disease. PMID:27499830

  7. Miniature Grating for Spectrally-Encoded Endoscopy

    PubMed Central

    Kang, Dongkyun; Martinez, Ramses V.; Whitesides, George M.

    2013-01-01

    Spectrally-encoded endoscopy (SEE) is an ultraminiature endoscopy technology that acquires high-definition images of internal organs through a sub-mm endoscopic probe. In SEE, a grating at the tip of the imaging optics diffracts the broadband light into multiple beams, where each beam with a distinctive wavelength is illuminated on a unique transverse location of the tissue. By encoding one transverse coordinate with the wavelength, SEE can image a line of the tissue at a time without using any beam scanning devices. This feature of the SEE technology allows the SEE probe to be miniaturized to sub-mm dimensions. While previous studies have shown that SEE has the potential to be utilized for various clinical imaging applications, the translation of SEE for medicine has been hampered by challenges in fabricating the miniature grating inherent to SEE probes. This paper describes a new fabrication method for SEE probes. The new method uses a soft lithographic approach to pattern a high-aspect-ratio grating at the tip of the miniature imaging optics. Using this technique, we have constructed a 500-μm-diameter SEE probe. The miniature grating at the tip of the probe had a measured diffraction efficiency of 75%. The new SEE probe was used to image a human finger and formalin fixed mouse embryos, demonstrating the capability of this device to visualize key anatomic features of tissues with high image contrast. In addition to providing high quality imaging SEE optics, the soft lithography method allows cost-effective and reliable fabrication of these miniature endoscopes, which will facilitate the clinical translation of SEE technology. PMID:23503940

  8. Development and validation of the Gastrointestinal Endoscopy Satisfaction Questionnaire (GESQ).

    PubMed

    Hutchings, Hayley A; Cheung, Wai-Yee; Alrubaiy, Laith; Durai, Dharmaraj; Russell, Ian T; Williams, John G

    2015-12-01

    Patient satisfaction is a key indicator of the quality of gastrointestinal (GI) endoscopy. The aim of this study was to develop and validate a specific patient satisfaction questionnaire for patients undergoing GI endoscopy--the Gastrointestinal Endoscopy Satisfaction Questionnaire (GESQ). We developed and validated the GESQ within the context of a national multi-institution nurse endoscopy trial, based in secondary care, in three stages: (1) item generation with a panel of patients and professionals following a detailed literature review to identify the most relevant items from existing scales; (2) development and piloting of a draft questionnaire on a sample of patients referred for GI endoscopy; and (3) testing of the questionnaire within a large multicenter pragmatic randomized trial. We undertook psychometric analysis of the questionnaire to identify the underlying dimensions and assessed the questionnaire for reliability and validity. The final version of the GESQ contains 21 items. Principal components analysis revealed four subscales with high internal consistency: skills and hospital (seven items; Cronbach's alpha 0.83), pain and discomfort during and after endoscopy (four items; Cronbach's alpha 0.84), information before endoscopy (five items; Cronbach's alpha 0.80), and information after endoscopy (five items; Cronbach's alpha 0.76). The four identified subscales are clinically relevant and correspond to domains of patient satisfaction identified in previous studies. Our development and validation of the GESQ confirmed that it is a valid, reliable, interpretable, and acceptable tool to measure satisfaction in patients who have undergone a GI endoscopy. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Recent Developments in Balloon Support Instrumentation at TIFR Balloon Facility, Hyderabad.

    NASA Astrophysics Data System (ADS)

    Vasudevan, Rajagopalan

    2012-07-01

    The Balloon Facility of Tata Institute of Fundamental Research has been conducting stratospheric balloon flights regularly for various experiments in Space Astronomy and Atmospheric Sciences. A continuous improvement in Balloon flight Support instrumentation by the Control Instrumentation Group to keep in space with the growing complexities of the scientific payloads have contributed to the total success of balloon flights conducted recently. Recent improvements in display of Balloon position during balloon flight by showing on real time the balloon GPS position against Google TM maps is of immense help in selecting the right spot for payload landing and safe recovery . For further speeding up the payload recovery process, a new GPS-GSM payload system has been developed which gives SMS of the payload position information to the recovery team on their cell phones. On parallel footing, a new GPS- VHF system has been developed using GPS and Radio Modems for Balloon Tracking and also for obtaining the payload impact point. On the Telecommand side, a single board Telecommand/ Timer weighing less than 2 Kg has been specially developed for use in the mesosphere balloon test flight. The interference on the existing Short Range Telemetry System has been eliminated by introducing a Band Pass Filter and LNA in the Receiving system of the modules, thereby enhancing its reliability. In this paper , we present the details of the above mentioned developments.

  10. Endoscopist Specialty Is Associated with High-Quality Endoscopy in Korea

    PubMed Central

    Cha, Jae Myung; Lee, Hang Lack; Kim, Young Ho; Chung, Il-Kwun; Kim, Hyun Soo; Moon, Jeong Seop; Cho, Yu Kyung

    2012-01-01

    Purpose The present study was aimed to determine whether endoscopist specialty is associated with high-quality endoscopy. Materials and Methods We prospectively collected endoscopy quality related data based on the Endoscopy Quality Rating Scale (EQRS) of 277 endoscopy units in a hospital setting from the National Cancer Screening Program of Korea in 2009. Gastroenterology medical professors (n=154) from university hospitals visited each endoscopy unit and graded the unit according to the EQRS. The scores from the EQRS were analyzed and compared in relation to endoscopy training during residency and endoscopy subspecialist certification. Results After excluding data from 3 endoscopy units, EQRS data from 274 endoscopy units were analyzed: 263 esophagogastroduodenoscopy (EGD) screening units and 90 colonoscopy screening units. There were no significant differences in the scores of EQRS with respect to endoscopy training during residency (p=no significance), except for scores of EGDs for "Facility and Equipment" (p=0.030). However, EQRS scores were significantly higher in the endoscopy units where endoscopy subspecialists performed the endoscopies than those where Endoscopy Subspecialists did not perform the endoscopies (p<0.05, except p=0.08 for the "Process" criteria of EGD). Conclusion Endoscopist specialty is an important determinant of high-quality endoscopy in Korea. PMID:22318818

  11. Sedation and Monitoring in the Pediatric Patient during Gastrointestinal Endoscopy.

    PubMed

    Chung, Hyun Kee; Lightdale, Jenifer R

    2016-07-01

    Sedation is a fundamental component of pediatric gastrointestinal procedures. The 2 main types of sedation for pediatric endoscopy remain general anesthesia and procedural sedation. Although anesthesiologist-administered sedation protocols are more common, there is no ideal regimen for endoscopy in children. This article discusses specific levels of sedation for endoscopy as well as various regimens that can be used to achieve each. Risks and considerations that may be specific to performing gastrointestinal procedures in children are reviewed. Finally, potential future directions for sedation and monitoring that may change the practice of pediatric gastroenterology and ultimately patient outcomes are examined.

  12. The Value of Endoscopy in a Wildlife Raptor Service.

    PubMed

    Desmarchelier, Marion R; Ferrell, Shannon T

    2015-09-01

    Although endoscopy is part of the basic standard of care in most avian practices, many wildlife rehabilitation centers do not have access to the equipment or do not use it on a regular basis. Endoscopic equipment is easily available at a lower cost on the used market or can be acquired through donations from local human hospitals. Several medical conditions encountered in wild raptors have an improved prognosis if they are diagnosed or treated early with the aid of endoscopy. In many cases, endoscopy provides a noninvasive alternative to exploratory surgery, saving cost and time and decreasing postoperative pain.

  13. The Helium Balloon Project: Expanding Student Horizons...

    ERIC Educational Resources Information Center

    Leyden, Michael B.

    1973-01-01

    An activity involving future elementary school teachers designed around inexpensive balloons which when launched contained postcards to determine the geographic location of the landing. The investigation is student-centered, involving unknown questions, and was conducted for enjoyment. (DF)

  14. MRI temperature mapping during thermal balloon angioplasty.

    PubMed

    Shmatukha, Andriy V; Bakker, Chris J G

    2006-04-21

    Knowledge on the thermal dose delivered during thermal balloon angioplasty (TBA) is desirable to understand why TBA's outcome varies widely among patients and why it is subject to high restenosis rates. In its conventional implementation, TBA involves injection of a heated medium into a balloon positioned within a stenotic blood vessel. The medium injection causes flow, motion and susceptibility-redistribution artefacts that are devastating to the proton resonance frequency shift (PRFS) technique of MRI temperature mapping. Here, we propose to separate in time medium injection and heating by first inflating a balloon with a medium at an initial temperature, and then by heating the medium up using laser light. The separation is shown to eliminate all the mentioned artefacts and to enable real-time MRI temperature mapping using the PRFS technique. Accurate and reliable temperature maps were acquired in a TBA balloon itself and in the surrounding phantom tissue during heat application.

  15. Balloon Thermal Model Design Parameters and Sensitivities

    NASA Technical Reports Server (NTRS)

    Ferguson, Douglas

    2017-01-01

    This presentation describes the thought process for determining balloon thermal model design parameters, including environmental parameters taken form NASA's top-of-atmosphere (TOA) database, and shows the sensitivity of an example model's key temperature results to those input parameters.

  16. Deployment Instabilities of Lobed-Pumpkin Balloon

    NASA Astrophysics Data System (ADS)

    Nakashino, Kyoichi

    A lobed-pumpkin balloon, currently being developed in ISAS/JAXA as well as in NASA, is a promising vehicle for long duration scientific observations in the stratosphere. Recent ground and flight experiments, however, have revealed that the balloon has deployment instabilities under certain conditions. In order to overcome the instability problems, a next generation SPB called 'tawara' type balloon has been proposed, in which an additional cylindrical part is appended to the standard lobed-pumpkin balloon. The present study investigates the deployment stability of tawara type SPB in comparison to that of standard lobed-pumpkin SPB through eigenvalue analysis on the basis of finite element methods. Our numerical results show that tawara type SPB enjoys excellent deployment performance over the standard lobed-pumpkin SPBs.

  17. Balloon Measurements of Winds in Planetary Atmospheres

    NASA Astrophysics Data System (ADS)

    Wayne, S.; Kitchen, A.; Perry, R.; Petersen, P.; Slater, J.; Oudrhiri, K.; Asmar, S.; Atkinson, D.

    2014-06-01

    Atmospheric dynamics can be better measured if data is recorded from many spatially separated capsules. One method under study is to use a planetary lander that releases multiple balloon-bourne transceivers that can be Doppler tracked by the lander.

  18. Balloon mania: news in the air.

    PubMed

    Kim, Mi Gyung

    2004-12-01

    The hot-air balloon, invented by the Montgolfier brothers in 1783, enabled the French King to project his glory, the nobility to exhibit their valor, the literary public to transmit the ideal of the Enlightenment and the plebian public to rejoice in a scientific spectacle. The ensuing balloon mania helped create an integrated public that, because of its size and composition, can only be described as 'democratic' just a few years before the French Revolution. The monumental impact of the balloon was well represented in a flood of poetry, pamphlets, books, journal reports, academic papers and consumer items. Sifting through these artifacts and considering the crowd that witnessed the ascent of the balloon will bring us to the historical moment when things, spectacles, and events (rather than words) shaped public and popular opinion.

  19. Analysis and prediction of stratospheric balloons trajectories

    NASA Astrophysics Data System (ADS)

    Cardillo, A.; Memmo, A.; Musso, I.; Ibba, R.; Spoto, D.

    The first step to manage a balloon flight from a trajectory point of view is the definition of launch location and period. Analysis data are used to realize a statistical study of the trajectories that can be obtained. The goal is define the conditions able to maximize the probability to respect mission objectives and constrains. Ones started with operations the balloon control centre has to manage the flight respecting safety and science. To predict stratospheric balloon trajectories we must utilize data from different forecast models and real-time measurements of wind and other meteorological entities. These sources of information have to be merged along the simulation of the balloon flight. Great attention has be paid for long duration flight from Pole and Equator, where QBO plays an important role.

  20. Optical design for the large balloon reflector

    NASA Astrophysics Data System (ADS)

    Cortes-Medellin, German; O'Dougherty, Stefan; Walker, Christopher; Goldsmith, Paul F.; Groppi, Chris; Smith, Steve; Bernasconi, Pietro

    2016-07-01

    We present the details of the optical design, corrector system, mechanical layout, tolerances, pointing requirements, and overall performance of the sub-millimeter wavelength Large Balloon Reflector telescope (LBR).

  1. Investigations of Balloon and Aeroplane Fabrics

    NASA Technical Reports Server (NTRS)

    Gibbons, Willis A; Smith, Omar H

    1917-01-01

    Report presents the experimental results of fabrics used for balloons and aeroplanes. Tensile properties, surface roughness, skin friction, flammability, permeability, and water absorption were tested for different combinations of materials.

  2. The Helium Balloon Project: Expanding Student Horizons...

    ERIC Educational Resources Information Center

    Leyden, Michael B.

    1973-01-01

    An activity involving future elementary school teachers designed around inexpensive balloons which when launched contained postcards to determine the geographic location of the landing. The investigation is student-centered, involving unknown questions, and was conducted for enjoyment. (DF)

  3. NASA Balloon Highlights 2015-2017

    NASA Technical Reports Server (NTRS)

    Fairbrother, Debora

    2017-01-01

    The NASA Balloon Program provides low-cost, quick response, near space access to NASAs science Community for conducting Cutting Edge Science Investigations. Serve as a technology development platform. Excellent training for NASA scientists and engineers.

  4. Mass and radius of cosmic balloons

    NASA Technical Reports Server (NTRS)

    Wang, Yun

    1994-01-01

    Cosmic balloons are spherical domain walls with relativistic particles trapped inside. We derive the exact mass and radius relations for a static cosmic balloon using Gauss-Codazzi equations. The cosmic balloon mass as a function of its radius, M(R), is found to have a functional form similar to that of fermion soliton stars, with a fixed point at 2GM(R)/R approximately or equal to 0.486 which corresponds to the limit of infinite central density. We derive a simple analytical approximation for the mass density of a spherically symmetric relativistic gas star. When applied to the computation of the mass and radius of a cosmic balloon, the analytical approximation yields fairly good agreement with the exact numerical solutions.

  5. Ballooning Ideas for the Science Classroom.

    ERIC Educational Resources Information Center

    Park, John C.; Carter, Glenda S.

    1988-01-01

    Introduces three demonstrations using rubber balloons: rate of reaction, air pressure, and solubility of gases in liquids. Provides the materials, procedure, questions, further investigation, and discussion in each demonstration. (YP)

  6. Power Systems Design for Long Duration Ballooning

    NASA Technical Reports Server (NTRS)

    Stilwell, Bryan; Chuzel, Alain

    2016-01-01

    The Columbia Scientific Balloon Facility has been designing and building high-altitude balloon power systems for over 26 years. With that experience, we have found certain types of PV panels, batteries, and charge controllers that are reliable in stratospheric environments. The ultimate goal is to ensure that power systems will provide power reliably throughout the duration of an LDB flight. The purpose of this presentation is to provide some general guidelines and best practices for power system design.

  7. Advances in Scientific Balloon Thermal Modeling

    NASA Technical Reports Server (NTRS)

    Bohaboj, T.; Cathey, H. M., Jr.

    2004-01-01

    The National Aeronautics and Space Administration's Balloon Program office has long acknowledged that the accurate modeling of balloon performance and flight prediction is dependant on how well the balloon is thermally modeled. This ongoing effort is focused on developing accurate balloon thermal models that can be used to quickly predict balloon temperatures and balloon performance. The ability to model parametric changes is also a driver for this effort. This paper will present the most recent advances made in this area. This research effort continues to utilize the "Thrmal Desktop" addition to AUTO CAD for the modeling. Recent advances have been made by using this analytical tool. A number of analyses have been completed to test the applicability of this tool to the problem with very positive results. Progressively detailed models have been developed to explore the capabilities of the tool as well as to provide guidance in model formulation. A number of parametric studies have been completed. These studies have varied the shape of the structure, material properties, environmental inputs, and model geometry. These studies have concentrated on spherical "proxy models" for the initial development stages and then to transition to the natural shaped zero pressure and super pressure balloons. An assessment of required model resolution has also been determined. Model solutions have been cross checked with known solutions via hand calculations. The comparison of these cases will also be presented. One goal is to develop analysis guidelines and an approach for modeling balloons for both simple first order estimates and detailed full models. This papa presents the step by step advances made as part of this effort, capabilities, limitations, and the lessons learned. Also presented are the plans for further thermal modeling work.

  8. TMBM: Tethered Micro-Balloons on Mars

    NASA Technical Reports Server (NTRS)

    Sims, M. H.; Greeley, R.; Cutts, J. A.; Yavrouian, A. H.; Murbach, M.

    2000-01-01

    The use of balloons/aerobots on Mars has been under consideration for many years. Concepts include deployment during entry into the atmosphere from a carrier spacecraft, deployment from a lander, use of super-pressurized systems for long duration flights, 'hot-air' systems, etc. Principal advantages include the ability to obtain high-resolution data of the surface because balloons provide a low-altitude platform which moves relatively slowly. Work conducted within the last few years has removed many of the technical difficulties encountered in deployment and operation of balloons/aerobots on Mars. The concept proposed here (a tethered balloon released from a lander) uses a relatively simple approach which would enable aspects of Martian balloons to be tested while providing useful and potentially unique science results. Tethered Micro-Balloons on Mars (TMBM) would be carried to Mars on board a future lander as a stand-alone experiment having a total mass of one to two kilograms. It would consist of a helium balloon of up to 50 cubic meters that is inflated after landing and initially tethered to the lander. Its primary instrumentation would be a camera that would be carried to an altitude of up to tens of meters above the surface. Imaging data would be transmitted to the lander for inclusion in the mission data stream. The tether would be released in stages allowing different resolutions and coverage. In addition during this staged release a lander camera system may observe the motion of the balloon at various heights above he lander. Under some scenarios upon completion of the primary phase of TMBM operations, the tether would be cut, allowing TMBM to drift away from the landing site, during which images would be taken along the ground.

  9. Cervical balloon for dysfunctional labor following amniotomy.

    PubMed

    Lurie, S; Rabinerson, D; Feinstein, M; Mamet, Y

    1998-01-01

    The conventional treatment for arrest of protracted active phase dilatation is amniotomy and oxitocin. This kind of labor dystocia is associated with an increased incidence in Cesarean delivery. We describe the use of cervical balloon after amniotomy for protracted active phase dilatation. We have used this approach in five parturients. All five patients had a spontaneous vaginal delivery. Intrapartum cervical balloon in patients with dysfunctional labor may reduce the need for Cesarean delivery.

  10. Advances in Scientific Balloon Thermal Modeling

    NASA Technical Reports Server (NTRS)

    Bohaboj, T.; Cathey, H. M., Jr.

    2004-01-01

    The National Aeronautics and Space Administration's Balloon Program office has long acknowledged that the accurate modeling of balloon performance and flight prediction is dependant on how well the balloon is thermally modeled. This ongoing effort is focused on developing accurate balloon thermal models that can be used to quickly predict balloon temperatures and balloon performance. The ability to model parametric changes is also a driver for this effort. This paper will present the most recent advances made in this area. This research effort continues to utilize the "Thrmal Desktop" addition to AUTO CAD for the modeling. Recent advances have been made by using this analytical tool. A number of analyses have been completed to test the applicability of this tool to the problem with very positive results. Progressively detailed models have been developed to explore the capabilities of the tool as well as to provide guidance in model formulation. A number of parametric studies have been completed. These studies have varied the shape of the structure, material properties, environmental inputs, and model geometry. These studies have concentrated on spherical "proxy models" for the initial development stages and then to transition to the natural shaped zero pressure and super pressure balloons. An assessment of required model resolution has also been determined. Model solutions have been cross checked with known solutions via hand calculations. The comparison of these cases will also be presented. One goal is to develop analysis guidelines and an approach for modeling balloons for both simple first order estimates and detailed full models. This papa presents the step by step advances made as part of this effort, capabilities, limitations, and the lessons learned. Also presented are the plans for further thermal modeling work.

  11. Advances in scientific balloon thermal modeling

    NASA Astrophysics Data System (ADS)

    Bohaboj, T.; Cathey, H.

    The National Aeronautics and Space Administration's Balloon Program Office has long acknowledged that the accurate modeling of balloon performance and flight prediction is dependant on how well the balloon is thermally modeled. This ongoing effort is focused on developing accurate balloon thermal models that can be used to quickly predict balloon temperatures and balloon performance. The ability to model parametric changes is also a driver for this effort. This paper will present the most recent advances made in this area. This research effort continues to utilize the ``Thermal Desktop'' addition to AUTO CAD for the modeling. Recent advances have been made by using this analytical tool. A number of analyses have been completed to test the applicability of this tool to the problem with very positive results. Progressively detailed models have been developed to explore the capabilities of the tool as well as to provide guidance in model formulation. A number of parametric studies have been completed. These studies have varied the shape of the structure, material properties, environmental inputs, and model geometry. These studies have concentrated on spherical ``proxy models'' for the initial development stages and then to transition to the natural shaped zero pressure and super pressure balloons. An assessment of required model resolution has also been determined. Model solutions have been cross checked with known solutions via hand calculations. The comparison of these cases will also be presented. One goal is to develop analysis guidelines and an approach for modeling balloons for both simple first order estimates and detailed full models. This paper presents the step by step advances made as part of this effort, capabilities, limitations, and the lessons learned. Also presented are the plans for further thermal modeling work.

  12. Test ventilation with smoke, bubbles, and balloons

    SciTech Connect

    Pickering, P.L.; Cucchiara, A.L.; Gonzales, M.; McAtee, J.L.

    1987-06-01

    The behavior of smoke, bubbles, and helium-filled balloons was videotaped to demonstrate the mixing of air in the plutonium chemistry laboratories a plutonium facility. The air-distribution patterns, as indicated by each method, were compared. Helium-filled balloons proved more useful than bubbles or smoke in the visualization of airflow patterns. The replay of various segments of the videotape proved useful in evaluating the different techniques and in identifying airflow trends responsible for air mixing.

  13. Test ventilation with smoke, bubbles, and balloons

    SciTech Connect

    Pickering, P.L.; Cucchiara, A.L.; McAtee, J.L.; Gonzales, M.

    1987-01-01

    The behavior of smoke, bubbles, and helium-filled balloons was videotaped to demonstrate the mixing of air in the plutonium chemistry laboratories, a plutonium facility. The air-distribution patterns, as indicated by each method, were compared. Helium-filled balloons proved more useful than bubbles or smoke in the visualization of airflow patterns. The replay of various segments of the videotape proved useful in evaluating the different techniques and in identifying airflow trends responsible for air mixing. 6 refs.

  14. TMBM: Tethered Micro-Balloons on Mars

    NASA Technical Reports Server (NTRS)

    Sims, M. H.; Greeley, R.; Cutts, J. A.; Yavrouian, A. H.; Murbach, M.

    2000-01-01

    The use of balloons/aerobots on Mars has been under consideration for many years. Concepts include deployment during entry into the atmosphere from a carrier spacecraft, deployment from a lander, use of super-pressurized systems for long duration flights, 'hot-air' systems, etc. Principal advantages include the ability to obtain high-resolution data of the surface because balloons provide a low-altitude platform which moves relatively slowly. Work conducted within the last few years has removed many of the technical difficulties encountered in deployment and operation of balloons/aerobots on Mars. The concept proposed here (a tethered balloon released from a lander) uses a relatively simple approach which would enable aspects of Martian balloons to be tested while providing useful and potentially unique science results. Tethered Micro-Balloons on Mars (TMBM) would be carried to Mars on board a future lander as a stand-alone experiment having a total mass of one to two kilograms. It would consist of a helium balloon of up to 50 cubic meters that is inflated after landing and initially tethered to the lander. Its primary instrumentation would be a camera that would be carried to an altitude of up to tens of meters above the surface. Imaging data would be transmitted to the lander for inclusion in the mission data stream. The tether would be released in stages allowing different resolutions and coverage. In addition during this staged release a lander camera system may observe the motion of the balloon at various heights above he lander. Under some scenarios upon completion of the primary phase of TMBM operations, the tether would be cut, allowing TMBM to drift away from the landing site, during which images would be taken along the ground.

  15. Dual-focus Magnification, High-Definition Endoscopy Improves Pathology Detection in Direct-to-Test Diagnostic Upper Gastrointestinal Endoscopy.

    PubMed

    Bond, Ashley; Burkitt, Michael D; Cox, Trevor; Smart, Howard L; Probert, Chris; Haslam, Neil; Sarkar, Sanchoy

    2017-03-01

    In the UK, the majority of diagnostic upper gastrointestinal (UGI) endoscopies are a result of direct-to-test referral from the primary care physician. The diagnostic yield of these tests is relatively low, and the burden high on endoscopy services. Dual-focus magnification, high-definition endoscopy is expected to improve detection and classification of UGI mucosal lesions and also help minimize biopsies by allowing better targeting. This is a retrospective study of patients attending for direct-to-test UGI endoscopy from January 2015 to June 2015. The primary outcome of interest was the identification of significant pathology. Detection of significant pathology was modelled using logistic regression. 500 procedures were included. The mean age of patients was 61.5 (±15.6) years; 60.8% of patients were female. Ninety-four gastroscopies were performed using dual-focus magnification high-definition endoscopy. Increasing age, male gender, type of endoscope, and type of operator were all identified as significant factors influencing the odds of detecting significant mucosal pathology. Use of dual-focus magnification, high-definition endoscopy was associated with an odds ratio of 1.87 (95%CI 1.11-3.12) favouring the detection of significant pathology. Subsequent analysis suggested that the increased detection of pathology during dual-focus magnification, high-definition endoscopy also influenced patient follow-up and led to a 3.0 fold (p=0.04) increase in the proportion of patients entered into an UGI endoscopic surveillance program. Dual-focus magnification, high-definition endoscopy improved the diagnostic yield for significant mucosal pathology in patients referred for direct-to-test endoscopy. If this finding is recapitulated elsewhere it will have substantial impact on the provision of UGI endoscopic services.

  16. Hybrid designs for super-pressure balloons

    NASA Astrophysics Data System (ADS)

    Schur, W.; Baginski, F.

    The desire of the scientific community to fly large payloads at mid latitudes over durations of months while keeping altitude has propelled NASA on the path of developing an Ultra Long Duration Balloon (ULDB) design. The first design considered for ULDB was a spherical balloon, but the strength of its fabric composite fell far short of the capacity goal set by NASA. Therefore, an alternative design, the pumpkin-shape balloon, was chosen. For large balloons with a large number of gores, the pumpkin design is found to be susceptible to flawed deployment. While research on pumpkin balloon deployment is on-going, the spherical balloon design has stirred new interest for certain applications. Current spherical super-pressure designs have a load skirt that consists of straps that are attached tangentially to the fully inflated sphere. The attachment points constitute stress raisers, and the straps provide an opportunity for entanglement. The pneumatic envelope is a compliant structure that accommodates concentrated loads by large out-of-plane deformation. By embedding sufficient unidirectional strength elements in the skin that radiate from the nadir upward, we will demonstrate that the load skirt is unnecessary and the entanglement problem is avoided. We will use analytical investigations to establish the advantages of this hybrid design.

  17. Stratospheric balloons trajectories predictions and optimizations

    NASA Astrophysics Data System (ADS)

    Musso, I.; Cardillo, A.; Memmo, A.

    Trajectory predictions are becoming an important part of the stratospheric balloons activities due to the increased safety and scientific requirements Often high-populated areas must be avoided while the balloon could be asked to reach regions interesting for scientific measurements The balloon trajectory s reconstruction is essentially a time propagation of local wind vectors along the expected altitudes As consequence the predictor is composed of two interconnected subsystems one for the definition of vertical position and one for the wind predictions and horizontal propagation at every time step Forecast data permits up to 6 days of wind vector predictions Below 10mb altitude mesoscale models reduce the wind prediction uncertainty Directly measured information comes from radiosoundings few hours before flight or during it GPS onboard the balloon telemetry is a second direct wind data source The software has to mesh these different flows of information giving to the measured values a weight inversely proportional to the time and space distance from wind measurements In this way sounding data if properly used are able to reduce the path s dispersion A thermodynamic model reconstructs the balloon vertical positions Heat exchanges between internal gas and external environment are very sensitive to air temperature infrared radiance and albedo Again forecast data have to be properly meshed with radiosoundings and satellite images to obtain the best values of these border conditions They will apply the thermodynamic balloon model We

  18. Esophageal balloon tamponade versus esophageal stent in controlling acute refractory variceal bleeding: A multicenter randomized, controlled trial.

    PubMed

    Escorsell, Àngels; Pavel, Oana; Cárdenas, Andrés; Morillas, Rosa; Llop, Elba; Villanueva, Càndid; Garcia-Pagán, Juan C; Bosch, Jaime

    2016-06-01

    Balloon tamponade is recommended only as a "bridge" to definitive therapy in patients with cirrhosis and massive or refractory esophageal variceal bleeding (EVB), but is frequently associated with rebleeding and severe complications. Preliminary, noncontrolled data suggest that a self-expandable, esophageal covered metal stent (SX-ELLA Danis; Ella-CS, Hradec Kralove, Czech Republic) may be an effective and safer alternative to balloon tamponade. We conducted a randomized, controlled trial aimed at comparing esophageal stent versus balloon tamponade in patients with cirrhosis and EVB refractory to medical and endoscopic treatment. Primary endpoint was success of therapy, defined as survival at day 15 with control of bleeding and without serious adverse events (SAEs). Twenty-eight patients were randomized to Sengstaken-Blakemore tube (n = 15) or SX-ELLA Danis stent (n = 13). Patients were comparable in severity of liver failure, active bleeding at endoscopy, and initial therapy. Success of therapy was more frequent in the esophageal stent than in balloon tamponade group (66% vs. 20%; P = 0.025). Moreover, control of bleeding was higher (85% vs. 47%; P = 0.037) and transfusional requirements (2 vs 6 PRBC; P = 0.08) and SAEs lower (15% vs. 47%; P = 0.077) in the esophageal stent group. TIPS was used more frequently in the tamponade group (4 vs. 10; P = 0.12). There were no significant differences in 6-week survival (54% vs. 40%; P = 0.46). Esophageal stents have greater efficacy with less SAEs than balloon tamponade in the control of EVB in treatment failures. Our findings favor the use of esophageal stents in patients with EVB uncontrolled with medical and endoscopic treatment. (Hepatology 2016;63:1957-1967). © 2015 by the American Association for the Study of Liver Diseases.

  19. Comparison of a Balloon Guide Catheter and a Non-Balloon Guide Catheter for Mechanical Thrombectomy.

    PubMed

    Velasco, Aglaé; Buerke, Boris; Stracke, Christian P; Berkemeyer, Shoma; Mosimann, Pascal J; Schwindt, Wolfram; Alcázar, Pedro; Cnyrim, Christian; Niederstadt, Thomas; Chapot, René; Heindel, Walter

    2016-07-01

    Purpose To evaluate the effectiveness of mechanical thrombectomy with the use of a stent retriever in acute ischemic stroke, performed by using a balloon guide catheter or non-balloon guide catheter. Materials and Methods In accordance with the institutional review board approval obtained at the two participating institutions, retrospective analysis was performed in 183 consecutive patients treated between 2013 and 2014 for occlusions in the middle cerebral artery or carotid terminus by using a stent retriever with a balloon guide catheter (n = 102) at one center and a non-balloon guide catheter (n = 81) at the other center. Data on procedure duration, number of passes, angiographic findings, type of stent retriever used, and expertise of the operators were collected. Successful recanalization was defined as grade 3 or 2b modified Treatment in Cerebral Ischemia recanalization accomplished in up to three passes. Univariate and multivariate subgroup analyses were conducted to control for the confounding variables of prior thrombolysis, location of occlusion, and operator expertise. Results Successful recanalization with the balloon guide catheter was achieved in 89.2% of thrombectomies (91 of 102) versus 67.9% (55 of 81) achieved with the non-balloon guide catheter (P = .0004). The one-pass thrombectomy rate with the balloon guide catheter was significantly higher than for that with the non-balloon guide catheter (63.7% [65 of 102] vs 35.8% [29 of 81], respectively; P = .001). The procedure duration was significantly shorter by using the balloon guide catheter than the non-balloon guide catheter (median, 20.5 minutes vs 41.0 minutes, respectively; P < .0001). Conclusion The effectiveness of mechanical thrombectomy with stent retrievers in acute ischemic stroke in the anterior circulation in terms of angiographic results and procedure duration was improved when performed in combination with the balloon guide catheter. (©) RSNA, 2016.

  20. Gondola development for CNES stratospheric balloons

    NASA Astrophysics Data System (ADS)

    Vargas, A.; Audoubert, J.; Cau, M.; Evrard, J.; Verdier, N.

    The CNES has been supporting scientific ballooning since its establishment in 1962. The two main parts of the balloon system or aerostat are the balloon itself and the flight train, comprising the house-keeping gondola, for the control of balloon flight (localization and operational telemetry & telecommand - TM/TC), and the scientific gondola with its dedicated telecommunication system. For zero pressure balloon, the development of new TM/TC system for the housekeeping and science data transmission are going on from 1999. The main concepts are : - for balloon house-keeping and low rate scientific telemetry, the ELITE system, which is based on single I2C bus standardizing communication between the different components of the system : trajectography, balloon control, power supply, scientific TM/TC, .... In this concept, Radio Frequency links are developed between the house keeping gondola and the components of the aerostat (balloon valve, ballast machine, balloon gas temperature measurements, ...). The main objectives are to simplify the flight train preparation in term of gondola testing before flight, and also by reducing the number of long electrical cables integrated in the balloon and the flight train; - for high rate scientific telemetry, the use of functional interconnection Internet Protocol (IP) in interface with the Radio Frequency link. The main idea is to use off-the-shelf IP hardware products (routers, industrial PC, ...) and IP software (Telnet, FTP, Web-HTTP, ...) to reduce the development costs; - for safety increase, the adding, in the flight train, of a totally independent house keeping gondola based on the satellite Inmarsat M and Iridium telecommunication systems, which permits to get real time communications between the on-board data mobile and the ground station, reduced to a PC computer with modem connected to the phone network. These GEO and LEO telecommunication systems give also the capability to operate balloon flights over longer distance