Sample records for double balloon enteroscopy

  1. A prospective comparison of performance during back-to-back, anterograde manual spiral enteroscopy and double-balloon enteroscopy.

    PubMed

    Despott, Edward J; Murino, Alberto; Bourikas, Leonidas; Nakamura, Masanao; Ramachandra, Vino; Fraser, Chris

    2015-05-01

    Spiral enteroscopy is a recently introduced technology alternative to balloon-assisted enteroscopy for examination of the small bowel. To compare small bowel insertion depths and procedure duration by spiral enteroscopy and double-balloon enteroscopy performed in the same cohort of patients, in immediate succession, using the same method of insertion depth estimation. A prospective, back-to-back comparative study was performed in 15 patients. Spiral enteroscopy procedures were performed first and a tattoo was placed to mark the most distal point. Double-balloon enteroscopy passed the tattoo placed at spiral enteroscopy in 14/15 cases (93%). Median insertion depths for double-balloon enteroscopy and spiral enteroscopy were 265cm and 175cm, respectively (P=0.004). Median time to achieve maximal depth of insertion was significantly shorter for spiral enteroscopy compared with double-balloon enteroscopy (24min vs. 45min, respectively; P=0.0005). However, in 14 patients no differences were found in median time to reach the same insertion depth (P=0.28). Double-balloon enteroscopy achieved significantly greater small bowel insertion depth than spiral enteroscopy. Although overall double-balloon enteroscopy procedure duration was longer, the time taken to reach the same small bowel insertion depth by both spiral enteroscopy and double-balloon enteroscopy was similar. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Enteroscopy

    MedlinePlus

    Small bowel biopsy; Push enteroscopy; Double-balloon enteroscopy; Capsule enteroscopy ... into the upper gastrointestinal tract. During a double-balloon enteroscopy, balloons attached to the endoscope can be ...

  3. Multicenter comparison of double-balloon enteroscopy and spiral enteroscopy.

    PubMed

    Rahmi, Gabriel; Samaha, Elia; Vahedi, Kouroche; Ponchon, Thierry; Fumex, Fabien; Filoche, Bernard; Gay, Gerard; Delvaux, Michel; Lorenceau-Savale, Camille; Malamut, Georgia; Canard, Jean-Marc; Chatellier, Gilles; Cellier, Christophe

    2013-06-01

    Spiral enteroscopy is a novel technique for small bowel exploration. The aim of this study is to compare double-balloon and spiral enteroscopy in patients with suspected small bowel lesions. Patients with suspected small bowel lesion diagnosed by capsule endoscopy were prospectively included between September 2009 and December 2010 in five tertiary-care academic medical centers. After capsule endoscopy, 191 double-balloon enteroscopy and 50 spiral enteroscopies were performed. Indications were obscure gastrointestinal bleeding in 194 (80%) of cases. Lesions detected by capsule endoscopy were mainly angioectasia. Double-balloon and spiral enteroscopy resulted in finding one or more lesions in 70% and 75% of cases, respectively. The mean diagnosis procedure time and the average small bowel explored length during double-balloon and spiral enteroscopy were, respectively, 60 min (45-80) and 55 min (45-80) (P=0.74), and 200 cm (150-300) and 220 cm (200-300) (P=0.13). Treatment during double-balloon and spiral enteroscopy was possible in 66% and 70% of cases, respectively. There was no significant major procedure-related complication. Spiral enteroscopy appears as safe as double-balloon enteroscopy for small bowel exploration with a similar diagnostic and therapeutic yield. Comparison between the two procedures in terms of duration and length of small bowel explored is slightly in favor of spiral enteroscopy but not significantly. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  4. Clinical outcomes of enteroscopy using the double-balloon method for strictures of the small intestine

    PubMed Central

    Sunada, Keijiro; Yamamoto, Hironori; Kita, Hiroto; Yano, Tomonori; Sato, Hiroyuki; Hayashi, Yoshikazu; Miyata, Tomohiko; Sekine, Yutaka; Kuno, Akiko; Iwamoto, Michiko; Ohnishi, Hirohide; Ido, Kenichi; Sugano, Kentaro

    2005-01-01

    AIM: To evaluate the clinical outcome of enteroscopy, using the double-balloon method, focusing on the involvement of neoplasms in strictures of the small intestine. METHODS: Enteroscopy, using the double-balloon method, was performed between December 1999 and December 2002 at Jichi Medical School Hospital, Japan and strictures of the small intestine were found in 17 out of 62 patients. These 17 consecutive patients were subjected to analysis. RESULTS: The double-balloon enteroscopy contributed to the diagnosis of small intestinal neoplasms found in 3 out of 17 patients by direct observation of the strictures as well as biopsy sampling. Surgical procedures were chosen for these three patients, while balloon dilation was chosen for the strictures in four patients diagnosed with inflammation without involvement of neoplasm. CONCLUSION: Double-balloon enteroscopy is a useful method for the diagnosis and treatment of strictures in the small bowel. PMID:15742422

  5. [Efficacy of double balloon enteroscopy for patients with intestinal lymphangiectasia, case report of primary intestinal lymphangiectasia].

    PubMed

    Yakami, Yoshikazu; Watanabe, Kenji; Kameda, Natsuhiko; Machida, Hirohisa; Okazaki, Hirotoshi; Yamagami, Hirokazu; Shiba, Masatsugu; Fujiwara, Yasuhiro; Oshitani, Nobuhide; Arakawa, Tetsuo

    2008-11-01

    A 31-year-old man has visited our hospital, complaining diarrhea and leg edema. Blood test showed hypoalbuminea, but we couldn't find the reason by several examinations. Therefore, we performed double balloon enteroscopy, and intestinal lymphangiectasia was diagnosed histologically by biopsy. It's useful and effective to perform double balloon enteroscopy and histological examination for the unknown origin case of protein loosing enteropathy.

  6. Balloon enteroscopy versus spiral enteroscopy for small-bowel disorders: a systematic review and meta-analysis.

    PubMed

    Baniya, Ramkaji; Upadhaya, Sunil; Subedi, Subash Chandra; Khan, Jahangir; Sharma, Prabin; Mohammed, Tabrez Shaik; Bachuwa, Ghassan; Jamil, Laith H

    2017-12-01

    Two novel enteroscopic procedures, balloon enteroscopy and spiral enteroscopy, have revolutionized the diagnostic and therapeutic approach to small-bowel disorders. These disorders that historically required surgical interventions are now investigated and managed nonsurgically. Only a few weakly powered studies have compared the outcomes of spiral enteroscopy and balloon enteroscopy. We conducted a systematic review and meta-analysis to compare the efficacy and safety of these 2 procedures. PubMed, Cochrane Library, Scopus, and clinicaltrials.gov databases were searched for all studies published up to January 12, 2017 comparing the efficacy and safety of balloon enteroscopy (single or double) and spiral enteroscopy. Primary outcomes of interest were diagnostic and therapeutic success rates. Other outcomes included procedure length, depth of maximal insertion (DMI), rate of complete enteroscopy, and adverse events. We calculated Odds ratios (ORs) for categorical variables and mean difference (MD) for continuous variables. The Mantel-Haenszel method was used to analyze the data. Fixed and random effect models were used for <50% heterogeneity and >50% heterogeneity, respectively. Eight studies met the inclusion criteria for this meta-analysis. A total of 615 procedures were analyzed, which included 394 balloon enteroscopy and 221 spiral enteroscopy procedures. There were no significant differences in diagnostic and therapeutic success rates (OR, 1.27; 95% confidence interval [CI], .86-1.88; P = .22; and OR, 1.23; 95% CI, .82-1.84; P = .32, respectively) between the 2 procedures. Similarly, DMI was not significantly different between the 2 groups (MD, 26.29; 95% CI, 20.92-73.49; P = .28). However, the procedure time was significantly shorter for the spiral enteroscopy group compared with the balloon enteroscopy group (MD, 11.26; 95% CI, 2.72-19.79; P = .010). A subgroup analysis comparing double balloon enteroscopy with spiral enteroscopy yielded similar results. Both procedures achieved similar diagnostic and therapeutic outcomes and with similar depth of insertion. Spiral enteroscopy has the benefit of shorter procedural time. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  7. [Characteristics of Crohn's disease under 
double balloon enteroscopy].

    PubMed

    Jia, Jia; Liu, Rui; Liu, Xiangjie; Shen, Shourong; Guo, Qin

    2018-05-28

    To observe ulcer characteristics of Crohn's disease under double balloon enteroscopy, and to evaluate the correlation between endoscopic severity and clinical manifestations.
 Methods: A prospective, observational study from July 2015 to December 2016 in the Third Xiangya Hospital, Central South University, we selected 45 patients with positive double-balloon enteroscopy (DBE) and confirmed Crohn's disease. Two digestive internal physician observed the ulcer characteristics of Crohn's disease under double balloon enteroscopy, and gave a simple endoscopic score for CD (SES-CD). We analyzed the correlation between SES-CD and Crohn's disease activity index (CDAI).
 Results: DBE indicated 24 patient ulcers (53.33%) locating at the end of the ileum, 5 (11.11%) locating at ileocolon, 16 (35.56%) locating at upper gatrointestinal tract and they did not affect the end of the ileum. Among them, 8 cases (17.78%) affected only jejunum. Thirty-two patients with longitudinal ulcers in Crohn's disease, accounting for 71.11%. There was no correlation between SES-CD score and CDAI score (r=0.237, P=0.136).
 Conclusion: The ulcerative appearance in Crohn's disease were diverse under double balloon enteroscopy. Crohn's disease could only affect the upper gastrointestinal tract or jejunum. The unwounded ileum and ileocecal valve couldn't be a sign to exclude Crohn's disease. CDAI score couldn't fully assess the prognosis of Crohn's disease.

  8. Primary intestinal lymphangiectasia diagnosed by double-balloon enteroscopy and treated by medium-chain triglycerides: a case report.

    PubMed

    Lai, Yu; Yu, Tao; Qiao, Xiao-Yu; Zhao, Li-Na; Chen, Qi-Kui

    2013-01-14

    Primary intestinal lymphangiectasia is a disorder characterized by exudative enteropathy resulting from morphologic abnormalities of the intestinal lymphatics. Intestinal lymphangiectasia can be primary or secondary, so the diagnosis of primary intestinal lymphangiectasia must first exclude the possibility of secondary intestinal lymphangiectasia. A double-balloon enteroscopy and biopsy, as well as the pathology can be used to confirm the diagnosis of intestinal lymphangiectasia. A polymeric diet containing medium-chain triglycerides and total parenteral nutrition may be a useful therapy. A 17-year-old girl of Mongoloid ethnicity was admitted to our hospital with a history of diarrhea and edema. She was diagnosed with protein-losing enteropathy caused by intestinal lymphangiectasia. This was confirmed by a double-balloon enteroscopy and multi-dot biopsy. After treatment with total parenteral nutrition in hospital, which was followed by a low-fat and medium-chain triglyceride diet at home, she was totally relieved of her symptoms. Intestinal lymphangiectasia can be diagnosed with a double-balloon enteroscopy and multi-dot biopsy, as well as the pathology of small intestinal tissue showing edema of the submucosa and lymphangiectasia. Because intestinal lymphangiectasia can be primary or secondary, the diagnosis of primary intestinal lymphangiectasia must first exclude the possibility of secondary intestinal lymphangiectasia. A positive clinical response to the special diet therapy, namely a low-fat and medium-chain triglyceride diet, can further confirm the diagnosis of primary intestinal lymphangiectasia.

  9. Primary intestinal lymphangiectasia diagnosed by double-balloon enteroscopy and treated by medium-chain triglycerides: a case report

    PubMed Central

    2013-01-01

    Introduction Primary intestinal lymphangiectasia is a disorder characterized by exudative enteropathy resulting from morphologic abnormalities of the intestinal lymphatics. Intestinal lymphangiectasia can be primary or secondary, so the diagnosis of primary intestinal lymphangiectasia must first exclude the possibility of secondary intestinal lymphangiectasia. A double-balloon enteroscopy and biopsy, as well as the pathology can be used to confirm the diagnosis of intestinal lymphangiectasia. A polymeric diet containing medium-chain triglycerides and total parenteral nutrition may be a useful therapy. Case presentation A 17-year-old girl of Mongoloid ethnicity was admitted to our hospital with a history of diarrhea and edema. She was diagnosed with protein-losing enteropathy caused by intestinal lymphangiectasia. This was confirmed by a double-balloon enteroscopy and multi-dot biopsy. After treatment with total parenteral nutrition in hospital, which was followed by a low-fat and medium-chain triglyceride diet at home, she was totally relieved of her symptoms. Conclusion Intestinal lymphangiectasia can be diagnosed with a double-balloon enteroscopy and multi-dot biopsy, as well as the pathology of small intestinal tissue showing edema of the submucosa and lymphangiectasia. Because intestinal lymphangiectasia can be primary or secondary, the diagnosis of primary intestinal lymphangiectasia must first exclude the possibility of secondary intestinal lymphangiectasia. A positive clinical response to the special diet therapy, namely a low-fat and medium-chain triglyceride diet, can further confirm the diagnosis of primary intestinal lymphangiectasia. PMID:23316917

  10. Secondary lymphangiectasia of the small bowel: utility of double balloon enteroscopy for diagnosis and management.

    PubMed

    Safatle-Ribeiro, Adriana Vaz; Iriya, Kiyoshi; Couto, Décio Sampaio; Kawaguti, Fábio Shiguehiss; Retes, Felipe; Ribeiro, Ulysses; Sakai, Paulo

    2008-01-01

    Sporadic lymphangiectasias are commonly found throughout the small bowel and are considered to be normal. Not uncommonly, lymphangiectasias are pathologic and can lead to mid-gastrointestinal bleeding, abdominal pain and protein-losing enteropathy. Pathologic lymphangiectasias of the small bowel include primary lymphangiectasia, secondary lymphangiectasia and lymphaticovenous malformations. In this report we present three different cases of small bowel lymphangiectasia detected by double balloon enteroscopy. The patients were diagnosed with South American blastomycosis, tuberculosis and primary small bowel lymphangioma. 2009 S. Karger AG, Basel

  11. 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

    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.

  12. Pancreatic and Gastric Heterotopia with Associated Submucosal Lipoma Presenting as a 7-cm Obstructive Tumor of the Ileum: Resection with Double Balloon Enteroscopy.

    PubMed

    Jiang, Kun; Stephen, F Otis; Jeong, Daniel; Pimiento, Jose M

    2015-01-01

    Pancreatic and gastric heterotopias are rare clinical entities which have been identified throughout the entire length of the gastrointestinal tract. Combined gastric and pancreatic heterotopias, although unusual, have been described in the duodenum and jejunum, and in other structures, including Meckel's diverticulum and the ampulla of Vater. We report a novel case of pancreatic and gastric heterotopia with an associated submucosal lipoma in a 38-year-old female with a recent history of rectal cancer and chronic crampy abdominal pain. On computed tomography, a 7-cm luminal polypoid mass extending into the distal ileum was discovered. The mass was successfully resected using retrograde double balloon enteroscopy. We believe this is the first report of all three histological entities co-existing in an obstructive ileal lesion in an adult. It highlights endoscopic resection trough double enteroscopy as a safe alternative to more invasive surgical approaches for this type of lesion.

  13. Balloon-assisted enteroscopy for suspected Meckel’s diverticulum and indefinite diagnostic imaging workup

    PubMed Central

    Gomes, Guilherme Francisco; Bonin, Eduardo Aimore; Noda, Rafael William; Cavazzola, Leandro Totti; Bartholomei, Thiago Ferreira

    2016-01-01

    Meckel’s diverticulum (MD) is estimated to affect 1%-2% of the general population, and it represents a clinically silent finding of a congenital anomaly in up to 85% of the cases. In adults, MD may cause symptoms, such as overt occult lower gastrointestinal bleeding. The diagnostic imaging workup includes computed tomography scan, magnetic resonance imaging enterography, technetium 99m scintigraphy (99mTc) using either labeled red blood cells or pertechnetate (known as the Meckel’s scan) and angiography. The preoperative detection rate of MD in adults is low, and many patients ultimately undergo exploratory laparoscopy. More recently, however, endoscopic identification of MD has been possible with the use of balloon-assisted enteroscopy via direct luminal access, which also provides visualization of the diverticular ostium. The aim of this study was to review the diagnosis by double-balloon enteroscopy of 4 adults with symptomatic MD but who had negative diagnostic imaging workups. These cases indicate that balloon-assisted enteroscopy is a valuable diagnostic method and should be considered in adult patients who have suspected MD and indefinite findings on diagnostic imaging workup, including negative Meckel’s scan. PMID:27803776

  14. Idiopathic small bowel diaphragm disease identified by laparoscopic-assisted double-balloon enteroscopy in a child: an integrated successful definitive therapeutic method.

    PubMed

    Soccorso, Giampiero; Sarkhy, Ahmed; Lindley, Richard M; Marven, Sean S; Thomson, Mike

    2012-08-01

    In adults, small bowel diaphragm disease is a rare complication of small bowel enteropathy secondary to the use of nonsteroidal antiinflammatory drugs. The main clinical manifestations are gastrointestinal bleeding and subacute obstruction, and management can be challenging. We present a case of a 5-year-old girl with small bowel diaphragm disease. To our knowledge, this is the first idiopathic case (no history of nonsteroidal antiinflammatory drug use) in the pediatric age group. This report describes an integrated successful definitive therapeutic method of double-balloon enteroscopy and minimal invasive bowel surgery for small bowel pathology. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Patient burden and patient preference: comparing magnetic resonance enteroclysis, capsule endoscopy and balloon-assisted enteroscopy.

    PubMed

    Wiarda, Bart M; Stolk, Mark; Heine, Dimitri G N; Mensink, Peter; Thieme, Mai E; Kuipers, Ernst J; Stoker, Jaap

    2013-03-01

    We aimed to prospectively determine patient burden and patient preference for magnetic resonance enteroclysis, capsule endoscopy and balloon-assisted enteroscopy in patients with suspected or known Crohn's disease (CD) or occult gastrointestinal bleeding (OGIB).  Consecutive consenting patients with CD or OGIB underwent magnetic resonance enteroclysis, capsule endoscopy and balloon-assisted enteroscopy. Capsule endoscopy was only performed if magnetic resonance enteroclysis showed no high-grade small bowel stenosis. Patient preference and burden was evaluated by means of standardized questionnaires at five moments in time. From January 2007 until March 2009, 76 patients were included (M/F 31/45; mean age 46.9 years; range 20.0-78.4 years): 38 patients with OGIB and 38 with suspected or known CD. Seventeen patients did not undergo capsule endoscopy because of high-grade stenosis. Ninety-five percent (344/363) of the questionnaires were suitable for evaluation. Capsule endoscopy was significantly favored over magnetic resonance enteroclysis and balloon-assisted enteroscopy with respect to bowel preparation, swallowing of the capsule (compared to insertion of the tube/scope), burden of the entire examination, duration and accordance with the pre-study information. Capsule endoscopy and magnetic resonance enteroclysis were significantly preferred over balloon-assisted enteroscopy for clarity of explanation of the examination, and magnetic resonance enteroclysis was significantly preferred over balloon-assisted enteroscopy for bowel preparation, painfulness and burden of the entire examination. Balloon-assisted enteroscopy was significantly favored over magnetic resonance enteroclysis for insertion of the scope and procedure duration. Pre- and post-study the order of preference was capsule endoscopy, magnetic resonance enteroclysis and balloon-assisted enteroscopy. Capsule endoscopy was preferred to magnetic resonance enteroclysis and balloon-assisted enteroscopy; it also had the lowest burden. Magnetic resonance enteroclysis was preferred over balloon-assisted enteroscopy for clarity of explanation of the examination, bowel preparation, painfulness and burden of the entire examination, and balloon-assisted enteroscopy over magnetic resonance enteroclysis for scope insertion and study duration. © 2012 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  16. Single- and double-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with Roux-en-Y plus hepaticojejunostomy anastomosis and Whipple resection.

    PubMed

    Itokawa, Fumihide; Itoi, Takao; Ishii, Kentaro; Sofuni, Atsushi; Moriyasu, Fuminori

    2014-04-01

    In patients with Roux-en-Y hepaticojejunostomy (HJ with R-Y) and Whipple resection, endoscopic retrograde cholangiopancreatography (ERCP) can be challenging. We report our experience with ERCP using balloon-assisted enteroscopy (BAE) (BAE-ERCP) in patients with HJ with R-Y, and Whipple resection. BAE-ERCP procedures were carried out in 62 patients (HJ with R-Y:Whipple resection=34:28). Overall, the rates of reaching the anastomosis were 85.3% (29/34) in HJ with R-Y and 96.4% (27/28) in Whipple resection. In terms of HJ with R-Y, insertion success rate by standard single-balloon enteroscopy (SBE) was 89.3% (25/28). Insertion success rate by short BAE, including SBE and double-balloon enteroscopy (DBE), was 50% (3/6). There was a statistically significant difference of insertion success rate between standard long BE and short BE (P=0.021). However, in the Whipple patients, insertion success rate by standard and short SBE was 93.8% (15/16) and 91.7% (11/12), respectively. Initial insertion success rate by short BAE in Whipple patients was significantly higher than in HJ with R-Y (91.7% vs 50%, P=0.045). Therapeutic interventions included dilation of anastomosis stricture, stone extraction, endoscopic mechanical lithotripsy, biliary stent placement, stent extraction, endoscopic nasobiliary drainage, direct cholangioscopy, and electrohydraulic lithotripsy. Our HJ with R-Y series and Whipple series treatment success rate was 90% (18/20) and 95.0% (19/20), respectively. BAE-ERCP enabled ERCP to be carried out in patients with HJ. It is considered safe and feasible. Further experience and device improvement are needed. © 2014 The Authors. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

  17. Is there still a role for intraoperative enteroscopy in patients with obscure gastrointestinal bleeding?

    PubMed

    Monsanto, Pedro; Almeida, Nuno; Lérias, Clotilde; Figueiredo, Pedro; Gouveia, Hermano; Sofia, Carlos

    2012-04-01

    in 21st century, endoscopic study of the small intestine has undergone a revolution with capsule endoscopy and balloon-assisted enteroscopy. The difficulties and morbidity associated with intraoperative enteroscopy, the gold-standard in the 20th century, made this technique to be relegated to a second level. evaluate the actual role and assess the diagnostic and therapeutic value of intraoperative enteroscopy in patients with obscure gastrointestinal bleeding. we conducted a retrospective study of 19 patients (11 males; mean age: 66.5 ± 15.3 years) submitted to 21 IOE procedures for obscure GI bleeding. Capsule endoscopy and double balloon enteroscopy had been performed in 10 and 5 patients, respectively. with intraoperative enteroscopy a small bowel bleeding lesion was identified in 79% of patients and a gastrointestinal bleeding lesion in 94%. Small bowel findings included: angiodysplasia (n = 6), ulcers (n = 4), small bowel Dieulafoy´s lesion (n = 2), bleeding from anastomotic vessels (n = 1), multiple cavernous hemangiomas (n = 1) and bleeding ectopic jejunal varices (n = 1). Agreement between capsule endoscopy and intraoperative enteroscopy was 70%. Endoscopic and/or surgical treatment was used in 77.8% of the patients with a positive finding on intraoperative enteroscopy, with a rebleeding rate of 21.4% in a mean 21-month follow-up period. Procedure-related mortality and postoperative complications have been 5 and 21%, respectively. intraoperative enteroscopy remains a valuable tool in selected patients with obscure GI bleeding, achieving a high diagnostic yield and allowing an endoscopic and/or surgical treatment in most of them. However, as an invasive procedure with relevant mortality and morbidity, a precise indication for its use is indispensable.

  18. Partial stent-in-stent placement of biliary metallic stents using a short double-balloon enteroscopy.

    PubMed

    Tsutsumi, Koichiro; Kato, Hironari; Tomoda, Takeshi; Matsumoto, Kazuyuki; Sakakihara, Ichiro; Yamamoto, Naoki; Noma, Yasuhiro; Sonoyama, Takayuki; Okada, Hiroyuki; Yamamoto, Kazuhide

    2012-12-07

    Endoscopic intervention is less invasive than percutaneous or surgical approaches and should be considered the primary drainage procedure in most cases with obstructive jaundice. Recently, therapeutic endoscopic retrograde cholangiopancreatography (ERCP) using double-balloon enteroscopy (DBE) has been shown to be feasible and effective, even in patients with surgically altered anatomies. On the other hand, endoscopic partial stent-in-stent (PSIS) placement of self-expandable metallic stents (SEMSs) for malignant hilar biliary obstruction in conventional ERCP has also been shown to be feasible, safe and effective. We performed PSIS placement of SEMSs for malignant hilar biliary obstruction due to liver metastasis using a short DBE in a patient with Roux-en-Y anastomosis and achieved technical and clinical success. This procedure can result in quick relief from obstructive jaundice in a single session and with short-term hospitalization, even in patients with surgically altered anatomies.

  19. Double- vs. single-balloon enteroscopy: single center experience with emphasis on procedural performance.

    PubMed

    Lenz, Philipp; Roggel, Moritz; Domagk, Dirk

    2013-09-01

    This study aims to compare double- (DBE) and single-balloon enteroscopy (SBE) in small bowel disorders with respect to procedural performance and clinical impact. This retrospective analysis at a tertial referral center included 1,052 DBEs and 515 SBEs performed in 904 patients over 7 years. Procedural and patients' characteristics were precisely analyzed. Significantly more patients with anemia and gastrointestinal bleeding were investigated by DBE (P < 0.01). Oral insertion depth and length of investigated small bowel in the combined approach were significantly higher in the DBE compared to the SBE group (245 ± 65.3 vs. 218 ± 62.6 and 355 ± 101.9 vs. 319 ± 91.2, respectively; P < 0.001, each). By analyzing only recent years of enteroscopy (2008-2011), no difference in small bowel visualization could be observed. The anal insertion depths and complete enteroscopy rates (CER) were comparable. Procedure times were significantly shorter within the SBE procedure (oral: 50 vs. 40 min; anal: 55 vs. 46 min, P < 0.001) and the usage of sedation was significantly less (propofol: P < 0.001; pethidine: P < 0.05). Diagnostic yield was significantly higher in the SBE, compared to the DBE group (61.7 vs. 48.2 %; P < 0.001). The rate of severe adverse events was close to zero. Both enteroscopy techniques are safe diagnostic tools and proved to be indispensable in the daily gastroenterological practice. The lower insertion depths, but higher diagnostic yield, of SBE may reflect the more focused selection of patients scheduled for small bowel diagnostics in recent years.

  20. Current status of device-assisted enteroscopy: Technical matters, indication, limits and complications

    PubMed Central

    Riccioni, Maria Elena; Urgesi, Riccardo; Cianci, Rossella; Bizzotto, Alessandra; Galasso, Domenico; Costamagna, Guido

    2012-01-01

    Enteroscopy, defined as direct visualization of the small bowel with the use of a fiberoptic or capsule endoscopy, has progressed considerably over the past several years. The need for endoscopic access to improve diagnosis and treatment of small bowel disease has led to the development of novel technologies one of which is non-invasive, the video capsule, and a type of invasive technique, the device-assisted enteroscopy. In particular, the device-assisted enteroscopy consists then of three different types of instruments all able to allow, in skilled hands, to display partially or throughout its extension (if necessary) the small intestine. Newer devices, double balloon, single balloon and spiral endoscopy, are just entering clinical use. The aim of this article is to review recent advances in small bowel enteroscopy, focusing on indications, modifications to improve imaging and techniques, pitfalls, and clinical applications of the new instruments. With new technologies, the trials and tribulations of learning new endoscopic skills and determining their role in the diagnosis and treatment of small bowel disease come. Identification of small bowel lesions has dramatically improved. Studies are underway to determine the best strategy to apply new enteroscopy technologies for the diagnosis and management of small bowel disease, particularly obscure bleeding. Vascular malformations such as angiectasis and small bowel neoplasms as adenocarcinoma or gastrointestinal stromal tumors. Complete enteroscopy of the small bowel is now possible. However, because of the length of the small bowel, endoscopic examination and therapeutic maneuvers require significant skill, radiological assistance, the use of deep sedation with the assistance of the anesthetist. Prospective randomized studies are needed to guide diagnostic testing and therapy with these new endoscopic techniques. PMID:23189216

  1. 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

  2. Primary intestinal lymphangiectasia diagnosed by capsule endoscopy and double balloon enteroscopy

    PubMed Central

    Oh, Tak Geun; Chung, Joo Won; Kim, Hee Man; Han, Seok-Joo; Lee, Jin Sung; Park, Jung Yeob; Song, Si Young

    2011-01-01

    Primary intestinal lymphangiectasia (PIL) is a rare disorder characterized by dilated intestinal lymphatics and the development of protein-losing enteropathy. Patients with PIL develop hypoalbuminemia, hypocalcemia, lymphopenia and hypogammaglobulinemia, and present with bilateral lower limb edema, fatigue, abdominal pain and diarrhea. Endoscopy reveals diffusely elongated, circumferential and polypoid mucosae covered with whitish enlarged villi, all of which indicate intestinal lymphangiectasia. Diagnosis is confirmed by characteristic tissue pathology, which includes dilated intestinal lymphatics with diffusely swollen mucosa and enlarged villi. The prevalence of PIL has increased since the introduction of capsule endoscopy. The etiology and prevalence of PIL remain unknown. Some studies have reported that several genes and regulatory molecules for lymphangiogenesis are related to PIL. We report the case of a patient with PIL involving the entire small bowel that was confirmed by capsule endoscopy and double-balloon enteroscopy-guided tissue pathology who carried a deletion on chromosome 4q25. The relationship between this deletion on chromosome 4 and PIL remains to be investigated. PMID:22110841

  3. 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. © 2013 Baishideng Publishing Group Co., Limited. All rights reserved.

  4. 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.

  5. Risk Factors of Acute Pancreatitis in Oral Double Balloon Enteroscopy.

    PubMed

    Kopáčová, Marcela; Bureš, Jan; Rejchrt, Stanislav; Vávrová, Jaroslava; Bártová, Jolana; Soukup, Tomáš; Tomš, Jan; Tachecí, Ilja

    Double balloon enteroscopy (DBE) was introduced 15 years ago. The complications of diagnostic DBE are rare, acute pancreatitis is most redoubtable one (incidence about 0.3%). Hyperamylasemia after DBE seems to be a rather common condition respectively. The most probable cause seems to be a mechanical straining of the pancreas. We tried to identify patients in a higher risk of acute pancreatitis after DBE. We investigated several laboratory markers before and after DBE (serum cathepsin B, lactoferrin, E-selectin, SPINK 1, procalcitonin, S100 proteins, alfa-1-antitrypsin, hs-CRP, malondialdehyde, serum and urine amylase and serum lipase). Serum amylase and lipase rose significantly with the maximum 4 hours after DBE. Serum cathepsin and procalcitonin decreased significantly 4 hours after DBE compared to healthy controls and patients values before DBE. Either serum amylase or lipase 4 hours after DBE did not correlate with any markers before DBE. There was a trend for an association between the number of push-and-pull cycles and procalcitonin and urine amylase 4 hours after DBE; between procalcitonin and alfa-1-antitrypsin, cathepsin and hs-CRP; and between E-selectin and malondialdehyde 4 hours after DBE. We found no laboratory markers determinative in advance those patients in a higher risk of acute pancreatitis after DBE.

  6. Crossed-clip strangulation for the management of small intestinal polyps in patients with Peutz-Jeghers syndrome.

    PubMed

    Yano, Tomonori; Shinozaki, Satoshi; Yamamoto, Hironori

    2018-05-19

    Peutz-Jeghers syndrome is an autosomal dominant disorder with multiple hamartomatous polyps throughout the gastrointestinal tract. The clinical history of patients with Peutz-Jeghers syndrome usually includes multiple laparotomies to treat intestinal obstruction caused by polyps. The development of double-balloon enteroscopy enables endoscopic resection of polyps, even in the distal small intestine. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  7. Hookworm Infection: A Neglected Cause of Overt Obscure Gastrointestinal Bleeding.

    PubMed

    Wei, Kun-Yan; Yan, Qiong; Tang, Bo; Yang, Shi-Ming; Zhang, Peng-Bing; Deng, Ming-Ming; Lü, Mu-Han

    2017-08-01

    Hookworm infections are widely prevalent in tropical and subtropical areas, especially in low income regions. In the body, hookworms parasitize the proximal small intestine, leading to chronic intestinal hemorrhage and iron deficiency anemia. Occasionally, hookworms can cause overt gastrointestinal bleeding, but this is often ignored in heavily burdened individuals from endemic infectious areas. A total of 424 patients with overt obscure gastrointestinal bleeding were diagnosed by numerous blood tests or stool examinations as well as esophagogastroduodenoscopy, colonoscopy, capsule endoscopy or double-balloon enteroscopy. All of the patients lived in hookworm endemic areas and were not screened for hookworm infection using sensitive tests before the final diagnosis. The patients recovered after albendazole treatment, blood transfusion, and iron replacement, and none of the patients experienced recurrent bleeding in the follow-up. All the 31 patients were diagnosed with hookworm infections without other concomitant bleeding lesions, a rate of 7.3% (31/424). Seventeen out of 227 patients were diagnosed with hookworm infections in the capsule endoscopy (CE), and 14 out of 197 patients were diagnosed with hookworm infections in the double balloon enteroscopy (DBE). Hookworm infections can cause overt gastrointestinal bleeding and should be screened in patients with overt obscure gastrointestinal bleeding (OGIB) in endemic infectious areas with sensitive methods. Specifically, the examination of stool specimens is clinically warranted for most patients, and the proper examination for stool eggs relies on staff's communication.

  8. Single Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients Who Underwent a Gastrectomy with Roux-en-Y Anastomosis: Six Cases from a Single Center.

    PubMed

    Soh, Jae Seung; Yang, Dong-Hoon; Lee, Sang Soo; Lee, Seohyun; Bae, Jungho; Byeon, Jeong-Sik; Myung, Seung-Jae; Yang, Suk-Kyun

    2015-09-01

    Patients with altered anatomy such as a Roux-en-Y anastomosis often present with various pancreaticobiliary problems requiring therapeutic intervention. However, a conventional endoscopic approach to the papilla is very difficult owing to the long afferent limb and acute angle of a Roux-en-Y anastomosis. Balloon-assisted enteroscopy can be used for endoscopic retrograde cholangiopancreatography (ERCP) in patients with altered anatomy. We experienced six cases of Roux-en-Y anastomosis with biliary problems, and attempted ERCP using single balloon enteroscopy (SBE). SBE insertion followed by replacement with a conventional endoscope was attempted in five of six patients. The papilla was successfully approached using SBE in all cases. However, therapeutic intervention was completed in only three cases because of poor maneuverability caused by postoperative adhesion. We conclude that in patients with Roux-en-Y anastomosis, the ampulla can be readily accessed with SBE, but longer dedicated accessories are necessary to improve this therapeutic intervention.

  9. Ileal Varices Treated with Balloon-Occluded Retrograde Transvenous Obliteration

    PubMed Central

    Sato, Takahiro; Yamazaki, Katsu; Toyota, Jouji; Karino, Yoshiyasu; Ohmura, Takumi; Akaike, Jun

    2009-01-01

    A 55-year-old man with hepatitis B virus antigen-positive liver cirrhosis was admitted to our hospital with anal bleeding. Colonoscopy revealed blood retention in the entire colon, but no bleeding lesion was found. Computed tomography images showed that vessels in the ileum were connected to the right testicular vein, and we suspected ileal varices to be the most probable cause of bleeding. We immediately performed double balloon enteroscopy, but failed to find any site of bleeding owing to the difficulty of fiberscope insertion with sever adhesion. Using a balloon catheter during retrograde transvenous venography, we found ileal varices communicating with the right testicular vein (efferent vein) with the superior mesenteric vein branch as the afferent vein of these varices. We performed balloon occluded retrograde transvenous obliteration by way of the efferent vein of the varices and have detected no further bleeding in this patient one year after treatment. PMID:27956966

  10. Ileal Varices Treated with Balloon-Occluded Retrograde Transvenous Obliteration.

    PubMed

    Sato, Takahiro; Yamazaki, Katsu; Toyota, Jouji; Karino, Yoshiyasu; Ohmura, Takumi; Akaike, Jun

    2009-04-01

    A 55-year-old man with hepatitis B virus antigen-positive liver cirrhosis was admitted to our hospital with anal bleeding. Colonoscopy revealed blood retention in the entire colon, but no bleeding lesion was found. Computed tomography images showed that vessels in the ileum were connected to the right testicular vein, and we suspected ileal varices to be the most probable cause of bleeding. We immediately performed double balloon enteroscopy, but failed to find any site of bleeding owing to the difficulty of fiberscope insertion with sever adhesion. Using a balloon catheter during retrograde transvenous venography, we found ileal varices communicating with the right testicular vein (efferent vein) with the superior mesenteric vein branch as the afferent vein of these varices. We performed balloon occluded retrograde transvenous obliteration by way of the efferent vein of the varices and have detected no further bleeding in this patient one year after treatment.

  11. Viability of single balloon enteroscopy performed under endoscopist-directed sedation.

    PubMed

    López Rosés, Leopoldo; Álvarez, Beatriz; González Ramírez, Abel; López Baz, Alina; Fernández López, Alexia; Alonso, Sara; Dacal, Andrés; Martí, Eva; Albines, Gino; Fernández Molina, Julieta; Lancho, Ángel

    2018-04-01

    there is a lot of controversy with regard to who should be responsible for sedation during digestive endoscopy, particularly in advanced procedures that require deep sedation such as enteroscopy. The aim of this study was to evaluate the endoscopist-directed sedation viability during single balloon enteroscopy. this was a prospective, observational study of a series of consecutive enteroscopies. The clinical staff included an endoscopist, scrub nurse and a nurse in charge of monitoring and sedative administration. The following parameters were monitored: pulse oximetry, blood pressure (every five minutes), electrocardiogram and respiratory rate. There was continuous supplemental oxygen and CO2 insufflation. The patient was in the left lateral decubitus position and a fluoroscopic control was used. forty-four explorations were performed in 39 patients, 24 were male and 15 female. The median age was 74 (18-89) and the ASA score was I in 12 cases, II in 23 cases and III in nine cases. Comorbidities were present in 68% of cases. The drugs used included propofol in 23 cases, propofol and midazolam in ten cases, propofol/midazolam/fentanyl in two cases, propofol and fentanyl in two cases, and midazolam/fentanyl in seven cases. All procedures were complete. The length of the procedure was 52 minutes (20-120). There were diagnostic findings in 65.9% of cases and therapeutic measures in 47.7%. There were no severe complications and the rate of complications derived from sedation was 22.7%. endoscopist-directed sedation is effective and safe for single balloon enteroscopy. Multi-center and wider studies are needed in order to better assess the efficacy, safety and efficiency of sedation controlled by a non-anesthetist during advanced endoscopy in this field.

  12. Feasibility of spiral enteroscopy in Japanese patients: study in two tertiary hospitals.

    PubMed

    Yamada, Atsuo; Watabe, Hirotsugu; Oka, Shiro; Kogure, Hirofumi; Imagawa, Hiroki; Kobayashi, Yuka; Suzuki, Hirobumi; Watari, Ikue; Aoyama, Taiki; Isayama, Hiroyuki; Yamaji, Yutaka; Fujishiro, Mitsuhiro; Tanaka, Shinji; Koike, Kazuhiko

    2013-07-01

    Despite recent advances in enteroscopy, such as balloon enteroscopy, accessing the small intestine remains challenging. Spiral enteroscopy is a novel technique in which an endoscope is fitted with a rotating overtube that has a soft spiral fin at the tip. Whereas spiral enteroscopy is beginning to be carried out in Western countries, it is not common in many Asian countries. The aim of the present study was to evaluate the efficacy and safety of spiral enteroscopy in Japanese patients. We prospectively conducted spiral enteroscopy in patients with suspected or known small bowel disease. All procedures were carried out using a spiral overtube. The main outcome measurements of the study were diagnosis rate, endoscopic intervention rate, and complication rate. Thirty-two patients underwent spiral enteroscopy. Spiral enteroscopy diagnosed 16 patients (50%) with small intestinal lesions, including six malignant lymphomas (19%), three erosions or ulcers (9%), three polyps (9%), two angioectasias (6%), one carcinoma (3%), and one submucosal tumor (3%). Additionally, four patients underwent endoscopic interventions (13%). Mallory-Weiss syndrome occurred in one patient (3%). No perforation occurred in any patient (0%). Our initial experience of spiral enteroscopy suggests that it can be introduced safely, but it is relatively invasive and technically demanding. More experience is needed to conduct spiral enteroscopy easily and safely. © 2012 The Authors. Digestive Endoscopy © 2012 Japan Gastroenterological Endoscopy Society.

  13. Detection Rate and Clinical Relevance of Ink Tattooing during Balloon-Assisted Enteroscopy

    PubMed Central

    Ebigbo, A.; Schrempf, M.; Messmann, H.; Gölder, S. K.

    2017-01-01

    Background and Aims Balloon-assisted enteroscopy (BAE) is a well-established tool in the diagnosis and therapy of small bowel diseases. Ink tattooing of the small bowel is used to mark pathologic lesions or the depth of small bowel insertion. The purpose of this study was to determine the safety, the detection rate, and the clinical relevance of ink tattooing during BAE. Methods We performed a retrospective analysis of all 81 patients who received an ink tattooing during BAE between 2010 and 2015. Results In all patients, ink tattooing was performed with no complications. 26 patients received a capsule endoscopy after BAE. The tattoo could be detected via capsule endoscopy in 19 of these 26 patients. The tattoo of the previous BAE could be detected via opposite BAE in 2 of 11 patients. In 9 patients, ink tattooing influenced the choice of approach for reenteroscopy. In 7 patients, the tattoo was used for intraoperative localization and in 3 patients for intraoperative localization as well as for reenteroscopy. The intraoperative detection rate of the tattoo was 100%. Conclusion Ink tattooing of the small intestine is a safe endoscopic procedure to mark the depth of scope insertion or a pathologic lesion during balloon-assisted enteroscopy. PMID:29230241

  14. Systematic review and meta-analysis of single-balloon enteroscopy-assisted ERCP in patients with surgically altered GI anatomy.

    PubMed

    Inamdar, Sumant; Slattery, Eoin; Sejpal, Divyesh V; Miller, Larry S; Pleskow, Douglas K; Berzin, Tyler M; Trindade, Arvind J

    2015-07-01

    Surgically altered pancreaticobiliary anatomy increases the difficulty of performing ERCP. Single-balloon enteroscopy (SBE) is a relatively new technique that can be used for ERCP in patients with surgically altered anatomy. To evaluate the therapeutic and diagnostic success of SBE-ERCP among patients with surgically altered anatomy. Systematic review and meta-analysis of studies involving SBE-ERCP in patients with Roux-en-Y gastric bypass, hepaticojejunostomy, or Whipple procedure. Enteroscopy success was defined as success in reaching the papilla and/or biliary anastomosis by using SBE. Diagnostic success was defined as obtaining a cholangiogram. Procedural success was defined as the ability to provide successful intervention, if appropriate. A random-effects model was used. A total of 461 patients underwent SBE-ERCP from 15 trials. The pooled enteroscopy, diagnostic, and procedural success rates were 80.9% (95% confidence interval [CI], 75.3%-86.4%), 69.4% (95% CI, 61.0%-77.9%), and 61.7% (95% CI, 52.9%-70.5%), respectively. There was statistical large heterogeneity for enteroscopy, diagnostic, and therapeutic success (P < .001 for all). Adverse events occurred in 6.5% (95% CI, 4.7%-9.1%) of patients. There was no evidence of publication bias in this meta-analysis. Our findings and interpretations are limited by the quantity and heterogeneity of the studies included in the analysis. SBE-ERCP has high diagnostic and procedural success rates in this challenging patient population. It should be considered a first-line intervention when biliary access is required after Roux-en-Y gastric bypass, hepaticojejunostomy, or Whipple procedure. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  15. Enteroscopy in the diagnosis and management of celiac disease.

    PubMed

    Rondonotti, Emanuele; Villa, Federica; Saladino, Valeria; de Franchis, Roberto

    2009-07-01

    Esophagogastroduodenoscopy (EGD) with 3 to 6 biopsies in the descending duodenum is the gold standard for the diagnosis of celiac disease. At the time of the first diagnosis of celiac disease, an extensive evaluation of the small bowel is not recommended. However, video capsule endoscopy, because of its good sensitivity and specificity in recognizing the Endoscopic features of celiac disease, can be considered a valid alternative to EGD in patients unable or unwilling to undergo EGD with biopsies. Capsule endoscopy is also a possible option in selected cases with strong suspicion of celiac disease but negative first-line tests. In evaluating patients with refractory or complicated celiac disease, in whom a complete evaluation of the small bowel is mandatory (at least in refractory celiac disease type II patients) because of the possible presence of complications beyond the reach of conventional endoscopes, both capsule endoscopy and balloon-assisted enteroscopy have been found to be helpful. In these patients, capsule endoscopy offers several advantages: it is well tolerated, it allows inspection of the entire small bowel, and it is able to recognize subtle mucosal changes. However, in this setting, capsule endoscopy should ideally be coupled with imaging techniques that provide important information about the thickness of the wall of the intestine and about extraluminal abnormalities. Although deep enteroscopy (such as balloon enteroscopy) is expensive, time-consuming, and potentially risky in these frail patients, they may have a key role, because they make it possible to take tissue samples from deep in the small intestine.

  16. Double-balloon endoscopy for retrograde cholangiography in patients with choledochojejunostomy and Roux-en-Y reconstruction.

    PubMed

    Pohl, J; May, A; Aschmoneit, I; Ell, C

    2009-02-01

    Choledochojejunal anastomoses with Roux-en-Y reconstruction excludes the biliary tract from conventional endoscopic retrograde cholangiography (ERC) with standard endoscopes due to the length of the interposed small bowel segment. Double-balloon enteroscopy (DBE) facilitates deep insertion into the small bowel and may be used to perform ERC in these patients. In the present case series we report our experience with diagnostic and therapeutic double-balloon ERC in patients with choledochojejunostomy to a long Roux-en-Y loop previously unavailable for standard length endoscopes. Between December 2004 and May 2008 15 patients (mean age: 60.2 years) with choledochojejunal anastomosis underwent a total of 25 DBE-ERC procedures. Cannulation of the bile ducts was achieved in 22 / 25 procedures (84 %). Twenty-one therapeutic interventions, including stone removal, biliary duct dilation, stent placement and removal of previously placed stents were performed during 16 procedures in 8 patients. The mean total duration time of the procedures was 74.6 +/- 25.0 minutes. Postinterventional self-limiting fever occurred after 4 procedures in 3 patients with cholangitis. After therapeutic interventions all patients had a significant drop of bilirubin levels and all except one patient were free of complaints (follow-up 10.4 +/- 8.6 months). The DBE system permits diagnostic and therapeutic ERC in surgically modified anatomy, previously unavailable for endoluminal access. In our experience this procedure is safe and has a high success rate with a favourable patient outcome.

  17. Protein C deficiency related obscure gastrointestinal bleeding treated by enteroscopy and anticoagulant therapy.

    PubMed

    Hsu, Wei-Fan; Tsang, Yuk-Ming; Teng, Chung-Jen; Chung, Chen-Shuan

    2015-01-21

    Obscure gastrointestinal bleeding is an uncommonly encountered and difficult-to-treat clinical problem in gastroenterology, but advancements in endoscopic and radiologic imaging modalities allow for greater accuracy in diagnosing obscure gastrointestinal bleeding. Ectopic varices account for less than 5% of all variceal bleeding cases, and jejunal variceal bleeding due to extrahepatic portal hypertension is rare. We present a 47-year-old man suffering from obscure gastrointestinal bleeding. Computed tomography of the abdomen revealed multiple vascular tufts around the proximal jejunum but no evidence of cirrhosis, and a visible hypodense filling defect suggestive of thrombus was visible in the superior mesenteric vein. Enteroscopy revealed several serpiginous varices in the proximal jejunum. Serologic data disclosed protein C deficiency (33.6%). The patient was successfully treated by therapeutic balloon-assisted enteroscopy and long-term anticoagulant therapy, which is normally contraindicated in patients with gastrointestinal bleeding. Diagnostic modalities for obscure gastrointestinal bleeding, such as capsule endoscopy, computed tomography enterography, magnetic resonance enterography, and enteroscopy, were also reviewed in this article.

  18. 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

  19. Update on imaging of Peutz-Jeghers syndrome

    PubMed Central

    Tomas, Catherine; Soyer, Philippe; Dohan, Anthony; Dray, Xavier; Boudiaf, Mourad; Hoeffel, Christine

    2014-01-01

    Peutz-Jeghers syndrome (PJS) is a rare, autosomal dominant disease linked to a mutation of the STK 11 gene and is characterized by the development of benign hamartomatous polyps in the gastrointestinal tract in association with a hyperpigmentation on the lips and oral mucosa. Patients affected by PJS have an increased risk of developing gastrointestinal and extra-digestive cancer. Malignancy most commonly occurs in the small-bowel. Extra-intestinal malignancies are mostly breast cancer and gynecological tumors or, to a lesser extent, pancreatic cancer. These polyps are also at risk of acute gastrointestinal bleeding, intussusception and bowel obstruction. Recent guidelines recommend regular small-bowel surveillance to reduce these risks associated with PJS. Small-bowel surveillance allows for the detection of large polyps and the further referral of selected PJS patients for endoscopic enteroscopy or surgery. Video capsule endoscopy, double balloon pushed enteroscopy, multidetector computed tomography and magnetic resonance enteroclysis or enterography, all of which are relatively new techniques, have an important role in the management of patients suffering from PJS. This review illustrates the pathological, clinical and imaging features of small-bowel abnormalities as well as the role and performance of the most recent imaging modalities for the detection and follow-up of PJS patients. PMID:25152588

  20. Single-photon emission computed tomography enhanced Tc-99m-pertechnetate disodium-labelled red blood cell scintigraphy in the localization of small intestine bleeding: a single-centre twelve-year study.

    PubMed

    Dolezal, Jiri; Vizda, Jaroslav; Kopacova, Marcela

    2011-01-01

    To present our experience with the detection of bleeding in the small intestine by means of scintigraphy with in vivo-labelled red blood cells (RBCs) in the period of 1998-2009. A 12-year prospective study was accomplished with 40 patients (23 men, 17 women, aged 12-91, mean 56 years) who had lower gastrointestinal bleeding (obscure-overt bleeding) and underwent scintigraphy with in vivo-labelled RBCs by means of technetium 99m. The scintigraphy was usually performed after other diagnostic tests had failed to locate the bleeding. A total of 26 patients had a positive scintigraphy with in vivo-labelled RBCs and 14 patients had negative scintigraphy. The final diagnosis was confirmed in 20 of 26 patients with a positive scintigraphy by push enteroscopy (6/20), intraoperative enteroscopy (7/20), surgery (4/20), duodenoscopy (1/20), double-balloon enteroscopy (1/20) and X-ray angiography (1/20). The correct location of the bleeding site was identified by RBC scintigraphy in 15 of 20 (75%) patients with the confirmed source. The locations of the bleeding site identified by scintigraphy and enteroscopy (push, intraoperative) and surgical investigations were highly correlated in patients with a positive scintigraphy within the first 3 h. Eleven of the 20 correctly localized studies and none of the incorrectly localized studies were positive in the dynamic phase of imaging. In 5 patients (all erroneously localized), scintigraphy was positive only at a period longer than 18 h. RBC scintigraphy is an effective imaging modality in localizing lower gastrointestinal bleeding in patients for whom other diagnostic tests have failed to locate the bleeding. RBC scintigraphy can be successful in the detection of bleeding sites in the small intestine. Copyright © 2011 S. Karger AG, Basel.

  1. Linitis plastica of the bypassed stomach 7 years after Roux-en-Y gastric bypass: a case report.

    PubMed

    Haenen, Filip Wn; Gys, Ben; Moreels, Tom; Michielsen, Maartje; Gys, Tobie; Lafullarde, Thierry

    2017-12-01

    Laparoscopic Roux-en-Y gastric bypass (RYGB) is currently the preferred surgical procedure to treat morbid obesity. It has proven its effects on excess weight loss and its positive effect on comorbidities. One of the main issues, however, is the post-operative evaluation of the bypassed gastric remnant. In literature, cancer of the excluded stomach after RYGB is rare. We describe the case of a 52-year-old woman with gastric linitis plastica in the bypassed stomach after Roux-en-Y gastric bypass, diagnosed by means of laparoscopy and Single-Balloon enteroscopy, and it is clinical importance. Linitis plastica of the excluded stomach after RYGB is a very rare entity. This case report shows the importance of long-term post-operative follow-up, and the importance of single-balloon enteroscopy for visualization of the bypassed stomach remnant, when other investigations remain without results. This case report is only the second report of a linitis plastica in the bypassed stomach after Roux-en-Y gastric bypass.

  2. Success of single-balloon enteroscopy in patients with surgically altered anatomy.

    PubMed

    Kurzynske, Frank C; Romagnuolo, Joseph; Brock, Andrew S

    2015-08-01

    Single-balloon enteroscopy (SBE) was introduced in 2007 to diagnose and treat small-bowel disorders. No study to date has evaluated SBE in patients with surgically altered anatomy outside of ERCP. To evaluate the efficacy, yield, and safety of SBE in patients with surgically altered anatomy. Retrospective study. Tertiary-care academic medical center. All patients with altered surgical anatomy who underwent SBE at the Medical University of South Carolina from July 2007 to September 2013. SBE. Diagnostic yield, therapeutic yield, technical success, and adverse events. A total of 48 patients met inclusion criteria. Mean age was 56 years (77% female). Eleven patients underwent single-balloon PEG placement, 8 single-balloon ERCP, 22 non-PEG/non-ERCP anterograde SBE, and 7 retrograde SBE. Previous surgeries included Roux-en-Y gastric bypass (n=26), small-intestine resection (n=6), colon resection (n=5), Whipple procedure (n=4), choledochojejunostomy (n=3), hepaticojejunostomy (n=1), Billroth I (n=1), Billroth II (n=1), and Puestow procedure (n=1). Procedural indications were PEG tube placement (n=11), choledocholithiasis (n=2), biliary stricture (n=2), obstructive jaundice (n=1), cholangitis (n=1), ampullary mass (n=1), sphincter of Oddi dysfunction (n=1), anemia and/or bleeding (n=15), abdominal pain (n=9), radiologic evidence of obstruction (n=3), and Peutz-Jeghers syndrome (n=2). The technical success rate was 73% in single-balloon PEG placement, 88% in single-balloon ERCP, 82% in other anterograde SBEs, and 86% in retrograde SBEs. No intraprocedural or postprocedural adverse events were observed. Single center, retrospective study. SBE is safe and effective in patients with surgically altered anatomy. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  3. Enteroscopic Tattooing for Better Intraoperative Localization of a Bleeding Jejunal GIST Facilitates Minimally Invasive Laparoscopically-assisted Surgery.

    PubMed

    Iacob, Razvan; Dimitriu, Anca; Stanciulea, Oana; Herlea, Vlad; Popescu, Irinel; Gheorghe, Cristian

    2016-03-01

    We present the case of a 63-year-old man that was admitted for melena and severe anemia. Upper GI endoscopy and colonoscopy failed to identify the lesion responsible for bleeding, and enteroCT scan was also non-contributive to the diagnosis. Capsule endoscopy indicated possible jejunal bleeding but could not indicate the source of bleeding, recommending anterograde enteroscopy. Single balloon enteroscopy identified a 2 cm submucosal tumour in the distal part of the jejunum, with a macroscopic appearance suggesting a gastrointestinal stromal tumour (GIST). The tumor location was marked using SPOT tattoo and subsequently easily identified by the surgeon and resected via minimally invasive laparoscopic-assisted approach. Histological and immunohistochemical analysis indicated a low risk GIST. The unusual small size of the GIST as a modality of presentation, with digestive bleeding and anemia and the ability to use VCE/enteroscopy to identify and mark the lesion prior to minimally invasive surgery, represent the particularities of the presented case.

  4. 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 knife using a guidewire. The mean total duration of the procedure was 93.6 ± 6.8 min and the mean time required to reach the papilla was 30.5 ± 3.7 min. The mean time required to reach the papilla tended to be shorter in Billroth II reconstruction (20.9 ± 5.8 min) than that in Roux-en-Y total gastrectomy (37.1 ± 4.9 min) but there was no significant difference (P = 0.09). A major complication occurred in one patient (3.5%); perforation of the long limb in a patient with Billroth II anastomosis. CONCLUSION: Short-type DBE combined with several technical innovations enabled us to perform ERCP in most patients with altered gastrointestinal anatomy. PMID:23239923

  5. Digital clubbing in primary intestinal lymphangiectasia: a case report.

    PubMed

    Wiedermann, Christian J; Kob, Michael; Benvenuti, Stefano; Carella, Rodolfo; Lucchin, Lucio; Piazzi, Lucia; Chilovi, Fausto; Mazzoleni, Guido

    2010-08-01

    Primary intestinal lymphangiectasia (PIL), also known as Waldmann's disease, is a rare disorder characterized by dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen and responsible for protein-losing enteropathy leading to lymphopenia, hypoalbuminemia and hypogammaglobulinemia. The symptoms usually start in early infancy. We report a case of secondary hyperparathyroidism, osteopenia, monoclonal gammopathy and digital clubbing in a 57-year-old patient with a 12-year history of discontinuous diarrhea. Malabsorption with inability to gain weight, and finally weight loss and formation of leg edema were associated with protein-losing enteropathy. A low-fat diet associated with medium-chain triglyceride supplementation was clinically effective as medical management in reducing diarrhea and leg edema, and promoting weight gain. Double-balloon enteroscopy and small bowel biopsy histopathology confirmed dilated intestinal lacteals. Digital clubbing associated with primary intestinal lymphangiectasia which may causally be related to chronic platelet excess has not been reported before.

  6. Peutz-Jeghers syndrome: Diagnostic and therapeutic approach

    PubMed Central

    Kopacova, Marcela; Tacheci, Ilja; Rejchrt, Stanislav; Bures, Jan

    2009-01-01

    Peutz-Jeghers syndrome (PJS) is an inherited, autosomal dominant disorder distinguished by hamartomatous polyps in the gastrointestinal tract and pigmented mucocutaneous lesions. Prevalence of PJS is estimated from 1 in 8300 to 1 in 280 000 individuals. PJS predisposes sufferers to various malignancies (gastrointestinal, pancreatic, lung, breast, uterine, ovarian and testicular tumors). Bleeding, obstruction and intussusception are common complications in patients with PJS. Double balloon enteroscopy (DBE) allows examination and treatment of the small bowel. Polypectomy using DBE may obviate the need for repeated urgent operations and small bowel resection that leads to short bowel syndrome. Prophylaxis and polypectomy of the entire small bowel is the gold standard in PJS patients. Intraoperative enteroscopy (IOE) was the only possibility for endoscopic treatment of patients with PJS before the DBE era. Both DBE and IOE facilitate exploration and treatment of the small intestine. DBE is less invasive and more convenient for the patient. Both procedures are generally safe and useful. An overall recommendation for PJS patients includes not only gastrointestinal multiple polyp resolution, but also regular lifelong cancer screening (colonoscopy, upper endoscopy, computed tomography, magnetic resonance imaging or ultrasound of the pancreas, chest X-ray, mammography and pelvic examination with ultrasound in women, and testicular examination in men). Although the incidence of PJS is low, it is important for clinicians to recognize these disorders to prevent morbidity and mortality in these patients, and to perform presymptomatic testing in the first-degree relatives of PJS patients. PMID:19916169

  7. A case of gastrojejunocolic fistula with steatohepatitis.

    PubMed

    Omori, Teppei; Tokushige, Katsutoshi; Kinoshita, Fukiko; Ito, Ayumi; Taniai, Makiko; Taneichi, Mikiko; Iizuka, Bunei; Itabashi, Michio; Nagashima, Yoji; Yamamoto, Masakazu; Nakamura, Shinichi; Hashimoto, Etsuko

    2017-02-01

    A man in his 30s, who had undergone retrocolic Billroth II reconstruction for perforated duodenal ulcer, presented with watery diarrhea for 2 years and suspected fatty liver. He was referred to our hospital for management of chronic diarrhea, weight loss, hepatopathy and hypoalbuminemia. Initial upper and lower gastrointestinal endoscopies were negative. Since a small bowel lesion was suspected, peroral single-balloon enteroscopy was performed, which identified feces-like residue near the Billroth II anastomotic site and a connection to the colon separate from the afferent and efferent loops. Transanal single-balloon enteroscopy identified a fistula between the gastrojejunal anastomosis and transverse colon, with the scope reaching the stomach transanally. Barium enema confirmed flow of contrast medium from the transverse colon through the fistula to the anastomotic site, allowing the diagnosis of gastrojejunocolic fistula. Liver biopsy showed relatively severe steatohepatitis (Brunt's classification: stage 2-3, grade 3). Resection of the anastomotic site and partial transverse colectomy were performed to remove the fistula, followed by Roux-en-Y reconstruction. Postoperatively, watery diarrhea resolved and the stools became normal. Hepatopathy and hypoproteinemia improved. One year later, liver biopsy showed marked improvement of steatosis. This case demonstrated marked improvement of both diarrhea/nutritional status and steatohepatitis after treatment of gastrojejunocolic fistula, suggesting that the fistula caused non-alcoholic steatohepatitis.

  8. Small bowel capsule endoscopy in 2007: Indications, risks and limitations

    PubMed Central

    Rondonotti, Emanuele; Villa, Federica; Mulder, Chris JJ; Jacobs, Maarten AJM; de Franchis, Roberto

    2007-01-01

    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). PMID:18069752

  9. Primary intestinal lymphangiectasia: Minireview

    PubMed Central

    Ingle, Sachin B; Hinge (Ingle), Chitra R

    2014-01-01

    Primary idiopathic intestinal lymphangiectasia is an unusual disease featured by the presence of dilated lymphatic channels which are located in the mucosa, submucosa or subserosa leading to protein loosing enteropathy.Most often affected were children and generally diagnosed before third year of life but may be rarely seen in adults too. Bilateral pitting oedema of lower limb is the main clinical manifestation mimicking the systemic disease and posing a real diagnostic dilemma to the clinicians to differentiate it from other common systemic diseases like Congestive cardiac failure, Nephrotic Syndrome, Protein Energy Malnutrition, etc. Diagnosis can be made on capsule endoscopy which can localise the lesion but unable to take biopsy samples. Thus, recently double-balloon enteroscopy and biopsy in combination can be used as an effective diagnostic tool to hit the correct diagnosis. Patients respond dramatically to diet constituting low long chain triglycerides and high protein content with supplements of medium chain triglyceride. So early diagnosis is important to prevent untoward complications related to disease or treatment for the sake of accurate pathological diagnosis. PMID:25325063

  10. Usefulness of positron emission tomography in primary intestinal follicular lymphoma

    PubMed Central

    Tari, Akira; Asaoku, Hideki; Kunihiro, Masaki; Tanaka, Shinji; Yoshino, Tadashi

    2013-01-01

    Double-balloon enteroscopy (DBE) and video capsule endoscopy are useful for the diagnosis of lymphoma in the small intestine. However, DBE cannot be safely performed in cases with passage disturbance due to wall thickening and stenosis. Additionally, video capsule endoscopy cannot be performed in such cases because of the risk of retention. Here, we report 4 cases of primary follicular lymphoma of the gastrointestinal tract that could be detected using 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (PET-CT). The endoscopic findings of these 4 cases included lesions with wall thickening, which comprised macroscopically clusters of nodules, dense clusters of whitish granules or small nodules, fold thickening and ulcers with irregular margins that occupied the whole lumen with edematous mucosa. All patients fulfilled the World Health Organization grade 1 criteria. 18F-fluorodeoxyglucose PET-CT can help predict the risks that may result from certain endoscopic examinations, such as DBE and video capsule endoscopy. PMID:23569346

  11. Peritoneal Lipomatosis: A Case Report of a 12-Year-Old Boy

    PubMed Central

    Fotis, L.; Koglmeier, J.; Shah, N.

    2013-01-01

    Peritoneal lipomatosis is a rare disease in childhood with only two cases previously described in children. We report a further case of a 12-year-old boy diagnosed with peritoneal lipomatosis. His main symptoms were abdominal pain, alternating bowel habit, abdominal distension, and melaena. His diagnostic work up included an abdominal MRI, wireless capsule endoscopy and single-balloon enteroscopy. Peritoneal lipomatosis although rare can be diagnosed in childhood. It is a benign clinical entity with variable manifestations. PMID:23762668

  12. Endoscopic features of gastro-intestinal lymphomas: From diagnosis to follow-up

    PubMed Central

    Vetro, Calogero; Romano, Alessandra; Amico, Irene; Conticello, Concetta; Motta, Giovanna; Figuera, Amalia; Chiarenza, Annalisa; Di Raimondo, Cosimo; Giulietti, Giorgio; Bonanno, Giacomo; Palumbo, Giuseppe Alberto; Di Raimondo, Francesco

    2014-01-01

    Many progresses have been done in the management of gastrointestinal (GI) lymphomas during last decades, especially after the discovery of Helicobacter pylori-dependent lymphoma development. The stepwise implementation of new endoscopic techniques, by means of echoendoscopy or double-balloon enteroscopy, enabled us to more precisely describe the endoscopic features of GI lymphomas with substantial contribution in patient management and in tailoring the treatment strategy with organ preserving approaches. In this review, we describe the recent progresses in GI lymphoma management from disease diagnosis to follow-up with a specific focus on the endoscopic presentation according to the involved site and the lymphoma subtype. Additionally, new or emerging endoscopic technologies that have an impact on the management of gastrointestinal lymphomas are reported. We here discuss the two most common subtypes of GI lymphomas: the mucosa-associated lymphoid tissue and the diffuse large B cell lymphoma. A general outline on the state-of-the-art of the disease and on the role of endoscopy in both diagnosis and follow-up will be performed. PMID:25278693

  13. Prevention and management of non-steroidal anti-inflammatory drugs-induced small intestinal injury

    PubMed Central

    Park, Sung Chul; Chun, Hoon Jai; Kang, Chang Don; Sul, Donggeun

    2011-01-01

    Non-steroidal anti-inflammatory drug (NSAID)-induced small bowel injury is a topic that deserves attention since the advent of capsule endoscopy and balloon enteroscopy. NSAID enteropathy is common and is mostly asymptomatic. However, massive bleeding, stricture, or perforation may occur. The pathogenesis of small intestine injury by NSAIDs is complex and different from that of the upper gastrointestinal tract. No drug has yet been developed that can completely prevent or treat NSAID enteropathy. Therefore, a long-term randomized study in chronic NSAID users is needed. PMID:22180706

  14. Effect of a quality program with adverse events identification on airway management during overtube-assisted enteroscopy.

    PubMed

    Lara, Luis F; Ukleja, Andrew; Pimentel, Ronnie; Charles, Roger J

    2014-11-01

    Adverse events associated with overtube-assisted enteroscopy are similar to those with routine endoscopy. Our endoscopy quality program identified a number of respiratory adverse events resulting in emergency resuscitation efforts. The aim is to report all adverse events identified by quality monitoring and outcomes of adverse events associated with overtube-assisted enteroscopy. A retrospective study used data prospectively obtained from consecutive patients undergoing overtube-assisted enteroscopy between December 2008 and July 2012. Patient characteristics, medical history, procedure indication, and procedure outcomes, including diagnosis, endoscopic therapy, and complications, were obtained. In 432 overtube-assisted enteroscopies, 15 adverse events (most frequently hypoxemia, 9 /15, 60 %) occurred in 14 patients (3.2 % of total cohort; 12 were outpatients) mostly during antegrade enteroscopy. Four patients required endotracheal intubation and 4 /12 outpatients required intensive care. The procedure was aborted in 13 /14 patients, and only 1 of 10 patients scheduled for repeat antegrade enteroscopy returned. There was no mortality. Based on the frequency of adverse events, and in consultation with anesthesia providers, from August 2012 all antegrade overtube-assisted enteroscopies at our institution were done with general anesthesia. From then till September 2013, 145 antegrade and 52 retrograde overtube-assisted enteroscopies have been done, with no adverse events. Monitoring of endoscopy practice identified adverse events associated with overtube-assisted enteroscopy. The peer-review prompted a change in practice: all patients undergoing antegrade overtube-assisted enteroscopy at our institution now have endotracheal intubation which has dramatically decreased the rate of respiratory adverse events. The impact of endoscopic quality measurements on practices, procedures, and outcomes will be of further interest. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Classification of intestinal lymphangiectasia with protein-losing enteropathy: white villi type and non-white villi type.

    PubMed

    Ohmiya, Naoki; Nakamura, Masanao; Yamamura, Takeshi; Yamada, Koji; Nagura, Asuka; Yoshimura, Toru; Hirooka, Yoshiki; Hirata, Ichiro; Goto, Hidemi

    2014-01-01

    We classified intestinal lymphangiectasia (IL) into two categories, the white and non-white villi types, and evaluated their clinical characteristics and therapeutic responses. Of the 988 patients who underwent double-balloon enteroscopy, 14 consecutive patients (7 men and 7 women, median age at onset 34 years) were enrolled with immunohistochemically confirmed IL with protein-losing enteropathy. Enteroscopically the white villi type (n = 8) showed white plaques and white-tipped villi were scattered in the small bowel, while non-white villi type (n = 6) showed that apparently normal but under more detailed observation, low and round villi with a normal color were diffused. The serum albumin levels and fecal α1-antitrypsin clearance before treatment were significantly worse in the non-white villi type (p = 0.017 and 0.039, respectively), whereas the serum immunoglobulin A and M levels were significantly lower in the white villi type (p = 0.010 and 0.046, respectively). At gastroscopy, a non-cirrhotic snakeskin appearance was significantly observed in the non-white villi type (p = 0.015). The corticosteroid response was better in the non-white villi type (p = 0.015). Two distinct subgroups were found in IL. This classification was useful in pathophysiological clustering and in predicting the therapeutic response. © 2014 S. Karger AG, Basel.

  16. A novel method of forceps biopsy improves the diagnosis of proximal biliary malignancies.

    PubMed

    Kulaksiz, Hasan; Strnad, Pavel; Römpp, Achim; von Figura, Guido; Barth, Thomas; Esposito, Irene; Schirmacher, Peter; Henne-Bruns, Doris; Adler, Guido; Stiehl, Adolf

    2011-02-01

    Tissue specimen collection represents a cornerstone in diagnosis of proximal biliary tract malignancies offering great specificity, but only limited sensitivity. To improve the tumor detection rate, we developed a new method of forceps biopsy and compared it prospectively with endoscopic transpapillary brush cytology. 43 patients with proximal biliary stenoses, which were suspect for malignancy, undergoing endoscopic retrograde cholangiography were prospectively recruited and subjected to both biopsy [using a double-balloon enteroscopy (DBE) forceps under a guidance of a pusher and guiding catheter with guidewire] and transpapillary brush cytology. The cytological/histological findings were compared with the final clinical diagnosis. 35 out of 43 patients had a malignant disease (33 cholangiocarcinomas, 1 hepatocellular carcinoma, 1 gallbladder carcinoma). The sensitivity of cytology and biopsy in these patients was 49 and 69%, respectively. The method with DBE forceps allowed a pinpoint biopsy of the biliary stenoses. Both methods had 100% specificity, and, when combined, 80% of malignant processes were detected. All patients with non-malignant conditions were correctly assigned by both methods. No clinically relevant complications were observed. The combination of forceps biopsy and transpapillary brush cytology is safe and offers superior detection rates compared to both methods alone, and therefore represents a promising approach in evaluation of proximal biliary tract processes.

  17. Small Bowel Bleeding

    MedlinePlus

    ... the term is used specifically to indicate a procedure using a standard upper endoscope, but it can also be used ... approximately 70% of the patients who require the ... enteroscopy, deep enteroscopy, or intraoperative enteroscopy (depending on ...

  18. Double balloon protection during carotid artery stenting for vulnerable carotid stenosis reduces the incidence of new brain lesions.

    PubMed

    Nakazaki, Masahito; Nonaka, Tadashi; Takahashi, Akira; Yonemasu, Yasuyuki; Nomura, Tatsufumi; Onda, Toshiyuki; Honda, Osamu; Hashimoto, Yuji; Ohnishi, Hirofumi; Sasaki, Masanori; Daibo, Masahiko; Honmou, Osamu

    2016-07-01

    The use of distal filter protection alone is associated with a high risk of ischemic complications when vulnerable carotid stenosis is treated by carotid artery stenting (CAS). Double balloon protection, a combination of distal balloon protection and proximal balloon occlusion, can be utilized. We assessed the outcome and complications of the double balloon protection method for vulnerable carotid stenosis. Among 130 patients who underwent CAS from 2009 to 2014, we enrolled the following patients: those whose target lesion was vulnerable as evaluated by MRI, i.e., a signal ratio of plaque to posterior cervical muscle on T1-weighted images before CAS of ≥1.5, and those who underwent diffusion-weighted imaging (DWI) studies within 48 h after the procedure. Ninety patients were enrolled. We investigated DWI findings of the double balloon protection group compared with those of the simple distal balloon protection and distal filter protection groups. Sixty-four patients (71 %) underwent double balloon protection, 15 patients (17 %) simple distal balloon protection, and 11 patients (12 %) distal filter protection. Symptomatic embolic complications and new lesions on DWI after CAS were significantly less common in patients undergoing double balloon protection compared to distal balloon protection or distal filter protection (0 % vs. 20 %, 9 %, P < 0.01, and 30 % vs. 67 %, 82 %, P < 0.01, respectively). Logistic regression analysis also identified the odds ratio of double balloon protection for new lesions on DWI after CAS of 0.23 (95 % confidence interval: 0.07-0.70, P < 0.01) compared to simple distal protections. In the patients who underwent CAS for vulnerable carotid stenosis, double balloon protection was an independent significant factor associated with a reduction in the risk of new lesions on DWI after the procedure compared to conventional distal protections.

  19. Wireless capsule endoscopy: a comparison with push enteroscopy in patients with gastroscopy and colonoscopy negative gastrointestinal bleeding

    PubMed Central

    Mylonaki, M; Fritscher-Ravens, A; Swain, P

    2003-01-01

    Background: The development of wireless capsule endoscopy allows painless imaging of the small intestine. Its clinical use is not yet defined. The aim of this study was to compare the clinical efficacy and technical performance of capsule endoscopy and push enteroscopy in a series of 50 patients with colonoscopy and gastroscopy negative gastrointestinal bleeding. Methods: A wireless capsule endoscope was used containing a CMOS colour video imager, transmitter, and batteries. Approximately 50 000 transmitted images are received by eight abdominal aerials and stored on a portable solid state recorder, which is carried on a belt. Push enteroscopy was performed using a 240 cm Olympus video enteroscope. Results: Studies in 14 healthy volunteers gave information on normal anatomical appearances and preparation. In 50 patients with gastrointestinal bleeding and negative colonoscopy and gastroscopy, push enteroscopy was compared with capsule endoscopy. A bleeding source was discovered in the small intestine in 34 of 50 patients (68%). These included angiodysplasia (16), focal fresh bleeding (eight), apthous ulceration suggestive of Crohn’s disease (three), tumour (two), Meckel’s diverticulum (two), ileal ulcer (one), jejunitis (one), and ulcer due to intussusception (one). One additional intestinal diagnosis was made by enteroscopy. The yield of push enteroscopy in evaluating obscure bleeding was 32% (16/50). The capsule identified significantly more small intestinal bleeding sources than push enteroscopy (p<0.05). Patients preferred capsule endoscopy to push enteroscopy (p<0.001). Conclusions: In this study capsule endoscopy was superior to push enteroscopy in the diagnosis of recurrent bleeding in patients who had a negative gastroscopy and colonoscopy. It was safe and well tolerated. PMID:12865269

  20. Single balloon versus double balloon bipedicular kyphoplasty: a systematic review and meta-analysis.

    PubMed

    Jing, Zehao; Dong, Jianli; Li, Zhengwei; Nan, Feng

    2018-06-19

    Kyphoplasty has been widely used to treat vertebral compression fractures (VCFs). In standard procedure of kyphoplasty, two balloons were inserted into the vertebral body through bipedicular and inflated simultaneously, while using a single balloon two times is also a common method in clinic to lessen the financial burden of patients. However, the effect and safety of single balloon versus double balloon bipedicular kyphoplasty are still controversy. In this systematic review and meta-analysis, eligible studies were identified through a comprehensive literature search of PubMed, Cochrane library EMBASE, Web of Science, Wanfang, CNKI, VIP and CBM until January 1, 2018. Results from individual studies were pooled using a random or fixed effects model. Seven articles were included in the systematic review and five studies were consisted in meta-analysis. We observed no significant difference between single balloon and double balloon bipedicular kyphoplasty in visual analog scale (VAS), angle (kyphotic angle and Cobb angle), consumption (operation time, cement volume and volume of bleeding), vertebral height (anterior height, medium height and posterior height) and complications (cement leakage and new VCFs), while the cost of single balloon bipedicular kyphoplasty is lower than that of double balloon bipedicular kyphoplasty. The results of our meta-analysis also demonstrated that single balloon can significantly improve the VAS, angle and vertebral height of patients suffering from VCFs. This systematic review and meta-analysis collectively concludes that single balloon bipedicular kyphoplasty is as effective as double balloon bipedicular kyphoplasty in improving clinical symptoms, deformity and complications of VCFs but not so expensive. These slides can be retrieved under Electronic Supplementary Material.

  1. Double balloon catheter for induction of labour in Chinese women with previous caesarean section: one-year experience and literature review.

    PubMed

    Cheuk, Queenie K Y; Lo, T K; Lee, C P; Yeung, Anita P C

    2015-06-01

    To evaluate the efficacy and safety of double balloon catheter for induction of labour in Chinese women with one previous caesarean section and unfavourable cervix at term. Retrospective cohort study. A regional hospital in Hong Kong. Women with previous caesarean delivery requiring induction of labour at term and with an unfavourable cervix from May 2013 to April 2014. Primary outcome was to assess rate of successful vaginal delivery (spontaneous or instrument-assisted) using double balloon catheter. Secondary outcomes were double balloon catheter induction-to-delivery and removal-to-delivery interval; cervical score improvement; oxytocin augmentation; maternal or fetal complications during cervical ripening, intrapartum and postpartum period; and risk factors associated with unsuccessful induction. All 24 Chinese women tolerated double balloon catheter well. After double balloon catheter expulsion or removal, the cervix successfully ripened in 18 (75%) cases. The improvement in Bishop score 3 (interquartile range, 2-4) was statistically significant (P<0.001). Overall, 18 (75%) cases were delivered vaginally. The median insertion-to-delivery and removal-to-delivery intervals were 19 (interquartile range, 13.4-23.0) hours and 6.9 (interquartile range, 4.1-10.8) hours, respectively. Compared with cases without, the interval to delivery was statistically significantly shorter in those with spontaneous balloon expulsion or spontaneous membrane rupture during ripening (7.8 vs 3.0 hours; P=0.025). There were no major maternal or neonatal complications. The only factor significantly associated with failed vaginal birth after caesarean was previous caesarean section for failure to progress (P<0.001). This is the first study using double balloon catheter for induction of labour in Asian Chinese women with previous caesarean section. Using double balloon catheter, we achieved a vaginal birth after caesarean rate of 75% without major complications.

  2. 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

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

    PubMed Central

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

    2017-01-01

    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. PMID:29263765

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

    PubMed

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

    2016-01-01

    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.

  5. Capsule Endoscopy in the Assessment of Obscure Gastrointestinal Bleeding: An Economic Analysis

    PubMed Central

    Palimaka, S; Blackhouse, Gord; Goeree, Ron

    2015-01-01

    Background Small-bowel capsule endoscopy is a tool used to visualize the small bowel to identify the location of bleeds in obscure gastrointestinal bleeding (OGIB). Capsule endoscopy is currently funded in Ontario in cases where there has been a failure to identify a source of bleeding via conventional diagnostic procedures. In Ontario, capsule endoscopy is a diagnostic option for patients whose findings on esophagogastroduodenoscopy, colonoscopy, and push enteroscopy have been negative (i.e., the source of bleeding was not found). Objectives This economic analysis aims to estimate the budget impact of different rates of capsule endoscopy use as a complement to push enteroscopy procedures in patients aged 18 years and older. Data Sources Population-based administrative databases for Ontario were used to identify patients receiving push enteroscopy and small-bowel capsule endoscopy in the fiscal years 2008 to 2012. Review Methods A systematic literature search was performed to identify economic evaluations of capsule endoscopy for the investigation of OGIB. Studies were assessed for their methodological quality and their applicability to the Ontarian setting. An original budget impact analysis was performed using data from Ontarian administrative sources and published literature. The budget impact was estimated for different levels of use of capsule endoscopy as a complement to push enteroscopy due to the uncertain clinical utility of the capsule based on current clinical evidence. The analysis was conducted from the provincial public payer perspective. Results With varying rates of capsule endoscopy use, the budgetary impact spans from savings of $510,000,1 when no (0%) push enteroscopy procedures are complemented with capsule endoscopy, to $2,036,000, when all (100%) push enteroscopy procedures are complemented with capsule endoscopy. A scenario where 50% of push enteroscopy procedures are complemented with capsule endoscopy (expected use based on expert opinion) would result in additional expenditure of about $763,000. Limitations In the literature on OGIB, estimates of rebleeding rates after endoscopic procedures or spontaneous cessation rates are unreliable, with a lack of data. Rough estimates from expert consultation can provide an indication of expected additional use of capsule endoscopy; however, a wide range of capsule uses was explored. Conclusions The budgetary impact in the first year in Ontario of capsule endoscopy use to complement push enteroscopy procedures ranges from $510,000 in savings to an additional expenditure of $2,036,000 (at 0% and 100% push enteroscopy procedures complemented, respectively). The expected scenario of 50% of push enteroscopy procedures likely to benefit from the use of capsule endoscopy, based on expert opinion, would result in additional expenditures of $763,000 in the first year. PMID:26355732

  6. Occlusion of M1 segment after superficial temporal artery-middle cerebral artery bypass in a giant M1 aneurysm with Onyx-34 injected via a double-lumen balloon under balloon inflation.

    PubMed

    Clarençon, Frédéric; Nouet, Aurelien; Redondo, Aimée; Di Maria, Federico; Iosif, Christina; Le Jean, Lise; Chiras, Jacques; Sourour, Nader

    2013-05-31

    A 29-year-old patient attended our institution for recurrent strokes related to a giant partially thrombosed M1 aneurysm. Superficial temporal artery-middle cerebral artery (STA-MCA) bypass and subsequent occlusion of both the aneurysm and the dysplastic M1 segment were planned. However, owing to the shortness of the non-dysplastic segment of M1 and the risk of occlusion of the lenticulostriate arteries, the use of a double-lumen balloon was considered for coiling and subsequent injection of Onyx. STA-MCA bypass was performed using a regular technique. Endovascular occlusion of both the aneurysm and the parent artery was subsequently performed by means of coils and Onyx-34 that was injected via the Ascent balloon under balloon inflation. No complications were recorded and no stroke was observed on control MRI. The injection of Onyx-34 through a double-lumen balloon under balloon inflation is a quick and safe technique for precise occlusion of a parent artery.

  7. Occlusion of M1 segment after superficial temporal artery-middle cerebral artery bypass in a giant M1 aneurysm with Onyx-34 injected via a double-lumen balloon under balloon inflation.

    PubMed

    Clarençon, Frédéric; Nouet, Aurelien; Redondo, Aimée; Di Maria, Federico; Iosif, Christina; Le Jean, Lise; Chiras, Jacques; Sourour, Nader

    2014-05-01

    A 29-year-old patient attended our institution for recurrent strokes related to a giant partially thrombosed M1 aneurysm. Superficial temporal artery-middle cerebral artery (STA-MCA) bypass and subsequent occlusion of both the aneurysm and the dysplastic M1 segment were planned. However, owing to the shortness of the non-dysplastic segment of M1 and the risk of occlusion of the lenticulostriate arteries, the use of a double-lumen balloon was considered for coiling and subsequent injection of Onyx. STA-MCA bypass was performed using a regular technique. Endovascular occlusion of both the aneurysm and the parent artery was subsequently performed by means of coils and Onyx-34 that was injected via the Ascent balloon under balloon inflation. No complications were recorded and no stroke was observed on control MRI. The injection of Onyx-34 through a double-lumen balloon under balloon inflation is a quick and safe technique for precise occlusion of a parent artery.

  8. Occlusion of M1 segment after superficial temporal artery-middle cerebral artery bypass in a giant M1 aneurysm with Onyx-34 injected via a double-lumen balloon under balloon inflation

    PubMed Central

    Clarençon, Frédéric; Nouet, Aurelien; Redondo, Aimée; Di Maria, Federico; Iosif, Christina; Le Jean, Lise; Chiras, Jacques; Sourour, Nader

    2013-01-01

    A 29-year-old patient attended our institution for recurrent strokes related to a giant partially thrombosed M1 aneurysm. Superficial temporal artery-middle cerebral artery (STA-MCA) bypass and subsequent occlusion of both the aneurysm and the dysplastic M1 segment were planned. However, owing to the shortness of the non-dysplastic segment of M1 and the risk of occlusion of the lenticulostriate arteries, the use of a double-lumen balloon was considered for coiling and subsequent injection of Onyx. STA-MCA bypass was performed using a regular technique. Endovascular occlusion of both the aneurysm and the parent artery was subsequently performed by means of coils and Onyx-34 that was injected via the Ascent balloon under balloon inflation. No complications were recorded and no stroke was observed on control MRI. The injection of Onyx-34 through a double-lumen balloon under balloon inflation is a quick and safe technique for precise occlusion of a parent artery. PMID:23729720

  9. Utility of the balloon-overtube-assisted modified over-the-wire stenting technique to treat post-sleeve gastrectomy complications.

    PubMed

    Ponte, Ana; Pinho, Rolando; Proença, Luísa; Silva, Joana; Rodrigues, Jaime; Sousa, Mafalda; Silva, João Carlos; Carvalho, João

    2017-06-16

    To describe a modified technique of deployment of stents using the overtube developed for balloon-assisted enteroscopy in post-sleeve gastrectomy (SG) complications. Between January 2010 and December 2015, all patients submitted to an endoscopic stenting procedure to treat a post-SG stenosis or leakage were retrospectively collected. Procedures from patients in which the stent was deployed using the balloon-overtube-assisted modified over-the-wire (OTW) stenting technique were described. The technical success, corresponding to proper placement of the stent in the stomach resulting in exclusion of the SG leak or the stenosis, was evaluated. Complications related to stenting were also reported. Five procedures were included to treat 2 staple line leaks and 3 stenoses. Two types of stents were used, including a fully covered self-expandable metal stent designed for the SG anatomy (Hanarostent, ECBB-30-240-090; M.I. Tech, Co., Ltd, Seoul, South Korea) in 4 procedures and a biodegradable stent (BD stent 019-10A-25/20/25-080, SX-ELLA, Hradec Kralove, Czech Republic) in the remaining procedure. In all cases, an overtube was advanced with the endoscope through the SG to the duodenum. After placement of the guidewire and removal of the endoscope, the stent was easily advanced through the overtube. The overtube was pulled back and the stent was successfully deployed under fluoroscopic guidance. Technical success was achieved in all patients. The adoption of a modified technique of deployment of OTW stents using an overtube may represent an effective option in the approach of SG complications.

  10. Utility of the balloon-overtube-assisted modified over-the-wire stenting technique to treat post-sleeve gastrectomy complications

    PubMed Central

    Ponte, Ana; Pinho, Rolando; Proença, Luísa; Silva, Joana; Rodrigues, Jaime; Sousa, Mafalda; Silva, João Carlos; Carvalho, João

    2017-01-01

    AIM To describe a modified technique of deployment of stents using the overtube developed for balloon-assisted enteroscopy in post-sleeve gastrectomy (SG) complications. METHODS Between January 2010 and December 2015, all patients submitted to an endoscopic stenting procedure to treat a post-SG stenosis or leakage were retrospectively collected. Procedures from patients in which the stent was deployed using the balloon-overtube-assisted modified over-the-wire (OTW) stenting technique were described. The technical success, corresponding to proper placement of the stent in the stomach resulting in exclusion of the SG leak or the stenosis, was evaluated. Complications related to stenting were also reported. RESULTS Five procedures were included to treat 2 staple line leaks and 3 stenoses. Two types of stents were used, including a fully covered self-expandable metal stent designed for the SG anatomy (Hanarostent, ECBB-30-240-090; M.I. Tech, Co., Ltd, Seoul, South Korea) in 4 procedures and a biodegradable stent (BD stent 019-10A-25/20/25-080, SX-ELLA, Hradec Kralove, Czech Republic) in the remaining procedure. In all cases, an overtube was advanced with the endoscope through the SG to the duodenum. After placement of the guidewire and removal of the endoscope, the stent was easily advanced through the overtube. The overtube was pulled back and the stent was successfully deployed under fluoroscopic guidance. Technical success was achieved in all patients. CONCLUSION The adoption of a modified technique of deployment of OTW stents using an overtube may represent an effective option in the approach of SG complications. PMID:28690770

  11. Cutting balloon and high-pressure balloon dilation for palliative treatment of congenital double-chambered right ventricle and primary infundibular stenosis in a Golden retriever dog.

    PubMed

    Schober, Karsten E; Rhinehart, Jaylyn; Kohnken, Rebecca; Bonagura, John D

    2017-12-01

    Combined cutting balloon and high-pressure balloon dilation was performed in a dog with a double-chambered right ventricle and severe infundibular stenosis of the right ventricular outflow tract. The peak systolic pressure gradient across the stenosis decreased by 65% after dilation (from 187 mmHg before to 66 mmHg after) affirming the intervention as successful. However, early re-stenosis occurred within 3 months leading to exercise intolerance, exercise-induced syncope, and right-sided congestive heart failure. Cutting balloon followed by high-pressure balloon dilation provided temporary but not long-term relief of right ventricular obstruction in this dog. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Double-Balloon-Assisted n-Butyl-2-Cyanoacrylate Embolization of Intrahepatic Arterioportal Shunt Prior to Chemoembolization of Hepatocellular Carcinoma

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

    Takao, Hidemasa, E-mail: takaoh-tky@umin.ac.jp; Shibata, Eisuke; Ohtomo, Kuni

    A case of multiple hepatocellular carcinomas with a severe intrahepatic arterioportal shunt that was successfully embolized with n-butyl-2-cyanoacrylate with coaxial double-balloon occlusion prior to transcatheter arterial chemoembolization is presented. A proximal balloon positioned at the proper hepatic artery was used for flow control, and a coaxial microballoon, positioned in the closest of three arterial feeding branches to the arterioportal shunt, was used to control the delivery of n-butyl-2-cyanoacrylate. This coaxial double-balloon technique can prevent proximal embolization and distal migration of n-butyl-2-cyanoacrylate and enable precise control of the distribution of n-butyl-2-cyanoacrylate. It could also be applicable to n-butyl-2-cyanoacrylate embolization for othermore » than intrahepatic arterioportal shunt.« less

  13. 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

  14. Carotid artery stenting with double cerebral embolic protection in asymptomatic patients - a diffusion-weighted MRI controlled study.

    PubMed

    Vuruskan, Ertan; Saracoglu, Erhan; Ergun, Ugur; Poyraz, Fatih; Duzen, İrfan Veysel

    2017-01-01

    The aim of this study was to compare the simultaneous double-protection method (proximal balloon plus distal filter) with distal-filter protection or proximal-balloon protection alone in asymptomatic patients during carotid artery stenting. 119 consecutive patients were investigated for carotid artery stentings in the extracranial internal carotid artery with the use of distal filters (n = 41, 34.4 %), proximal balloon (MoMa) protection (n = 40, 33.6 %) or double protection (n = 38, 31.9 %). Magnetic resonance imaging (MRI) was performed on all patients before the procedure, and control diffusion-weighted MRI (DW-MRI) was obtained within 24-48 h after the procedure. Procedural data, complications, success rate, major adverse cardiovascular events, and MRI findings were collected. New cerebral high-intensity (HI) lesions were observed in 47 (39.4 %) patients. HI lesions were observed in 22 (53.6 %), 15 (37.5 %), and 10 (26.3 %) of the patients with distal filters, proximal protection, and double protection, respectively (p = 0.004). The average number of HI lesions on DW-MRI was 1.80 in the distal-filter group, 0.90 in the proximal-balloon group, and 0.55 in the double-protection group (p < 0.001). Procedure and fluoroscopy times were slightly longer in the double-protection group compared to the distal- or proximal-protection groups (p = 0.001). The double (proximal plus distal) cerebral embolic protection technique is safe and effective for minimizing the risk of cerebral embolization, even in patients with asymptomatic carotid artery stenosis, despite slightly longer procedure and fluoroscopy times.
.

  15. Small-bowel capsule endoscopy in patients with suspected Crohn's disease-diagnostic value and complications.

    PubMed

    Figueiredo, Pedro; Almeida, Nuno; Lopes, Sandra; Duque, Gabriela; Freire, Paulo; Lérias, Clotilde; Gouveia, Hermano; Sofia, Carlos

    2010-01-01

    The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD). Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%). The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy.

  16. Small bowel endoluminal imaging (capsule and enteroscopy).

    PubMed

    Murino, Alberto; Despott, Edward J

    2017-04-01

    Over the last 16 years, the disruptive technologies of small bowel capsule endoscopy and device-assisted enteroscopy have revolutionised endoluminal imaging and minimally invasive therapy of the small bowel. Further technological developments continue to expand their indications and use. This brief review highlights the state-of-the-art in this arena and aims to summarise the current and potential future role of these technologies in clinical practice.

  17. Small bowel endoluminal imaging (capsule and enteroscopy)

    PubMed Central

    Murino, Alberto

    2017-01-01

    Over the last 16 years, the disruptive technologies of small bowel capsule endoscopy and device-assisted enteroscopy have revolutionised endoluminal imaging and minimally invasive therapy of the small bowel. Further technological developments continue to expand their indications and use. This brief review highlights the state-of-the-art in this arena and aims to summarise the current and potential future role of these technologies in clinical practice. PMID:28839900

  18. Small-Bowel Capsule Endoscopy in Patients with Suspected Crohn's Disease—Diagnostic Value and Complications

    PubMed Central

    Figueiredo, Pedro; Almeida, Nuno; Lopes, Sandra; Duque, Gabriela; Freire, Paulo; Lérias, Clotilde; Gouveia, Hermano; Sofia, Carlos

    2010-01-01

    Background. The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD). Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%). The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Conclusions. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy. PMID:20811612

  19. Double Guiding Catheters for Complex Percutaneous Coronary Intervention

    PubMed Central

    Chou, Shing-Hsien; Lin, Chia-Pin; Lin, Yen-Chen; Kuo, Chi-Tai; Lin, Ming-Shyan; Chang, Chi-Jen

    2012-01-01

    A large-lumen guiding catheter is often used for complex percutaneous coronary intervention—particularly when a final kissing-balloon or 2-stent technique is required. However, catheter insertion is sometimes restricted by diseased vascular access sites or a tortuous vascular route. We report 2 cases in which a unique double guiding catheter technique was used to create a lumen of sufficient size for complex percutaneous coronary intervention. In each patient, two 6F guiding catheters were used concurrently to engage the ostium of 1 target vessel. In 1 patient, these catheters were used for the delivery of 2 balloons to complete kissing-balloon dilation after single-stent placement. In the other patient, the catheters were used to deliver 2 stents sequentially to their respective target lesions. The stents were then deployed simultaneously as kissing stents, followed by high-pressure kissing-balloon postdilation. PMID:22412243

  20. Antigravity ESD - double-balloon-assisted underwater with traction hybrid technique.

    PubMed

    Sharma, Sam K; Hiratsuka, Takahiro; Hara, Hisashi; Milsom, Jeffrey W

    2018-06-01

     Complex colorectal polyps or those positioned in difficult anatomic locations are an endoscopic therapeutic challenge. Underwater endoscopic submucosal dissection (UESD) is a potential technical solution to facilitate efficient polyp removal. In addition, endoscopic tissue retraction has been confined to limited methods of varying efficacy and complexity. The aim of this study was to evaluate the efficiency of a unique UESD technique for removing complex polyps using double-balloon-assisted retraction (R).  Using fresh ex-vivo porcine rectum, 4-cm polyps were created using electrosurgery and positioned at "6 o'clock" within an established ESD model. Six resections were performed in each group. Underwater techniques were facilitated using a novel double-balloon platform (Dilumen, Lumendi, Westport, Connecticut, United States).  UESD-R had a significantly shorter total procedural time than cap-assisted ESD and UESD alone (24 vs. 58 vs. 56 mins). UESD-R produced a dissection time on average of 5 minutes, attributed to the retraction provided. There was also a subjective significant reduction in electrosurgical smoke with the underwater techniques contributing to improved visualization.  Here we report the first ex-vivo experience of a unique double-balloon endoscopic platform optimized for UESD with tissue traction capability. UESD-R removed complex lesions in significantly shorter time than conventional means. The combined benefits of UESD and retraction appeared to be additive when tackling complex polyps and should be studied further.

  1. Steroid-refractory extensive enteritis complicated by ulcerative colitis successfully treated with adalimumab

    PubMed Central

    Okabayashi, Shinji; Sujino, Tomohisa; Ozaki, Ryo; Umeda, Satoko; Toyonaga, Takahiko; Saito, Eiko; Nakano, Masaru; Tablante, Maria Carla; Morinaga, Shojiroh; Hibi, Toshifumi

    2017-01-01

    Extracolonic involvement of the gastrointestinal tract is extremely uncommon in ulcerative colitis (UC) and rarely found in the upper gastrointestinal tract or in postoperative cases since it typically responds to steroids. Here we report a case of UC complicated by extensive ileal inflammation that was refractory to steroids. A 20-year-old man was diagnosed with UC of typical pancolitis without ileal involvement and started treatment with pH-dependent mesalazine and oral prednisolone. Although his symptoms transiently resolved, the condition flared when the steroid dose was tapered down. Computed tomography revealed marked thickening of the ileal wall, and capsule endoscopy and balloon-assisted enteroscopy found diffuse mucosal inflammation with ulcers in the ileum. On the contrary, the inflammation in the colon and rectum was improving. Since the response to the second steroid course was inadequate, treatment with adalimumab and 6-mercaptopurine was initiated and finally achieved clinical and endoscopic remission. The investigation of small intestinal lesions is necessary in patients with UC whose clinical deterioration cannot be explained by colonic lesions. PMID:29142523

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

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

    Schievano, Silvia; Kunzelman, Karyn; Nicosia, Mark

    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 stenosismore » 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.« less

  3. Enteroendocrine K and L cells in healthy and type 2 diabetic individuals.

    PubMed

    Jorsal, Tina; Rhee, Nicolai A; Pedersen, Jens; Wahlgren, Camilla D; Mortensen, Brynjulf; Jepsen, Sara L; Jelsing, Jacob; Dalbøge, Louise S; Vilmann, Peter; Hassan, Hazem; Hendel, Jakob W; Poulsen, Steen S; Holst, Jens J; Vilsbøll, Tina; Knop, Filip K

    2018-02-01

    Enteroendocrine K and L cells are pivotal in regulating appetite and glucose homeostasis. Knowledge of their distribution in humans is sparse and it is unknown whether alterations occur in type 2 diabetes. We aimed to evaluate the distribution of enteroendocrine K and L cells and relevant prohormone-processing enzymes (using immunohistochemical staining), and to evaluate the mRNA expression of the corresponding genes along the entire intestinal tract in individuals with type 2 diabetes and healthy participants. In this cross-sectional study, 12 individuals with type 2 diabetes and 12 age- and BMI-matched healthy individuals underwent upper and lower double-balloon enteroscopy with mucosal biopsy retrieval from approximately every 30 cm of the small intestine and from seven specific anatomical locations in the large intestine. Significantly different densities for cells positive for chromogranin A (CgA), glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide, peptide YY, prohormone convertase (PC) 1/3 and PC2 were observed along the intestinal tract. The expression of CHGA did not vary along the intestinal tract, but the mRNA expression of GCG, GIP, PYY, PCSK1 and PCSK2 differed along the intestinal tract. Lower counts of CgA-positive and PC1/3-positive cells, respectively, were observed in the small intestine of individuals with type 2 diabetes compared with healthy participants. In individuals with type 2 diabetes compared with healthy participants, the expression of GCG and PYY was greater in the colon, while the expression of GIP and PCSK1 was greater in the small intestine and colon, and the expression of PCSK2 was greater in the small intestine. Our findings provide a detailed description of the distribution of enteroendocrine K and L cells and the expression of their products in the human intestinal tract and demonstrate significant differences between individuals with type 2 diabetes and healthy participants. NCT03044860.

  4. Cutting Balloon Angioplasty in the Treatment of Short Infrapopliteal Bifurcation Disease.

    PubMed

    Iezzi, Roberto; Posa, Alessandro; Santoro, Marco; Nestola, Massimiliano; Contegiacomo, Andrea; Tinelli, Giovanni; Paolini, Alessandra; Flex, Andrea; Pitocco, Dario; Snider, Francesco; Bonomo, Lorenzo

    2015-08-01

    To evaluate the safety, feasibility, and effectiveness of cutting balloon angioplasty in the management of infrapopliteal bifurcation disease. Between November 2010 and March 2013, 23 patients (mean age 69.6±9.01 years, range 56-89; 16 men) suffering from critical limb ischemia were treated using cutting balloon angioplasty (single cutting balloon, T-shaped double cutting balloon, or double kissing cutting balloon technique) for 47 infrapopliteal artery bifurcation lesions (16 popliteal bifurcation and 9 tibioperoneal bifurcation) in 25 limbs. Follow-up consisted of clinical examination and duplex ultrasonography at 1 month and every 3 months thereafter. All treatments were technically successful. No 30-day death or adverse events needing treatment were registered. No flow-limiting dissection was observed, so no stent implantation was necessary. The mean postprocedure minimum lumen diameter and acute gain were 0.28±0.04 and 0.20±0.06 cm, respectively, with a residual stenosis of 0.04±0.02 cm. Primary and secondary patency rates were estimated as 89.3% and 93.5% at 6 months and 77.7% and 88.8% at 12 months, respectively; 1-year primary and secondary patency rates of the treated bifurcation were 74.2% and 87.0%, respectively. The survival rate estimated by Kaplan-Meier analysis was 82.5% at 1 year. Cutting balloon angioplasty seems to be a safe and effective tool in the routine treatment of short/ostial infrapopliteal bifurcation lesions, avoiding procedure-related complications, overcoming the limitations of conventional angioplasty, and improving the outcome of catheter-based therapy. © The Author(s) 2015.

  5. Spiral assisted ERCP is equivalent to single balloon assisted ERCP in patients with Roux-en-Y anatomy.

    PubMed

    Lennon, Anne Marie; Kapoor, Sumit; Khashab, Mouen; Corless, Erin; Amateau, Stuart; Dunbar, Kerry; Chandrasekhara, Vinay; Singh, Vikesh; Okolo, Patrick I

    2012-05-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is often unsuccessful in patients with Roux-en-Y anatomy. Augmented enteroscopy allows deep insertion into the small bowel and can be useful in patients with Roux-en-Y anatomy. The aim of this study was to compare single balloon assisted ERCP (SBE-ERCP) and spiral assisted ERCP (SE-ERCP) in patients with Roux-en-Y anatomy in terms of diagnostic and therapeutic yield, procedure time, and complications. This is a retrospective cohort study of consecutive patients with Roux-en-Y anatomy who underwent SBE-ERCP or SE-ERCP between October 2007 and March 2011. Diagnostic yield was defined as successful duct cannulation. Therapeutic yield was defined as the ability to successfully carry out endoscopic therapy in those cannulated. Procedure time and complications were assessed. Thirty-four consecutive patients with Roux-en-Y anatomy underwent 54 ERCP procedures. The overall diagnostic yield was 44.4% with no significant difference between the diagnostic yield of SBE-ERCP (48.3%) and SE-ERCP (40%). The diagnostic yield was lower in patients with gastric by-pass (38.9%) compared with other types of Roux-en-Y anatomy (47.2%) but this was not statistically significant (P = 0.772). The overall therapeutic yield was 93.8%, with a therapeutic yield of 100% for SBE-ERCP and 87.5% for SE-ERCP (P = 1.0). There was one perforation during SBE-ERCP, giving a complication rate of 3.5%. The mean procedure time did not differ between the two techniques. Diagnostic and therapeutic yields are similar with SBE-ERCP and SE-ERCP in patients with Roux-en-Y anatomy with no significant difference in procedure time or complication rates.

  6. Small bowel enteroscopy and intraoperative enteroscopy for obscure gastrointestinal bleeding.

    PubMed

    Lewis, B S; Wenger, J S; Waye, J D

    1991-02-01

    Intraoperative endoscopy (IOE) is accepted as the ultimate diagnostic procedure for completely evaluating the small bowel in patients with obscure gastrointestinal (GI) bleeding. Small bowel enteroscopy (SBE) has been reported useful in the nonsurgical evaluation of the small intestine in these patients, but findings may be limited because of incomplete small bowel intubation and a lack of tip deflection. Twenty-three patients underwent 25 SBE exams and subsequently had 25 IOE exams during surgical exploration for continued bleeding. Patients' bleeding histories averaged 2 yr, with an average transfusion requirement of 27 units. Findings on IOE were the same as with SBE in 17/22 (77%) of examinations. We conclude that SBE and IOE are comparable in depth of insertion and ability to detect small vascular ectasias. Both procedures missed pathology due to limited visibility and the evanescent nature of ectasias. Long-term success in abolishing bleeding with these combined techniques can be expected in 55% of these patients. SBE should precede surgery, since the finding of diffuse ectasias precludes any benefit from operative intervention.

  7. Distinct management issues with Crohn's disease of the small intestine.

    PubMed

    Fong, Steven C M; Irving, Peter M

    2015-03-01

    Small bowel Crohn's disease can present with clinical challenges that are specific to its location. In this review, we address some of the areas that present particular problems in small bowel Crohn's disease. A key issue specific to small bowel Crohn's disease relates to its diagnosis given that access to the small bowel is limited. Radiological advances, particularly in small bowel ultrasonography and MRI, as well as the introduction of capsule endoscopy and balloon enteroscopy are helping to address this. In addition, our ability to differentiate small bowel Crohn's disease from other causes of inflammation, such as tuberculosis, is improving on the basis of better understanding of the features that differentiate these conditions. It is also becoming apparent that jejunal Crohn's disease represents a distinct disease phenotype with potentially worse clinical outcomes. Finally, because it is a rare complication, our understanding of small bowel cancer associated with Crohn's disease remains limited. Recent publications are, however, starting to improve our knowledge of this condition. Although small bowel Crohn's disease presents specific management issues not seen in patients with Crohn's disease elsewhere in the gastrointestinal tract, our knowledge of how to manage these is improving.

  8. Primary Jejunal Adenocarcinoma Presenting as Bilateral Ovarian Metastasis

    PubMed Central

    Ofori, Emmanuel; Ramai, Daryl; Papafragkakis, Charilaos; Changela, Kinesh; Krishnaiah, Mahesh

    2017-01-01

    Small intestinal tumors are rare with adenocarcinoma of the small intestine accounting for less than 2% of all gastrointestinal cancers. Primary jejunal adenocarcinoma constitutes a minute portion of small intestine adenocarcinomas. Clinically, this cancer presents at latter stages of its progression, mainly due to vague and non-specific symptoms, and the difficulty encountered in accessing the jejunum on upper endoscopy. Diagnosis of jejunal adenocarcinoma is usually inconclusive with the use of computed tomography (CT) scan, small bowel series, or upper endoscopy. Laparoscopy followed by frozen section biopsy provides a definitive diagnosis. In the past decade, balloon-assisted enteroscopy (BAE) and capsule endoscopy have become popular as useful modalities for diagnosing small bowel diseases. Wide excisional jejunectomy is the only treatment option with an estimated 5-year survival of 40-65%. Physicians are advised to suspect jejunal adenocarcinoma as a differential diagnosis in patients who present with non-specific symptoms of abdominal pain, nausea, vomiting, weight loss, anemia, gastrointestinal bleeding or signs of small bowel obstruction. We present a rare case of a 37-year-old woman with suspected bilateral ovarian masses, which was immunohistochemically confirmed as primary jejunal adenocarcinoma with bilateral ovarian metastasis. PMID:29317945

  9. Primary Jejunal Adenocarcinoma Presenting as Bilateral Ovarian Metastasis.

    PubMed

    Ofori, Emmanuel; Ramai, Daryl; Papafragkakis, Charilaos; Changela, Kinesh; Krishnaiah, Mahesh

    2017-12-01

    Small intestinal tumors are rare with adenocarcinoma of the small intestine accounting for less than 2% of all gastrointestinal cancers. Primary jejunal adenocarcinoma constitutes a minute portion of small intestine adenocarcinomas. Clinically, this cancer presents at latter stages of its progression, mainly due to vague and non-specific symptoms, and the difficulty encountered in accessing the jejunum on upper endoscopy. Diagnosis of jejunal adenocarcinoma is usually inconclusive with the use of computed tomography (CT) scan, small bowel series, or upper endoscopy. Laparoscopy followed by frozen section biopsy provides a definitive diagnosis. In the past decade, balloon-assisted enteroscopy (BAE) and capsule endoscopy have become popular as useful modalities for diagnosing small bowel diseases. Wide excisional jejunectomy is the only treatment option with an estimated 5-year survival of 40-65%. Physicians are advised to suspect jejunal adenocarcinoma as a differential diagnosis in patients who present with non-specific symptoms of abdominal pain, nausea, vomiting, weight loss, anemia, gastrointestinal bleeding or signs of small bowel obstruction. We present a rare case of a 37-year-old woman with suspected bilateral ovarian masses, which was immunohistochemically confirmed as primary jejunal adenocarcinoma with bilateral ovarian metastasis.

  10. Factors Influencing Cecal Intubation Time during Retrograde Approach Single-Balloon Enteroscopy

    PubMed Central

    Chen, Peng-Jen; Shih, Yu-Lueng; Huang, Hsin-Hung; Hsieh, Tsai-Yuan

    2014-01-01

    Background and Aim. The predisposing factors for prolonged cecal intubation time (CIT) during colonoscopy have been well identified. However, the factors influencing CIT during retrograde SBE have not been addressed. The aim of this study was to determine the factors influencing CIT during retrograde SBE. Methods. We investigated patients who underwent retrograde SBE at a medical center from January 2011 to March 2014. The medical charts and SBE reports were reviewed. The patients' characteristics and procedure-associated data were recorded. These data were analyzed with univariate analysis as well as multivariate logistic regression analysis to identify the possible predisposing factors. Results. We enrolled 66 patients into this study. The median CIT was 17.4 minutes. With univariate analysis, there was no statistical difference in age, sex, BMI, or history of abdominal surgery, except for bowel preparation (P = 0.021). Multivariate logistic regression analysis showed that inadequate bowel preparation (odds ratio 30.2, 95% confidence interval 4.63–196.54; P < 0.001) was the independent predisposing factors for prolonged CIT during retrograde SBE. Conclusions. For experienced endoscopist, inadequate bowel preparation was the independent predisposing factor for prolonged CIT during retrograde SBE. PMID:25505904

  11. Double-lumen balloon for Onyx® embolization via extracranial arteries in transverse sigmoid dural arteriovenous fistulas: initial experience.

    PubMed

    Clarençon, Frédéric; Di Maria, Federico; Gabrieli, Joseph; Carpentier, Alexandre; Pistochi, Silvia; Bartolini, Bruno; Zeghal, Chiheb; Chiras, Jacques; Sourour, Nader-Antoine

    2016-10-01

    Transverse-sigmoid dural arteriovenous fistulas (TS DAVFs) can be challenging to treat by endovascular means. Indeed, a total cure of the fistula can only be achieved when complete occlusion of the fistulous point(s) is obtained by penetration of the embolic agent. However, in some cases, especially for transosseous branches from extracranial arteries like the occipital artery (OcA) or the superficial temporal artery (STA), such penetration is usually poor, leading to major proximal reflux and incomplete fistula obliteration. We present three cases of embolization in two patients with TS DAVF through the OcA and/or the STA with Onyx® using a double-lumen balloon (Microvention, Tustin, CA, USA). This technique allows the penetration of the embolic agent in the transosseous branches by forming a counter-pressure with the inflated balloon. This technique may be useful to achieve complete occlusion of TS DAVFs by endovascular means.

  12. Adventitial nab-rapamycin injection reduces porcine femoral artery luminal stenosis induced by balloon angioplasty via inhibition of medial proliferation and adventitial inflammation.

    PubMed

    Gasper, Warren J; Jimenez, Cynthia A; Walker, Joy; Conte, Michael S; Seward, Kirk; Owens, Christopher D

    2013-12-01

    Endovascular interventions on peripheral arteries are limited by high rates of restenosis. Our hypothesis was that adventitial injection of rapamycin nanoparticles would be safe and reduce luminal stenosis in a porcine femoral artery balloon angioplasty model. Eighteen juvenile male crossbred swine were included. Single-injury (40%-60% femoral artery balloon overstretch injury; n=2) and double-injury models (endothelial denudation injury 2 weeks before a 20%-30% overstretch injury; n=2) were compared. The double-injury model produced significantly more luminal stenosis at 28 days, P=0.002, and no difference in medial fibrosis or inflammation. Four pigs were randomized to the double-injury model and adventitial injection of saline (n=2) or 500 μg of nanoparticle albumin-bound rapamycin (nab-rapamycin; n=2) with an endovascular microinfusion catheter. There was 100% procedural success and no difference in endothelial regeneration. At 28 days, nab-rapamycin led to significant reductions in luminal stenosis, 17% (interquartile range, 12%-35%) versus 10% (interquartile range, 8.3%-14%), P=0.001, medial cell proliferation, P<0.001, and fibrosis, P<0.001. There were significantly fewer adventitial leukocytes at 3 days, P<0.001, but no difference at 28 days. Pharmacokinetic analysis (single-injury model) found rapamycin concentrations 1500× higher in perivascular tissues than in blood at 1 hour. Perivascular rapamycin persisted ≥8 days and was not detectable at 28 days. Adventitial nab-rapamycin injection was safe and significantly reduced luminal stenosis in a porcine femoral artery balloon angioplasty model. Observed reductions in early adventitial leukocyte infiltration and late medial cell proliferation and fibrosis suggest an immunosuppressive and antiproliferative mechanism. An intraluminal microinfusion catheter for adventitial injection represents an alternative to stent- or balloon-based local drug delivery.

  13. Non-steroidal anti-inflammatory drug-induced small bowel injuries identified by double-balloon endoscopy

    PubMed Central

    Hayashi, Yoshikazu; Yamamoto, Hironori; Kita, Hiroto; Sunada, Keijiro; Sato, Hiroyuki; Yano, Tomonori; Iwamoto, Michiko; Sekine, Yutaka; Miyata, Tomohiko; Kuno, Akiko; Iwaki, Takaaki; Kawamura, Yoshiyuki; Ajibe, Hironari; Ido, Kenichi; Sugano, Kentaro

    2005-01-01

    AIM: To clarify clinical features of the NSAID-induced small bowel lesions using a new method of endoscopy. METHODS: This is a retrospective study and we analyzed seven patients with small bowel lesions while taking NSAIDs among 61 patients who had undergone double-balloon endoscopy because of gastro-intestinal bleeding or anemia between September 2000 and March 2004, at Jichi Medical School Hospital in Japan. Neither conventional EGD nor colonoscopy revealed any lesions of potential bleeding sources including ulcerations. Double-balloon endoscopy was carried out from oral approach in three patients, from anal approach in three patients, and from both approaches in one patient. RESULTS: Ulcers or erosions were observed in the ileum in six patients and in the jejunum in one patient, respectively. The ulcers were multiple in all the patients with different features from tiny punched out ulcers to deep ulcerations with oozing hemorrhage or scar. All the patients recovered uneventfully and had full resolution of symptoms after suspension of the drug. CONCLUSION: NSAIDs can induce injuries in the small bowel even in patients without any lesions in both the stomach and colon. PMID:16097059

  14. Laparotomy and intraoperative enteroscopy for obscure gastrointestinal bleeding before and after the era of video capsule endoscopy and deep enteroscopy: a tertiary center experience

    PubMed Central

    Manatsathit, Wuttiporn; Khrucharoen, Usah; Jensen, Dennis M.; Hines, O. Joe; Kovacs, Thomas; Ohning, Gordon; Jutabha, Rome; Ghassemi, Kevin; Dulai, Gareth S.; Machicado, Gustavo

    2017-01-01

    Background To evaluate roles of intraoperative endoscopy (IOE) in management of severe obscure GI bleeding (OGIB) before vs. after introduction of video capsule endoscopy (VCE) and deep enteroscopy (DE). Methods We retrospectively reviewed prospectively collected data of patients undergoing IOE for severe OGIB in a tertiary referral center. Results 52 patients had laparotomy/IOE for OGIB, 11 pre and 41 post VCE/DE eras. In the pre VCE/DE era, 36.4% (4/11) had preoperative presumptive diagnoses while in the post VCE/DE era presumptive diagnoses were made in 48.8% (20/41) (p= 0.18). Preoperative evaluation led to correct diagnoses in 18.2% (2/11) in the pre and 51.2% (21/41) in the post VCE/DE era (p=0.09). Vascular lesions and ulcers were the most common diagnoses, but rebleeding was common. No rebleeding was found among patients with tumors, Meckel's diverticulum, and aortoenteric fistula. Conclusions Presumptive diagnoses in the post VCE/DE era were usually accurate. If VCE or DE are negative, the probability of negative IOE is high. Patients with tumors and Meckel's diverticulum were the best candidates for IOE. PMID:28629608

  15. 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.

  16. Advances in endoscopic management of biliary complications after living donor liver transplantation: Comprehensive review of the literature

    PubMed Central

    Shin, Milljae; Joh, Jae-Won

    2016-01-01

    Apart from noticeable improvements in surgical techniques and immunosuppressive agents, biliary complications remain the major causes of morbidity and mortality after living donor liver transplantation (LDLT). Bile leakage and stricture are the predominant complications. The reported incidence of biliary complications is 15%-40%, and these are known to occur more frequently in living donors than in deceased donors. Despite the absence of a confirmed therapeutic algorithm, many approaches have been used for treatment, including surgical, endoscopic, and percutaneous transhepatic techniques. In recent years, nonsurgical approaches have largely replaced reoperation. Among these, the endoscopic approach is currently the preferred initial treatment for patients who undergo duct-to-duct biliary reconstruction. Previously, endoscopic management was achieved most optimally through balloon dilatation and single or multiple stents placement. Recently, there have been significant developments in endoscopic devices, such as novel biliary stents, as well as advances in endoscopic technologies, including deep enteroscopy, the rendezvous technique, magnetic compression anastomosis, and direct cholangioscopy. These developments have resulted in almost all patients being managed by the endoscopic approach. Multiple recent publications suggest superior long-term results, with overall success rates ranging from 58% to 75%. This article summarizes the advances in endoscopic management of patients with biliary complications after LDLT. PMID:27468208

  17. Use of the Ascent balloon for a 2-in-1 remodeling technique: feasibility and initial experience: case report.

    PubMed

    Clarençon, Frédéric; Pérot, Guillaume; Biondi, Alessandra; Di Maria, Federico; Szatmary, Zoltan; Chiras, Jacques; Sourour, Nader

    2012-03-01

    To present the feasibility of using the Ascent balloon, a new double-lumen remodeling balloon, for a new 2-in-1 technique allowing coiling through the lumen of the balloon without the use of an additional coiling microcatheter. Remodeling technique had enlarged the indications for endovascular treatment of intracranial aneurysm. Nevertheless, one of the limitations of this technique is that it requires using 2 devices in the same parent artery. A 55-year-old woman presented with a 7.7 × 4.5-mm incidental anterior communicating artery aneurysm. Only 1 A1 segment (left side) was patent on the cerebral angiogram. A 6F Fargo Max guiding catheter was positioned in the left petrous internal carotid artery. The Ascent balloon was placed in front of the neck of the aneurysm after navigation on a Traxcess 0.014-in guidewire. Coiling of the aneurysm sac was performed via 1 lumen of the device under iterative inflations of the balloon through the second lumen. This new 2-in-1 technique using a sole remodeling balloon without an additional coiling microcatheter is very promising, especially in cases of a small-caliber parent artery.

  18. Design and Status of the Balloon Experimental Twin Telescope for Infrared Interferometry (BETTII): An Interferometer at the Edge of Space

    NASA Technical Reports Server (NTRS)

    Rinehart, Stephen A.; Barclay, Richard B.; Barry, R. K.; Benford, D. J.; Calhoun, P. C.; Fixsen, D. J.; Gorman, E. T.; Jackson, M. L.; Jhabvala, C. A.; Leisawitz, D. T.; hide

    2012-01-01

    The Balloon Experimental Twin Telescope for Infrared Interferometry (BETTII) is an 8-meter baseline far-infraredinterferometer designed to fly on a high altitude balloon. BETTII uses a double-Fourier Michelson interferometer tosimultaneously obtain spatial and spectral information on science targets; the long baseline permits 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.

  19. 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.

  20. 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.

  1. ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding.

    PubMed

    Gerson, Lauren B; Fidler, Jeff L; Cave, David R; Leighton, Jonathan A

    2015-09-01

    Bleeding from the small intestine remains a relatively uncommon event, accounting for ~5-10% of all patients presenting with gastrointestinal (GI) bleeding. Given advances in small bowel imaging with video capsule endoscopy (VCE), deep enteroscopy, and radiographic imaging, the cause of bleeding in the small bowel can now be identified in most patients. The term small bowel bleeding is therefore proposed as a replacement for the previous classification of obscure GI bleeding (OGIB). We recommend that the term OGIB should be reserved for patients in whom a source of bleeding cannot be identified anywhere in the GI tract. A source of small bowel bleeding should be considered in patients with GI bleeding after performance of a normal upper and lower endoscopic examination. Second-look examinations using upper endoscopy, push enteroscopy, and/or colonoscopy can be performed if indicated before small bowel evaluation. VCE should be considered a first-line procedure for small bowel investigation. Any method of deep enteroscopy can be used when endoscopic evaluation and therapy are required. VCE should be performed before deep enteroscopy if there is no contraindication. Computed tomographic enterography should be performed in patients with suspected obstruction before VCE or after negative VCE examinations. When there is acute overt hemorrhage in the unstable patient, angiography should be performed emergently. In patients with occult hemorrhage or stable patients with active overt bleeding, multiphasic computed tomography should be performed after VCE or CTE to identify the source of bleeding and to guide further management. If a source of bleeding is identified in the small bowel that is associated with significant ongoing anemia and/or active bleeding, the patient should be managed with endoscopic therapy. Conservative management is recommended for patients without a source found after small bowel investigation, whereas repeat diagnostic investigations are recommended for patients with initial negative small bowel evaluations and ongoing overt or occult bleeding.

  2. Arterioureteral Fistula: Treatment of a Hemorrhagic Shock with Massive Hematuria by Placing a Balloon Catheter.

    PubMed

    Merzeau, Nicolas; Riquet, Hervé; Nicolacopoulos, Ioannis; Alame, Abbas; Larré, Stéphane

    2017-01-01

    Arterioureteral fistulas (AUF) are serious diseases with increasing incidence. This case report relates the management of AUF in a patient with a history of abdominal oncological surgery, pelvic radiotherapy, and a double J stent in place. The fistula was discovered during a hemorrhagic shock with massive hematuria. The bleeding was controlled by a balloon catheter which led to endovascular treatment consisting of a covered stent.

  3. Arterioureteral Fistula: Treatment of a Hemorrhagic Shock with Massive Hematuria by Placing a Balloon Catheter

    PubMed Central

    Riquet, Hervé; Nicolacopoulos, Ioannis; Alame, Abbas

    2017-01-01

    Arterioureteral fistulas (AUF) are serious diseases with increasing incidence. This case report relates the management of AUF in a patient with a history of abdominal oncological surgery, pelvic radiotherapy, and a double J stent in place. The fistula was discovered during a hemorrhagic shock with massive hematuria. The bleeding was controlled by a balloon catheter which led to endovascular treatment consisting of a covered stent. PMID:28465857

  4. Novel Software-Assisted Hemodynamic Evaluation of Pelvic Flow During Chemoperfusion of Pelvic Arteries for Bladder Cancer: Double- Versus Single-Balloon Technique

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

    Yamamoto, Kiyohito, E-mail: rad105@poh.osaka-med.ac.jp; Yamamoto, Kazuhiro, E-mail: rad043@poh.osaka-med.ac.jp; Nakai, Go, E-mail: rad091@poh.osaka-med.ac.jp

    2016-06-15

    PurposeApproximately 83 % of patients with bladder cancer have achieved a complete response after undergoing a novel bladder preservation therapy involving balloon-occluded intra-arterial infusion chemotherapy (BOAI) using a four-lumen double-balloon catheter, known as the Osaka Medical College regimen. This study aimed to show the quantitative difference in hemodynamics of the bladder arteries using syngo iFlow (Siemens Healthcare, Erlangen, Germany), which provides an automatic tool for quantitative blood flow analysis between double BOAI (D-BOAI) and conventional single BOAI (S-BOAI).Materials and MethodsFifty patients were included. The catheters were introduced into both posterior trunks of the internal iliac arteries via contralateral femoral artery access.more » A side hole between the distal and proximal balloons was placed at the origin of each bladder artery to allow clear visualization of angiographic flow of the injected agent into the urinary bladder. Digital subtraction angiography was used during analysis with the syngo iFlow to evaluate the hemodynamics of the contrast medium in the pelvic arteries during BOAI. The comparative change in the amount of contrast medium in the bladder arteries between D-BOAI and S-BOAI was assessed using syngo iFlow.ResultsOne-hundred pelvic sides were analyzed. The amount of contrast medium in the bladder arteries using D-BOAI was more than twice that using S-BOAI (right, 3.03-fold; left, 2.81-fold).ConclusionThe amount of contrast medium in the bladder arteries using D-BOAI was higher than that using conventional S-BOAI. This may increase the anticancer drug concentration in the affected bladder, leading to a good clinical response.« less

  5. Capsule endoscopy

    MedlinePlus

    Capsule enteroscopy; Wireless capsule endoscopy; Video capsule endoscopy (VCE); Small bowel capsule endoscopy (SBCE) ... a computer and software turns them into a video. Your provider watches the video to look for ...

  6. Monorail Piccolino catheter: a new rapid exchange/ultralow profile coronary angioplasty system.

    PubMed

    Mooney, M R; Douglas, J S; Mooney, J F; Madison, J D; Brandenburg, R O; Fernald, R; Van Tassel, R A

    1990-06-01

    The Monorail Piccolino coronary angioplasty balloon catheter (MBC) was evaluated on 118 patients at two centers. Technical success was achieved in 110 patients (93%). Time for catheter exchange and total fluoroscopy time were significantly lower for the Monorail catheter than with standard equipment (exchange time 97 vs. 170 seconds P less than .05 and fluoroscopy time 17 vs. 88 seconds P less than .001). The advantages of rapid exchange and the ability of utilize 2 Monorail balloon catheters through one 9F guiding catheter for simultaneous inflations allowed for maximal flexibility in treating patients with bifurcation lesions. The double wire approach utilizing one Monorail balloon catheter with a 7F guiding catheter was also technically successful. The Monorail Piccolino balloon catheter has unique features that allow for greater ease of operator use, rapid catheter exchange, and optimal angiographic visualization. It is felt that this catheter design provides distinct advantages over standard angioplasty equipment.

  7. Primary obstructive megaureter: the role of high pressure balloon dilation.

    PubMed

    Romero, Rosa M; Angulo, Jose Maria; Parente, Alberto; Rivas, Susana; Tardáguila, Ana Rosa

    2014-05-01

    There is a growing interest in minimally invasive treatment of primary obstructive megaureter (POM) in children. The absence of long-term follow-up data, however, makes it difficult to establish the indication for an endoscopic approach. The aim of our study is to determine the long-term efficacy of endourologic high-pressure balloon dilation of the vesicoureteral junction (VUJ) in children with POM that necessitates surgical treatment. We retrospectively reviewed the clinical records from children with POM who were treated with endourologic high-pressure balloon dilation of the VUJ from March 2003 to April 2010. To determine the long-term, a cohort study was conducted in November 2011. Endourologic dilation of the VUJ was performed with a semicompliant high-pressure balloon (2.7 FG) with a minimum balloon size of 3 mm, followed by placement of a Double-J stent. We have treated 29 (32 renal units, left [n=16], right [n=10] and bilateral [n=3]) children with a diagnosis of POM within this period. The median age at the time of the endourologic treatment was 4.04 months (range 1.6-39 months). In three cases, an open ureteral reimplantation was needed, in two cases because of intraoperative technical failure and postoperative Double-J stent migration in one patient. The 26 children (29 renal units) who had a successful endourologic dilation of the VUJ were followed with ultrasonography and MAG-3-Lasix (furosemide) studies that showed a progressive improvement of both the ureterohydronephrosis and drainage in the first 18 months in 20 patients (23 renal units) (69%). In two patients who were treated with a 3 mm balloon, a further dilation was needed, with an excellent outcome. The cohort study (at a median follow-up of 47 months) showed that in all patients who had a good outcome at the 18-month follow-up after endourologic balloon dilation remained asymptomatic with resolution of ureterohydronephrosis on the US and good drainage on the renogram, in the children with some persistent hydronephrosis. Our study shows that children with POM who were treated with high-pressure ballon dilation of the VUJ who have satisfactory appearance at 18 months maintain these results over time.

  8. Telemetry Options for LDB Payloads

    NASA Technical Reports Server (NTRS)

    Stilwell, Bryan D.; Field, Christopher J.

    2016-01-01

    The Columbia Scientific Balloon Facility provides Telemetry and Command systems necessary for balloon operations and science support. There are various Line-Of-Sight (LOS) and Over-The-Horizon (OTH) systems and interfaces that provide communications to and from a science payload. This presentation will discuss the current data throughput options available and future capabilities that may be incorporated in the LDB Support Instrumentation Package (SIP) such as doubling the TDRSS data rate. We will also explore some new technologies that could potentially expand the data throughput of OTH communications.

  9. Duplication cyst of the small intestine found by double-balloon endoscopy: A case report

    PubMed Central

    Ogino, Haruei; Ochiai, Toshiaki; Nakamura, Norimoto; Yoshimura, Daisuke; Kabemura, Teppei; Kusumoto, Tetsuya; Matsuura, Hiroshi; Nakashima, Akihiko; Honda, Kuniomi; Nakamura, Kazuhiko

    2008-01-01

    A 35-year-old man was admitted due to bloody stool and anemia. The bleeding source could not be detected by esophagogastroduodenoscopy or colonoscopy. Double balloon endoscopy (DBE) revealed a diverticulum-like hole in which coagula stuck in the ileum at 1 meter on the oral side from the ileocecal valve. The adjacent mucosa just to the oral side of the hole was elevated like a submucosal tumor. The lesion was considered the source of bleeding and removed surgically. It was determined to be a cyst with an ileal structure on the mesenteric aspect accompanying gastric mucosa. The diagnosis was a duplication cyst of the ileum, which is a rare entity that can cause gastrointestinal bleeding. In the present case, DBE was used to find the hemorrhagic duplication cyst in the ileum. PMID:18609722

  10. Primary small-bowel malignancy: update in tumor biology, markers, and management strategies.

    PubMed

    Shenoy, Santosh

    2014-12-01

    Primary small-bowel malignancies (SBM) are rare tumors but their incidence is rising. An estimated 9160 new cases and 1210 deaths due to SBM may occur in the USA in 2014. We review advances made in tumor biology, immunohistochemistry, and discuss treatment strategies for these malignancies. Relevant articles from PubMed/Medline and Embase searches were collected using the phrases "small-bowel adenocarcinoma, gastrointestinal carcinoids, gastrointestinal stromal tumors, small-bowel leiomyosarcoma, and small-bowel lymphoma". Advances in imaging techniques such as wireless capsule endoscopy, CT and MRI enterography, and endoscopy (balloon enteroscopy) along with discovery of molecular markers such as c-kit and PDGFRA for GIST tumors have improved our ability to diagnose, localize, and treat these patients. Early detection and surgical resection offers the best chance for long-term survival in all tumors except bowel lymphoma where chemotherapy plays the main role. Adjuvant therapy with imatinib has improved overall survival for GIST tumors, somatostatin analogs have improved symptoms and also inhibited tumor growth and stabilized metastatic disease in carcinoid disease, but chemotherapy has not improved survival for adenocarcinoma. Recent advances in molecular characterization holds promise in novel targeted therapies. Currently ongoing trials are exploring efficacy of targeted therapies and role of adjuvant therapy for adenocarcinoma and results are awaited. Early detection and aggressive surgical therapy for all localized tumors and lymph node sampling particularly for adenocarcinoma remains the main treatment modality.

  11. Small bowel adenocarcinoma of the jejunum: a case report and literature review.

    PubMed

    Li, Jie; Wang, Zhiliang; Liu, Na; Hao, Junfeng; Xu, Xin

    2016-07-04

    In practice, small bowel cancer is a rare entity. The most common histologic subtype is adenocarcinoma. Adenocarcinoma of the small bowel (SBA) is challenging to diagnose, often presents at a late stage and has a poor prognosis. The treatment of early-stage SBA is surgical resection. No standard protocol has been established for unresectable or metastatic disease. We report here on a 26-year-old man with SBA in the jejunum, lacking specific symptoms and with a delay of 6 months in diagnosis. The diagnosis was finally achieved with a combination of balloon-assisted enteroscopy, computed tomography scans, positron emission computed tomography scans and the values of carcino-embryonic antigen and carbohydrate antigen 19-9. The patient underwent segmental intestine with lymph node resection, followed by eight cycles of FOLFOX palliative chemotherapy with good tolerance. As of the 11-month postoperative follow-up, there has been no evidence of recurrent disease. This case is reported to arouse a clinical suspicion of SBA in patients with abdominal pain of unknown cause. We also provided evidence in this case of a response to palliative chemotherapy with FOLFOX. Because the incidence of SBA is very low, there is a need for further studies to evaluate the possible application of newer investigative agents and strategies to obtain a better outcome within the framework of international collaborations.

  12. 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.

  13. Bipolar versus balloon endometrial ablation in the office: a randomized controlled trial.

    PubMed

    Penninx, Josien P M; Herman, Malou C; Kruitwagen, Roy F P M; Ter Haar, Annette J F; Mol, Ben W; Bongers, Marlies Y

    2016-01-01

    To compare the effectiveness of bipolar radiofrequency (Novasure®) ablation and balloon endometrial ablation (Thermablate®). We performed a multi-center double blind, randomized controlled trial in three hospitals in The Netherlands. Women with heavy menstrual bleeding were randomly allocated to bipolar or balloon endometrial ablation, performed in the office, using a paracervical block. The primary outcome was amenorrhea. Secondary outcome measures were pain, satisfaction, quality of life and reintervention. 104 women were randomized into the bipolar (52) and balloon (52) groups. After 12 months amenorrhea rates were 56% (29/52) in the bipolar group and 23% (12/52) in the balloon group (relative risk (RR) 0.6, 95% confidence interval (CI) 0.4-0.8). The mean visual analog pain score of the total procedure was 7.1 in the bipolar group and 7.4 in the balloon group (P<.577). 87% (45/52) of the patients in the bipolar group were satisfied with the result of the treatment versus 69% (36/52) in the balloon group (RR 0.44, 95% CI 0.2-0.97). The reintervention rates were 5/52 (10%) in the bipolar group and 6/52 (12%) in the balloon group (RR 1.02, 95% CI 0.9-1.2). Quality of life (Shaw score) improved over time (P<.001) and was significantly higher in the bipolar group at 12 months follow-up (P=.025). In the treatment of heavy menstrual bleeding, bipolar radiofrequency endometrial ablation is superior to balloon endometrial ablation as an office procedure in amenorrhea rate, patient satisfaction and quality of life. Copyright © 2015. Published by Elsevier Ireland Ltd.

  14. Science Results From The ARCADE Open-Aperture Cryogenic Balloon Payload

    NASA Technical Reports Server (NTRS)

    Kogut, Alan J.

    2010-01-01

    The Absolute Radiometer for Cosmology, Astrophysics, and Diffuse Emission (ARCADE) is a balloon-borne instrument to measure the frequency spectrum of the cosmic microwave background and diffuse Galactic foregrounds at centimeter wavelengths. ARCADE greatly reduces measurement uncertainties compared to previous balloon-borne or ground-based instrument using a double-nulled design that features fully cryogenic optics with no windows between the atmosphere and the 2.7 K instrument. A four-hour flight in 2006 achieved sensitivity comparable to the COBE/FIRAS satellite measurement while providing new insights for emission ranging from spinning dust in the interstellar medium to an unexpectedly bright extragalactic radio background. I will discuss scientific results from the ARCADE program and implications of the ARCADE cold optics for millimeter and sub-mm astronomy.

  15. The detection of high charge cosmic ray nuclei. [by balloon-borne electronic particle telescope

    NASA Technical Reports Server (NTRS)

    Scarlett, W. R.; Freier, P. S.; Waddington, C. J.

    1975-01-01

    A large-area, light-weight electronic particle telescope was flown on a high altitude balloon in the summer of 1974 to study the heavy nuclei in the cosmic radiation. This telescope consisted of a double Cerenkov-double scintillator array composed of four 1.22 m diameter disk radiators mounted in light diffusion boxes, each looked at by multiple photomultipliers. The impact point of each particle on the scintillation radiators was determined by studying the relative signals observed by three equally spaced peripheral photomultipliers and one mounted at the center of the diffusion boxes. This telescope was flown in a configuration having a geometric factor of 0.45 sq m sr and observed some 5 x 10 to the 4 nuclei with Z exceeding 14 in a 11 hr exposure. The response and sensitivity of this telescope are discussed in detail.

  16. Cerebral ischemic lesions detected with diffusion-weighted magnetic resonance imaging after carotid artery stenting: Comparison of several anti-embolic protection devices.

    PubMed

    Taha, Mahmoud M; Maeda, Masayuki; Sakaida, Hiroshi; Kawaguchi, Kenji; Toma, Naoki; Yamamoto, Akitaka; Hirose, Tomofumi; Miura, Youichi; Fujimoto, Masashi; Matsushima, Satoshi; Taki, Waro

    2009-09-01

    Distal embolism is an important periprocedural technical complication with carotid angioplasty and carotid artery stenting (CAS). We evaluated the safety and efficacy of protection devices used during CAS by detecting new cerebral ischemic lesions using diffusion-weighted magnetic resonance imaging in 95 patients who underwent 98 CAS procedures: 34 using single PercuSurge GuardWire, 31 using double balloon protection, 15 using proximal flow reverse protection devices, 14 using Naviballoon, and 4 using filter anti-embolic devices. Diffusion-weighted imaging was performed preoperatively and postoperatively to evaluate the presence of any new embolic cerebral lesions. Postoperative diffusion-weighted imaging revealed 117 new ischemic lesions. Three patients had new ischemic stroke, two minor and one major, all ipsilateral to the treated carotid artery. The remaining patients had clinically silent ischemia. The incidence of new embolic lesions was lower using the proximal flow reverse protection device than with the double balloon protection (33% vs. 48.4%), but the volume of ipsilateral new ischemic lesions per patient was 136.6 mm(3) vs. 86.9 mm(3), respectively. Neuroprotection with Naviballoon yielded ipsilateral lesions of large volume (86.6 mm(3)) and higher number (5.7 lesions per patient) than using the filter anti-embolic device (34.8 mm(3) and 1 lesion per patient). New cerebral ischemic lesions after neuroprotected CAS are usually silent. The lower incidence of distal ischemia using proximal flow reverse and double balloon protection devices is limited by the larger volume and higher number of ischemic lesions.

  17. Discussion on the Timing of Balloon Occlusion of the Abdominal Aorta during a Caesarean Section in Patients with Pernicious Placenta Previa Complicated with Placenta Accreta

    PubMed Central

    Yang, Kaili; Cai, Lina

    2017-01-01

    Objective This paper is aimed at investigating the role and value of the timing of balloon occlusion of the abdominal aorta during caesarean section in patients with pernicious placenta previa complicated with placenta accreta. Methods 79 cases admitted to the Second Affiliated Hospital of Zhengzhou University from September 2015 to December 2016 were treated with ultrasound mediated abdominal aortic balloon occlusion. Among them, 42 cases, whose balloon occlusion time was selected before the delivery and transverse incision was taken, were group A. The other 37 cases were group B, whose timing of balloon occlusion was selected after the delivery and the uterine incision made trying to avoid the placenta or double incisions. The intraoperative blood loss, utilization of blood, and other indicators were compared between the two groups. Results The intraoperative blood loss in groups A and B was 413.8 ± 105.9 ml and 810.3 ± 180.3 ml, and the utilization of blood products in groups A and B was 30.23% and 89.2%. The total hysterectomy rate was 2.53% (2/79), with no hysterectomies in groups A and 2 cases in group B. Conclusion The balloon occlusion of the abdominal aorta before the delivery combined with a transverse incision is more effective. PMID:29230417

  18. Enteroscopic biopsies in the management of pancreas transplants: a proof of concept study for a novel monitoring tool.

    PubMed

    Margreiter, Christian; Aigner, Felix; Resch, Thomas; Berenji, Anna-Katharina; Oberhuber, Rupert; Sucher, Robert; Profanter, Christoph; Veits, Lothar; Öllinger, Robert; Margreiter, Raimund; Pratschke, Johann; Mark, Walter

    2012-01-27

    Although percutaneous biopsies are considered to be the gold standard in diagnosing pancreas graft rejection, they are not performed routinely because of their association with severe complications. On the other hand, correct diagnosis of rejection is essential but may be difficult in cases of enteric drainage, particularly in patients with a pancreas transplant alone or a pancreas after kidney transplant. Pancreas recipients who underwent enteroscopy between May 2005 and September 2009 were included in this retrospective analysis. Biopsies were graded 0 to 4 for interstitial and vascular changes. During the study period a total of 65 simultaneous pancreas-kidney transplants, 13 pancreas after kidney transplants and 4 pancreas transplants alone were performed. Sixty-three patients underwent a single enteroscopy, 10 had two, and 6 had three or more. Indications were protocol graft monitoring (n=73), graft dysfunction (n=17), enteric hemorrhage (n=9), or other (n=3). The duodenal segment was accessed in 76 instances (75%) with abnormal findings in 23. A total of 69 biopsies were obtained and revealed normal mucosa in 49 cases (71%). Histology showed signs of acute rejection in 11 cases. The upper gastrointestinal tract was also assessed, and, in 13 cases, additional pathologies were identified including gastroduodenitis (n=10), gastric/duodenal ulcer (n=2), and hemorrhagic esophagitis (n=1). No procedure-related complication occurred. This series of enteroscopies demonstrates that the duodenal segment of a pancreatic graft is accessible using our implant technique, and thus permitting biopsies to be obtained and endoscopic interventions to be performed.

  19. Access to a New Plasma Edge State with High Density and Pressures using Quiescent H-mode

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

    Solomon, Wayne M.; Snyder, P. B.; Burrell, K. H.

    2014-07-01

    A path to a new high performance regime has been discovered in tokamaks that could improve the attractiveness of a fusion reactor. Experiments on DIII-D using a quiescent H-mode edge have navigated a valley of improved edge peeling-ballooning stability that opens up with strong plasma shaping at high density, leading to a doubling of the edge pressure over standard edge localized mode (ELM)ing H-mode at these parameters. The thermal energy confinement time increases both as a result of the increased pedestal height and improvements in the core transport and reduced low-k turbulence. Calculations of the pedestal height and width asmore » a function of density using constraints imposed by peeling-ballooning and kinetic-ballooning theory are in quantitative agreement with the measurements.« less

  20. Alien crop circle? No, that’s just NASA’s newest balloon launch pad

    NASA Image and Video Library

    2017-12-08

    Aviators, skydivers and other altitude-seeking enthusiasts flying out of Wanaka Airport, New Zealand, are double taking at a new topographical feature reminiscent of an alien crop circle. Rest assured, the nearly 2,000-foot (600-meter) diameter circle with a pie-shaped wedge on one side and spokes on the other is no extraterrestrial footprint and it’s definitely no hoax. It’s NASA’s newest launch pad for launching the agency’s most advanced high-altitude, heavy-lift scientific balloon: the super pressure balloon. The four spokes emanating from the center and toward the west, each nearly 1,000 feet (300 meters) long, align with magnetic compass directions at 240, 260, 290 and 320 degrees. On launch day, balloon flight experts from NASA’s Columbia Scientific Balloon Facility will assess meteorological data and determine if the conditions are suitable to support a launch opportunity. The new pad is the first major project in developing a long-term super pressure balloon launch site in Wanaka. Earlier in 2017, NASA signed a 10-year lease with the Queenstown Airport Corporation to conduct balloon operations from a newly acquired piece of land adjacent to the Wanaka Airport. Credit: NASA/Dave Webb 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

  1. Clinical radiology of the small intestine

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

    Herlinger, H.; Maglinte, D.

    1989-01-01

    This book discussed embryology, anatomy, physiology, and immunology of the small intestine. Radiographic procedures in the small intestine especially enterolysis are presented. Focus is on the role of other types of imaging techniques including sonography, computed tomography, radionuclide imaging, angiography, biopsy, and enteroscopy.

  2. Successful balloon dilatation of both orifices in a case of double-orifice mitral valve with severe rheumatic stenosis.

    PubMed

    Nath, Ranjit Kumar; Soni, Dheeraj Kumar

    2016-08-01

    A 24-year-old female patient presented to us with progressive dyspnea on exertion for last three year. She was not a known case of rheumatic heart disease. Her physical examination showed regular pulse and her blood pressure was 100/76 mm Hg. Cardiac palpation showed grade 3 parasternal heave and auscultation revelled an accentuated first heart sound, loud P2 and mid-diastolic long rumbling murmur at apex and pansystolic murmur of tricuspid regurgitation at lower left sterna border. Chest X-ray showed evidence of grade 3 pulmonary venous congestion. Transthoracic and transesophageal two-dimensional echocardiography revealed a double-orifice mitral valve of complete bridge type at the leaflet level. Both orifice sizes were unequal, with the anterolateral orifice being smaller than its counterpart. There was moderate subvalvular fusion and both commisures were fused. Color doppler examination showed two separate mitral diastolic flows with mean gradients of 22 mm and 20 mm of Hg, respectively. There was no mitral regurgitation and no left atrial or appendage clot was seen by transesophageal echocardiography. Transseptal puncture was done by the modified fluoroscopic method. Posteromedial orifice was crossed with a 24 mm Inoue balloon and dilated using the stepwise dilation technique. Anterolateral orifice was not crossed by Inuoe balloon after multiple attempts. A TYSHAK (NuMAD Canada Inc.) balloon (16 × 40mm) was taken over the wire and inflated successfully across the anterolateral orifice with the help of transthoracic echocardiography guidance. Mean gradient become 9 and 8 mm across the medial and lateral orifice. Patient was discharged in stable condition after two day. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  3. Access to a new plasma edge state with high density and pressures using the quiescent H mode

    DOE PAGES

    Solomon, Wayne M.; Snyder, Philip B.; Burrell, Keith H.; ...

    2014-09-24

    A path to a new high performance regime has been discovered in tokamaks that could improve the attractiveness of a fusion reactor. Experiments on DIII-D using a quiescent H-mode edge have navigated a valley of improved edge peeling-ballooning stability that opens up with strong plasma shaping at high density, leading to a doubling of the edge pressure over the standard H mode with edge localized modes at these parameters. The thermal energy confinement time increases as a result of both the increased pedestal height and improvements in the core transport and reduced low-k turbulence. As a result, calculations of themore » pedestal height and width as a function of density using constraints imposed by peeling-ballooning and kinetic-ballooning theory are in quantitative agreement with the measurements.« less

  4. Interferometry on a Balloon; Paving the Way for Space-based Interferometers

    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 scale 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 (BETTII), 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.

  5. 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,

  6. 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.

  7. Percutaneous Mitral Valvuloplasty in a Mid-Term Pregnant Woman with Severe Rheumatic Mitral Stenosis

    PubMed Central

    Lee, Myoung Mook; Sohn, Dae-Won; Oh, Byung Hee; Kim, Jung Goo; Park, Young Bae; Choi, Yun Shik; Seo, Jung Don; Lee, Young Woo

    1992-01-01

    A 28-year-old woman with severe mitral stenosis underwent percutaneous mitral valvuloplasty at 26 weeks’ gestation. Balloon dilation using a double 18-18 mm balloon resulted in improvement in mean mitral pressure gradient (32 to 8 mmHg) and in calculated mitral valve area (0.9 to 2.4 cm2) without complications and any evidence of fetal distress during procedures with an estimated radiation exposure to the fetus of 0.13 rem. This procedure resulted in the disappearance of symptoms of congestive heart failure and allowed for normal full term spontaneous delivery of a 3.51 kg boy without any complication. PMID:1477032

  8. Retrograde Endopyelotomy with Cutting Balloon™ for Treatment of Ureteropelvic Junction Obstruction in Infants.

    PubMed

    Parente, Alberto; Perez-Egido, Laura; Romero, Rosa Maria; Ortiz, Ruben; Burgos, Laura; Angulo, Jose Maria

    2016-01-01

    The aim of this study is to analyze results of retrograde endopyelotomy with cutting balloon for treatment of ureteropelvic junction obstruction (UPJO) in infants. We routinely treat patients with UPJO under 18 months of age with retrograde high-pressure balloon dilatation of the pelviureteric junction (PUJ). During the procedure, in these cases where narrowing at the PUJ persists, endopyelotomy with cutting balloon is performed. Endopyelotomy is performed over guidewire with 5-mm Cutting Balloon™ under fluoroscopic control. Double-J stents is left in situ for 4 weeks. We retrospectively analyzed the postoperative, clinical, and radiological outcome infants treated with cutting balloon endopyelotomy between 2007 and 2015. Sixteen patients required cutting balloon endopyelotomy to achieve complete resolution of narrowing of the waist observed during high-pressure balloon dilatation of the PUJ. Mean operative time was 35 ± 21 min (mean ± SD) and hospital stay was <24 h in all patients. Complete resolution of the narrowing at the PUJ under fluoroscopy was achieved in all cases, with no perioperative complications. One patient presented with urinary tract infection, postoperatively (Clavien grade II). Preoperatively, all cases had grade IV SFU hydronephrosis with parenchymal thinning. During follow-up, resolution of the hydronephrosis was observed in 11 patients (grade I SFU). In four infants, there was an improvement of the hydronephrosis (grade II SFU) and the renogram curve. In one case, an open pyeloplasty was required due to persistent hydronephrosis and obstructive curve. We believe that endopyelotomy with cutting balloon could be a valid and safe option in minimally invasive management of UPJO in infants.

  9. 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 is about 10% of the AB balloon, largely due to the much lower flow rate. The LGC balloon must compress some lift gas at sunrise, but this can be managed by one of several strategies. We conclude that while the weight constraints are likely to be significant, LGC altitude-controlled balloons may be feasible for accessing the 60 to 75 km altitude range on Venus. The underlying concept of balloons on Venus was proven by the Soviet Union's successful deployment of their two superpressure VEGA balloons in 1981 operating at a fixed altitude near 55 km. Superpressure balloon concepts for similar altitudes and larger payloads have since been proposed for NASA's Discovery program and ESA's Cosmic Visions program. The LGC balloon would add a zero-pressure envelope and a compressor to the established superpressure design, allowing it to ascend above the deployment altitude and realize lossless altitude control over a range of several scale heights. The thermodynamic equations, flight data, and conceptual analysis presented are intended to foster further discussion about the feasibility and potential benefits of a balloon mission to Venus.

  10. 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.

  11. Charles Theodore Dotter: The Father of Intervention

    PubMed Central

    Payne, Misty M.

    2001-01-01

    The 1st percutaneous transluminal angioplasty marked a new era in the treatment of peripheral atherosclerotic lesions. The early techniques used in peripheral percutaneous transluminal angioplasty form the basis for subsequent percutaneous intervention both in the peripheral and coronary arteries and are largely the contribution of Charles Dotter. Dotter was the 1st to describe flow-directed balloon catheterization, the double-lumen balloon catheter, the safety guidewire, percutaneous arterial stenting, and more. This practical genius dedicated his considerable energy to the belief that there is always a better way to treat disease. His personal contributions to clinical medicine, research, and teaching have saved millions of limbs and lives all over the world. PMID:11330737

  12. The Balloon Experimental Twin Telescope for Infrared Interferometry (BETTII): Spatially Resolved Spectroscopy in the Far-Infrared

    NASA Technical Reports Server (NTRS)

    Rinehart, Stephen

    2009-01-01

    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 scale 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 (BETTII), 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 and for suborbital programs optimized for studying extrasolar planets.

  13. [Mitral valvuloplasty with double balloon catheter. Analysis of 200 cases].

    PubMed

    Gomes, N L; Esteves, C A; Braga, S L; Ramos, A I; Meneghelo, Z M; Mattos, L A; Pontes Júnior, S C; Arnoni, A S; Fontes, V F; Sousa, J E

    1992-04-01

    To study the immediate clinical, echocardiographic and hemodynamic results of 200 patients who underwent percutaneous mitral balloon valvotomy (PMV) with double balloon technique. Two hundred patients were submitted to PVM for treatment of congestive heart failure secondary to severe mitral stenosis, between August 1987 to July 1991. Their mean age was 35.2 years, and 86.5% were female patients: 81% of them was in functional class, New York Heart Association (NYHA) III or IV; 4% was in atrial fibrilation and 4% had previous surgical commissurotomy. PMV was successfully performed in 89% of the patients. The mitral valve area, by pressure half time method, increased from 0.91 +/- 0.27 to 2.10 +/- 0.47 cm2, p < 0.001; the mean mitral gradient decreased from 20.86 +/- 6.16 to 4.26 +/- 3.13 mmHg, p < 0.001; the left atrium and mean pulmonary artery pressure decreased from 22.3 +/- 7.1 to 11.9 +/- 8.3 and 36.47 +/- 12.93 to 24.56 +/- 9.98 mmHg, p < 0.001, respectively. Complications related to transeptal technique occurred in 12 patients, which resulted in cardiac tamponade in 5 and death in 1. In 19 patients the punction of the atrial septum could not be performed. Mitral regurgitation (MR) immediately after PMV appeared 1+ or more grade in 50 patients, increased in 8 patients and remained unchanged in 11 patients. Ten patients needed mitral valve replacement in the first 48h after PMV, for treatment of severe MR. PMV produces excellent immediate results and can be considered an alternative to surgery for the relief of mitral stenosis.

  14. The Balloon Experimental Twin Telescope for Infrared Interferometry

    NASA Technical Reports Server (NTRS)

    Silverburg, Robert

    2009-01-01

    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 comparatively low spatial 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. We have proposed a new high altitude balloon experiment, the Balloon Experimental Twin Telescope for Infrared Interferometry (BETTII). High altitude operation makes far-infrared (30- 300micron) observations possible, and BETTII's 8-meter baseline provides unprecedented angular resolution (approx. 0.5 arcsec) in this band. BETTII will use a double-Fourier instrument to simultaneously obtain both spatial and spectral information. The spatially resolved spectroscopy provided by BETTII will address key questions about the nature of disks in young cluster stars and active galactic nuclei and the envelopes of evolved stars. BETTII will also lay the groundwork for future space interferometers.

  15. The Balloon Experimental Twin Telescope for Infrared Interferometry (BETTII): High Angular Resolution Astronomy at Far-Infrared Wavelengths

    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 comparatively low spatial 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. We have proposed a new high altitude balloon experiment, the Balloon Experimental Twin Telescope for Infrared Interferometry (BETTII). High altitude operation makes far-infrared (30- 300micron) observations possible, and BETTII's 8-meter baseline provides unprecedented angular resolution (-0.5 arcsec) in this band. BETTII will use a double- Fourier instrument to simultaneously obtain both spatial and spectral informatioT. he spatially resolved spectroscopy provided by BETTII will address key questions about the nature of disks in young cluster stars and active galactic nuclei and the envelopes of evolved stars. BETTII will also lay the groundwork for future space interferometers.

  16. 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.

  17. [Coronary angioplasty simultaneous with the "kissing" technique in a bifurcation lesion: use of a guidewire, and 2 monorail systems of rapid interchange].

    PubMed

    Escudero, X

    1996-01-01

    Coronary branch occlusion complicating percutaneous coronary angioplasty has been recognized in certain bifurcation lesions. The utilization of double angioplasty systems simultaneously has been called "kissing" because the image of contact between balloons, and has been utilized as an alternative to protect the jeopardized branch or prevent snowplow lesion of the principal artery. The technological advance with the use of wide lumen catheters and low profile dilation balloons make the application of this technique possible in those type of lesions using a single guiding catheter. The present paper describes one case treated with this technique using conventional angioplasty systems in a complex bifurcating lesion of the circumflex artery. Some technical considerations about the procedure are made.

  18. Asian Perspectives on Diagnostic and Therapeutic Strategies in Inflammatory Bowel Disease: Report and Analysis of a Survey with Questionnaires.

    PubMed

    Yoshida, Atsushi; Ueno, Fumiaki; Morizane, Toshio; Joh, Takashi; Kamiya, Takeshi; Takahashi, Shin''ichi; Tokunaga, Kengo; Iwakiri, Ryuichi; Kinoshita, Yoshikazu; Suzuki, Hidekazu; Naito, Yuji; Uchiyama, Kazuhiko; Fukodo, Shin; Chan, Francis K L; Halm, Ki-Baik; Kachintorn, Udom; Fock, Kwong Ming; Rani, Abdul Aziz; Syam, Ari Fahrial; Sollano, Jose D; Zhu, Qi

    2017-01-01

    Diagnostic and therapeutic strategies in inflammatory bowel disease (IBD) vary among countries in terms of availability of modalities, affordability of health care resource, health care policy and cultural background. This may be the case in different countries in Eastern Asia. The aim of this study was to determine and understand the differences in diagnostic and therapeutic strategies of IBD between Japan and the rest of Asian countries (ROA). Questionnaires with regard to clinical practice in IBD were distributed to members of the International Gastroenterology Consensus Symposium Study Group. The responders were allowed to select multiple items for each question, as multiple modalities are frequently utilized in the diagnosis and the management of IBD. Dependency and independency of selected items for each question were evaluated by the Bayesian network analysis. The selected diagnostic modalities were not very different between Japan and ROA, except for those related to small bowel investigations. Balloon-assisted enteroscopy and small bowel follow through are frequently used in Japan, while CT/MR enterography is popular in ROA. Therapeutic modalities for IBD depend on availability of such modalities in clinical practice. As far as modalities commonly available in both regions are concerned, there seemed to be similarity in the selection of each therapeutic modality. However, evaluation of dependency of separate therapeutic modalities by Bayesian network analysis disclosed some difference in therapeutic strategies between Japan and ROA. Although selected modalities showed some similarity, Bayesian network analysis elicited certain differences in the clinical approaches combining multiple modalities in various aspects of IBD between Japan and ROA. © 2016 S. Karger AG, Basel.

  19. Technical considerations in percutaneous hepatic perfusion--a multi-center experience.

    PubMed

    Antoine, Radcliffe A

    2011-03-01

    Patients diagnosed with primary or metastatic liver cancer face a daunting future that is complicated by limited treatment options. Percutaneous hepatic perfusion is a novel approach to chemotherapy delivery that offers significant benefits over contemporary modalities. Percutaneous hepatic perfusion is a procedure in which a chemotherapeutic agent is administered at high doses via the hepatic artery where it perfuses the liver, is extracted and filtered using a veno-veno bypass circuit, a fenestrated multi-lumen double-balloon catheter, and two biocompatible hemoperfusion filters. Venous access is gained at the groin through the femoral vein after which the catheter is advanced and positioned in the inferior vena cava just below the right atrium.The catheter's proximal and distal balloons are inflated to occlude the inferior vena cava above and below the hepatic veins. The occlusion isolated the chemo-rich venous outflow of the liver from the systemic venous circulation. This maneuver also diverts venous blood returning to the heart from lower extremities of the azygos vein. Once the patient is on bypass, the agent is infused through the hepatic artery where it saturates the liver. The chemo-rich venous outflow is extracted through the double-balloon catheter by the bypass circuit. The blood is continuously filtered and cleared of the agent as it passes through the filters and returned to the patient through a catheter placed in the right internal jugular vein. A phase I study demonstrated efficacy with an overall radiographic response rate of 30% observed in treated patients. In 10 patients with ocular melanoma, a 50% overall response rate was observed, including two complete responses. The technique is minimally invasive and can be performed safely by a well-trained multi-disciplinary team. It offers significant benefits including multiple procedures without risks commonly associated with open abdominal surgery.

  20. Technical Considerations in Percutaneous Hepatic Perfusion—A Multi-Center Experience

    PubMed Central

    Antoine, Radcliffe A.

    2011-01-01

    Abstract: Patients diagnosed with primary or metastatic liver cancer face a daunting future that is complicated by limited treatment options. Percutaneous hepatic perfusion is a novel approach to chemotherapy delivery that offers significant benefits over contemporary modalities. Percutaneous hepatic perfusion is a procedure in which a chemotherapeutic agent is administered at high doses via the hepatic artery where it perfuses the liver, is extracted and filtered using a veno-veno bypass circuit, a fenestrated multi-lumen double-balloon catheter, and two biocompatible hemoperfusion filters. Venous access is gained at the groin through the femoral vein after which the catheter is advanced and positioned in the inferior vena cava just below the right atrium. The catheter’s proximal and distal balloons are inflated to occlude the inferior vena cava above and below the hepatic veins. The occlusion isolated the chemo-rich venous outflow of the liver from the systemic venous circulation. This maneuver also diverts venous blood returning to the heart from lower extremities of the azygos vein. Once the patient is on bypass, the agent is infused through the hepatic artery where it saturates the liver. The chemorich venous outflow is extracted through the double-balloon catheter by the bypass circuit. The blood is continuously filtered and cleared of the agent as it passes through the filters and returned to the patient through a catheter placed in the right internal jugular vein. A phase I study demonstrated efficacy with an overall radiographic response rate of 30% observed in treated patients. In 10 patients with ocular melanoma, a 50% overall response rate was observed, including two complete responses. The technique is minimally invasive and can be performed safely by a well-trained multi-disciplinary team. It offers significant benefits including multiple procedures without risks commonly associated with open abdominal surgery. PMID:21449232

  1. Case report of primary intestinal lymphangiectasia diagnosed in an octogenarian by ileal intubation and by push enteroscopy after missed diagnosis by standard colonoscopy and EGD.

    PubMed

    Cappell, Mitchell S; Edhi, Ahmed; Amin, Mitual

    2018-01-01

    Primary intestinal lymphangiectasia (PIL) is a rare, presumably congenital lesion that is usually diagnosed in patients < 3 years old, is rarely first diagnosed in adulthood, and when first diagnosed in adulthood typically presents with symptoms for many years. Although PIL is often identified by endoscopic abnormalities, it must be emphasized that the jejunoileum/distal duodenum must be intubated for diagnosis because the lesions are present in these regions. This work demonstrates that 1)-PIL can occur in an octogenarian; 2)-shows that the characteristic endoscopic findings are not found at colonoscopy without terminal ileal intubation; and 3)-may be missed at standard EGD without distal duodenal intubation. A patient initially presented at age 83 with symptoms of watery diarrhea, abdominal distention, 5-Kg-weight-gain, and weakness for one month, and had typical clinical findings of PIL including chylous ascites, pleural effusions, bilateral pitting leg edema, hypoalbuminemia, borderline lymphopenia, hypovitaminosis-D, and hypocalcemia. Protein-losing-enteropathy was demonstrated by positive stool tests for alpha-1-antitrypsin. Standard colonoscopy revealed no significant lesions, but terminal ileal intubation during colonoscopy demonstrated creamy-white, punctate, mucosal lesions in terminal ileum, characteristic of lymphangiectasia. EGD with intubation to mid-descending duodenum revealed no significant lesions, but subsequent enteroscopy demonstrated lesions in distal duodenum/proximal jejunum similar to those in terminal ileum characteristic of lymphangiectasia. Histopathologic analysis of lesions of terminal ileum/distal duodenum demonstrated dilated mucosal vessels, confirmed as lymphatic vessels by immunohistochemistry. PIL was diagnosed after excluding secondary causes of intestinal lymphangiectasia. Patient placed on standard PIL diet: oral supplements of medium-chain triglycerides, a high protein diet, supplements of fat-soluble vitamins, and avoiding long-chain fatty acids, with marked clinical improvement. This work shows that: 1)-standard EGD and colonoscopy may miss characteristic lesions of PIL, 2)-enteroscopy or terminal ileal intubation at colonoscopy may be required for the diagnosis because lesions are typically located in distal duodenum/jejunoileum; and 3)-PIL can first present in the very elderly even with symptoms of short duration. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  2. Case report of primary intestinal lymphangiectasia diagnosed in an octogenarian by ileal intubation and by push enteroscopy after missed diagnosis by standard colonoscopy and EGD

    PubMed Central

    Cappell, Mitchell S.; Edhi, Ahmed; Amin, Mitual

    2018-01-01

    Abstract Rationale: Primary intestinal lymphangiectasia (PIL) is a rare, presumably congenital lesion that is usually diagnosed in patients < 3 years old, is rarely first diagnosed in adulthood, and when first diagnosed in adulthood typically presents with symptoms for many years. Although PIL is often identified by endoscopic abnormalities, it must be emphasized that the jejunoileum/distal duodenum must be intubated for diagnosis because the lesions are present in these regions. This work demonstrates that 1)-PIL can occur in an octogenarian; 2)-shows that the characteristic endoscopic findings are not found at colonoscopy without terminal ileal intubation; and 3)-may be missed at standard EGD without distal duodenal intubation. Diagnoses: A patient initially presented at age 83 with symptoms of watery diarrhea, abdominal distention, 5-Kg-weight-gain, and weakness for one month, and had typical clinical findings of PIL including chylous ascites, pleural effusions, bilateral pitting leg edema, hypoalbuminemia, borderline lymphopenia, hypovitaminosis-D, and hypocalcemia. Protein-losing-enteropathy was demonstrated by positive stool tests for alpha-1-antitrypsin. Standard colonoscopy revealed no significant lesions, but terminal ileal intubation during colonoscopy demonstrated creamy-white, punctate, mucosal lesions in terminal ileum, characteristic of lymphangiectasia. EGD with intubation to mid-descending duodenum revealed no significant lesions, but subsequent enteroscopy demonstrated lesions in distal duodenum/proximal jejunum similar to those in terminal ileum characteristic of lymphangiectasia. Histopathologic analysis of lesions of terminal ileum/distal duodenum demonstrated dilated mucosal vessels, confirmed as lymphatic vessels by immunohistochemistry. PIL was diagnosed after excluding secondary causes of intestinal lymphangiectasia. Interventions/Outcomes: Patient placed on standard PIL diet: oral supplements of medium-chain triglycerides, a high protein diet, supplements of fat-soluble vitamins, and avoiding long-chain fatty acids, with marked clinical improvement. Lessons: This work shows that: 1)-standard EGD and colonoscopy may miss characteristic lesions of PIL, 2)-enteroscopy or terminal ileal intubation at colonoscopy may be required for the diagnosis because lesions are typically located in distal duodenum/jejunoileum; and 3)-PIL can first present in the very elderly even with symptoms of short duration. PMID:29505002

  3. The Electron Calorimeter (ECAL) Long Duration Balloon Experiment

    NASA Technical Reports Server (NTRS)

    Guzik, T. G.; Adams, J. H.; Bashindzhagyan, G.; Binns, W. R.; Chang, J.; Cherry, M. L.; Christl, M.; Dowkontt, P.; Ellison, B.; Isbert, J. B.; hide

    2007-01-01

    Accurate measurements of the cosmic ray electron energy spectrum in the energy region 50 GeV to greater than 1 TeV may reveal structure caused by the annihilation of exotic dark matter particles and/or individual cosmic ray sources. Here we describe a new long duration balloon (LDB) experiment, ECAL, optimized to directly measure cosmic ray electrons up to several TeV. ECAL includes a double layer silicon matrix, a scintillating optical fiber track imager, a neutron detector and a fully active calorimeter to identify more than 90% of the incident electrons with an energy resolution of about 1.7% while misidentifying only 1 in 200,000 protons and 0.8% of secondary gamma rays as electrons. Two ECAL flights in Antarctica are planned for a total exposure of 50 days with the first flight anticipate for December 2009.

  4. Postoperative vesicoureteral reflux after high-pressure balloon dilation of the ureterovesical junction in primary obstructive megaureter. Incidence, management and predisposing factors.

    PubMed

    García-Aparicio, Luis; Blázquez-Gómez, Eva; de Haro, Irene; Garcia-Smith, Natalie; Bejarano, Miguel; Martin, Oriol; Rodo, Joan

    2015-12-01

    To describe the incidence, predisposing factors and management of postoperative vesicoureteral reflux (VUR) after high-pressure balloon dilation to treat primary obstructive megaureter (POM). We have reviewed patients that underwent endoscopic treatment for POM from May 2008 to November 2013. All patients were evaluated with renal ultrasound, voiding cystourethrography and diuretic renogram. Endoscopic treatment was done with high-pressure balloon dilation of the ureterovesical junction under general anesthesia; a double-J stenting was done in all patients. Follow-up was performed with ultrasonography, voiding cystourethrography and a diuretic renogram in all patients. Fifteen boys and five girls with a mean age of 14.18 months (3-103) were reviewed. A total of 22 ureters underwent HPBD to treat POM. Ureterohydronephrosis improves in 19 ureters. After endoscopic treatment, six ureters developed VUR. Four ureters were managed surgically, and in the other two, VUR disappeared in a second cystogram. The presence of parameatal diverticulum in the preoperative cystography and those patients with bilateral POM are factors related to postoperative VUR (p < 0.05). Urinary tract infection after HPBD was observed in four patients, but only one of them was affected with VUR.

  5. Correlation analysis of 1 to 30 MeV celestial gamma rays

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

    Long, J.L.

    1984-01-01

    This paper outlines the development of a method of producing celestial sky maps from the data generated by the University of California, Riverside's double Compton scatter gamma ray telescope. The method makes use of a correlation between the telescope's data and theoretical calculated response functions. The results of applying this technique to northern hemisphere data obtained from a 1978 balloon flight from Palestine, Texas are included.

  6. Functional Correlation Between the Pancreas and the Small Intestine in Humans: The First Evaluation Using a Newly Developed Enteroscopy.

    PubMed

    Hayashi, Daijuro; Hirooka, Yoshiki; Kawashima, Hiroki; Ohno, Eizaburo; Ishikawa, Takuya; Kuwahara, Takamichi; Kawai, Manabu; Yamamura, Takeshi; Furukawa, Kazuhiro; Funasaka, Kohei; Nakamura, Masanao; Miyahara, Ryoji; Watanabe, Osamu; Ishigami, Masatoshi; Hashimoto, Senju; Goto, Hidemi

    The aim of this study is to evaluate a functional correlation between the pancreas and the small intestine and the association of this relationship with nutritional status, using magnifying enteroscopy. The subjects were adults aged 20 years or older who underwent upper gastrointestinal endoscopy. An endoscope was inserted into the jejunum, and 10% glucose was sprayed under magnifying observation to evaluate changes in blood flow in the villous capillary network. Mucosal biopsy was performed before and after spraying to evaluate the incretin response in the jejunal mucosa. A total of 124 patients participated in the study. There was a positive correlation between villous blood flow change and exocrine pancreas function (R = 0.4337, P < 0.0001). Changes of gastric inhibitory polypeptide and glucagon-like peptide messenger RNAs in biopsy samples were positively correlated with endocrine pancreas function in 88 patients without treatment for diabetes (R = 0.4314, P = 0.0012; R = 0.4112, P = 0.0081). In patients with lower villous blood flow change and decreased pancreatic exocrine function, the prognostic nutritional index were significantly lower (P = 0.0098), compared with other patients. This study provides the first evidence of a close functional correlation between the pancreas and the small intestine.

  7. A double Gerdien instrument for simultaneous bipolar air conductivity measurements on balloon platforms.

    PubMed

    Nicoll, K A; Harrison, R G

    2008-08-01

    A bipolar air conductivity instrument is described for use with a standard disposable meteorological radiosonde package. It is intended to provide electrical measurements at cloud boundaries, where the ratio of the bipolar air conductivities is affected by the presence of charged particles. The sensors are two identical Gerdien-type electrodes, which, through a voltage decay method, measure positive and negative air conductivities simultaneously. Voltage decay provides a thermally stable approach and a novel low current leakage electrometer switch is described which initiates the decay sequence. The radiosonde supplies power and telemetry, as well as measuring simultaneous meteorological data. A test flight using a tethered balloon determined positive (sigma(+)) and negative (sigma(-)) conductivities of sigma(+)=2.77+/-0.2 fS m(-1) and sigma(-)=2.82+/-0.2 fS m(-1), respectively, at 400 m aloft, with sigma(+)sigma(-)=0.98+/-0.04.

  8. Radiation profiles through the atmosphere measured by an auto controlled glider aircraft

    NASA Astrophysics Data System (ADS)

    Kräuchi, Andreas; Philipona, Rolf

    2014-05-01

    In 2011 radiation measurements through the atmosphere were made with a balloon borne short- and longwave net radiometer. These measurements were very promising and therefore new and improved sensors from Kipp&Zonen were used to equip a glider aircraft together with the standard Swiss radiosonde from Meteolabor AG. The glider serves as returning platform for the expensive and well calibrated radiation sensors. Double balloon technique is used to prevent pendulum motion during the ascent and to keep the radiation instruments as horizontal as possible. The built-in autopilot allows to return the gliderradiosonde to the launch site or to land it on predefined open space, which makes recovery much easier. The new return gliderradiosonde technique as well as new measurement possibilities will be shown. First measurements show radiation profiles through the atmosphere during different cloud conditions. Radiation profiles during different daytimes show the temporal resolution of vertical radiation profiles trough the atmosphere.

  9. Search for medium-energy gamma-ray pulsars

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

    Sweeney, W.E. Jr.

    1987-01-01

    Results are presented from a search for pulsed gamma rays from four radio pulsars, chosen for their interest to gamma-ray astronomers in previous studies. The data set used for the search consists of gamma-ray events at energies of 1-30 MeV, detected during a 40-hour balloon flight of the UCR double Compton scatter telescope launched at the National Scientific Balloon Facility in Palestine, Texas, USA on September 30, 1978. No statistically significant signals were detected from any of the pulsars. Three sigma upper limits to pulsed 1-30 MeV gamma ray flux from PSR 0950+08, PSR 1822+09, PSR 1929+10, and PSR 1953+29more » are presented. Two complete exposures to PSR 0950+08 were obtained. The reported tentative detection of 1-20 MeV gamma rays from PSR 0950+08 is not confirmed.« less

  10. Local mediator release after antigen challenge of a bronchial segment in allergic dogs.

    PubMed

    Reiss, T F; Rubinstein, I; Emery, D L; Gold, W M; Boushey, H A

    1989-12-01

    To investigate the local intraluminal bronchial response to an antigenic stimulus, we developed a bronchoscopic double-balloon system to challenge and lavage a segment of the left main-stem bronchus. We studied whether fluid from above or below the occlusion balloons leaked into the bronchial segment. Lavage was performed before and after placement of red and blue pigments proximal and distal to the inflated balloons, respectively, and the recovered lavage fluid was analyzed visually and spectrophotometrically in three experiments. There was no evidence for pigment leakage into the segment. In six anesthetized ragweed-allergic dogs, local ragweed antigen challenges were performed. After balloon inflation in the left main-stem bronchus, we performed two baseline lavages of the interballoon segment, introduced a ragweed antigen solution, and performed two postchallenge lavages. The recovered fluid was analyzed for the concentrations of prostaglandin D2 (PGD2; radioimmunoassay) and histamine (fluorometric technique) and for total and differential cell counts. Antigen challenge was associated with a significant increase in PGD2 concentration in the recovered fluid, rising from a median of 178 pg/ml (range, 157-647) before to 919 pg/ml (range, 149-2,452) after challenge. Median histamine concentrations were 3.1 ng/ml (range, 1-5.4 ng/ml) before and 5.6 ng/ml (range, 1-16.2) after challenge (P = not significant). In four dogs, a control challenge with the antigen vehicle alone showed no change in either mediator. Changes in cell counts after challenge were inconsistent.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. [Effects of electroacupuncture on bispectral index and plasma beta-endorphin in patients undergoing colonoscopy].

    PubMed

    Ni, Yu-Fei; Li, Jun; Wang, Ben-Fu; Jiang, Song-He; Chen, Yi; Zhang, Wei-Feng; Lian, Qing-Quan

    2009-10-01

    To observe the effect of electroacupuncture (EA) on bispectral index (BIS) and plasma beta-endorphin (beta-EP) level in patients undergoing colonoscopy. Sixty patients were equally randomized into EA group and control group with 30 cases in each. EA (2 Hz/100 Hz, 4-6 V) was applied to the right Zusanli (ST 36) and Shangjuxu (ST 37), and the left Yinlingquan (SP 9), Sanyinjiao (SP 6) and bilateral Hegu (LI 4) respectively 30 min before colonoscopy. The mean arterial pressure (MAP), heart rate (HR) and BIS in two groups were continuously monitored during the study. Plasma beta-EP concentration was detected by radioimmunoassay. The patient's adverse reactions (including pain, satisfaction degree, etc.) were evaluated by visual analog scale (VAS) and verbal stress scale (VSS). Self-comparison showed that MAP and HR in control group increased significantly during colonoscope's splenic flexure passing (P<0.05). Whereas the 2 indexes in EA group had no significant changes during colonoscope insertion, and its splenic flexure passing, hepatic flexure passing and post-enteroscopy (P>0.05). Comparison between two groups showed that MAP at the time-point of colonoscope insertion, and HR at the time-point of colonoscope's splenic flexure passing in EA group were significantly lower than those in control group (P<0.05). BIS values of EA group were significantly lower than those of control group at different time-points after colonoscope insertion (P<0.01). Plasma beta-EP concentrations at the time-points of colonoscope's hepatic flexure passing and post-enteroscopy were evidently increased in both groups in comparison with pre-enteroscopy (P<0.01), and beta-EP was significantly lower in EA group than that in control group at the time-point of colonoscope's hepatic flexure passing (P<0.05). The dosage of Midazolam used for conscious-sedation and the scores of VAS and VSS were also considerably lower in EA group than those in control group (P<0.05, P<0.01). No significant differences were found between two groups in the adverse reactions as dizziness, nausea, vomiting and abdominal pain, but the patients' satisfaction degree in EA group was evidently higher than that in control group (P<0.05). Acupuncture analgesia can effectively lower the colonoscopy patients' BIS value and plasma beta-EP level, meaning attenuation of the patients' stress responses during colonoscopy after EA.

  12. Bioresorbable vascular scaffolds for LMCA with double vessel disease under IVUS guidance.

    PubMed

    Kasturi, Sridhar; Vilvanathan, Vinoth Kumar

    2015-12-01

    An 80-year-old male patient, presented with chest pain. ECG showed ST elevation in leads V2 to V4 and T wave inversion in leads V2-V6. Check angiogram revealed ostial LMCA 70% lesion & mid-LAD 90% lesion and LCX proximal 80% lesion. Predilatation of LMCA lesion was done with 2.0 × 12 mm NC Trek balloon and the LAD lesion with 2.0 × 12 mm and 2.5 × 08 mm (NC Trek balloons). Prestenting IVUS (Intravascular ultrasound) was done with Atlantis SR pro 40 MHz 3.6 Fr catheter. IVUS showed the LAD to have a minimal lumen area of 2.6 sq mm with 90% fibrotic plaque and a vessel size of 2.5mm and the LMCA to have a minimal lumen area of 8.8 sq mm with 70% fibrotic plaque and vessel size of 3.8mm. Mid-LAD stenting was done with 2.5 × 28 mm Absorb Stent (BVS). Predilatation of LCX lesion was done with 2.5 × 08 mm NC Trek balloon. Then stenting was performed with 3.0 × 28 mm Absorb Stent (BVS). Check angiogram showed edge dissection proximal to the BVS Stent which was covered with 3.0 × 12 mm Xience Xpedtion Stent (DES). Then LMCA Stenting was done with 3.5 × 12 mm Absorb Stent. Post dilatation was done with 4.0 × 08 mm NC Trek balloon. Post Stenting LMCA - LAD IVUS was done. LMCA and LAD Stents were well opposed without any dissection or residual stenosis. TIMI III Flow was achieved in the final results. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  13. Reporting trends and outcomes in ST-segment-elevation myocardial infarction national hospital quality assessment programs.

    PubMed

    McCabe, James M; Kennedy, Kevin F; Eisenhauer, Andrew C; Waldman, Howard M; Mort, Elizabeth A; Pomerantsev, Eugene; Resnic, Frederic S; Yeh, Robert W

    2014-01-14

    For patients who undergo primary percutaneous coronary intervention (PCI) for ST-segment-elevation myocardial infarction, the door-to-balloon time is an important performance measure reported to the Centers for Medicare & Medicaid Services (CMS) and tied to hospital quality assessment and reimbursement. We sought to assess the use and impact of exclusion criteria associated with the CMS measure of door-to-balloon time in primary PCI. All primary PCI-eligible patients at 3 Massachusetts hospitals (Brigham and Women's, Massachusetts General, and North Shore Medical Center) were evaluated for CMS reporting status. Rates of CMS reporting exclusion were the primary end points of interest. Key secondary end points were between-group differences in patient characteristics, door-to-balloon times, and 1-year mortality rates. From 2005 to 2011, 26% (408) of the 1548 primary PCI cases were excluded from CMS reporting. This percentage increased over the study period from 13.9% in 2005 to 36.7% in the first 3 quarters of 2011 (P<0.001). The most frequent cause of exclusion was for a diagnostic dilemma such as a nondiagnostic initial ECG, accounting for 31.2% of excluded patients. Although 95% of CMS-reported cases met door-to-balloon time goals in 2011, this was true of only 61% of CMS-excluded cases and consequently 82.6% of all primary PCI cases performed that year. The 1-year mortality for CMS-excluded patients was double that of CMS-included patients (13.5% versus 6.6%; P<0.001). More than a quarter of patients who underwent primary PCI were excluded from hospital quality reports collected by CMS, and this percentage has grown substantially over time. These findings may have significant implications for our understanding of process improvement in primary PCI and mechanisms for reimbursement through Medicare.

  14. [Interventional radiology in treatment of biliodigestive anastomoses strictures].

    PubMed

    Okhotnikov, O I; Yakovleva, M V; Grigoriev, S N

    2016-01-01

    To analyze efficacy of interventional methods via antegrade transhepatic approach in treatment of patients with strictures of biliodigestive anastomoses. 24 patients aged 47.2 years were treated for the period 2002-2015. Average time from extrahepatic biliary reconstruction using transhepatic stented tubes to strictures appearance varied from 9 months to 12 years. One- and double-sided percutaneous transhepatic cholangiostomy was performed to abort biliary hypertension. Stricture recanalization was achieved using «catheter-wire» system. Antegrade dilatation of stricture was made using balloon catheter 8 mm and pressure up to 6 atm and stage exposition up to 10 minutes. Balloon repair of anastomosis was supplemented by stented outer-inner drainage of the area of stricture. Restoration of patency of stricture area using antegrade interventional methods was effective in 22 patients. Recurrent stricture occurred in 2 cases within 1.5 years that required repeated biliary reconstruction including antegrade extraction of blocked uncovered stent in 1 patient. There were no major postoperative complications and deaths. Maximal recurrence-free follow-up after stent installation was 11 years.

  15. Double-balloon endoscopy as the primary method for small-bowel video capsule endoscope retrieval.

    PubMed

    Van Weyenberg, Stijn J B; Van Turenhout, Sietze T; Bouma, Gerd; Van Waesberghe, Jan Hein T M; Van der Peet, Donald L; Mulder, Chris J J; Jacobs, Maarten A J M

    2010-03-01

    Capsule retention in the small bowel is a known complication of small-bowel video capsule endoscopy. Surgery is the most frequently used method of capsule retrieval. To determine the incidence and causes of capsule retention and to describe double-balloon endoscopy (DBE) as the primary technique used for capsule retrieval. Retrospective analysis of all video capsule studies was performed at our center, and evaluation of the outcome of DBE was the first method used to retrieve entrapped video capsules. Tertiary referral center. A total of 904 patients who underwent small-bowel video capsule endoscopy. Capsule retrieval by DBE. The number of patients in whom capsule retention occurred and the number of patients in whom an entrapped capsule could be retrieved by using DBE. Capsule retention occurred in 8 patients (incidence 0.88%; 95% CI, 0.41%-1.80%) and caused acute small-bowel obstruction in 6 patients. All retained capsules were successfully removed during DBE. Five patients underwent elective surgery to treat the underlying cause of capsule retention. One patient required emergency surgery because of multiple small-bowel perforations. Retrospective design. In our series, the incidence of capsule retention was low. DBE is a reliable method for removing retained capsules and might prevent unnecessary surgery. If surgery is required, preoperative capsule retrieval allows preoperative diagnosis, adequate staging in case of malignancy, and optimal surgical planning. 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  16. Bleeding from duodenal ulcer in a patient with bilio-pancreatic diversion.

    PubMed

    Garancini, Mattia; Luperto, Margherita; Delitala, Alberto; Maternini, Matteo; Uggeri, Franco

    2011-12-01

    Scopinaro's bilio-pancreatic diversion is considered as an acceptable malabsorptive surgical approach for the treatment of morbid obesity. We describe a case of acute recurrent gastro-intestinal bleeding in a patient with a previous Scopinaro's bilio-pancreatic diversion. At the first admission in our department, gastroscopy, colonoscopy, contrast-enhanced computerized tomography and angiography resulted negative for active bleeding. Hypovolemic shock indicated laparotomy and an intraoperative enteroscopy performed through a small enterotomy showed an ulcerative perforation sourced in an ischemic portion of a distended duodenal stump, with a bleeding branch of gastro-duodenal artery at the bottom. Hemorrhage was stopped with stitches. Two years later a new episode of duodenal bleeding associated with severe malnutrition occurred. A covered chronic ischemic perforation sustained by duodenal distension due to biliopancreatic limb sub-obstruction appeared to be the most probable etiology of the recurrent duodenal bleeding. The patient underwent again to laparotomy and adhesiolysis; hemorrhage was stopped by means of ligation of gastroduodenal artery and bilio-pancreatic diversion was converted into a standard Roux-en-Y gastroenterostomy with an entero-entero anastomosis 40 cm from the Treitz ligament in order to restore an anatomo-functional condition guaranteeing normal absorption and intestinal transit. After Scopinaro's bilio-pancreatic diversion duodenal bleeding can represent a rare serious presentation of biliopancreatic limb obstruction; because of the complex anatomical reconstruction performed during this intervention, the duodenum results unavailable during upper gastro-intestinal endoscopy, and if a duodenal bleeding is suspected laparotomy followed by enteroscopy represents an effective diagnostic approach.

  17. Blood detection in wireless capsule endoscopy using expectation maximization clustering

    NASA Astrophysics Data System (ADS)

    Hwang, Sae; Oh, JungHwan; Cox, Jay; Tang, Shou Jiang; Tibbals, Harry F.

    2006-03-01

    Wireless Capsule Endoscopy (WCE) is a relatively new technology (FDA approved in 2002) allowing doctors to view most of the small intestine. Other endoscopies such as colonoscopy, upper gastrointestinal endoscopy, push enteroscopy, and intraoperative enteroscopy could be used to visualize up to the stomach, duodenum, colon, and terminal ileum, but there existed no method to view most of the small intestine without surgery. With the miniaturization of wireless and camera technologies came the ability to view the entire gestational track with little effort. A tiny disposable video capsule is swallowed, transmitting two images per second to a small data receiver worn by the patient on a belt. During an approximately 8-hour course, over 55,000 images are recorded to a worn device and then downloaded to a computer for later examination. Typically, a medical clinician spends more than two hours to analyze a WCE video. Research has been attempted to automatically find abnormal regions (especially bleeding) to reduce the time needed to analyze the videos. The manufacturers also provide the software tool to detect the bleeding called Suspected Blood Indicator (SBI), but its accuracy is not high enough to replace human examination. It was reported that the sensitivity and the specificity of SBI were about 72% and 85%, respectively. To address this problem, we propose a technique to detect the bleeding regions automatically utilizing the Expectation Maximization (EM) clustering algorithm. Our experimental results indicate that the proposed bleeding detection method achieves 92% and 98% of sensitivity and specificity, respectively.

  18. Effect of Roux-en-Y gastric bypass on the distribution and hormone expression of small-intestinal enteroendocrine cells in obese patients with type 2 diabetes.

    PubMed

    Rhee, Nicolai A; Wahlgren, Camilla D; Pedersen, Jens; Mortensen, Brynjulf; Langholz, Ebbe; Wandall, Erik P; Friis, Steffen U; Vilmann, Peter; Paulsen, Sarah J; Kristiansen, Viggo B; Jelsing, Jacob; Dalbøge, Louise S; Poulsen, Steen S; Holst, Jens J; Vilsbøll, Tina; Knop, Filip K

    2015-10-01

    We studied the impact of Roux-en-Y gastric bypass (RYGB) on the density and hormonal gene expression of small-intestinal enteroendocrine cells in obese patients with type 2 diabetes. Twelve patients with diabetes and 11 age- and BMI-matched controls underwent RYGB followed by enteroscopy ~10 months later. Mucosal biopsies taken during surgery and enteroscopy were immunohistochemically stained for glucagon-like peptide-1 (GLP-1), peptide YY (PYY), cholecystokinin (CCK), glucose-dependent insulinotropic polypeptide (GIP) and prohormone convertase 2 (PC2) and the expression of GCG (encoding preproglucagon), PYY, CCK, GIP, GHRL (encoding ghrelin), SCT (encoding secretin), NTS (encoding neurotensin) and NR1H4 (encoding farnesoid X receptor) was evaluated. The density of cells immunoreactive for GLP-1, CCK and GIP increased in patients after RYGB and the density of those immunoreactive for GLP-1, PYY, CCK and PC2 increased in controls. In both groups, GHRL, SCT and GIP mRNA was reduced after RYGB while PYY, CCK, NTS and NR1H4 gene expression was unaltered. GCG mRNA was upregulated in both groups. Numerous alterations in the distribution of enteroendocrine cells and their expression of hormonal genes are seen after RYGB and include increased density of GLP-1-, PYY-, CCK-, GIP- and PC2-positive cells, reduced gene expression of GHRL, SCT and GIP and increased expression of GCG.

  19. The management of lower gastrointestinal bleeding.

    PubMed

    Marion, Y; Lebreton, G; Le Pennec, V; Hourna, E; Viennot, S; Alves, A

    2014-06-01

    Lower gastrointestinal (LGI) bleeding is generally less severe than upper gastrointestinal (UGI) bleeding with spontaneous cessation of bleeding in 80% of cases and a mortality of 2-4%. However, unlike UGI bleeding, there is no consensual agreement about management. Once the patient has been stabilized, the main objective and greatest difficulty is to identify the location of bleeding in order to provide specific appropriate treatment. While upper endoscopy and colonoscopy remain the essential first-line examinations, the development and availability of angiography have made this an important imaging modality for cases of active bleeding; they allow diagnostic localization of bleeding and guide subsequent therapy, whether therapeutic embolization, interventional colonoscopy or, if other techniques fail or are unavailable, surgery directed at the precise site of bleeding. Furthermore, newly developed endoscopic techniques, particularly video capsule enteroscopy, now allow minimally invasive exploration of the small intestine; if this is positive, it will guide subsequent assisted enteroscopy or surgery. Other small bowel imaging techniques include enteroclysis by CT or magnetic resonance imaging. At the present time, exploratory surgery is no longer a first-line approach. In view of the lesser gravity of LGI bleeding, it is most reasonable to simply stabilize the patient initially for subsequent transfer to a specialized center, if minimally invasive techniques are not available at the local hospital. In all cases, the complexity and diversity of LGI bleeding require a multidisciplinary collaboration involving the gastroenterologist, radiologist, intensivist and surgeon to optimize diagnosis and treatment of the patient. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. Observation of nuclear reactors on satellites with a balloon-borne gamma-ray telescope

    NASA Technical Reports Server (NTRS)

    O'Neill, Terrence J.; Kerrick, Alan D.; Ait-Ouamer, Farid; Tumer, O. Tumay; Zych, Allen D.

    1989-01-01

    Four Soviet nuclear-powered satellites flying over a double Compton gamma-ray telescope resulted in the detection of gamma rays with 0.3-8.0 MeV energies on April 15, 1988, as the balloonborne telescope searched, from a 35-km altitude, for celestial gamma-ray sources. The satellites included Cosmos 1900 and 1932. The USSR is the only nation currently employing moderated nuclear reactors for satellite power; reactors in space may cause significant problems for gamma-ray astronomy by increasing backgrounds, especially in the case of gamma-ray bursts.

  1. Consent, common adverse events, and post-adverse event actions in endoscopy.

    PubMed

    Adler, Douglas G

    2015-01-01

    Endoscopy constitutes a wide range of procedures with many indications. Esophagogastroduodenoscopy, colonoscopy, endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography, and enteroscopy comprise the most commonly performed procedures. These examinations all carry risk to the patient, and incumbent in this is some legal risk with regard to how the procedure is conducted, decisions made based on the intraprocedure findings, and the postprocedure results, in addition to events that occur following the procedure. This article provides an overview of consent and complications of endoscopy. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Bacterial characteristics and clinical significance of ureteral double-J stents in children.

    PubMed

    García-Aparicio, L; Blázquez-Gómez, E; Martin, O; Krauel, L; de Haro, I; Rodó, J

    2015-01-01

    To determine the incidence of urinary tract infection in those patients that we have used an ureteral double-J stent as internal diversion after urological procedures. We reviewed all the medical records of patients who had a ureteral double-J stent after a urological procedure from August 2007 to May 2013. We have analyzed the following data: age, gender, type of prophylaxis, incidence of urinary tract infection (UTI), days of internal diversion with double-J stent, surgical procedure, bacterial characteristics, bacterial sensibility to antibiotics and UTI treatment. We have used 73 double-J stents as ureteral internal diversion in 67 patients with a mean age of 44.73±57.23. Surgical procedures were 50 laparoscopic Anderson-Hynes pyeloplasties in 49 patients, and 20 high-pressure balloon dilatation of the ureterovesical junction to treat primary obstructive megaureter in 15 patients; and 3 patients with ureterovesical obstruction after endoscopic treatment of vesicoureteral reflux. Forty three stents showed a bacterial colonization in cultures. Pseudomona aeruginosa was present in 9 (20.9%) stents. Only in 12 stents, bacterial colonization was sensible to antibiotic prophylaxis. Stent colonization was higher in boys and younger patients. Four patients had a febrile UTI. Incidence of UTI in younger patients that underwent HBPD of UVJ is higher. Bacterial colonization is frequent in double-J stents but the incidence of UTI is low. Double-J colonization is higher in younger patients. Patients that underwent HPBD have a higher risk of UTI related with ureteral double J stent. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Fireball multi object spectrograph: as-built optic performances

    NASA Astrophysics Data System (ADS)

    Grange, R.; Milliard, B.; Lemaitre, G.; Quiret, S.; Pascal, S.; Origné, A.; Hamden, E.; Schiminovich, D.

    2016-07-01

    Fireball (Faint Intergalactic Redshifted Emission Balloon) is a NASA/CNES balloon-borne experiment to study the faint diffuse circumgalactic medium from the line emissions in the ultraviolet (200 nm) above 37 km flight altitude. Fireball relies on a Multi Object Spectrograph (MOS) that takes full advantage of the new high QE, low noise 13 μm pixels UV EMCCD. The MOS is fed by a 1 meter diameter parabola with an extended field (1000 arcmin2) using a highly aspherized two mirror corrector. All the optical train is working at F/2.5 to maintain a high signal to noise ratio. The spectrograph (R 2200 and 1.5 arcsec FWHM) is based on two identical Schmidt systems acting as collimator and camera sharing a 2400 g/mm aspherized reflective Schmidt grating. This grating is manufactured from active optics methods by double replication technique of a metal deformable matrix whose active clear aperture is built-in to a rigid elliptical contour. The payload and gondola are presently under integration at LAM. We will present the alignment procedure and the as-built optic performances of the Fireball instrument.

  4. High-resolution ultraviolet observations of interstellar lines toward Zeta Persei observed with the balloon-borne ultraviolet stellar spectrometer

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

    Snow, T.P.; Lamers, H.J.G.L.M.; Joseph, C.L.

    1987-10-01

    The balloon-borne ultraviolet stellar spectrometer payload has been used to obtain high-resolution data on interstellar absorption lines toward Zeta Per. The only lines clearly present in the 2150-2450 region were several Fe II features, which show double structure. The two velocity components were sufficiently well separated that it was possible to construct separate curves of growth to derive the Fe II column densities for the individual components. These column densities and the component velocity separation were then used to compute a realistic two-component curve of growth for the line of sight to Zeta Per, which was then used to reanalyzemore » existing ultraviolet data from Copernicus. The results were generally similar to an earlier two-component analysis of the Copernicus data, with the important exception that the silicon depletion increased from near zero to about 1 dex. This makes the Zeta Per depletion pattern quite similar to those derived for other reddened lines of sight, supporting the viewpoint that the general diffuse interstellar medium has a nearly constant pattern of depletions. 31 references.« less

  5. Return glider radiosonde to measure temperature, humidity and radiation profiles through the atmosphere

    NASA Astrophysics Data System (ADS)

    Kraeuchi, Andreas; Philipona, Rolf

    2015-04-01

    Very promising radiation profile measurements through the atmosphere were made in 2011 with a balloon borne short- and longwave net radiometer. New and improved radiation sensors from Kipp&Zonen are now used in a glider aircraft together with a standard Swiss radiosonde from Meteolabor AG. This new return glider radiosonde (RG-R), is lifted up with double balloon technique to prevent pendulum motion and to keep the radiation instruments as horizontal as possible during the ascent measuring phase. The RG-R is equipped with a mechanism that allows to release the radiosonde at a preset altitude, and an autopilot allowing to fly the radiosonde back to the launch site and to land it savely with a parachute at a preset location. The return glider radiosonde technique as well as new measurement possibilities will be shown. First measurements show temperature, humidity and radiation profiles through the atmosphere up to 30 hPa (24 km) during different atmospheric conditions. Radiation profiles during different daytimes show possibilities with respect to temporal resolution of vertical radiation profiles trough the atmosphere.

  6. Immediate Clinical and Echocardiographic Outcome of Percutaneous Transvenous Mitral Commissurotomy for Patients of Mitral Stenosis with Atrial Fibrillation.

    PubMed

    Rahman, M T; Rahman, M M; Islam, M M; Khan, M R; Haque, S A; Chowdhury, A W; Majumder, A S; Rahman, A; Islam, Q I

    2015-07-01

    Rheumatic fever and rheumatic heart disease continue to be the major health problem in all developing countries including Bangladesh. Rheumatic mitral stenosis is a very common problem in our population having an incidence of 54 percent among rheumatic heart disease with a female preponderance of 2:1. Percutaneous balloon mitral commissurotomy is appealing because the mechanism of valve dilation closely parallels the mechanism of surgical mitral commissurotomy. The technique of balloon mitral commissurotomy has evolved rapidly, with improvements in balloons, guide wires, and the application of double-balloon techniques. There is controversy that whether the presence of AF has a direct negative effect on the immediate or long-term outcome after PTMC in mitral stenosis patients. The purpose of this study was to see the effect of atrial fibrillation (AF) on the immediate clinical and echocardiographic outcome of patients undergoing Percutaneous Transvenous Mitral Commissurotomy (PTMC). The immediate procedural and in-hospital clinical outcome after PTMC of 264 patients with AF were prospectively collected and compared with those of 288 patients in normal sinus rhythm (NSR) with mitral stenosis admitted in National Institute of Cardiovascular Diseases, Dhaka and Al-Helal Heart Institute, Mirpur, Dhaka, Bangladesh. Patients with AF were older than patients with normal sinus rhythm (53 ± 11 vs. 33 ± 12 years; p<0.0001) and presented more frequently with New York Heart Association (NYHA) class III-IV (78.3% vs. 58.5%; p<0.0001), echocardiographic score >8 (38.9% vs. 22.7%; p<0.0001), calcified valves under fluoroscopy (22.2% vs.12.4%, p<0.0001) and with history of previous surgical commissurotomy (21.7% vs. 10.5%; p<0.0001). In patients with AF, PTMC resulted in worse outcomes, as reflected in a smaller post-PTMC mitral valve area (1.6±0.4 vs. 2.1 ± 0.8 cm²; p<0.0001). Patients with atrial fibrillation have a worse immediate clinical and echocardiographic outcome after PTMC.

  7. [Brief history of interventional radiology].

    PubMed

    Tang, Zhenliang; Jia, Aiqin; Li, Luoyun; Li, Chunyu

    2014-05-01

    In 1923, angiography was first successively used for the human body. In 1953, a Swedish doctor Sven-Ivar Seldinger pioneered the Seldinger technique, which laid down the foundation of interventional radiology. In 1963, Charles Dotter first proposed the idea of interventional radiology. In 1964, Charles Dotter opened a new era of percutaneous angioplasty through accidental operation, marking the formation of interventional radiology. On this basis, the techniques of balloon catheter dilation and metal stent implantation was developed. Endovascular stent was proposed in 1969. In 1973, the percutaneous angioplasty has been a breakthrough with the emergence of soft double-lumen balloon catheter. Percutaneous coronary angioplasty is applied in 1977. Since the 1990s, balloon angioplasty relegated to secondary status with the emergence of metal stent. Currently, endovascular stent have entered a new stage with the emergence of temporary stent and stent grafts and biological stent. Transcatheter arterial embolization had been one of the most important basic techniques for interventional radiology since 1965, it had also been a corresponding development with the improvement of embolic agents and catheter technology for the treatment of diseases now. Transjugular intrahepatic portosystemic stent-shunt is a comprehensive interventional radiology technology since 1967, in which the biliary system can be reached through a jugular vein, and the improvement appeared with balloon expandable stent in 1986.Since 1972, non-vascular interventional techniques was another important branch of interventional radiology. Currently, it is applied in the diagnosis and treatment of many diseases of the internal organs like the pancreas, liver, kidney, spinal cord, Fallopian tubes, esophagus and other organs. In 1973, Chinese radiologist first conducted the angiography test. Interventional radiology was introduced into China in the 1980s, it was readily developed through the sponsoring of training class (1981) and academic conferences (1986). Along with the return of the overseas scholars, the gap in the interventional diagnosis and treatment technology between China and the world has been narrowing since the 1990s.

  8. Onyx Embolization for Isolated Type Dural Arteriovenous Fistula Using a Dual-Lumen Balloon Catheter.

    PubMed

    Kim, Jin Woo; Kim, Byung Moon; Park, Keun Young; Kim, Dong Joon; Kim, Dong Ik

    2016-05-01

    Utilization of a dual-lumen balloon may improve Onyx penetration into isolated dural arteriovenous fistulas (i-DAVFs). To compare the results of Onyx embolization using a dual-lumen balloon with those using a non-balloon catheter for i-DAVFs. Twenty-nine patients underwent Onyx embolization for i-DAVFs using a non-balloon (n = 14) or a dual-lumen balloon catheter (n = 15). Since its introduction, a dual-lumen balloon catheter has been preferred. We compared the dual-lumen balloon group with the non-balloon catheter group regarding angiographic outcome, treatment-related complications, total procedural time, Onyx injection time, and the number of feeders requiring embolization. The dual-lumen balloon group showed complete occlusion of i-DAVFs in 13 and near-complete in 2 patients, while the non-balloon group showed complete occlusion in 5, near-complete in 5, and incomplete in 4 patients (P < .05). Treatment-related complications occurred in 2 patients: 1 in the non-balloon group and 1 in the dual-lumen balloon group. The mean total procedural time was 62 ± 32 minutes in the dual-lumen balloon and 171 ± 88 minutes in the non-balloon group (P < .05). The mean Onyx injection time was 10 ± 6 minutes in the dual-lumen balloon and 49 ± 32 minutes in the non-balloon group (P < .05). The median number of feeders requiring embolization was 1 (range, 1-3) in the dual-lumen balloon and 2 (range, 1-4) in the non-balloon group (P < .05). Utilization of a dual-lumen balloon catheter for Onyx embolization of i-DAVF seemed to significantly increase the immediate complete occlusion rate and decrease total procedural time, Onyx injection time, and number of feeders requiring embolization.

  9. Calibration and performance of the UCR double Compton gamma ray telescope

    NASA Technical Reports Server (NTRS)

    Ait-Ouamer, Farid; Kerrick, Alan D.; Sarmouk, Abderrezak; O'Neill, Terrence J.; Sweeney, William E.

    1990-01-01

    Results of the field calibration and performance of the UCR double Compton gamma-ray telescope are presented. The telescope is a balloon-borne instrument with an upper array of 16 plastic scintillator bars and a lower one of 16 NaI(Tl) bars. The telescope is sensitive to celestial gamma rays from 1 to 30 MeV. The data were collected on February 14, 1988 prior to launch in Alice Springs, Australia to observe SN 1987A. Radioactive sources were used to calibrate the energy deposits in the scintillators. Each bar was analyzed laterally using pulse height or timing to obtain the positions of the gamma ray interactions. Double scatter events from an Na-24 source simulating a celestial source were studied to obtain the general performance of the telescope and to develop imaging techniques, later used with the flight data. An angular resolution of 11 deg FWHM and energy resolutions of 13 and 10 percent FWHM at 1.37 and 2.75 MeV, respectively, were found. The efficiency of the telescope is 0.0035 at 1.37 MeV and zenith angle 31 deg.

  10. Comparison of magnetic resonance imaging and video capsule enteroscopy in diagnosing small-bowel pathology: localization-dependent diagnostic yield.

    PubMed

    Böcker, Ulrich; Dinter, Dietmar; Litterer, Caroline; Hummel, Frank; Knebel, Phillip; Franke, Andreas; Weiss, Christel; Singer, Manfred V; Löhr, J-Matthias

    2010-04-01

    New technology has considerably advanced the diagnosis of small-bowel pathology. However, its significance in clinical algorithms has not yet been fully assessed. The aim of the present analysis was to compare the diagnostic utility and yield of video-capsule enteroscopy (VCE) to that of magnetic resonance imaging (MRI) in patients with suspected or established Crohn's disease (Group I), obscure gastrointestinal blood loss (Group II), or suspected tumors (Group III). Forty-six out of 182 patients who underwent both modalities were included: 21 in Group I, 20 in Group II, and five in Group III. Pathology was assessed in three predetermined sections of the small bowel (upper, middle, and lower). The McNemar and Wilcoxon tests were used for statistical analysis. In Group I, lesions were found by VCE in nine of the 21 patients and by MRI in six. In five patients, both modalities showed pathology. In Group II, pathological changes were detected in 11 of the 20 patients by VCE and in eight patients by MRI. In five cases, pathology was found with both modalities. In Group III, neither modality showed small-bowel pathology. For the patient groups combined, diagnostic yield was 43% with VCE and 30% with MRI. The diagnostic yield of VCE was superior to that of MRI in the upper small bowel in both Groups I and II. VCE is superior to MRI for the detection of lesions related to Crohn's disease or obscure gastrointestinal bleeding in the upper small bowel.

  11. Ideal MHD stability of double transport barrier plasmas in DIII-D

    NASA Astrophysics Data System (ADS)

    Li, G. Q.; Wang, S. J.; Lao, L. L.; Turnbull, A. D.; Chu, M. S.; Brennan, D. P.; Groebner, R. J.; Zhao, L.

    2008-01-01

    The ideal MHD stability for double transport barrier (DTB or DB) plasmas with varying edge and internal barrier width and height was investigated, using the ideal MHD stability code GATO. A moderate ratio of edge transport barriers (ETB) height to internal transport barriers (ITBs) height is found to be beneficial to MHD stability and the βN is limited by global low n instabilities. For moderate ITB width DB plasmas, if the ETB is weak, the stability is limited by n = 1 (n is the toroidal mode number) global mode; whereas if the ETB is strong it is limited by intermediate-n edge peeling-ballooning modes. Broadening the ITB can improve stability if the ITB half width wi lsim 0.3. For very broad ITB width plasmas the stability is limited by stability to a low n (n > 1) global mode.

  12. Microprocessor-controlled laser tracker for atmospheric sensing

    NASA Technical Reports Server (NTRS)

    Johnson, R. A.; Webster, C. R.; Menzies, R. T.

    1985-01-01

    An optical tracking system comprising a visible HeNe laser, an imaging detector, and a microprocessor-controlled mirror, has been designed to track a moving retroreflector located up to 500 m away from an atmospheric instrument and simultaneously direct spectrally tunable infrared laser radiation to the retroreflector for double-ended, long-path absorption measurements of atmospheric species. The tracker has been tested during the recent flight of a balloon-borne tunable diode laser absorption spectrometer which monitors the concentrations of stratospheric species within a volume defined by a 0.14-m-diameter retroreflector lowered 500 m below the instrument gondola.

  13. Balloon mitral valvuloplasty during pregnancy--our experience.

    PubMed

    Salomé, Nuno; Dias, Carla C; Ribeiro, José; Gonçalves, Manuel; Fonseca, Conceição; Ribeiro, Vasco Gama

    2002-12-01

    Mitral stenosis is the most common valvular heart lesion found in pregnancy. When severe, it leads to significant maternal and fetal morbidity and mortality, since the hemodynamic adaptations to pregnancy are badly tolerated. Pregnancy can lead to development of heart failure in patients with asymptomatic or even unknown mitral stenosis, as a result of the increased mitral valve pressure gradient caused by the physiologic increase in heart rate and blood volume in pregnancy. When symptoms persist despite optimal medical therapy, the poor prognosis justifies the correction of mitral stenosis during pregnancy. To present our experience in treating severe mitral stenosis in women who develop severe heart failure during pregnancy, using percutaneous balloon mitral valvuloplasty. From 1996 to March 2002, in our department, 47 balloon mitral valvuloplasties were successfully performed in women, three of them pregnant. These were patients with congestive heart failure, New York Heart Association (NYHA) functional class III or IV, at the end of the second trimester of pregnancy, who did not respond positively to drug treatment with diuretics and digitalis. We performed percutaneous balloon mitral valvuloplasty using the Inoue technique in the three pregnant patients, with success, at around 25 weeks of gestation. After the procedure, the patients showed clinical improvement, returning to the NYHA functional class that they were in before becoming pregnant (I-II). The previous mitral valve area was 0.9-1.2 cm2, nearly doubling after valvuloplasty. Mean left atrial pressure decreased on average by 42%, and the maximum pressure (V wave) decreased on average by 40%. The mitral valve pressure gradient decreased from 15, 10 and 28 mmHg to 7, 5 and 5 mmHg after valvuloplasty. During the procedure there were no maternal or fetal complications. All patients were discharged 24 to 48 h after valvuloplasty, continuing their pregnancies without complications. One woman had vaginal delivery, and the other two had cesarean sections at 35 weeks of gestation, all without complications with healthy newborns that developed normally. In follow-up, one patient who had moderate mitral regurgitation after valvuloplasty developed severe mitral regurgitation, requiring surgical correction after two years. In pregnant patients who have severe mitral stenosis and persistent congestive heart failure symptoms despite conventional medical treatment, when feasible, percutaneous balloon mitral valvuloplasty is the best treatment.

  14. 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.

  15. 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…

  16. Development of a super-pressure balloon with a diamond-shaped net --- result of a ground inflation test of a 2,000 cubic-meter balloon ---

    NASA Astrophysics Data System (ADS)

    Saito, Yoshitaka; Nakashino, Kyoichi; Akita, Daisuke; Matsushima, Kiyoho; Shimadu, Shigeyuki; Goto, Ken; Hashimoto, Hiroyuki; Matsuo, Takuma

    2016-07-01

    A light super-pressure balloon has been developed using a method to cover a balloon with a diamond-shaped net of high-tensile fibers. The goal is to fly a payload of 900 kg to the altitude of 37 km with a 300,000 m^{3} balloon. Beginning from a demonstration test of the net-balloon with a 10 m^{3} balloon in 2010, we have been polished the net-balloon through ground inflation tests and flight tests, including a flight test of a 3,000 m ^{3} balloon in the tandem balloon configuration with a 15,000 m^{3} zero-pressure balloon in 2012, and a flight test of a 10 m^{3} balloon in the tandem balloon configuration with a 2 kg rubber balloon in 2013, as reported in the last COSPAR. In 2014, we developed a 5,000 m^{3} balloon and performed a ground inflation test to find that the balloon burst from a lip panel for termination with a differential pressure of 425 Pa. It was due to a stress concentration at the edge of a thick tape attached along the termination mechanism. In 2015, we modified the balloon by adding tapes on the lip panel to avoid the stress concentration, and also shorten the net length to leave some margin of the film and performed a ground inflation test again to find the balloon showed asymmetrical deployment and burst from the edge of the net with a differential pressure of 348 Pa. We consider it is due to the margin of the film along the circumferential direction, and proposed a gore shape which circumference length is kept as determined by the pumpkin shape of the balloon but setting meridian length longer than that. We developed a 10 m^{3} balloon with the gore design to find that the balloon deployed symmetrically and showed the burst pressure of 10,000 Pa. In 2016, we are going to develop a 2,000 m^{3} balloon with the gore design and perform its ground inflation test. In this paper, we are going to report its result with the sequence of the development.

  17. Pravastatin and endothelium dependent vasomotion after coronary angioplasty: the PREFACE trial.

    PubMed

    Mulder, H J; Schalij, M J; Kauer, B; Visser, R F; van Dijkman, P R; Jukema, J W; Zwinderman, A H; Bruschke, A V

    2001-11-01

    To test the hypothesis that the 3-hydroxy-3-methylglutaryl coenzyme-A reductase inhibitor pravastatin ameliorates endothelium mediated responses of dilated coronary segments: the PREFACE (pravastatin related effects following angioplasty on coronary endothelium) trial. A double blind, randomised, placebo controlled, multicentre study. Four hospitals in the Netherlands. 63 non-smoking, non-hypercholesterolaemic patients scheduled for elective balloon angioplasty (pravastatin 34, placebo 29). The effects of three months of pravastatin treatment (40 mg daily) on endothelium dependent vasomotor function were studied. Balloon angioplasty was undertaken one month after randomisation, and coronary vasomotor function tests using acetylcholine were performed two months after balloon angioplasty. The angiograms were analysed quantitatively. The efficacy measure was the acetylcholine induced change in mean arterial diameter, determined in the dilated segment and in an angiographically normal segment of an adjacent non-manipulated coronary artery. Increasing acetylcholine doses produced vasoconstriction in the dilated segments (p = 0.004) but not in the normal segments. Pravastatin did not affect the vascular response to acetylcholine in either the dilated segments (p = 0.09) or the non-dilated sites. Endothelium dependent vasomotion in normal segments was correlated with that in dilated segments (r = 0.47, p < 0.001). There were fewer procedure related events in the pravastatin group than in the placebo group (p < 0.05). Endothelium dependent vasomotion in normal segments is correlated with that in dilated segments. A significant beneficial effect of pravastatin on endothelial function could not be shown, but in the dilated segments there was a trend towards a beneficial treatment effect in the pravastatin group.

  18. Countermeasures to the US National Missile Defense

    NASA Astrophysics Data System (ADS)

    Gronlund, Lisbeth

    2001-04-01

    One of the key technical questions about national missile defenses is whether they can be expected to work under real-world conditions if the attacker takes steps to defeat the defense. This talk will discuss steps that an emerging missile state could take to confuse, overwhelm, or otherwise defeat the planned US NMD system developed by the Clinton administration. It will consider three such ``countermeasures" that would be within the technical capability of a state that could develop and deploy a long-range missile capable of reaching the United States, which is the threat the NMD system is intended to defend against. The talk will be based on the April 2000 report ``Countermeasures: A Technical Evaluation of the Operational Effectiveness of the Planned US National Missile Defense System," which was co-authored by the speaker and 10 other physicists and engineers. Although the talk will refer to the ground-based NMD system under development, the conclusions are applicable to any mid-course NMD system using hit-to-kill infrared-homing interceptors, regardless of their basing mode. The three countermeasures considered are: (1) biological weapons deployed on 100 or more small bomblets, or submunitions, that would be released shortly after the boost phase; (2) nuclear warheads with anti-simulation balloon decoys, in which the attacker disguises the warhead by enclosing it in an aluminum-coated mylar balloon and releasing it along with a large number of otherwise similar but empty balloons; and (3) nuclear warheads with cooled shrouds, in which the attacker foils the kill vehicle's homing process by covering each nuclear warhead with a double-walled cone containing liquid nitrogen.

  19. Microwave endometrial ablation versus thermal balloon endometrial ablation (MEATBall): 5-year follow up of a randomised controlled trial.

    PubMed

    Sambrook, A M; Elders, A; Cooper, K G

    2014-05-01

    To compare long-term outcomes following microwave endometrial ablation (MEA™) and thermal balloon ablation (TBall). Follow up of a prospective, double-blind randomised controlled trial at 5 years. A teaching hospital in the UK. A total of 320 women eligible for and requesting endometrial ablation. Eligible women were randomised in a 1:1 ratio to undergo MEA or Tball. Postal questionnaires were sent to participants at a minimum of 5 years postoperatively to determine satisfaction with outcome, menstrual status, bleeding scores and quality of life measurement. Subsequent surgery was ascertained from the women and the hospital operative database. The primary outcome measure was overall satisfaction with treatment. Secondary outcomes included evaluation of menstrual loss, change in quality of life scores and subsequent surgery. Of the women originally randomised 217/314 (69.1%) returned questionnaires. Nonresponders were assumed to be treatment failures for data analysis. The primary outcome of satisfaction was similar in both groups (58% for MEA™ versus 53% for TBall, difference 5%; 95% CI -6 to 16%). Amenorrhoea rates were high following both techniques (51% versus 45%, difference 6%; 95% CI -5 to 17%). There was no significant difference in the hysterectomy rates between the two arms (9% versus 7%, difference 2%; 95% CI -5 to 9%). At 5 years post-treatment there were no significant clinical differences in patient satisfaction, menstrual status, quality of life scores or hysterectomy rates between MEA™ and Thermachoice 3, thermal balloon ablation. © 2014 Royal College of Obstetricians and Gynaecologists.

  20. Analysis of actinic flux profiles measured from an ozonesonde balloon

    NASA Astrophysics Data System (ADS)

    Wang, P.; Allaart, M.; Knap, W. H.; Stammes, P.

    2015-04-01

    A green light sensor has been developed at KNMI to measure actinic flux profiles using an ozonesonde balloon. In total, 63 launches with ascending and descending profiles were performed between 2006 and 2010. The measured uncalibrated actinic flux profiles are analysed using the Doubling-Adding KNMI (DAK) radiative transfer model. Values of the cloud optical thickness (COT) along the flight track were taken from the Spinning Enhanced Visible and Infrared Imager (SEVIRI) Cloud Physical Properties (CPP) product. The impact of clouds on the actinic flux profile is evaluated on the basis of the cloud modification factor (CMF) at the cloud top and cloud base, which is the ratio between the actinic fluxes for cloudy and clear-sky scenes. The impact of clouds on the actinic flux is clearly detected: the largest enhancement occurs at the cloud top due to multiple scattering. The actinic flux decreases almost linearly from cloud top to cloud base. Above the cloud top the actinic flux also increases compared to clear-sky scenes. We find that clouds can increase the actinic flux to 2.3 times the clear-sky value at cloud top and decrease it to about 0.05 at cloud base. The relationship between CMF and COT agrees well with DAK simulations, except for a few outliers. Good agreement is found between the DAK-simulated actinic flux profiles and the observations for single-layer clouds in fully overcast scenes. The instrument is suitable for operational balloon measurements because of its simplicity and low cost. It is worth further developing the instrument and launching it together with atmospheric chemistry composition sensors.

  1. Distension of the esophagogastric junction augments triggering of transient lower esophageal sphincter relaxation.

    PubMed

    van Wijk, Michiel P; Blackshaw, L Ashley; Dent, John; Benninga, Marc A; Davidson, Geoffrey P; Omari, Taher I

    2011-10-01

    Patients with gastroesophageal reflux disease show an increase in esophagogastric junction (EGJ) distensibility and in frequency of transient lower esophageal sphincter relaxations (TLESR) induced by gastric distension. The objective was to study the effect of localized EGJ distension on triggering of TLESR in healthy volunteers. An esophageal manometric catheter incorporating an 8-cm internal balloon adjacent to a sleeve sensor was developed to enable continuous recording of EGJ pressure during distension of the EGJ. Inflation of the balloon doubled the cross-section of the trans-sphincteric portion of the catheter from 5 mm OD (round) to 5 × 11 mm (oval). Ten healthy subjects were included. After catheter placement and a 30-min adaptation period, the EGJ was randomly distended or not, followed by a 45-min baseline recording. Subjects consumed a refluxogenic meal, and recordings were made for 3 h postprandially. A repeat study was performed on another day with EGJ distension status reversed. Additionally, in one subject MRI was performed to establish the exact position of the balloon in the inflated state. The number of TLESR increased during periods of EGJ distension with the effect being greater after a meal [baseline: 2.0(0.0-4.0) vs. 4.0(1.0-11.0), P=0.04; postprandial: 15.5(10.0-33.0) vs. 22.0(17.0-58.0), P=0.007 for undistended and distended, respectively]. EGJ distension augments meal-induced triggering of TLESR in healthy volunteers. Our data suggest the existence of a population of vagal afferents located at sites in/around the EGJ that may influence triggering of TLESR.

  2. Terahertz photometers to observe solar flares from space (SOLAR-T project)

    NASA Astrophysics Data System (ADS)

    Kaufmann, Pierre; Raulin, Jean-Pierre

    The space experiment SOLAR-T designed to observe solar flares at THz frequencies was completed. We present the concept, fabrication and performance of a double THz photometers system. An innovative optical setup allows observations of the full solar disk and the detection of small burst transients at the same time. It is the first detecting system conceived to observe solar flare THz emissions on board of stratospheric balloons. The system has been integrated to data acquisition and telemetry modules for this application. SOLAR-T uses two Golay cell detectors preceded by low-pass filters made of rough surface primary mirrors and membranes, 3 and 7 THz band-pass filters, and choppers. Its photometers can detect small solar bursts (tens of solar flux units) with sub second time resolution. One artificial Sun setup was developed to simulate actual observations. Tests comprised the whole system performance, on ambient and low pressure and temperature conditions. It is intended to provide data on the still unrevealed spectral shape of the mysterious THz solar flares emissions. The experiment is planned to be on board of two long-duration stratospheric balloon flights over Antarctica and Russia in 2014-2016. The SOLAR-T development, fabrication and tests has been accomplished by engineering and research teams from Mackenzie, Unicamp and Bernard Lyot Solar Observatory; Propertech Ltda.; Neuron Ltda.; and Samsung, Brazil; Tydex LCC, Russia; CONICET, Argentina; the stratospheric balloon missions will be carried in cooperation with teams from University of California, Berkeley, USA (flight over Antarctica), and Lebedev Physical Institute, Moscow, Russia (flight over Russia).

  3. Properties of nylon 12 balloons after thermal and liquid carbon dioxide treatments.

    PubMed

    Ro, Andrew J; Davé, Vipul

    2013-03-01

    Critical design attributes of angioplasty balloons include the following: tear resistance, high burst pressures, controlled compliance, and high fatigue. Balloons must have tear resistance and high burst pressures because a calcified stenosis can be hard and nominal pressures of up to 16 atm can be used to expand the balloon. The inflated balloon diameter must be a function of the inflation pressure, thus compliance is predictable and controlled. Reliable compliance is necessary to prevent damage to vessel walls, which may be caused by over-inflation. Balloons are often inflated multiple times in a clinical setting and they must be highly resistant to fatigue. These design attributes are dependent on the mechanical properties and polymer morphology of the balloon. The effects of residual stresses on shrinkage, crystallite orientation, balloon compliance, and mechanical properties were studied for angioplasty nylon 12 balloons. Residual stresses of these balloons were relieved by oven heat treatment and liquid CO2 exposure. Residual stresses were measured by quantifying shrinkage at 80 °C of excised balloon samples using a dynamic mechanical analyzer. Shrinkage was lower after oven heat treatment and liquid CO2 exposure compared to the as-received balloons, in the axial and radial directions. As-received, oven heat treated, and liquid CO2-exposed balloon samples exhibited similar thermal properties (T(g), T(m), X(t)). Crystallite orientation was not observed in the balloon cylindrical body using X-ray scattering and polarized light microscopy, which may be due to balloon fabrication conditions. Significant differences were not observed between the stress-strain curves, balloon compliance, and average burst pressures of the as-received, oven heat treated, and liquid CO2-exposed balloons. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. A stress index model for ascending balloons

    NASA Technical Reports Server (NTRS)

    Smith, I. S.

    1986-01-01

    Attention is given to the development on the part of NASA of a simplified stress 'index' model to establish the relative stress magnitudes along a balloon's gore position as a function of altitude. Application of this model to several hundred balloon flights showed a good correlation between balloon failure rate and stress 'index' level. This model can be used during the balloon design process to lower the levels of stress in the balloon. By increasing the wall thickness of the balloon, adding caps, lengthening caps, or using external caps, lower stress can be accomplished. As a result, in January 1985, the NASA Balloon Program established a stress index specification to limit the design and flight stresses for NASA balloons.

  5. Effect of routine rapid insertion of Bakri balloon tamponade on reducing hemorrhage from placenta previa during and after cesarean section.

    PubMed

    Soyama, Hiroaki; Miyamoto, Morikazu; Sasa, Hidenori; Ishibashi, Hiroki; Yoshida, Masashi; Nakatsuka, Masaya; Takano, Masashi; Furuya, Kenichi

    2017-09-01

    To evaluate the effectiveness of routine rapid insertion of a Bakri balloon during cesarean section for placenta previa based on a retrospective control study. Women with singleton pregnancies who underwent cesarean section for placenta previa at our institution between 2003 and 2016 were enrolled. Between 2015 and 2016, women who routinely underwent balloon tamponade during cesarean section were defined as the balloon group. Between 2003 and 2014, women who underwent no hemostatic procedures except balloon tamponade were defined as the non-balloon group. The clinical outcomes of the two groups were retrospectively analyzed. Of the 266 women with placenta previa, 50 were in the balloon group and 216 were in the non-balloon group. The bleeding amounts were significantly smaller in the balloon group than in the non-balloon group: intraoperative bleeding (991 vs. 1250 g, p < 0.01), postoperative bleeding (62 vs. 150 g, p < 0.01), and total bleeding (1066 vs. 1451 g, p < 0.01). Furthermore, the mean surgical duration was shorter in the balloon group than the non-balloon group (30 vs. 50 min, p < 0.01). In the balloon group, five patients suffered from increasing hemorrhage due to prolapse of the balloon from the uterus after the operation, but the hemorrhage was controlled by balloon re-insertion without additional hemostatic procedures. This study demonstrated that the routine rapid insertion of Bakri balloon tamponade during cesarean section significantly decreased intra- and postoperative hemorrhage and shortened the surgical duration in women with placenta previa.

  6. 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 to...

  7. 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 to...

  8. 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 to...

  9. Status of the NASA Balloon Program

    NASA Astrophysics Data System (ADS)

    Needleman, H. C.; Nock, R. S.; Bawcom, D. W.

    1993-02-01

    In the early 1980's the U.S. National Aeronautics and Space Administration (NASA) Balloon Program was faced with a problem of catastrophic balloon failures. In 1986 a balloon recovery program was initiated. This program included qualification of new balloon films, and investigations into materials, processing, structures and performance of balloons. This recovery program has been very successful. To date, more than 100 balloons manufactured of newly developed films have been flown with unprecedented success. There has been much progress made across the spectrum of balloon related disciplines. A new design philosophy has been developed and is being used for all NASA balloons. An updated balloon reliability and quality assurance program is in effect. The long duration balloon development project has been initiated with the first flight test having been conducted in December 1989 from Antarctica. A comprehensive research and development (R&D) effort has been initiated and is progressing well. The progress, status and future plans for these and other aspects of the NASA program, along with a description of the comprehensive balloon R&D activity, will be presented.

  10. Evolution of scientific ballooning and its impact on astrophysics research

    NASA Astrophysics Data System (ADS)

    Jones, William Vernon

    2014-05-01

    As we celebrate the centennial year of the discovery of cosmic rays on a manned balloon, it seems appropriate to reflect on the evolution of ballooning and its scientific impact. Balloons have been used for scientific research since they were invented in France more than 200 years ago. Ballooning was revolutionized in 1950 with the introduction of the so-called natural shape balloon with integral load tapes. This basic design has been used with more or less continuously improved materials for scientific balloon flights for more than a half century, including long-duration balloon (LDB) flights around Antarctica for the past two decades. The U.S. National Aeronautics and Space Administration (NASA) is currently developing the next generation super-pressure balloon that would enable extended duration missions above 99.5% of the Earth's atmosphere at any latitude. The Astro2010 Decadal Survey report supports super-pressure balloon development and the giant step forward it offers with ultra-long-duration balloon (ULDB) flights at constant altitudes for about 100 days.

  11. 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.

  12. 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.

  13. Clinical experience with the Monorail balloon catheter for coronary angioplasty.

    PubMed

    Finci, L; Meier, B; Roy, P; Steffenino, G; Rutishauser, W

    1988-01-01

    The Monorail balloon catheter is distinctly different from other current balloon catheters: the guidewire passes through the balloon itself, exits the catheter proximal to the balloon, and runs alongside its small shaft (3 French) through the guiding catheter. Monorail coronary angioplasty was attempted in 61 patients on 73 lesions with balloons from 2.0 to 3.7 mm. Angiographic success was obtained in 66 lesions (90%). For 15 lesions, balloon exchanges were needed. In three lesions, the Monorail balloon failed to cross the lesion, while a standard balloon succeeded; two lesions could not be crossed with any balloon. Vessel occlusion occurred in four patients: two had emergency surgery without infarct (one died suddenly 4 days later and one had a stroke 1 day later), one was recanalized with a standard balloon, and one had a myocardial infarct. Continuous infusion of urokinase was used until patient 3 in whom problems with the delivery system led to cardiocerebral air embolization (with complete recovery). No thrombotic complications were observed in the subsequent 58 patients with only a bolus of 10,000 U of heparin. The Monorail balloon facilitates contrast injections and balloon exchanges but appears more difficult to pass through tight lesions. Omission of the previously recommended infusion with a thrombolytic agent proved safe.

  14. Use of monorail PTCA balloon catheter for local drug delivery.

    PubMed

    Trehan, Vijay; Nair, Girish M; Gupta, Mohit D

    2007-01-01

    We report the use of monorail coronary balloon as an infusion catheter to give bailout abciximab selectively into the site of stent thrombosis as an adjunct to plain old balloon angioplasty (POBA) in a patient of subacute stent thrombosis of the left anterior descending coronary artery. The balloon component (polyamide material) of the monorail balloon catheter was shaved off the catheter so that abciximab injected through the balloon port of the catheter exited out the shaft of the balloon catheter at the site from where the balloon material was shaved off. We believe that selective infusion with abciximab along with POBA established antegrade flow and relieved the patient's ischemia. In the absence of essential hardware to give intracoronary drugs in an emergency situation, one may employ our technique of infusion through a monorail balloon catheter after shaving the balloon component from the catheter.

  15. 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)

  16. 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.

  17. Development of a Super-Pressure Balloon with an Improved Design

    NASA Astrophysics Data System (ADS)

    Izutsu, Naoki; Akita, Daisuke; Fuke, Hideyuki; Iijima, Issei; Kato, Yoichi; Kawada, Jiro; Matsushima, Kiyoho; Matsuzaka, Yukihiko; Mizuta, Eiichi; Nakada, Takashi; Nonaka, Naoki; Saito, Yoshitaka; Takada, Atsushi; Tamura, Keisuke; Yamada, Kazuhiko; Yoshida, Tetsuya

    A zero-pressure balloon used for scientific observation in the stratosphere has an unmanageable limitation that its floating altitude decreases during a nighttime because of temperature drop of the lifting gas. Since a super-pressure balloon may not change its volume, the lifetime can extend very long. We had introduced so called the ‘lobed-pumpkin’ type of super-pressure balloon that can realize a full-scale long-duration balloon and it will be in practical use in the very near future. As for larger super-pressure balloons, however, we still have some potential difficulties to be resolved. We here propose a new design suitable for a larger super-pressure balloon, which is roughly ‘lobed pumpkin with lobed cylinder’ and can adapt a single design for balloons of a wide range of volumes. Indoor inflation tests were successfully carried out with balloons designed and made by the method. It has been shown that the limit of the resisting pressure differential for a new designed balloon is same as that of a normal lobed-pumpkin balloon.

  18. Direct retrograde cholangioscopy with a new prototype double-bending cholangioscope.

    PubMed

    Beyna, Torsten; Farnik, Harald; Sarrazin, Christoph; Gerges, Christian; Neuhaus, Horst; Albert, Jörg G

    2016-10-01

    Direct retrograde cholangioscopy (DRC) enables high quality video imaging of the bile ducts and allows intraductal treatment with optical control. We evaluated the feasibility, success, and complications of a new third-generation prototype cholangioscope. All consecutive patients from two tertiary endoscopy centers who had undergone DRC with the prototype were included. Indications for DRC were: evaluation of indeterminate strictures, filling defects, and complex bile duct stones. Technical success was investigated in terms of indication and treatment performed. All adverse events were recorded. DRC with the prototype was performed in 74 patients. Therapeutic interventions included laser or electrohydraulic lithotripsy and stone removal, among others. The papilla was entered in 72/74 patients (97 %). The targeted bile duct segment was reached in 62 /74 patients (84 %), with an anchoring balloon catheter needed in 21/74 (28 %). Mean investigation time was 21 minutes (15 - 27 minutes) DRC using the prototype is feasible, safe, and attains access to the bile ducts in almost all patients, with less need of an anchoring balloon catheter compared with the standard technique and short investigation and fluoroscopy times. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Radiation Budget Profiles measured through the Atmosphere with a Return Glider Radiosonde

    NASA Astrophysics Data System (ADS)

    Philipona, R.; Kraeuchi, A.; Kivi, R.

    2015-12-01

    Very promising radiation budget profile measurements through the atmosphere were made in 2011 with a balloon borne short- and longwave net radiometer. New and improved radiation sensors from Kipp&Zonen are now used in a glider aircraft together with a standard Swiss radiosonde from Meteolabor AG. This new return glider radiosonde (RG-R), is lifted up with double balloon technique to prevent pendulum motion and to keep the radiation instruments as horizontal as possible during the ascent measuring phase. The RG-R is equipped with a release mechanism and an autopilot that flies the glider radiosonde back to the launch site, or to a predefined open space, where it releases a parachute for landing once it is 100 meter above ground. The RG-R was successfully tested and deployed for tropospheric and stratospheric radiation measurements up to 30 hPa (24 km altitude) at the GRUAN sites Payerne (Switzerland) and Sodankylä (Finland). Radiation profiles and the radiation budget through the atmosphere during different daytimes and under cloud-free and cloudy situations will be shown in relation to temperature and humidity at the surface and in the atmosphere. The RG-R flight characteristics and new measurement possibilities will also be discussed.

  20. Initial design of a novel suction enteroscope for endoscopic locomotion in the small bowel (with video).

    PubMed

    Wagh, Mihir S; Montane, Roberto

    2012-02-01

    The upper GI tract and the colon are readily accessible endoscopically, but the small intestine is relatively difficult to evaluate. To demonstrate the feasibility of using suction as a means of locomotion and to assess the initial design of a suction enteroscope. Feasibility study. Animal laboratory. Various prototype suction devices designed in our laboratory were tested in swine small intestine in a force test station. For in vivo experiments in live anesthetized animals, two suction devices (1 fixed tip and 1 movable tip) were attached to the outside of the endoscope. By creating suction in the fixed tip, the endoscope was anchored while the movable tip was advanced. Suction was then applied to the extended tip to attach it to the distal bowel. Suction on the fixed tip was then released and the movable tip with suction pulled back, resulting in advancement of the endoscope. These steps were sequentially repeated. Intestinal segments were sent for pathologic assessment after testing. Force generated ranged from 0.278 to 4.74 N with 64.3 to 88 kPa vacuum pressure. A linear relationship was seen between the pull force and vacuum pressures and tip surface area. During in vivo experiments, the endoscope was advanced in 25-cm segmental increments with sequential suction-and-release maneuvers. No significant bowel trauma was seen on pathology and necropsy. The enteroscopy system requires further refinement. A novel suction enteroscope was designed and tested. Suction tip characteristics played a critical role impacting the functionality of this enteroscopy system. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  1. Development of a 5,000 m(3) super-pressure balloon with a diamond-shaped net

    NASA Astrophysics Data System (ADS)

    Saito, Yoshitaka; Tanaka, Shigeki; Nakashino, Kyoichi; Matsushima, Kiyoho; Goto, Ken; Furuta, Ryosuke; Domoto, Kodai; Akita, Daisuke; Hashimoto, Hiroyuki

    A light super-pressure balloon of which weight will be comparable to the weight of the zero-pressure balloon has been developed using a method to cover a balloon with a diamond-shaped net of high-tensile fibers. The goal is to fly a payload of 900 kg to the altitude of 37 km with a 300,000 m(3) balloon. A flight test of a 3,000 m(3) balloon in the tandem balloon configuration with a 15,000 m(3) zero-pressure balloon was performed in 2012. Although a small gas leak occurred in the super-pressure balloon at the differential pressure of 400 to 500 Pa, the differential pressure reached the highest value of 814 Pa and kept positive through the level flight lasting for 25 minutes due to its slow leakage. To avoid a possible stress concentration to films at the polar area, a new design setting the meridian length of the balloon gore film equal to the length of the net was adopted. A 3-m balloon with the design was developed and its capacity to resist pressure at room temperature and at -30 (°) C was checked through the ground inflation tests. In 2013, a balloon of the same model was launched in the tandem balloon configuration with 2 kg rubber balloons. It was confirmed that the balloon could withstand the maximum differential pressure of 6,280 Pa, could withstand the differential pressure of 5,600 Pa for 2 hours, and there was a small gas leak through a hole with an area of 0.4 mm(2) which was also found in the ground leakage test. These results indicated that the improvement was adequate and there was no problem for the super-pressure balloon to fly in the environment of the stratosphere except for the problem of the small gas leak. In 2014, a flight test of a 5,000 m(3) balloon will be performed. In this paper, after reviewing the method to cover a balloon with a diamond-shaped net, the current status of the development will be reported.

  2. Flight Qualification of the NASA's Super Pressure Balloon

    NASA Astrophysics Data System (ADS)

    Cathey, Henry; Said, Magdi; Fairbrother, Debora

    Designs of new balloons to support space science require a number of actual flights under various flight conditions to qualify them to as standard balloon flight offerings to the science community. Development of the new Super Pressure Balloon for the National Aeronautics and Space Administration’s Balloon Program Office has entailed employing new design, analysis, and production techniques to advance the state of the art. Some of these advances have been evolutionary steps and some have been revolutionary steps requiring a maturing understanding of the materials, designs, and manufacturing approaches. The NASA Super Pressure Balloon development end goal is to produce a flight vehicle that is qualified to carry a ton of science instrumentation, at an altitude greater than 33 km while maintaining a near constant pressure altitude for extended periods of up to 100 days, and at any latitude on the globe. The NASA’s Balloon Program Office has pursued this development in a carefully executed incremental approach by gradually increasing payload carrying capability and increasing balloon volume to reach these end goal. 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. A larger balloon was flown from Antarctica in early 2011. This ~422,400 m3 flew at a constant altitude for 22 days making one circuit around Antarctica. Although the performance was nominal, the flight was terminated via command to recover high valued assets from the payload. The balloon designed to reach the program goals is a ~532,200 m3 pumpkin shaped Super Pressure Balloon. A test flight of this balloon was launched from the Swedish Space Corporation’s Esrange Balloon Launch Facilities near Kiruna, Sweden on 14 August, 2012. This flight was another success for this development program. Valuable information was gained from this short test flight by successfully demonstrated balloon vehicle performance, obtained a large amount of videos, measured balloon differential pressure, obtained temperature and altitude data, assessed structure strength through pressurization, and demonstrated the balloon vehicles altitude stability. This flight was the first of several to qualify this design for the science community. Results of the most recent flights will be presented. Some of the related material characterization testing which is vital to the balloon design development for the balloon will also be presented. Additionally, this paper will provide a current overview of the development and qualification approach pursued for the NASA’s Super Pressure Balloon. Future plans and goals of future test flights will also be presented. This will include the projected balloon volumes, payload capabilities, test flight locations, and proposed flight schedule.

  3. Status of the NASA Balloon Program

    NASA Technical Reports Server (NTRS)

    Needleman, H. C.; Nock, R. S.; Bawcom, D. W.

    1993-01-01

    The NASA Balloon Program (BP) is examined in an overview of design philosophy, R&D activities, flight testing, and the development of a long-duration balloon for Antarctic use. The Balloon Recovery Program was developed to qualify the use of existing films and to design improved materials and seals. Balloon flights are described for studying the supernova SN1987a, and systems were developed to enhance balloon campaigns including mobile launch vehicles and tracking/data-acquisition systems. The technical approach to long-duration ballooning is reviewed which allows the use of payloads of up to 1350 kg for two to three weeks. The BP is responsible for the development of several candidate polyethylene balloon films as well as design/performance standards for candidate balloons. Specific progress is noted in reliability and in R&D with respect to optimization of structural design, resin blending, and extrusion.

  4. 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.

  5. Concepts for autonomous flight control for a balloon on Mars

    NASA Technical Reports Server (NTRS)

    Heinsheimer, Thomas F.; Friend, Robyn C.; Siegel, Neil G.

    1988-01-01

    Balloons operating as airborne rovers have been suggested as ideal candidates for early exploration of the Martian surface. An international study team composed of scientists from the U.S.S.R., France, and the U.S.A. is planning the launching in 1994 of a balloon system to fly on Mars. The current likely design is a dual thermal/gas balloon that consists of a gas balloon suspended above a solar-heated thermal balloon. At night, the thermal balloon provides no lift, and the balloon system drifts just above the Martian surface; the lift of the gas balloon is just sufficient to prevent the science payload from hitting the ground. During the day, the balloon system flies at an altitude of 4 to 5 kilometers, rising due to the added lift provided by the thermal balloon. Over the course of a single Martian day, there may be winds in several directions, and in fact it can be expected that there will be winds simultaneously in different directions at different altitudes. Therefore, a balloon system capable of controlling its own altitude, via an autonomous flight control system, can take advantage of these different winds to control its direction, thereby greatly increasing both its mission utility and its longevity.

  6. Under Pressure: Intraluminal Filling Pressures of Postpartum Hemorrhage Tamponade Balloons

    PubMed Central

    Antony, Kathleen M.; Racusin, Diana A.; Belfort, Michael A.; Dildy, Gary A.

    2017-01-01

    Objective Uterine tamponade by fluid-filled balloons is now an accepted method of controlling postpartum hemorrhage. Available tamponade balloons vary in design and material, which affects the filling attributes and volume at which they rupture. We aimed to characterize the filling capacity and pressure-volume relationship of various tamponade balloons. Study Design Balloons were filled with water ex vivo. Intraluminal pressure was measured incrementally (every 10 mL for the Foley balloons and every 50 mL for all other balloons). Balloons were filled until they ruptured or until 5,000 mL was reached. Results The Foley balloons had higher intraluminal pressures than the larger-volume balloons. The intraluminal pressure of the Sengstaken-Blakemore tube (gastric balloon) was initially high, but it decreased until shortly before rupture occurred. The Bakri intraluminal pressure steadily increased until rupture occurred at 2,850 mL. The condom catheter, BT-Cath, and ebb all had low intraluminal pressures. Both the BT-Cath and the ebb remained unruptured at 5,000 mL. Conclusion In the setting of acute hemorrhage, expeditious management is critical. Balloons that have a low intraluminal pressure-volume ratio may fill more rapidly, more easily, and to greater volumes. We found that the BT-Cath, the ebb, and the condom catheter all had low intraluminal pressures throughout filling. PMID:28497006

  7. Effectiveness of a reusable low-cost balloon trocar dissection device in the creation of preperitoneal space during endoscopic surgery. An experimental study in swine.

    PubMed

    Nácul, Miguel Prestes; Cavazzola, Leandro Totti; Loureiro, Marcelo de Paula; Bonin, Eduardo Aimoré; Ferreira, Paulo Roberto Walter

    2015-09-01

    To evaluate a new, low-cost, reusable balloon trocar device for dissection of the preperitoneal space during endoscopic surgery. Twenty swine (weight: 15-37 kg) were randomized to two groups, according to whether the preperitoneal space was created with a new balloon device manufactured by Bhio-Supply (group B) or with the commercially available OMSPDB 1000® balloon device manufactured by Covidien (group C). Quality and size of the created preperitoneal space, identification of anatomic structures, balloon dissection time, total procedure time, balloon resistance and internal pressure after insufflation with 300 mL of ambient air, balloon-related complications, and procedure cost were assessed. No significant differences in dissection time, total procedure time, or size of the created preperitoneal space were found between the groups. Balloons in group B had a significantly higher internal pressure compared to balloons in group C. None of the balloons ruptured during the experiment. Three animals in group C had balloon-related peritoneal lacerations. Despite a higher individual device cost, group B had a lower procedure cost over the entire experiment. The new balloon device is not inferior to the commercially available device in terms of the safety and effectiveness for creating a preperitoneal space in swine.

  8. Dose Reduction Study in Vaginal Balloon Packing Filled With Contrast for HDR Brachytherapy Treatment;HDR; Uterine cervix cancer; Vaginal balloon packing; Contrast; Monte Carlo

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

    Saini, Amarjit S.; Zhang, Geoffrey G., E-mail: geoffrey.zhang@moffitt.org; Finkelstein, Steven E.

    2011-07-15

    Purpose: Vaginal balloon packing is a means to displace organs at risk during high dose rate brachytherapy of the uterine cervix. We tested the hypothesis that contrast-filled vaginal balloon packing reduces radiation dose to organs at risk, such as the bladder and rectum, in comparison to water- or air-filled balloons. Methods and Materials: In a phantom study, semispherical vaginal packing balloons were filled with air, saline solution, and contrast agents. A high dose rate iridium-192 source was placed on the anterior surface of the balloon, and the diode detector was placed on the posterior surface. Dose ratios were taken withmore » each material in the balloon. Monte Carlo (MC) simulations, by use of the MC computer program DOSXYZnrc, were performed to study dose reduction vs. balloon size and contrast material, including commercially available iodine- and gadolinium-based contrast agents. Results: Measured dose ratios on the phantom with the balloon radius of 3.4 cm were 0.922 {+-} 0.002 for contrast/saline solution and 0.808 {+-} 0.001 for contrast/air. The corresponding ratios by MC simulations were 0.895 {+-} 0.010 and 0.781 {+-} 0.010. The iodine concentration in the contrast was 23.3% by weight. The dose reduction of contrast-filled balloon ranges from 6% to 15% compared with water-filled balloon and 11% to 26% compared with air-filled balloon, with a balloon size range between 1.4 and 3.8 cm, and iodine concentration in contrast of 24.9%. The dose reduction was proportional to the contrast agent concentration. The gadolinium-based contrast agents showed less dose reduction because of much lower concentrations in their solutions. Conclusions: The dose to the posterior wall of the bladder and the anterior wall of the rectum can be reduced if the vaginal balloon is filled with contrast agent in comparison to vaginal balloons filled with saline solution or air.« less

  9. 14 CFR 101.7 - Hazardous operations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE BALLOONS General § 101.7 Hazardous operations. (a) No person may operate any moored balloon, kite, amateur rocket, or... operating any moored balloon, kite, amateur rocket, or unmanned free balloon may allow an object to be...

  10. 14 CFR 101.7 - Hazardous operations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE BALLOONS General § 101.7 Hazardous operations. (a) No person may operate any moored balloon, kite, amateur rocket, or... operating any moored balloon, kite, amateur rocket, or unmanned free balloon may allow an object to be...

  11. 14 CFR 101.7 - Hazardous operations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE BALLOONS General § 101.7 Hazardous operations. (a) No person may operate any moored balloon, kite, amateur rocket, or... operating any moored balloon, kite, amateur rocket, or unmanned free balloon may allow an object to be...

  12. 14 CFR 101.7 - Hazardous operations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE BALLOONS General § 101.7 Hazardous operations. (a) No person may operate any moored balloon, kite, amateur rocket, or... operating any moored balloon, kite, amateur rocket, or unmanned free balloon may allow an object to be...

  13. 14 CFR 101.7 - Hazardous operations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE BALLOONS General § 101.7 Hazardous operations. (a) No person may operate any moored balloon, kite, amateur rocket, or... operating any moored balloon, kite, amateur rocket, or unmanned free balloon may allow an object to be...

  14. Inversion of solar extinction data from the Apollo-Soyuz Test Project Stratospheric Aerosol Measurement (ASTP/SAM) experiment

    NASA Technical Reports Server (NTRS)

    Pepin, T. J.

    1977-01-01

    The inversion methods are reported that have been used to determine the vertical profile of the extinction coefficient due to the stratospheric aerosols from data measured during the ASTP/SAM solar occultation experiment. Inversion methods include the onion skin peel technique and methods of solving the Fredholm equation for the problem subject to smoothing constraints. The latter of these approaches involves a double inversion scheme. Comparisons are made between the inverted results from the SAM experiment and near simultaneous measurements made by lidar and balloon born dustsonde. The results are used to demonstrate the assumptions required to perform the inversions for aerosols.

  15. A search for solar neutrons from 10-100 MeV

    NASA Technical Reports Server (NTRS)

    Monn, S.; Simnett, G. M.; White, R. S.

    1974-01-01

    A search for solar neutrons is reported from a balloon flight launched from Palestine, Texas on Sept. 26, 1971. The sun was observed from 8:30 to 19:30 CST. The neutrons were detected with a telescope consisting of two 0.5 sq m scintillation detectors spaced 1 meter apart using a double-scattering/time-of-flight technique. Upper limits for solar neutrons in the energy intervals 10 to 30, 30 to 50, and 50 to 100 MeV are .00011, .00026 and .00059 neutron/sq cm-sec, respectively. These are combined into an overall upper limit of .00051 neutron/sq cm-sec.

  16. 14 CFR 31.1 - Applicability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... applicable requirements of this part. (c) For purposes of this part— (1) A captive gas balloon is a balloon that derives its lift from a captive lighter-than-air gas; (2) A hot air balloon is a balloon that... STANDARDS: MANNED FREE BALLOONS General § 31.1 Applicability. (a) This part prescribes airworthiness...

  17. 14 CFR 31.1 - Applicability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... applicable requirements of this part. (c) For purposes of this part— (1) A captive gas balloon is a balloon that derives its lift from a captive lighter-than-air gas; (2) A hot air balloon is a balloon that... STANDARDS: MANNED FREE BALLOONS General § 31.1 Applicability. (a) This part prescribes airworthiness...

  18. 14 CFR 31.1 - Applicability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... applicable requirements of this part. (c) For purposes of this part— (1) A captive gas balloon is a balloon that derives its lift from a captive lighter-than-air gas; (2) A hot air balloon is a balloon that... STANDARDS: MANNED FREE BALLOONS General § 31.1 Applicability. (a) This part prescribes airworthiness...

  19. Energy from solar balloons

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

    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)

  20. NASA balloon design and flight - Philosophy and criteria

    NASA Technical Reports Server (NTRS)

    Smith, I. S., Jr.

    1993-01-01

    The NASA philosophy and criteria for the design and flight of scientific balloons are set forth and discussed. The thickness of balloon films is standardized at 20.3 microns to isolate potential film problems, and design equations are given for specific balloon parameters. Expressions are given for: flight-stress index, total required thickness, cap length, load-tape rating, and venting-duct area. The balloon design criteria were used in the design of scientific balloons under NASA auspices since 1986, and the resulting designs are shown to be 95 percent effective. These results represent a significant increase in the effectiveness of the balloons and therefore indicate that the design criteria are valuable. The criteria are applicable to four balloon volume classes in combination with seven payload ranges.

  1. New Pulmonary Valvuloplasty Technique by Use of an Hourglass-Shaped Balloon in 3 Adults with Severe Pulmonary Valve Stenosis

    PubMed Central

    Sahin, Tayfun; Karauzum, Kurtulus; Ural, Ertan; Pedersen, Wesley R.

    2018-01-01

    Percutaneous balloon pulmonary valvuloplasty is the preferred therapy for pulmonary valve stenosis. However, the designs of the cylindrical balloons historically used for valvuloplasty have limitations, especially in patients who have large pulmonary annular diameters. The hourglass-shaped V8 Aortic Valvuloplasty Balloon may prove to be an effective alternative. The balloon has 2 large bulbous segments that are separated by a narrowed waist. The geometric shape is maintained throughout inflation, improving fixation and enabling broader leaflet opening. We present our first experience with the V8 balloon in 3 adults who had severe, symptomatic pulmonary valve stenosis. In addition to describing their cases, we detail our sizing technique for pulmonary valvuloplasty with the V8 balloon. Our successful results suggest that the V8 balloon is efficient and safe for balloon pulmonary valvuloplasty in adults with severe pulmonary valve stenosis. PMID:29844739

  2. Percutaneous balloon pulmonary valvuloplasty (PBPV) of extreme pulmonary valve stenosis by the use of Accura balloon.

    PubMed

    Sinha, Santosh Kumar; Mishra, Vikas; Razi, Mahmadula; Jha, Mukesh Jitendra

    2017-10-04

    Transcatheter therapy of valvular pulmonary stenosis is one of first catheter interventions facilitating its application in field of structural heart disease and now treatment of choice for significant pulmonary stenosis. Myriads of balloon catheter have been used for this purpose starting from Diamond (Boston Scientific,Natick, MA USA), Marshal (Medi-Tech,Watertown MAUSA), Innoue balloon, Tyshak I and currently Tyshak II. Diameter and length of balloon depend on size of annulus and age group, respectively. Problem with shorter balloon is difficulty in keeping it across the annulus while inflation as it tends to slip distally whereas with longer balloon, potential of tricuspid leak or conduction block as it may impinge on adjacent structures. Potential advantage of Accura balloon over Tyshak balloon lies in its peculiar shape while inflation and variable diameter, making stepwise dilatation possible. Here, we report a case of successful balloon pulmonary valvuloplasty using Accura balloon (Vascular Concept, UK) with little modification of conventional technique. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Scientific Ballooning in India - Recent Developments

    NASA Astrophysics Data System (ADS)

    Manchanda, R. K.; Srinivasan, S.; Subbarao, J. V.

    Established in 1972, the National Balloon Facility operated by TIFR in Hyderabad, India is is a unique facility in the country, which provides a complete solution in scientific ballooning. It is also one of its kind in the world since it combines both, the in-house balloon production and a complete flight support for scientific ballooning. With a large team working through out the year to design, fabricate and launch scientific balloons, the Hyderabad Facility is a unique centre of expertise where the balloon design, Research and Development, the production and launch facilities are located under one roof. Our balloons are manufactured from 100% indigenous components. The mission specific balloon design, high reliability control and support instrumentation, in-house competence in tracking, telemetry, telecommand, data processing, system design and mechanics is a hallmark of the Hyderabad balloon facility. In the past few years we have executed a major programme of upgradation of different components of balloon production, telemetry and telecommand hardware and various support facilities. This paper focuses on our increased capability of balloon production of large sizes up to size of 780,000 M^3 using Antrix film, development of high strength balloon load tapes with the breaking strength of 182 kg, and the recent introduction of S-band telemetry and a commandable timer cut-off unit in the flight hardware. A summary of the various flights conducted in recent years will be presented along with the plans for new facilities.

  4. Stability of Balloon-Retention Gastrostomy Tubes with Different Concentrations of Contrast Material: In Vitro Study

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

    Lopera, Jorge E., E-mail: Lopera@uthscsa.ed; Alvarez, Alex; Trimmer, Clayton

    2009-01-15

    The purpose of this study was to determine the performance of two balloon-retention-type gastrostomy tubes when the balloons are inflated with two types of contrast materials at different concentrations. Two commonly used balloon-retention-type tubes (MIC and Tri-Funnel) were inflated to the manufacturer's recommended volumes (4 and 20 cm{sup 3}, respectively) with normal saline or normal saline plus different concentrations of contrast material. Five tubes of each brand were inflated with normal saline and 0%, 25%, 50%, 75%, and 100% contrast material dilutions, using either nonionic hyperosmolar contrast, or nonionic iso-osmolar contrast. The tubes were submerged in a glass basin containingmore » a solution with a pH of 4. Every week the tubes were visually inspected to determine the integrity of the balloons, and the diameter of the balloons was measured with a caliper. The tests were repeated every week for a total of 12 weeks. The MIC balloons deflated slightly faster over time than the Tri-Funnel balloons. The Tri-Funnel balloons remained relatively stable over the study period for the different concentrations of contrast materials. The deflation rates of the MIC balloons were proportionally related to the concentration of saline and inversely related to the concentration of the contrast material. At high contrast material concentrations, solidification of the balloons was observed. In conclusion, this in vitro study confirms that the use of diluted amounts of nonionic contrast materials is safe for inflating the balloons of two types of balloon-retention feeding tubes. High concentrations of contrast could result in solidification of the balloons and should be avoided.« less

  5. Retained intraaortic balloon. Case report and review of the literature.

    PubMed

    Grande, A M; Martinelli, L; Graffigna, A; Viganò, M

    1995-01-01

    We report a case of intraaortic balloon entrapment in a 70-year-old man who underwent emergency triple coronary bypass. Intraaortic balloon rupture caused the formation of a clot inside the balloon that eventually was responsible for the balloon's entrapment at the aortic bifurcation. The patient had severe atherosclerosis of the aorta and iliac arteries. Balloon removal required aorto-iliac exposure and aorto-bifemoral bypass. After 16 months, he is symptom free and at home.

  6. Scientific ballooning in India Recent developments

    NASA Astrophysics Data System (ADS)

    Manchanda, R. K.

    Established in 1971, the National Balloon Facility operated by TIFR in Hyderabad, India, is a unique facility in the country, which provides a complete solution in scientific ballooning. It is also one of its kind in the world since it combines both, the in-house balloon production and a complete flight support for scientific ballooning. With a large team working through out the year to design, fabricate and launch scientific balloons, the Hyderabad Facility is a unique centre of expertise where the balloon design, research and development, the production and launch facilities are located under one roof. Our balloons are manufactured from 100% indigenous components. The mission specific balloon design, high reliability control and support instrumentation, in-house competence in tracking, telemetry, telecommand, data processing, system design and mechanics is its hallmark. In the past few years, we have executed a major programme of upgradation of different components of balloon production, telemetry and telecommand hardware and various support facilities. This paper focuses on our increased capability of balloon production of large sizes up to 780,000 m 3 using Antrix film, development of high strength balloon load tapes with the breaking strength of 182 kg, and the recent introduction of S-band telemetry and a commandable timer cut-off unit in the flight hardware. A summary of the various flights conducted in recent years will be presented along with the plans for new facilities.

  7. Very high-pressure dilatation for undilatable coronary lesions: indications and results with a new dedicated balloon.

    PubMed

    Secco, Gioel Gabrio; Ghione, Matteo; Mattesini, Alessio; Dall'Ara, Gianni; Ghilencea, Liviu; Kilickesmez, Kadriye; De Luca, Giuseppe; Fattori, Rossella; Parisi, Rosario; Marino, Paolo Nicola; Lupi, Alessandro; Foin, Nicolas; Di Mario, Carlo

    2016-06-20

    Calcific coronary lesions impose a rigid obstacle to optimal balloon and stent expansion and the 20 to 30 atm limit that non-compliant (NC) balloons reach can be insufficient. The aim of our study was to evaluate the safety and efficacy of a new dedicated super high-pressure NC balloon (OPN NC®; SIS Medical AG, Winterthur, Switzerland). We retrospectively evaluated a consecutive series of 91 lesions in which conventional NC balloons at maximal pressure failed to achieve an adequate post-dilatation luminal gain and were therefore treated with an OPN NC balloon up to 40 atm. Angiographic success was defined as residual angiographic diameter stenosis <30%. MLD and %DS were measured at baseline, after NC balloon, OPN NC balloon and stent implantation. Angiographic success was achieved in 84 lesions (92.3%). All of the remaining lesions received rotational atherectomy with the exception of two cases in which rotational atherectomy was not attempted because of small vessel size and excessive tortuosity. MLD and acute gain were significantly greater and %DS was significantly lower post OPN NC balloon compared with conventional NC balloon inflation (p<0.001). No coronary perforations occurred. No acute or 30-day follow-up MACE was reported. When conventional NC balloons fail, the new OPN NC dedicated high-pressure balloon provides an effective and safe alternative strategy for the dilatation of resistant coronary lesions.

  8. Pravastatin and endothelium dependent vasomotion after coronary angioplasty: the PREFACE trial

    PubMed Central

    Mulder, H; Schalij, M; Kauer, B; Visser, R; van Dijkman, P R M; Jukema, J; Zwinderman, A; Bruschke, A

    2001-01-01

    OBJECTIVE—To test the hypothesis that the 3-hydroxy-3-methylglutaryl coenzyme-A reductase inhibitor pravastatin ameliorates endothelium mediated responses of dilated coronary segments: the PREFACE (pravastatin related effects following angioplasty on coronary endothelium) trial.
DESIGN—A double blind, randomised, placebo controlled, multicentre study.
SETTING—Four hospitals in the Netherlands.
PATIENTS—63 non-smoking, non-hypercholesterolaemic patients scheduled for elective balloon angioplasty (pravastatin 34, placebo 29).
INTERVENTIONS—The effects of three months of pravastatin treatment (40 mg daily) on endothelium dependent vasomotor function were studied. Balloon angioplasty was undertaken one month after randomisation, and coronary vasomotor function tests using acetylcholine were performed two months after balloon angioplasty. The angiograms were analysed quantitatively.
MAIN OUTCOME MEASURES—The efficacy measure was the acetylcholine induced change in mean arterial diameter, determined in the dilated segment and in an angiographically normal segment of an adjacent non-manipulated coronary artery.
RESULTS—Increasing acetylcholine doses produced vasoconstriction in the dilated segments (p = 0.004) but not in the normal segments. Pravastatin did not affect the vascular response to acetylcholine in either the dilated segments (p = 0.09) or the non-dilated sites. Endothelium dependent vasomotion in normal segments was correlated with that in dilated segments (r = 0.47, p < 0.001). There were fewer procedure related events in the pravastatin group than in the placebo group (p < 0.05).
CONCLUSIONS—Endothelium dependent vasomotion in normal segments is correlated with that in dilated segments. A significant beneficial effect of pravastatin on endothelial function could not be shown, but in the dilated segments there was a trend towards a beneficial treatment effect in the pravastatin group.


Keywords: angioplasty; endothelium; acetylcholine; pravastatin PMID:11602546

  9. Stability analysis and trend study of a balloon tethered in a wind, with experimental comparisons

    NASA Technical Reports Server (NTRS)

    Redd, L. T.; Bland, S. R.; Bennett, R. M.

    1973-01-01

    A stability analysis and trend study for a balloon tethered in a steady wind are presented. The linearized, stability-derivative type analysis includes balloon aerodynamics, buoyancy, mass (including apparent mass), and static forces resulting from the tether cable. The analysis has been applied to a balloon 7.64 m in length, and the results are compared with those from tow tests of this balloon. This comparison shows that the analysis gives reasonable predictions for the damping, frequencies, modes of motion, and stability boundaries exhibited by the balloon. A trend study for the 7.64-m balloon was made to illustrate how the stability boundaries are affected by changes in individual stability parameters. The trends indicated in this study may also be applicable to many other tethered-balloon systems.

  10. A comparative study of internally and externally capped balloons using small scale test balloons

    NASA Technical Reports Server (NTRS)

    Bell, Douglas P.

    1994-01-01

    Caps have been used to structurally reinforce scientific research balloons since the late 1950's. The scientific research balloons used by the National Aeronautics and Space Administration (NASA) use internal caps. A NASA cap placement specification does not exist since no empirical information exisits concerning cap placement. To develop a cap placement specification, NASA has completed two in-hangar inflation tests comparing the structural contributions of internal caps and external caps. The tests used small scale test balloons designed to develop the highest possible stresses within the constraints of the hangar and balloon materials. An externally capped test balloon and an internally capped test balloon were designed, built, inflated and simulated to determine the structural contributions and benefits of each. The results of the tests and simulations are presented.

  11. 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.

  12. 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)

  13. Retained intraaortic balloon. Case report and review of the literature.

    PubMed Central

    Grande, A M; Martinelli, L; Graffigna, A; Viganò, M

    1995-01-01

    We report a case of intraaortic balloon entrapment in a 70-year-old man who underwent emergency triple coronary bypass. Intraaortic balloon rupture caused the formation of a clot inside the balloon that eventually was responsible for the balloon's entrapment at the aortic bifurcation. The patient had severe atherosclerosis of the aorta and iliac arteries. Balloon removal required aorto-iliac exposure and aorto-bifemoral bypass. After 16 months, he is symptom free and at home. Images PMID:8605436

  14. The French balloon and sounding rocket space program

    NASA Astrophysics Data System (ADS)

    Coutin/Faye, S.; Sadourny, I.

    1987-08-01

    Stratospheric and long duration flight balloon programs are outlined. Open stratospheric balloons up to 1 million cu m volume are used to carry astronomy, solar system, aeronomy, stratosphere, biology, space physics, and geophysics experiments. The long duration balloons can carry 50 kg payloads at 20 to 30 km altitude for 10 days to several weeks. Pressurized stratospheric balloons, and infrared hot air balloons are used. They are used to study the dynamics of stratospheric waves and atmospheric water vapor. Laboratories participating in sounding rocket programs are listed.

  15. 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....

  16. Scientific ballooning. Proceedings. PSB Meeting of the COSPAR Panel on Technical Problems Related to Scientific Ballooning which was held during the Thirtieth COSPAR Scientific Assembly, Hamburg (Germany), 11 - 21 Jul 1994.

    NASA Astrophysics Data System (ADS)

    Riedler, W.; Torkar, K.

    1996-05-01

    This issue is grouped into sections on materials, design, performance and analysis of balloons, reviews of major national and international balloon programmes, novel instrumentation and systems for scientific ballooning, and selected recent scientific observations.

  17. 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…

  18. The National Scientific Balloon Facility. [balloon launching capabilities of ground facility

    NASA Technical Reports Server (NTRS)

    Kubara, R. S.

    1974-01-01

    The establishment and operation of the National Scientific Balloon Facility are discussed. The balloon launching capabilities are described. The ground support systems, communication facilities, and meteorological services are analyzed.

  19. Esrange Space Center, a Gate to Space

    NASA Astrophysics Data System (ADS)

    Widell, Ola

    Swedish Space Corporation (SSC) is operating the Esrange Space Center in northern Sweden. Space operations have been performed for more than 40 years. We have a unique combination of maintaining balloon and rocket launch operations, and building payloads, providing space vehicles and service systems. Sub-orbital rocket flights with land recovery and short to long duration balloon flights up to weeks are offered. The geographical location, land recovery area and the long term experience makes Swedish Space Corporation and Esrange to an ideal gate for space activities. Stratospheric balloons are primarily used in supporting atmospheric research, validation of satellites and testing of space systems. Balloon operations have been carried out at Esrange since 1974. A large number of balloon flights are yearly launched in cooperation with CNES, France. Since 2005 NASA/CSBF and Esrange provide long duration balloon flights to North America. Flight durations up to 5 days with giant balloons (1.2 Million cubic metres) carrying heavy payload (up to 2500kg) with astronomical instruments has been performed. Balloons are also used as a crane for lifting space vehicles or parachute systems to be dropped and tested from high altitude. Many scientific groups both in US, Europe and Japan have indicated a great need of long duration balloon flights. Esrange will perform a technical polar circum balloon flight during the summer 2008 testing balloon systems and flight technique. We are also working on a permission giving us the opportunity on a circular stratospheric balloon flight around the North Pole.

  20. 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…

  1. Current trends of balloon laryngoplasty in Thailand.

    PubMed

    Moungthong, Greetha; Bunbanjerdsuk, Sacarin; Wright, Nida; Sathavornmanee, Thanakrit; Setabutr, Dhave

    2017-06-01

    To describe the current trend in balloon laryngoplasty usage and experience by practicing otolaryngologists in Thailand. Anonymous 11 question online and paper survey of otolaryngologists on their current balloon laryngoplasty practices. Current practices and experience in balloon laryngoplasty were queried with multiple choice and open-ended questions. Laser use is the most commonly utilized instrument to treat airway stenosis in Thailand. 86% of respondents do not have experience with balloon dilatation; yet, almost half (47.6%) report they perform a minimum of five airway surgeries per year. Most respondents had been in practice for less than 6 years (41%) and reported that they did not have exposure to balloon use during residency training. The largest barrier reported for the use of balloon instrumentation in the airway is inexperience (44.4%) followed by cost (38.3%), yet most feel that treatment in airway stenosis could benefit by usage of balloons (95.5%). Most otolaryngologists in Thailand do not have experience with the use of balloon dilatation and lack of exposure remains the largest barrier to its use. Otolaryngologists in Thailand feel that increased usage of balloons in the airway could improve airway stenosis treatment in the country.

  2. Japanese Balloon Program

    NASA Astrophysics Data System (ADS)

    Yoshida, Tetsuya; Fuke, Hideyuki; Shoji, Yasuhiro; Iijima, Issei; Izutsu, Naoki; Kato, Yoichi; Matsuzaka, Yukihiko; Mizuta, Eiichi; Sato, Takatoshi; Tamura, Keisuke; Saito, Yoshitaka; Kakehashi, Yuya

    2012-07-01

    Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency conducts domestic balloon campaigns at Taiki Aerospace Research Field (TARF) in Hokkaido since 2008. The ballooning at TARF becomes stable after four year operation. Because the field faces to the Pacific Ocean, heavy balloons and payloads can be launched safely using a very unique sliding launcher. Recoveries at the inshore along the Tokachi coast can be done very quickly and smoothly. Unfortunately, flight opportunities are recently limited due to unfriendly weather condition. Unstable Jet stream also prevents us to have so-called `boomerang flight' to achieve long flight duration more than several hours. Six balloon-borne experiments were carried out in 2010 and 2011. Three of them were demonstrations of challenges of space engineering, two were in-situ atmospheric observation, and one was the technical flight of new high-resolution γ-ray telescope. In addition to these flights, we carried out two launches for next generation balloons: one for Tawara-shaped superpressure balloon and the other for ultra-thin high-altitude balloon. In this paper, recent activities of the Japanese scientific balloon program will be introduced. On-going development of the balloon system will also be presented.

  3. Development of a super-pressure balloon with a diamond-shaped net

    NASA Astrophysics Data System (ADS)

    Saito, Y.; Iijima, I.; Matsuzaka, Y.; Matsushima, K.; Tanaka, S.; Kajiwara, K.; Shimadu, S.

    2014-10-01

    The essential reason of the lobed-pumpkin shaped super-pressure balloon to withstand against the high pressure is that the local curvature of the balloon film is kept small. Recently, it has been found that the small local curvature can also be obtained if the balloon is covered by a diamond-shaped net with a vertically elongated shape. The development of the super-pressure balloon using this method was started from a 3-m balloon with a polyethylene film covered by a net using Kevlar ropes. The ground inflation test showed the expected high burst pressure. Then, a 6-m and a 12-m balloon using a polyethylene film and a net using the Vectran were developed and stable deployment was checked through the ground inflation tests. The flight test of a 3000 m3 balloon was performed in 2013 and shown to resist a pressure of at least 400 Pa. In the future, after testing a new design to relax a possible stress concentration around the polar area, test flights of scaled balloons will be performed gradually enlarging their size. The goal is to launch a 300,000 m3 super-pressure balloon.

  4. Fluoroscopically guided large balloon dilatation for treating congenital esophageal stenosis in children.

    PubMed

    Hu, Hong-Tao; Shin, Ji Hoon; Kim, Jin-Hyoung; Jang, Jong Keon; Park, Jung-Hoon; Kim, Tae-Hyung; Nam, Deok Ho; Song, Ho-Young

    2015-07-01

    We aimed to evaluate the safety and clinical effectiveness of fluoroscopically guided large balloon dilatation for treating congenital esophageal stenosis in children. Our study included seven children (mean age 4.0 years) who underwent a total of ten balloon dilatation sessions. The initial balloon diameters were 10-15 mm. The technical success, clinical success (improved food intake and reduced dysphagia within 1 month following the first balloon dilatation), dysphagia recurrence, and complications were retrospectively evaluated. Technical and clinical success rates were 100 %. During the mean 38-month follow-up period after the first balloon dilatation, 3 (43 %) patients underwent only one additional balloon dilatation 4-5 months after the first balloon dilatation for dysphagia recurrence. Two of them showed improvement without further recurrence, while the remaining one underwent partial esophagectomy. Well-contained transmural esophageal rupture (type 2) occurred in two (29 %, 2/7) patients and during two (20 %, 2/10) balloon dilatation sessions. All ruptures were successfully treated conservatively. Our study showed that fluoroscopically guided large balloon dilatation seems to be a simple and effective primary treatment technique for congenital esophageal stenosis in children. Esophageal ruptures were not uncommon although they were not fatal.

  5. Early usage of Bakri postpartum balloon in the management of postpartum hemorrhage: a large prospective, observational multicenter clinical study in South China.

    PubMed

    Wang, Dongyu; Xu, Shuqia; Qiu, Xiwen; Zhu, Caixia; Li, Zhuyu; Wang, Zilian; Hou, Hongying; Gao, Yu; Wang, Xiaoyi; He, Ping; Qin, Yiwei; Liu, Lihua

    2017-12-18

    To evaluate the success rate and protocol of the Bakri balloon for postpartum hemorrhage (PPH) in the course of a prospective observational multicenter cohort study in South China. At 20 hospitals in South China, women with postpartum bleeding who failed to respond to the first-line conservative management and received the Bakri balloon were recruited for the study. Maternal characteristics, PPH characteristics, PPH management and outcomes in regard to the Bakri balloon use were recorded. A total of 472 women had a Bakri balloon tamponade and 407 (86.23%) women were enrolled (67 after vaginal delivery and 340 either during or after cesarean delivery). The success rate of the Bakri balloon in this study was 91.65% (373/407 women). During vaginal deliveries, the group with a hemorrhage >2000 mL before balloon insertion had significantly more blood loss (551.67±635.17 mL vs. 242.06±313.69 mL, P=0.039) and lower maternal hemoglobin (73±21.77 g/L vs. 92.06±19.60 g/L, P=0.029) after using Bakri balloon than the group with a hemorrhage <1000 mL. Similar data were found during cesarean deliveries. The blood loss before and after balloon insertion were significantly higher in the Bakri balloon failure group (1700±1429.88 mL before and 1209.58±1139.72 mL after using the balloon) than those in the success group [918±493.92 mL before (P=0.002) and 266.57±361.60 mL after using the balloon (P=0.001)]. Rapid diagnosis or prognosis of PPH, in combination with early usage of the Bakri postpartum balloon is more effective for the management of PPH.

  6. Change in Imaging Findings on Angiography-Assisted CT During Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma

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

    Yoshimatsu, Rika; Yamagami, Takuji, E-mail: yamagami@kochi-u.ac.jp; Ishikawa, Masaki

    2016-06-15

    PurposeTo evaluate changes in imaging findings on CT during hepatic arteriography (CTHA) and CT during arterial portography (CTAP) by balloon occlusion of the treated artery and their relationship with iodized oil accumulation in the tumor during balloon-occluded transcatheter arterial chemoembolization (B-TACE).MethodsBoth B-TACE and angiography-assisted CT were performed for 27 hepatocellular carcinomas. Tumor enhancement on selective CTHA with/without balloon occlusion and iodized oil accumulation after B-TACE were evaluated. Tumorous portal perfusion defect size on CTAP was compared with/without balloon occlusion. Factors influencing discrepancies between selective CTHA with/without balloon occlusion and the degree of iodized oil accumulation were investigated.ResultsAmong 27 tumors, tumormore » enhancement on selective CTHA changed after balloon occlusion in 14 (decreased, 11; increased, 3). In 18 tumors, there was a discrepancy between tumor enhancement on selective CTHA with balloon occlusion and the degree of accumulated iodized oil, which was higher than the tumor enhancement grade in all 18. The tumorous portal perfusion defect on CTAP significantly decreased after balloon occlusion in 18 of 20 tumors (mean decrease from 21.9 to 19.1 mm in diameter; p = 0.0001). No significant factors influenced discrepancies between selective CTHA with/without balloon occlusion. Central area tumor location, poor tumor enhancement on selective CTHA with balloon occlusion, and no decrease in the tumorous portal perfusion defect area on CTAP after balloon occlusion significantly influenced poor iodized oil accumulation in the tumor.ConclusionsTumor enhancement on selective CTHA frequently changed after balloon occlusion, which did not correspond to accumulated iodized oil in most cases.« less

  7. Testing of the Anorectal and Pelvic Floor Area

    MedlinePlus

    ... minutes and is well tolerated by most people. Balloon capacity and compliance A balloon capacity and compliance ... while measurements of volume and pressure are recorded. Balloon evacuation study A balloon evacuation study tests pelvic ...

  8. On the response of superpressure balloons to displacements from equilibrium density level

    NASA Technical Reports Server (NTRS)

    Levanon, N.; Kushnir, Y.

    1976-01-01

    The response of a superpressure balloon to an initial displacement from its constant-density floating level is examined. An approximate solution is obtained to the governing vertical equation of motion for constant-density superpressure balloons. This solution is used to filter out neutrally buoyant oscillations in balloon records despite the nonlinear behavior of the balloon. The graph depicting the pressure data after deconvolution between the raw pressure data and the normalized balloon wavelet shows clearly the strong filtering-out of the neutral buoyancy oscillations.

  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. A buoyant tornado-probe concept incorporating an inverted lifting device. [and balloon combination

    NASA Technical Reports Server (NTRS)

    Grant, F. C.

    1973-01-01

    Addition of an inverted lifting device to a simple balloon probe is shown to make possible low-altitude entry to tornado cores with easier launch conditions than for the simple balloon probe. Balloon-lifter combinations are particularly suitable for penetration of tornadoes with average to strong circulation, but tornadoes of less than average circulation which are inaccessible to simple balloon probes become accessible. The increased launch radius which is needed for access to tornadoes over a wide range of circulation results in entry times of about 3 minutes. For a simple balloon probe the uninflated balloon must be first dropped on, or near, the track of the tornado from a safe distance. The increase in typical launch radius from about 0.75 kilometer to slightly over 1.0 kilometer with a balloon-lifter combination suggests that a direct air launch may be feasible.

  11. Measurement of polar stratospheric NO2 from the 23rd and 24th Japanese Antarctic Research Expedition (JARE) balloon experiments

    NASA Technical Reports Server (NTRS)

    Shibasaki, K.; Iwagami, N.; Ogawa, T.

    1985-01-01

    As a part of the Japanese activities of MAP in the Antarctica, balloon-borne measurements of the stratospheric NO2 profile were planned and carried out by the JARE 23rd and 24th wintering parties. Few results have been reported so far as the stratospheric NO2 profile at high latitude. There were no reported balloon measurements carried out in the Southern Hemisphere. Profiles are presented for the first balloon-borne measurement of the stratospheric NO2 in the Antarctica. Three balloons named JA21, JA25 and JA26 were launched from Syowa Station (69 deg S, 35.6 deg E) using 5000 cu. cm plastic balloons. JA21 balloon was launched on November 24, 1982, and JA25 and JA26 balloons on November 12 and 20, 1983, respectively.

  12. European Venus Explorer: An in-situ mission to Venus using a balloon platform

    NASA Astrophysics Data System (ADS)

    Chassefière, E.; Korablev, O.; Imamura, T.; Baines, K. H.; Wilson, C. F.; Titov, D. V.; Aplin, K. L.; Balint, T.; Blamont, J. E.; Cochrane, C. G.; Ferencz, Cs.; Ferri, F.; Gerasimov, M.; Leitner, J. J.; Lopez-Moreno, J.; Marty, B.; Martynov, M.; Pogrebenko, S. V.; Rodin, A.; Whiteway, J. A.; Zasova, L. V.; the EVE Team

    2009-07-01

    Planetary balloons have a long history already. A small super-pressure balloon was flown in the atmosphere of Venus in the eighties by the Russian-French VEGA mission. For this mission, CNES developed and fully tested a 9 m diameter super-pressure balloon, but finally replaced it by a smaller one due to mass constraints (when it was decided to send Vega to Halley's Comet). Furthermore, several kinds of balloons have been proposed for planetary exploration [Blamont, J., in: Maran, S.P. (Ed.), The Astronomy and Astrophysics Encyclopedia. Cambridge University Press, p. 494, 1991]. A Mars balloon has been studied for the Mars-94 Russian-French mission, which was finally cancelled. Mars and Venus balloons have also been studied and ground tested at JPL, and a low atmosphere Venus balloon is presently under development at JAXA (the Japanese Space Agency). Balloons have been identified as a key element in an ongoing Flagship class mission study at NASA, with an assumed launch date between 2020 and 2025. Recently, it was proposed by a group of scientists, under European leadership, to use a balloon to characterize - by in-situ measurements - the evolution, composition and dynamics of the Venus atmosphere. This balloon is part of a mission called EVE (European Venus Explorer), which has been proposed in response to the ESA AO for the first slice of the Cosmic Vision program by a wide international consortium including Europe, Russia, Japan and USA. The EVE architecture consists of one balloon platform floating at an altitude of 50-60 km, one short lived probe provided by Russia, and an orbiter with a polar orbit to relay data from the balloon and probe, and to perform remote sensing science observations. The balloon type preferred for scientific goals is one, which would oscillate in altitude through the cloud deck. To achieve this flight profile, the balloon envelope would contain a phase change fluid. While this proposal was not selected for the first slice of Cosmic Vision missions, it was ranked first among the remaining concepts within the field of solar system science.

  13. Endovascular balloon-assisted embolization of intracranial and cervical arteriovenous malformations using dual-lumen coaxial balloon microcatheters and Onyx: initial experience.

    PubMed

    Jagadeesan, Bharathi D; Grigoryan, Mikayel; Hassan, Ameer E; Grande, Andrew W; Tummala, Ramachandra P

    2013-12-01

    Ethylene vinyl alcohol copolymer (Onyx) is widely used for the embolization of arteriovenous malformations (AVMs) of the brain, head, and neck. Balloon-assisted Onyx embolization may provide additional unique advantages in the treatment of AVMs in comparison with traditional catheter-based techniques. To report our initial experience in performing balloon-assisted AVM embolization for brain and neck AVMs with the use of the new Scepter-C and Scepter-XC coaxial dual-lumen balloon microcatheters. Balloon-assisted transarterial embolization was performed in a series of 7 patients with AVMs (4 with brain AVMs, 1 with a dural arteriovenous fistula, and 2 with neck AVMs) by using Onyx delivered through the lumen of Scepter-C or Scepter XC coaxial balloon microcatheters. Following the initial balloon-catheter navigation into a feeding artery and the subsequent inflation of the balloon, the embolization was performed by using Onyx 18, Onyx 34, or both. A total of 12 embolization sessions were performed via 17 arterial feeders in these 7 patients. In 1 patient, there was an arterial perforation from the inflation of the balloon; in all others, the embolization goals were successfully achieved with no adverse events. The balloon microcatheters showed excellent navigability, and there were no problems with retrieval or with the repeated inflation and deflation of the balloons. A proximal Onyx plug, which is crucial in many AVM embolizations, was not necessary with this technique. Additionally, fluoroscopy and procedural times seemed lower with this technique compared with conventional embolization methods.

  14. Effect of intra-aortic balloon pump on coronary blood flow during different balloon cycles support: A computer study.

    PubMed

    Aye, Thin Pa Pa; Htet, Zwe Lin; Singhavilai, Thamvarit; Naiyanetr, Phornphop

    2015-01-01

    Intra-aortic balloon pump (IABP) has been used in clinical treatment as a mechanical circulatory support device for patients with heart failure. A computer model is used to study the effect on coronary blood flow (CBF) with different balloon cycles under both normal and pathological conditions. The model of cardiovascular and IABP is developed by using MATLAB SIMULINK. The effect on coronary blood flow has been studied under both normal and pathological conditions using different balloon cycles (balloon off; 1:4; 1:2; 1:1). A pathological heart is implemented by reducing the left ventricular contractility. The result of this study shows that the rate of balloon cycles is related to the level of coronary blood flow.

  15. Thermal performance modeling of NASA s scientific balloons

    NASA Astrophysics Data System (ADS)

    Franco, H.; Cathey, H.

    The flight performance of a scientific balloon is highly dependant on the interaction between the balloon and its environment. The balloon is a thermal vehicle. Modeling a scientific balloon's thermal performance has proven to be a difficult analytical task. Most previous thermal models have attempted these analyses by using either a bulk thermal model approach, or by simplified representations of the balloon. These approaches to date have provided reasonable, but not very accurate results. Improvements have been made in recent years using thermal analysis tools developed for the thermal modeling of spacecraft and other sophisticated heat transfer problems. These tools, which now allow for accurate modeling of highly transmissive materials, have been applied to the thermal analysis of NASA's scientific balloons. A research effort has been started that utilizes the "Thermal Desktop" addition to AUTO CAD. This paper will discuss the development of thermal models for both conventional and Ultra Long Duration super-pressure balloons. This research effort has focused on incremental analysis stages of development to assess the accuracy of the tool and the required model resolution to produce usable data. The first stage balloon thermal analyses started with simple spherical balloon models with a limited number of nodes, and expanded the number of nodes to determine required model resolution. These models were then modified to include additional details such as load tapes. The second stage analyses looked at natural shaped Zero Pressure balloons. Load tapes were then added to these shapes, again with the goal of determining the required modeling accuracy by varying the number of gores. The third stage, following the same steps as the Zero Pressure balloon efforts, was directed at modeling super-pressure pumpkin shaped balloons. The results were then used to develop analysis guidelines and an approach for modeling balloons for both simple first order estimates and detailed full models. The development of the radiative environment and program input files, the development of the modeling techniques for balloons, and the development of appropriate data output handling techniques for both the raw data and data plots will be discussed. A general guideline to match predicted balloon performance with known flight data will also be presented. One long-term goal of this effort is to develop simplified approaches and techniques to include results in performance codes being developed.

  16. Solar energy collector including a weightless balloon with sun tracking means

    DOEpatents

    Hall, Frederick F.

    1978-01-01

    A solar energy collector having a weightless balloon, the balloon including a transparent polyvinylfluoride hemisphere reinforced with a mesh of ropes secured to its outside surface, and a laminated reflector hemisphere, the inner layer being clear and aluminized on its outside surface and the outer layer being opaque, the balloon being inflated with lighter-than-air gas. A heat collection probe extends into the balloon along the focus of reflection of the reflective hemisphere for conducting coolant into and out of the balloon. The probe is mounted on apparatus for keeping the probe aligned with the sun's path, the apparatus being founded in the earth for withstanding wind pressure on the balloon. The balloon is lashed to the probe by ropes adhered to the outer surface of the balloon for withstanding wind pressures of 100 miles per hour. Preferably, the coolant is liquid sodium-potassium eutectic alloy which will not normally freeze at night in the temperate zones, and when heated to 4,000.degree. R exerts a pressure of only a few atmospheres.

  17. 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)

  18. 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.

  19. Are drug-coated balloons cost effective for femoropopliteal occlusive disease? A comparison of bare metal stents and uncoated balloons.

    PubMed

    Poder, Thomas G; Fisette, Jean-François

    2016-07-01

    To perform a cost-effectiveness analysis to help hospital decision-makers with regard to the use of drug-coated balloons compared with bare metal stents and uncoated balloons for femoropopliteal occlusive disease. Clinical outcomes were extracted from the results of meta-analyses already published, and cost units are those used in the Quebec healthcare network. The literature review was limited to the last four years to obtain the most recent data. The cost-effectiveness analysis was based on a 2-year perspective, and risk factors of reintervention were considered. The cost-effectiveness analysis indicated that drug-coated balloons were generally more efficient than bare metal stents, particularly for patients with higher risk of reintervention (up to CAD$1686 per patient TASC II C or D). Compared with uncoated balloons, results indicated that drug-coated balloons were more efficient if the reintervention rate associated with uncoated balloons is very high and for patients with higher risk of reintervention (up to CAD$3301 per patient). The higher a patient's risk of reintervention, the higher the savings associated with the use of a drug-coated balloon will be. For patients at lower risk, the uncoated balloon strategy is still recommended as a first choice for endovascular intervention.

  20. Hot-air balloon tours: crash epidemiology in the United States, 2000-2011.

    PubMed

    Ballard, Sarah-Blythe; Beaty, Leland P; Baker, Susan P

    2013-11-01

    Hot-air balloon tours are FAR Part 91-governed balloon rides conducted for compensation or hire. Part 91, General Aviation, in general involves the least strict federal regulations and accounts for the majority of aviation crashes and fatalities. National Transportation Safety Board reports of hot-air balloon tour crashes in the United States from 2000 through 2011 were read and analyzed. During the 12-yr period, 78 hot-air balloon tours crashed, involving 518 occupants. There were 91 serious injuries and 5 fatalities; 83% of crashes resulted in one or more serious or fatal outcomes. Of the serious injuries characterized, 56% were lower extremity fractures. Most crashes (81%) occurred during landing; 65% involved hard landings. Fixed object collisions contributed to 50% of serious injuries and all 5 fatalities. During landing sequences, gondola dragging, tipping, bouncing, and occupant ejection were associated with poor outcomes. Of the crashes resulting in serious or fatal outcomes, 20% of balloons were significantly damaged or destroyed. The incidence of morbidity and mortality is high among hot-air balloon tour crashes, and the proportion of balloon crashes attributed to paid rides appears to have increased over time. In addition to examining the role of restraint systems, personal protective equipment, and power line emergency procedures in ballooning, injury prevention efforts should target factors such hard landings, object strikes, gondola instability, and occupant ejections, which are associated with balloon injuries and deaths. Crash outcomes may also improve with vehicle engineering that enables balloons themselves to absorb impact forces.

  1. Coronary artery stent (image)

    MedlinePlus

    ... with a balloon catheter and expands when the balloon is inflated. The stent is then left there to help keep the artery open. ... with a balloon catheter and expands when the balloon is inflated. The stent is then left there to help keep the artery open.

  2. Fasting and meal-induced CCK and PP secretion following intragastric balloon treatment for obesity.

    PubMed

    Mathus-Vliegen, Elisabeth M H; de Groot, Gerrit H

    2013-05-01

    Satiety is centrally and peripherally mediated by gastrointestinal peptides and the vagal nerve. We aimed to investigate whether intragastric balloon treatment affects satiety through effects on fasting and meal-stimulated cholecystokinin (CCK) and pancreatic polypeptide (PP) secretion. Patients referred for obesity treatment were randomised to 13 weeks of sham treatment followed by 13 weeks of balloon treatment (group 1; sham/balloon) or to twice a 13-week period of balloon treatment (group 2; balloon/balloon). Blood samples were taken for fasting and meal-stimulated CCK and PP levels at the start (T0) and after 13 (T1) and 26 (T2) weeks. Patients filled out visual analogue scales (VAS) to assess satiety. Forty-two patients (35 females, body weight 125.1 kg, BMI 43.3 kg/m(2)) participated. In group 1, basal CCK levels decreased but meal-stimulated response remained unchanged after 13 weeks of sham treatment. In group 2, basal and meal-stimulated CCK levels decreased after 13 weeks of balloon treatment. At the end of the second 13-week period, when group 1 had their first balloon treatment, they duplicated the initial 13-week results of group 2, whereas group 2 continued their balloon treatment and reduced meal-stimulated CCK release. Both groups showed reduced meal-stimulated PP secretions at T1 and T2 compared to T0. Changes in diet composition and VAS scores were similar. Improvements in glucose homeostasis partly explained the PP results. The reduced CCK and PP secretion after balloon positioning was unexpected and may reflect delayed gastric emptying induced by the balloon. Improved glucose metabolism partly explained the reduced PP secretion. Satiety and weight loss were not adversely influenced by these hormonal changes.

  3. Endourological treatment of nonmalignant upper urinary tract complications after urinary diversion.

    PubMed

    El-Nahas, Ahmed R; Shokeir, Ahmed A

    2010-12-01

    Endourological modalities are considered the first line of treatment for benign ureterointestinal anastomotic strictures except in long strictures, completely obliterated lumen, prior radiation, and poor renal function. Endoureterotomy provided better success than balloon dilatation. In poor-operative risk patients, metal or double-J stents are viable options. Endourological treatments of upper tract stones after diversion are indicated for stones not suitable for shock wave lithotripsy (SWL) or to salvage SWL failure. Percutaneous nephrolithotomy was preferred for large or complex renal stones, whereas ureteroscopy was used for smaller stones. The evaluation of stone-free status and regular follow-up are mandatory because of the high recurrence rate. Copyright © 2010 Elsevier Inc. All rights reserved.

  4. Intra-aortic balloon shape change: effects on volume displacement during inflation and deflation.

    PubMed

    Khir, Ashraf William; Bruti, Gianpaolo

    2013-07-01

    It has been observed that operating the intra-aortic balloon at an angle to the horizontal resulted in a reduction of the volume displaced toward the coronary arteries and compromised afterload reduction. Therefore, the aim of this work is to examine whether changing the current balloon shape, which has not been altered for 40 years, could compensate for the negative hemodynamic effects due to angulation. We tested two tapered balloons, increasing diameter (TID) and decreasing diameter (TDD), and compared the results with those obtained from a standard cylindrical balloon. The balloons were tested in vitro at 60 beats/min and a static pressure of 90 mm Hg. The balloons were operated at four angles (0°, 20°, 30°, 45°), and the pressure at three locations along the balloon (base, middle, and tip) was also measured. Flow rate upstream of the tip of the balloon was also measured to indicate the flow displaced toward the coronary circulation. The relative volume displaced toward (VUTVi) and suctioned away from (VUTVd) the simulated ascending aorta, during inflation and deflation, respectively, is reduced when a standard cylindrical balloon is operated at an angle to the horizontal. The TDD provided the greatest VUTVi and also produced the largest pulse pressure during deflation. Although the TID provided less VUTVi and VUTVd at smaller angles, it was not markedly affected by the change of angle. According to these results, different balloon shapes analyzed, with comparable volume to that of a cylindrical balloon, produced greater inflation and deflation benefits, at the horizontal and at a range of angles to the horizontal. Further investigations are required to optimize the shape of the tapered balloons to fit into the available physiological space. © 2013 Wiley Periodicals, Inc. and International Center for Artificial Organs and Transplantation.

  5. Optimizing logistics for balloon-occluded retrograde transvenous obliteration (BRTO) of gastric varices by doing away with the indwelling balloon: concept and techniques.

    PubMed

    Saad, Wael E; Nicholson, David B

    2013-06-01

    Since the conception of balloon-occluded retrograde transvenous obliteration (BRTO) of gastric varices 25 years ago, the placement of an indwelling balloon for hours has been central to the BRTO procedure. Numerous variables and variations of the BRTO procedure have been described, including methods to reduce sclerosant, combining percutaneous transhepatic obliteration, varying sclerosant, and using multiple sclerosants within the same procedure. However, the consistent feature of BRTO has always remained the indwelling balloon. Placing an indwelling balloon over hours for the BRTO procedure is a logistical burden that taxes the interventional radiology team and hospital resources. Substituting the balloon with hardware (coils or Amplatzer vascular plugs [AVPs] or both) is technically feasible and its risks most likely correlate with gastrorenal shunt (GRS) size. The current authors use packed 0.018- or 0.035-in coils or both for small gastric variceal systems (GRS size A and B) and AVPs for GRS sizes up to size E (from size A-E). The current authors recommend an indwelling balloon (no hardware substitute) for very large gastric variceal system (GRS size F). Substituting the indwelling balloon for hardware in size F and potentially size E GRS can also be risky. The current article describes the techniques of placing up to 16-mm AVPs through balloon occlusion guide catheters and then deflating the balloon once it has been substituted with the AVPs. In addition, 22-mm AVPs can be placed through sheaths once the balloon occlusion catheters are removed to further augment the 16-mm Amplatzer occlusion. To date, there are no studies describing, let alone evaluating, the clinical feasibility of performing BRTO without indwelling balloons. The described techniques have been successfully performed by the current authors. However, the long-term safety and effectiveness of these techniques is yet to be determined. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. The effect of transient balloon occlusion of the mitral valve on left atrial appendage blood flow velocity and spontaneous echo contrast.

    PubMed

    Wang, J; Chung Ann Choo, D; Zhang, X; Yang, Q; Xian, T; Lu, D; Jiang, S

    2000-07-01

    Spontaneous echo contrast (SEC) is a phenomenon that is commonly seen in areas of blood stasis. It is a slowly moving, cloud-like swirling pattern of "smoke" or increased echogenicity recorded on echocardiography. SEC is commonly seen in the left atrium of patients with mitral stenosis or atrial fibrillation. The presence of SEC has been shown to be a marker of increased thromboembolic risk. By using transesophageal echocardiography during percutaneous balloon mitral valvotomy (PBMV), the study investigated the relationship between SEC and varying left atrial appendage (LAA) blood flow velocity in the human heart. Thirty-five patients with rheumatic mitral stenosis underwent percutaneous balloon mitral valvotomy with intraoperative transesophageal echocardiography monitoring. We alternatively measured LAA velocities and observed the left atrium for various grades of SEC (0 = none to 4 = severe) before and after each balloon inflation. Left atrial appendage maximal ejection velocity was reduced from 35 +/- 14 to 6 +/- 2 mm/s at peak balloon inflation and increased to 40 +/- 16 mm/s after balloon deflation. In comparison with the values before balloon inflation and after balloon deflation, LAA velocities were significantly lower (p < 0.001). New or increased SEC grade was observed during 54 of 61 (88%) inflations and unchanged in 7 (12%) inflations at peak balloon inflation. Spontaneous echo contrast became lower in grade after 55 balloon deflations (90%), completely disappeared after 18 deflations (30%), and remained unchanged after 6 deflations (10%). The mean time to achieve maximal SEC grade (2.5 +/- 1.2 s) coincided with the mean time to trough LAA velocities (2.3 +/- 1.1 s) after balloon inflation. Upon deflation, the mean time to lowest SEC grade (2.9 +/- 1.8 s) coincided with mean time to achieve maximal LAA velocities (2.7 +/- 1.6 s). During balloon inflation, the severity of SEC was enhanced with corresponding reduction in LAA flow velocity. Upon balloon deflation, SEC lightens or disappears with increase in LAA flow velocity.

  7. Predictable pollution: an assessment of weather balloons and associated impacts on the marine environment--an example for the Great Barrier Reef, Australia.

    PubMed

    O'Shea, Owen R; Hamann, Mark; Smith, Walter; Taylor, Heidi

    2014-02-15

    Efforts to curb pollution in the marine environment are covered by national and international legislation, yet weather balloons are released into the environment with no salvage agenda. Here, we assess impacts associated with weather balloons in the Great Barrier Reef World Heritage Area (GBRWHA). We use modeling to assess the probability of ocean endpoints for released weather balloons and predict pathways post-release. In addition, we use 21 months of data from beach cleanup events to validate our results and assess the abundance and frequency of weather balloon fragments in the GBRWHA. We found between 65% and 70% of balloons land in the ocean and ocean currents largely determine final endpoints. Beach cleanup data revealed 2460 weather balloon fragments were recovered from 24 sites within the GBRWHA. This is the first attempt to quantify this problem and these data will add support to a much-needed mitigation strategy for weather balloon waste. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Malignant Esophagogastric Junction Obstruction: Efficacy of Balloon Dilation Combined with Chemotherapy and/or Radiation Therapy

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

    Ko, Gi-Young; Song, Ho-Young, E-mail: hysong@amc.seoul.kr; Hong, Heuk-Jin

    2003-04-15

    Purpose: To assess the efficacy of balloon dilation combined with chemotherapy and/or radiation therapy for palliation of dysphagia due to malignant esophagogastric junction strictures. Methods: Fluoroscopically guided balloon dilation was attempted in 20 patients. The causes of strictures were gastric adenocarcinoma (n = 10) and esophageal squamous cell carcinoma (n = 10). Scheduled chemotherapy and/or radiation therapy followed balloon dilation in all patients. Results: There were no technical failures or major complications. After balloon dilation, 15 (75%) patients showed improvement of dysphagia. No patient complained of reflux esophagitis during the follow-up period. Among the 15 patients, seven needed no furthermore » treatment for palliation of dysphagia until their deaths. The remaining eight patients underwent repeat balloon dilation(n = 4) or stent placement (n = 4)3-43 weeks (mean 15 weeks) after the initial balloon dilation because of recurrent dysphagia. Conclusion: Balloon dilation combined with chemotherapy and/or radiation therapy seems to be an easy and reasonably effective palliative treatment for malignant esophagogastric strictures.« less

  9. Incremental balloon deflation following complete resuscitative endovascular balloon occlusion of the aorta results in steep inflection of flow and rapid reperfusion in a large animal model of hemorrhagic shock.

    PubMed

    Davidson, Anders J; Russo, Rachel M; Ferencz, Sarah-Ashley E; Cannon, Jeremy W; Rasmussen, Todd E; Neff, Lucas P; Johnson, M Austin; Williams, Timothy K

    2017-07-01

    To avoid potential cardiovascular collapse after resuscitative endovascular balloon occlusion of the aorta (REBOA), current guidelines recommend methodically deflating the balloon for 5 minutes to gradually reperfuse distal tissue beds. However, anecdotal evidence suggests that this approach may still result in unpredictable aortic flow rates and hemodynamic instability. We sought to characterize aortic flow dynamics following REBOA as the balloon is deflated in accordance with current practice guidelines. Eight Yorkshire-cross swine were splenectomized, instrumented, and subjected to rapid 25% total blood volume hemorrhage. After 30 minutes of shock, animals received 60 minutes of Zone 1 REBOA with a low-profile REBOA catheter. During subsequent resuscitation with shed blood, the aortic occlusion balloon was gradually deflated in stepwise fashion at the rate of 0.5 mL every 30 seconds until completely deflated. Aortic flow rate and proximal mean arterial pressure (MAP) were measured continuously over the period of balloon deflation. Graded balloon deflation resulted in variable initial return of aortic flow (median, 78 seconds; interquartile range [IQR], 68-105 seconds). A rapid increase in aortic flow during a single-balloon deflation step was observed in all animals (median, 819 mL/min; IQR, 664-1241 mL/min) and corresponded with an immediate decrease in proximal MAP (median, 30 mm Hg; IQR, 14.5-37 mm Hg). Total balloon volume and time to return of flow demonstrated no correlation (r = 0.016). This study is the first to characterize aortic flow during balloon deflation following REBOA. A steep inflection point occurs during balloon deflation that results in an abrupt increase in aortic flow and a concomitant decrease in MAP. Furthermore, the onset of distal aortic flow was inconsistent across study animals and did not correlate with initial balloon volume or relative deflation volume. Future studies to define the factors that affect aortic flow during balloon deflation are needed to facilitate controlled reperfusion following REBOA.

  10. Mobile, high-wind, balloon-launching apparatus

    NASA Technical Reports Server (NTRS)

    Rust, W. David; Marshall, Thomas C.

    1989-01-01

    In order to place instruments for measuring meteorological and electrical parameters into thunderstorms, an inexpensive apparatus has been developed which makes it possible to inflate, transport, and launch balloons in high winds. The launching apparatus is a cylinder of bubble plastic that is made by joining the sides of the cylinder together with a velcro rip strip. A balloon is launched by pulling the rip strip rapidly. This allows the balloon to pop upward into the ambient low-level wind and carry its instrumentation aloft. Different-sized launch tubes are constructed to accommodate particular sizes of balloons. Balloons have been launched in winds of about 20 m/s.

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

    Lee, Woong Hee; Kim, Jin Hyoung, E-mail: m1fenew@daum.net; Park, Jung-Hun

    Purpose: Little was known about the safety and long-term efficacy of fluoroscopically guided balloon dilation for postintubation tracheal stenosis. The purpose of this study was to evaluate the safety and long-term efficacy of fluoroscopically guided balloon dilation in patients with postintubation tracheal stenosis. Methods: From February 2000 to November 2010, 14 patients underwent fluoroscopically guided balloon dilation for postintubation tracheal stenosis. Technical success, clinical success, and complications were evaluated. Patients were followed up for recurrent symptoms. Results: In all patients, fluoroscopically guided balloon dilation was technically and clinically successful with no major complications. Following the initial procedure, six patients (43more » %) remained asymptomatic during a follow-up period. Obstructive symptoms recurred in eight patients (57 %) within 6 months (mean, 1.7 months), who were treated with repeat balloon dilation (n = 4) and other therapies. Of the four patients who underwent repeat balloon dilation, three became asymptomatic. One patient became asymptomatic after a third balloon dilation. On long-term (mean, 74 months) follow-up, 71 % of patients experienced relief of symptoms following fluoroscopically guided balloon dilation. Conclusions: Fluoroscopically guided balloon dilation may be safe, is easy to perform, and resulted in effective treatment in patients with postintubation tracheal stenosis.« less

  12. Technologies developed by CNES balloon team

    NASA Astrophysics Data System (ADS)

    Sosa-Sesma, Sergio; Charbonnier, Jean-Marc; Deramecourt, Arnaud

    CNES balloon team develops and operates all the components of this kind of vehicle: it means envelope and gondola. This abstract will point out only developments done for envelope. Nowadays CNES offers to scientists four types of envelops that cover a large range of mission demands. These envelops are: 1. Zero pressure balloons: Size going from 3,000m3 to 600,000m3, this kind of envelop is ideal for short duration flights (a few hours) but if we use an intelligent management of ballast consumption and if we chose the best launch site, it is possible to perform medium duration flights (10/20 days depending on the ballast on board). Flight train mass starts at 50kg for small balloons and reach 1000kg for larger ones. Zero pressure balloons are inflated with helium gas. 2. Super pressure balloons: Diameter going from 2.5m to 12m, this kind of envelop is ideal for long duration flights (1 to 6 months). Flight train is inside the envelop for small balloons, it means 2.5 diameter meters which is usually called BPCL (Super pressure balloon for Earth boundary layer) and it is about 3kg of mass. Larger ones could lift external flight trains about 50kg of mass. Super pressure balloons are inflated with helium gas. 3. MIR balloons: Size going from 36,000m3 to 46,000m3. Ceiling is reach with helium gas but after three days helium is no longer present inside and lift force is produced by difference of temperature between air inside and air of atmosphere. Flight trains must not be over 50kg. 4. Aero Clipper balloons: A concept to correlate measurements done in oceans and in nearest layers of atmosphere simultaneously. Flight train is made by a "fish" that drags inside water and an atmospheric gondola few meters above "fish", both pushed by a balloon which profits of the wind force. Materials used for construction and assembling depend on balloon type; they are usually made of polyester or polyethylene. Thickness varies from 12 micrometers to 120 micrometers. Balloon assembling is made at ZODIAC site (near Toulouse) by Zodiac teams although all mechanical machines belong to CNES. These machines had been developed by CNES to cut, to weld and to thermo-joint the different parts of the balloon.

  13. 78 FR 9785 - Airworthiness Directives; Lindstrand Hot Air Balloons Ltd Appliances

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-12

    ... Airworthiness Directives; Lindstrand Hot Air Balloons Ltd Appliances AGENCY: Federal Aviation Administration... airworthiness directive (AD) for certain Lindstrand Hot Air Balloons Ltd female ACME threaded hose connectors...., Washington, DC 20590. For service information identified in this AD, contact Lindstrand Hot Air Balloons Ltd...

  14. 77 FR 64763 - Airworthiness Directives; Lindstrand Hot Air Balloons Ltd Appliances

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-23

    ... Airworthiness Directives; Lindstrand Hot Air Balloons Ltd Appliances AGENCY: Federal Aviation Administration... propose to adopt a new airworthiness directive (AD) for certain Lindstrand Hot Air Balloons Ltd female... identified in this proposed AD, contact Lindstrand Hot Air Balloons Ltd., Maesbury Road, Oswestry, Shropshire...

  15. 78 FR 18533 - Airworthiness Directives; Lindstrand Hot Air Balloons Ltd Appliances

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-27

    ... Airworthiness Directives; Lindstrand Hot Air Balloons Ltd Appliances AGENCY: Federal Aviation Administration... Hot Air Balloons Ltd female ACME threaded hose connectors, part numbers HS6139 and HS6144, installed... follows: * * * * * (c) Applicability This AD applies to Lindstrand Hot Air Balloons Ltd female ACME...

  16. False coronary dissection with the new Monorail angioplasty balloon catheter.

    PubMed

    Esplugas, E; Cequier, A R; Sabaté, X; Jara, F

    1990-01-01

    During percutaneous transluminal coronary angioplasty, the appearance of persistent staining in the vessel by contrast media suggests coronary dissection. We report seven patients in whom a false image of severe coronary dissection was observed during angioplasty performed with the new Monorail balloon catheter. This image emerges at the moment of balloon inflation, is distally located to the balloon, and disappears with balloon catheter deflation. No complications were associated with the appearance of this image.

  17. Status report on the activities of National Balloon Facility at Hyderabad

    NASA Astrophysics Data System (ADS)

    Shankarnarayan, Sreenivasan; S, Sreenivasan; Shankarnarayan, Sreenivasan; Manchanda, R. K.; Subba Rao Jonnalagadda, Venkata; Buduru, Suneelkumar

    National balloon facility at Hyderabad has been mandated to provide launch support for Indian and International scientific balloon experiments and also perform the necessary research and development in the design and fabrication of plastic balloons. In the last 4 years, since our last report, NBF has launched many successful balloon flights for the astronomy payloads and a large number of high altitude GPS Sonde flights at different places in the country. We have also continued our efforts on qualification of raw materials for zero-failure performance of our balloons and major focus on upgrading of various facilities and load-line instrumentation for launching from remote sites. We foresee a surge of balloon based experimental activity for in-situ measurements in atmospheric sciences and concept validation payloads for future space based instruments. A new centre for research in Environmental Sciences and Payload Engineering (ESPE) has also been set up at the National Balloon Facility campus to develop and conduct research in various aspects of Environmental sciences in collaboration with other groups, with a specific goal to identify, development of advanced technologies leading to an improved understanding of the earth system. The Payload Engineering facility is geared to the Design and Fabrication of Micro and Nano Satellites and will act as Inter -University Centre for payload fabrication. In this paper we present an overview of the present and planned activities in scientific ballooning at National Balloon Facility Hyderabad.

  18. Balloon-Inflated Catheters for Enteral Feeding: a Word of Caution.

    PubMed

    Dash, Nihar Ranjan; Singh, Anand Narayan; Kilambi, Ragini

    2018-02-01

    Catheters with inflatable balloons such as a Foley catheter may be used for feeding gastrostomy/jejunostomy. The incorrect or improper use of these catheters can have serious consequences. We report 13 cases of feeding jejunostomy with balloon-inflated catheter's malfunction, some referred to our centre and others operated here over a period of 8 years. The most dramatic consequence of such improper use led to rupture of the small intestine due to inadvertent over-inflation (over 100 ml) of the balloon of the catheter during a contrast study. The patient required a laparotomy with resection and anastomosis of the bowel. Three other patients had similar over-inflation of the balloon leading to severe pain and discomfort. In all three patients, timely deflation of the balloon was sufficient to relieve the symptoms. One patient had intussusception with the inflated balloon acting as a lead point. The patient underwent resection of the small bowel with end jejunostomy and distal mucous fistula. All other patients presented with abdominal pain and distension and intestinal obstruction and were managed non-operatively with deflation of balloon either by aspiration, cutting the balloon port or ultrasound-guided puncture of balloon. Healthcare personnel dealing with patients with indwelling catheters must be educated to suspect, detect and manage such problems. The best measure for such unusual complications of otherwise safe devices would be prevention by training and generation of awareness.

  19. Sizing of patent ductus arteriosus in adults for transcatheter closure using the balloon pull-through technique.

    PubMed

    Shafi, Nabil A; Singh, Gagan D; Smith, Thomas W; Rogers, Jason H

    2018-05-01

    To describe a novel balloon sizing technique used during adult transcatheter patent ductus arteriosus (PDA) closure. In addition, to determine the clinical and procedural outcomes in six patients who underwent PDA balloon sizing with subsequent deployment of a PDA occluder device. Transcatheter PDA closure in adults has excellent safety and procedural outcomes. However, PDA sizing in adults can be challenging due to variable defect size, high flow state, or anatomical complexity. We describe a series of six cases where the balloon- pull through technique was successfully performed for PDA sizing prior to transcatheter closure. Consecutive adult patients undergoing adult PDA closure at our institution were studied retrospectively. A partially inflated sizing balloon was pulled through the defect from the aorta into the pulmonary artery and the balloon waist diameter was measured. Procedural success and clinical outcomes were obtained. Six adult patients underwent successful balloon pull-through technique for PDA sizing during transcatheter PDA closure, since conventional angiography often gave suboptimal opacification of the defect. All PDAs were treated with closure devices based on balloon PDA sizing with complete closure and no complications. In three patients that underwent preprocedure computed tomography, the balloon size matched the CT derived measurements. The balloon pull-through technique for PDA sizing is a safe and accurate sizing modality in adults undergoing transcatheter PDA closure. © 2017 Wiley Periodicals, Inc.

  20. 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.

  1. [Imprints of coronary plaque particles in the PTCA balloon surface during the dilatation processing].

    PubMed

    Werner, D; Behrend, D; Schmitz, K P; Urbaszek, W

    1995-05-01

    Seventy-six PTCA-balloons after coronary angioplasty were studied for superficial changes using scanning electron microscopy (SEM) after fixing in glutardialdehyde. Coronary plaque particles were identified on the balloon surface in 52 cases (68%). Twelve new and unused balloons were subjected to the same chemical treatment and SEM showed no imprints. The average length of the longest imprinted plaques was 128 +/- 201 microns and the average number of plaque particles per balloon was 4.9 +/- 2.7. The maximal dilatation pressure and the number of dilatations showed no influence on the impregnation of plaque particles. However, longer plaque imprints tended to occur under low dilatation pressure. Imprints of plaque particles were significantly higher in patients with low cholesterol (p = 0.0001) and low triglycerides (p = 0.0016). No correlation was seen between imprint length and lipid levels. Similarly, the different balloon materials (polyethylene, polyolefincopolymer) showed no significant differences with regard to plaque occurrence. The PTCA-balloons, plaque particles and six coronary plaques obtained after endatherectomy were subjected to energy dispersive x-ray analysis (EDX) under SEM as EDX reveals qualitative and quantitative information about the structural elements. Highly significant differences in calcium, sodium, phosphorus and silicon contents (p = 0.0000) between plaque particles and balloon surface were observed, owing to the absence of these in balloon material. Thus EDX offers additional advantages over SEM in that it clearly differentiates deformed balloon surface, plaque particle, and retained contrast medium. Plaque particles can be recovered from balloon surfaces after PTCA. Depending upon their size, they could lead to coronary spasm or microembolic phenomenon.

  2. Balloon augmented Onyx embolization utilizing a dual lumen balloon catheter: utility in the treatment of a variety of head and neck lesions.

    PubMed

    Spiotta, Alejandro M; Miranpuri, Amrendra S; Vargas, Jan; Magarick, Jordan; Turner, Raymond D; Turk, Aquilla S; Chaudry, M Imran

    2014-09-01

    Endovascular embolization for tumors and vascular malformations has emerged as an important preoperative adjunct prior to resection. We describe the advantages of utilizing a recently released dual lumen balloon catheter for ethylene vinyl alcohol copolymer, also known as Onyx (ev3, Irvine, California, USA), embolization for a variety of head and neck pathologies. A retrospective review of all cases utilizing the Scepter C balloon catheter (MicroVention Inc, Tustin, California, USA) for use in balloon augmented embolization was performed over a 4 month period from October 2012 to February 2013 at the Medical University of South Carolina, Charleston, South Carolina, USA. Charts and angiographic images were reviewed. Representative cases involving diverse pathologies are summarized and illustrate the observed advantages of balloon augmented Onyx embolization with a dual lumen balloon catheter. Balloon augmented Onyx embolization utilizing a novel dual lumen balloon catheter was employed to treat both ruptured and unruptured arteriovenous malformations, intracranial dural arteriovenous fistulae, intracranial neoplasms, carotid body tumors, a thyroid mass, and an extracranial arteriovenous fistula. The dual lumen balloon catheter has several advantages for use with Onyx embolization over older devices, including more efficient proximal plug formation and enhanced navigability for placement deep within the pedicles. The balloon augmented Onyx embolization technique represents a valuable tool to add to the armamentarium of the neurointerventionalist to address a variety of head and neck lesions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. New concepts for interplanetary balloons and blimps, particularly for Titan

    NASA Astrophysics Data System (ADS)

    Nott, J.

    This paper proposes novel approaches for balloons for planets Titan BALLUTE A balloon or blimp arriving at a planet or moon with an atmosphere might inflate falling under a parachute or after landing Neither is ideal In both cases the envelope must include qualities needed for inflation as well as those for flight A ballute BALLoon parachUTE could be used thus a ballute is like a hot air balloon with a large mouth Initially it fills by ram pressure descending through an atmosphere As proposed it would then be heated by solid propellant It would stop descending and float level with hot air lift It is now a perfect location for inflation without wind or movement through the atmosphere and away from the uncertainties of the surface A ballute could be used over several bodies in the solar system BALLOONS FOR LOW TEMPERATURES Flight in very low temperatures is also discussed Conditions are so different that it is useful to examine basic factors These apply for any planet with low temperature and weather calm enough for balloons or blimps First for terrestrial hot air balloons thermal radiation is usually the dominant way heat is lost But radiation rises with the 4th power of absolute temperature At Titan radiation will be one or two orders of magnitude smaller Also the dense atmosphere allows small balloons small temperature differences So convection is small It appears a hot air balloon can easily be heated by a radioactive source likely carried to make electricity Pinholes are not important in such a balloon

  4. Hot-Air Balloon Tours: Crash Epidemiology in the United States, 2000-2011

    PubMed Central

    Ballard, Sarah-Blythe; Beaty, Leland P.; Baker, Susan P.

    2016-01-01

    Introduction Hot-air balloon tours are FAR Part 91-governed balloon rides conducted for compensation or hire. Part 91, General Aviation, in general involves the least strict federal regulations and accounts for the majority of aviation crashes and fatalities. Methods National Transportation Safety Board reports of hot-air balloon tour crashes in the United States from 2000 through 2011 were read and analyzed. Results During the 12-yr period, 78 hot-air balloon tours crashed, involving 518 occupants. There were 91 serious injuries and 5 fatalities; 83% of crashes resulted in one or more serious or fatal outcomes. Of the serious injuries characterized, 56% were lower extremity fractures. Most crashes (81%) occurred during landing; 65% involved hard landings. Fixed object collisions contributed to 50% of serious injuries and all 5 fatalities. During landing sequences, gondola dragging, tipping, bouncing, and occupant ejection were associated with poor outcomes. Of the crashes resulting in serious or fatal outcomes, 20% of balloons were significantly damaged or destroyed. Discussion The incidence of morbidity and mortality is high among hot-air balloon tour crashes, and the proportion of balloon crashes attributed to paid rides appears to have increased over time. In addition to examining the role of restraint systems, personal protective equipment, and power line emergency procedures in ballooning, injury prevention efforts should target factors such hard landings, object strikes, gondola instability, and occupant ejections, which are associated with balloon injuries and deaths. Crash outcomes may also improve with vehicle engineering that enables balloons themselves to absorb impact forces. PMID:24279231

  5. Experimental characterization and numerical modelling of polymeric film damage, constituting the stratospheric super pressurized balloons

    NASA Astrophysics Data System (ADS)

    Chaabane, Makram; Chaabane, Makram; Dalverny, Olivier; Deramecourt, Arnaud; Mistou, Sébastien

    The super-pressure balloons developed by CNES are a great challenge in scientific ballooning. Whatever the balloon type considered (spherical, pumpkin...), it is necessary to have good knowledge of the mechanical behavior of the envelope regarding to the flight level and the lifespan of the balloon. It appears during the working stages of the super pressure balloons that these last can exploded prematurely in the course of the first hours of flight. For this reason CNES and LGP are carrying out research programs about experimentations and modelling in order to predict a good stability of the balloons flight and guarantee a life time in adequacy with the technical requirement. This study deals with multilayered polymeric film damage which induce balloons failure. These experimental and numerical study aims, are a better understanding and predicting of the damage mechanisms bringing the premature explosion of balloons. The following damages phenomena have different origins. The firsts are simple and triple wrinkles owed during the process and the stocking stages of the balloons. The second damage phenomenon is associated to the creep of the polymeric film during the flight of the balloon. The first experimental results we present in this paper, concern the mechanical characterization of three different damage phenomena. The severe damage induced by the wrinkles of the film involves a significant loss of mechanical properties. In a second part the theoretical study, concerns the choice and the development of a non linear viscoelastic coupled damage behavior model in a finite element code.

  6. Reduction of prostate intrafraction motion using gas-release rectal balloons

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

    Su Zhong; Zhao Tianyu; Li Zuofeng

    2012-10-15

    Purpose: To analyze prostate intrafraction motion using both non-gas-release (NGR) and gas-release (GR) rectal balloons and to evaluate the ability of GR rectal balloons to reduce prostate intrafraction motion. Methods: Twenty-nine patients with NGR rectal balloons and 29 patients with GR balloons were randomly selected from prostate patients treated with proton therapy at University of Florida Proton Therapy Institute (Jacksonville, FL). Their pretreatment and post-treatment orthogonal radiographs were analyzed, and both pretreatment setup residual error and intrafraction-motion data were obtained. Population histograms of intrafraction motion were plotted for both types of balloons. Population planning target-volume (PTV) margins were calculated withmore » the van Herk formula of 2.5{Sigma}+ 0.7{sigma} to account for setup residual errors and intrafraction motion errors. Results: Pretreatment and post-treatment radiographs indicated that the use of gas-release rectal balloons reduced prostate intrafraction motion along superior-inferior (SI) and anterior-posterior (AP) directions. Similar patient setup residual errors were exhibited for both types of balloons. Gas-release rectal balloons resulted in PTV margin reductions from 3.9 to 2.8 mm in the SI direction, 3.1 to 1.8 mm in the AP direction, and an increase from 1.9 to 2.1 mm in the left-right direction. Conclusions: Prostate intrafraction motion is an important uncertainty source in radiotherapy after image-guided patient setup with online corrections. Compared to non-gas-release rectal balloons, gas-release balloons can reduce prostate intrafraction motion in the SI and AP directions caused by gas buildup.« less

  7. Indwelling esophageal balloon catheter for benign esophageal stenosis in infants and children.

    PubMed

    van der Zee, David; Hulsker, Caroline

    2014-04-01

    Balloon dilatation of benign esophageal strictures is an established mode of therapy in adults and children. There remains a group of patients with refractory stenosis despite dilatation at regular intervals. An indwelling balloon catheter may offer an alternative. This is a retrospective study of 19 children who underwent esophagoscopy between 2004 and 2012 with placement of an indwelling balloon catheter for refractory esophageal stenosis. Total number of endoscopies, number of endoscopies with indwelling balloon catheter, as well as complications, reoperations, and mortality due to use of the balloon catheter were studied. Patient age ranged from 4 weeks to 15 years. The indwelling balloon catheter was used to treat refractory stenosis after corrective surgery of long gap esophageal atresia (n = 5), esophageal atresia with distal fistula (n = 2), refractory esophageal stenosis due to caustic esophageal burns (n = 7), reflux (n = 2), and stenosis of unknown cause (n = 3). With the indwelling balloon catheter in place, the mean number of endoscopies equalled four. Complications were restenosis after a symptom-free period for which a new indwelling balloon catheter was necessary (n = 3). Two others needed two to five additional dilations: balloon leakage requiring replacement (n = 7 in 5 patients), sputum retention (n = 1), and dislodgement (n = 5 in 4 patients). More importantly, there was no mortality or the need for any patient to undergo a surgical resection. The indwelling balloon catheter is safe to use and can be used by parents at home. More importantly it obviates the need for rethoracotomy/-scopy or esophageal replacement.

  8. Basic development of a small balloon-mounted telemetry and its operation system by university students

    NASA Astrophysics Data System (ADS)

    Yamamoto, Masa-yuki; Kakinami, Yoshihiro; Kono, Hiroki

    In Japan, the high altitude balloon for scientific observation has been continuously launched by JAXA. The balloon has a possibility to reach 50 km altitude without tight environmental condition for onboard equipments, operating with a cost lower than sounding rockets, however, development of the large-scale scientific observation balloons by university laboratories is still difficult. Being coupled with recent improvement of semiconductor sensors, laboratory-basis balloon experiments using small weather balloons has been becoming easily in these years. Owing to an advantage of wide land fields in continental regions, the launch of such small balloons has become to be carried out many times especially in continental countries (e.g. Near Space Ventures, Inc., 2013). Although the balloon is very small as its diameter of 6 feet, excluding its extra buoyancy and the weight of the balloon itself, it is expected that about 2 kg loading capacity is remained for payloads to send it up to about 35 km altitude. However, operation of such balloons in Japan is not in general because precise prediction of a landing area of the payload is difficult, thus high-risk situation for balloon releases is remained. In this study, we aim to achieve practical engineering experiments of weather balloons in Japan to be used for scientific observation within university laboratory level as an educational context. Here we report an approach of developing many devices for a small tethered balloon currently in progress. We evaluated an accuracy of altitude measurement by using a laboratory developed altitude data logger system that consists of a GPS-module and a barometric altimeter. Diameter of the balloon was about 1.4 m. Being fulfilled with about 1440 L helium, it produced buoyancy of about 15.7 N. Taking into account of total weight including the mooring equipments, available payload mass becomes to be about 1100 g. Applying an advantage of a 3D printer of FDM (Fused Deposition Modeling) method with a 3DCAD design software, we designed and manufactured a camera-platform type antenna rotator that automatically track the balloon direction based on the received GPS data as a balloon operation system on ground with automatic controlling software for the tracking system. In order to develop a future telemetry system onboard a small weather balloon, we have performed an onboard data logger system. In this presentation, system configuration of the automatic tracking system will be introduced more in detail. The telemetry system onboard the small balloon is currently under development. We have a plan to send the measured GPS coordinates, temperature, pressure, and humidity data detected by the onboard sensors to ground. A monitoring camera, a 3-axes accelerometer, geomagnetic azimuth measurement, and power monitoring were added to the developed data logger system. The acquired data will be stored in an SD card aboard as well as transmitted to the ground. Using a vacuum chamber with a pressure sensors and a constant-temperature reservoir in laboratory, environmental tests were operated. In this presentation, introducing the data obtained through the development of a prototype balloon system, our recent results and problems will be discussed.

  9. 14 CFR 61.115 - Balloon rating: Limitations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... takes a practical test in a balloon with an airborne heater: (1) The pilot certificate will contain a limitation restricting the exercise of the privileges of that certificate to a balloon with an airborne... removed when the person obtains the required aeronautical experience in a balloon with an airborne heater...

  10. 21 CFR 884.5050 - Metreurynter-balloon abortion system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Metreurynter-balloon abortion system. 884.5050... Devices § 884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to induce abortion. The device is inserted into the uterine cavity...

  11. 14 CFR 31.49 - Control systems.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    .... (c) Each balloon using a captive gas as the lifting means must have an automatic valve or appendix... STANDARDS: MANNED FREE BALLOONS Design Construction § 31.49 Control systems. (a) Each control must operate... minute when the balloon is at its maximum operating pressure. (d) Each hot air balloon must have a means...

  12. 14 CFR 31.49 - Control systems.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    .... (c) Each balloon using a captive gas as the lifting means must have an automatic valve or appendix... STANDARDS: MANNED FREE BALLOONS Design Construction § 31.49 Control systems. (a) Each control must operate... minute when the balloon is at its maximum operating pressure. (d) Each hot air balloon must have a means...

  13. 14 CFR 31.49 - Control systems.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    .... (c) Each balloon using a captive gas as the lifting means must have an automatic valve or appendix... STANDARDS: MANNED FREE BALLOONS Design Construction § 31.49 Control systems. (a) Each control must operate... minute when the balloon is at its maximum operating pressure. (d) Each hot air balloon must have a means...

  14. 14 CFR 31.49 - Control systems.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .... (c) Each balloon using a captive gas as the lifting means must have an automatic valve or appendix... STANDARDS: MANNED FREE BALLOONS Design Construction § 31.49 Control systems. (a) Each control must operate... minute when the balloon is at its maximum operating pressure. (d) Each hot air balloon must have a means...

  15. 78 FR 6838 - Certain Balloon Dissection Devices and Products Containing Same; Institution of Investigation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-865] Certain Balloon Dissection Devices... the United States after importation of certain dissection balloons and products containing the same by... importation of certain dissection balloons and products containing the same that infringe one or more of...

  16. 21 CFR 884.5050 - Metreurynter-balloon abortion system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Metreurynter-balloon abortion system. 884.5050... Devices § 884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to induce abortion. The device is inserted into the uterine cavity...

  17. 21 CFR 884.5050 - Metreurynter-balloon abortion system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Metreurynter-balloon abortion system. 884.5050... Devices § 884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to induce abortion. The device is inserted into the uterine cavity...

  18. 21 CFR 884.5050 - Metreurynter-balloon abortion system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Metreurynter-balloon abortion system. 884.5050... Devices § 884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to induce abortion. The device is inserted into the uterine cavity...

  19. 21 CFR 884.5050 - Metreurynter-balloon abortion system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Metreurynter-balloon abortion system. 884.5050... Devices § 884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to induce abortion. The device is inserted into the uterine cavity...

  20. 14 CFR 61.3 - Requirement for certificates, ratings, and authorizations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... with a glider category rating, a balloon class rating, or glider or balloon privileges; (ii) Is... than glider or balloon privileges and holds a U.S. driver's license; (iii) Is exercising the privileges... exercising the privileges of a sport pilot certificate with glider or balloon privileges; (v) Is exercising...

  1. 14 CFR 61.3 - Requirement for certificates, ratings, and authorizations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... with a glider category rating, a balloon class rating, or glider or balloon privileges; (ii) Is... than glider or balloon privileges and holds a U.S. driver's license; (iii) Is exercising the privileges... exercising the privileges of a sport pilot certificate with glider or balloon privileges; (v) Is exercising...

  2. 14 CFR 61.3 - Requirement for certificates, ratings, and authorizations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... with a glider category rating, a balloon class rating, or glider or balloon privileges; (ii) Is... than glider or balloon privileges and holds a U.S. driver's license; (iii) Is exercising the privileges... exercising the privileges of a sport pilot certificate with glider or balloon privileges; (v) Is exercising...

  3. Severe Sunburn After a Hot Air Balloon Ride: A Case Report and Literature Review.

    PubMed

    Ozturk, Sinan; Karagoz, Huseyin

    2015-01-01

    Hot air balloon tours are very popular among travelers worldwide. Preventable burn injuries associated with hot air balloon rides have been reported during crashes into power lines, in propane burner explosions, and following contact with the propane burner tanks. We present a case of severe repeated sunburn, which poses another risk of preventable injury during hot air balloon rides, and briefly discuss the injury epidemiology of hot air balloon rides. © 2015 International Society of Travel Medicine.

  4. Balloon concepts for scientific investigation of Mars and Jupiter

    NASA Technical Reports Server (NTRS)

    Ash, R. L.

    1979-01-01

    Opportunities for scientific investigation of the atmospheric planets using buoyant balloons have been explored. Mars and Jupiter were considered in this study because design requirements at those planets bracket nominally the requirements at Venus, and plans are already underway for a joint Russian-French balloon system at Venus. Viking data has provided quantitative information for definition of specific balloon systems at Mars. Free flying balloons appear capable of providing valuable scientific support for more sophisticated Martian surface probes, but tethered and powered aerostats are not attractive. The Jovian environment is so extreme, hot atmosphere balloons may be the only scientific platforms capable of extended operations there. However, the estimated system mass and thermal energy required are very large.

  5. Ozone profiles from tethered balloon measurements in an urban plume experiment

    NASA Technical Reports Server (NTRS)

    Youngbluth, O., Jr.; Storey, R. W.; Clendenin, C. G.; Jones, S.; Leighty, B.

    1981-01-01

    NASA Langley Research Center used two tethered balloon systems to measure ozone in the general area of Norfolk, Va. The large balloon system which has an altitude range of 1,500 meters was located at Wallops Island, Va., and the smaller balloon which has an altitude range of 900 meters was located at Chesapeake, Va. Each balloon system measured ozone, temperature, humidity, wind speed, and wind direction from ground to its maximum altitude. From these measurements and from the location of the balloon sites, areas of ozone generation and ozone transport may be inferred. The measurements which were taken during August 1979 are discussed as well as the measurement techniques.

  6. Low-Altitude Exploration of the Venus Atmosphere by Balloon

    NASA Technical Reports Server (NTRS)

    Landis, Geoffrey A.

    2010-01-01

    The planet Venus represents an exciting target for future exploration by spacecraft. One target of scientific interest is the lower atmosphere, which represents an environment of high temperature and moderate to high atmospheric pressure. This represents a considerable challenge to the technical art of ballooning, but one which may be amenable to solution. Several possible designs for low-altitude balloons are discussed. Conceptual design for three mission examples are analyzed: a conventional balloon operating below the cloud level at an altitude of 25 kilometers, a large rigid-envelope balloon operating near the surface at an altitude of 5 kilometers, and a small, technology demonstrator rigid-envelope balloon operating at 5 kilometers.

  7. [Pressure-volume recording of PTCA catheters with balloons of lower and higher compliance].

    PubMed

    Werner, C; Bloss, P; Kiessling, D; Patzschke, H; Unverdorben, M; Vallbracht, C

    1999-11-01

    In this report, the results of complementary studies of pressure-volume (p-V) measurements on balloon catheters with balloons of low (LC) and high compliance (HC) used for percutaneous transluminal coronary angioplasty are discussed. The measurements were performed with balloons unconfined in air (free dilatation) and also confined in different shells. In the case of rigid shells, a surprisingly high self-expansion of the catheters was found. Although this self-expansion does not contribute to the radial dilatation, it cannot be neglected, but must be taken into account when the success of balloon dilatation is determined on the basis of measured p-V curves. The investigations performed using wrapped shells clearly show the different dilatation properties of LC and HC balloons. The results provide important information on the feasibility of controlled balloon dilatation on the basis of p-V measurements performed on-line during PTCA.

  8. Wind-Tunnel Investigation of a Balloon as a Towed Decelerator at Mach Numbers from 1.47 to 2.50

    NASA Technical Reports Server (NTRS)

    McShera, John T.; Keyes, J. Wayne

    1961-01-01

    A wind-tunnel investigation has been conducted to study the characteristics of a towed spherical balloon as a drag device at Mach numbers from 1.47 to 2.50, Reynolds numbers from 0.36 x 10(exp 6) to 1.0 x 10(exp 6) , and angles of attack from -15 to 15 deg. Towed spherical balloons were found to be stable at supersonic speeds. The drag coefficient of the balloon is reduced by the presence of a tow cable and a further reduction occurs with the addition of a payload. The balloon inflation pressure required to maintain an almost spherical shape is about equal to the free-stream dynamic pressure. Measured pressure and temperature distribution around the balloon alone were in fair agreement with predicted values. There was a pronounced decrease in the pressure coefficients on the balloon when attached to a tow cable behind a payload.

  9. Advances in endoscopic balloon therapy for weight loss and its limitations

    PubMed Central

    Vyas, Dinesh; Deshpande, Kaivalya; Pandya, Yagnik

    2017-01-01

    The field of medical and surgical weight loss is undergoing an explosion of new techniques and devices. A lot of these are geared towards endoscopic approaches rather than the conventional and more invasive laparoscopic or open approach. One such recent advance is the introduction of intrgastric balloons. In this article, we discuss the recently Food and Drug Administration approved following balloons for weight loss: the Orbera™ Intragastric Balloon System (Apollo Endosurgery Inc, Austin, TX, United States), the ReShape® Integrated Dual Balloon System (ReShape Medical, Inc., San Clemente, CA, United States), and the Obalon (Obalon® Therapeutics, Inc.). The individual features of each of these balloons, the method of introduction and removal, and the expected weight loss and possible complications are discussed. This review of the various balloons highlights the innovation in the field of weight loss. PMID:29209122

  10. Gastric Ulceration and Bleeding with Hemodynamic Instability Caused by an Intragastric Balloon for Weight Loss.

    PubMed

    Reed, Larrite; Edriss, Hawa; Nugent, Kenneth

    2018-06-01

    Obesity in the United States is a medical crisis with many people attempting to lose weight with caloric restriction. Some patients choose minimally invasive weight loss solutions, such as intragastric balloon systems. These balloon systems were approved by the Federal Drug Administration (FDA) in 2015-2016 and have been considered safe, with minimal side effects. We report a patient with a two-day history of melena, abdominal pain, hypotension, and syncope which developed five months after placement of an intragastric balloon. Esophagogastroduodenoscopy with balloon removal revealed a small 8-mm gastric ulcer in the incisura. This gastric ulcer probably developed secondary to mechanical compression of the stomach mucosa by the gastric balloon which contained 900 mL of saline. The FDA is now investigating five deaths since 2016 associated with these second-generation balloons. Clinicians should be aware of these complications when evaluating patients with gastrointestinal complications, such as bleeding.

  11. 14 CFR 31.49 - Control systems.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... minute when the balloon is at its maximum operating pressure. (d) Each hot air balloon must have a means to allow the controlled release of hot air during flight. (e) Each hot air balloon must have a means... STANDARDS: MANNED FREE BALLOONS Design Construction § 31.49 Control systems. (a) Each control must operate...

  12. 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.

  13. 21 CFR 870.3535 - Intra-aortic balloon and control system

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Intra-aortic balloon and control system 870.3535... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3535 Intra-aortic balloon and control system (a) Identification. A intra-aortic balloon and control system is a device that...

  14. 21 CFR 870.3535 - Intra-aortic balloon and control system

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Intra-aortic balloon and control system 870.3535... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Prosthetic Devices § 870.3535 Intra-aortic balloon and control system (a) Identification. A intra-aortic balloon and control system is a device that...

  15. Auditory Risk of Exploding Hydrogen-Oxygen Balloons

    ERIC Educational Resources Information Center

    Gee, Kent L.; Vernon, Julia A.; Macedone, Jeffrey H.

    2010-01-01

    Although hydrogen-oxygen balloon explosions are popular demonstrations, the acoustic impulse created poses a hearing damage risk if the peak level exceeds 140 dB at the listener's ear. The results of acoustical measurements of hydrogen-oxygen balloons of varying volume and oxygen content are described. It is shown that hydrogen balloons may be…

  16. 14 CFR 61.23 - Medical certificates: Requirement and duration.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... pilot certificate with glider or balloon privileges; or (ii) A pilot certificate with a glider category... privileges in a glider or balloon; (3) When exercising the privileges of a pilot certificate with a glider category rating or balloon class rating in a glider or a balloon, as appropriate; (4) When exercising the...

  17. 14 CFR 61.23 - Medical certificates: Requirement and duration.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... pilot certificate with glider or balloon privileges; or (ii) A pilot certificate with a glider category... privileges in a glider or balloon; (3) When exercising the privileges of a pilot certificate with a glider category rating or balloon class rating in a glider or a balloon, as appropriate; (4) When exercising the...

  18. 14 CFR 61.23 - Medical certificates: Requirement and duration.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... pilot certificate with glider or balloon privileges; or (ii) A pilot certificate with a glider category... privileges in a glider or balloon; (3) When exercising the privileges of a pilot certificate with a glider category rating or balloon class rating in a glider or a balloon, as appropriate; (4) When exercising the...

  19. 14 CFR 61.23 - Medical certificates: Requirement and duration.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... pilot certificate with glider or balloon privileges; or (ii) A pilot certificate with a glider category... privileges in a glider or balloon; (3) When exercising the privileges of a pilot certificate with a glider category rating or balloon class rating in a glider or a balloon, as appropriate; (4) When exercising the...

  20. 21 CFR 870.3535 - Intra-aortic balloon and control system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... syndrome, cardiac and non-cardiac surgery, or complications of heart failure. The special controls for this... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Intra-aortic balloon and control system. 870.3535... balloon and control system. (a) Identification. An intra-aortic balloon and control system is a...

  1. Biliary sphincteroplasty facilitates retrieval of proximally migrated plastic biliary stent.

    PubMed

    Shah, Dharmesh K; Jain, Samit S; Somani, Piyush O; Rathi, Pravin M

    2014-01-01

    Proximal migration of biliary stents presents a technical challenge for the therapeutic endoscopist. It may require multiple, complicated corrective procedures resulting in significant morbidity to the patients. In this study we evaluated the utility of balloon biliary sphincteroplasty with CRE (Controlled Radial Expansion) Balloon Dilator on retrieval of proximally migrated biliary stents. We identified patients from our ERCP database who presented with proximal migration of biliary stent, between August 2011 and October 2013. Patients in whom the stent could not be retrieved with conventional methods, balloon sphincteroplasty was performed with a 12 mm CRETM Balloon Dilator (Boston Scientific). Stent removal was attempted with extraction balloon or basket thereafter. We identified 28 patients with proximal migration of biliary stents, placed for benign diseases of the common bile duct. Stent removal was successful in 18 patients (64.28%) with help of an extraction balloon or basket. Of the remaining 10 patients, balloon sphincteroplasty was successfully followed by stent removal in eight patients. Balloon biliary sphincteroplasty increases the success rate of retrieving proximally migrated biliary stents. The procedure is safe, technically easy and yields a good success rate in our experience.

  2. Long-Term Follow-up After Embolization of Pulmonary Arteriovenous Malformations with Detachable Silicone Balloons

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

    Andersen, Poul Erik; Kjeldsen, Anette D.

    2008-05-15

    Long-term follow-up results after embolization of 13 pulmonary arteriovenous malformations in 10 patients by use of 14 detachable silicone balloons are given. Patients were followed for a mean of 99 months (range, 63-123 months) with chest x-rays and for a mean of 62 months (range, 3-101 months) with pulmonary angiography. Fifty-four percent of the balloons were deflated at latest radiographic chest film follow-up, but at pulmonary angiographic follow-up all embolized malformations were without flow irrespective of whether or not the balloons were visible. Detachable silicone balloons are not available anymore, but use of these balloons for embolization of pulmonary arteriovenousmore » malformations has been shown to be a safe and precise method, with immediate occlusion of the feeding artery and with long-lasting occlusion, even though many balloons deflate with time, leaving a fibrotic scar replacing the pulmonary arteriovenous malformation. No case of recanalization has been discovered, and these results seem to justify a reduced number of controls of these balloon-embolized malformations.« less

  3. A Survey of Titan Balloon Concepts and Technology Status

    NASA Technical Reports Server (NTRS)

    Hall, Jeffery L.

    2011-01-01

    This paper surveys the options for, and technology status of, balloon vehicles to explore Saturn's moon Titan. A significant amount of Titan balloon concept thinking and technology development has been performed in recent years, particularly following the spectacular results from the descent and landing of the Huygens probe and remote sensing observations by the Cassini spacecraft. There is widespread recognition that a balloon vehicle on the next Titan mission could provide an outstanding and unmatched capability for in situ exploration on a global scale. The rich variety of revealed science targets has combined with a highly favorable Titan flight environment to yield a wide diversity of proposed balloon concepts. The paper presents a conceptual framework for thinking about balloon vehicle design choices and uses it to analyze various Titan options. The result is a list of recommended Titan balloon vehicle concepts that could perform a variety of science missions, along with their projected performance metrics. Recent technology developments for these balloon concepts are discussed to provide context for an assessment of outstanding risk areas and technological maturity. The paper concludes with suggestions for technology investments needed to achieve flight readiness.

  4. 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.

  5. Development of a Compact Captive Balloon and Its Level Supporting

    NASA Astrophysics Data System (ADS)

    Nakao, Tatsuya; Fujiwara, Kazuhito; Furukawa, Motoyasu; Hiroe, Tetsuyuki

    Many kinds of observation techniques have been developed to obtain the properties of atmospheric conditions. The advanced observation techniques of the flow in relatively large scale are remote sensing by satellite facilities, long range observations by radar or Doppler Sodar, etc., while data from conventional climometers set at fixed places are merely limited information about local scale flow. Captive balloons are also available and feasible for the observation of local flows if their standing mechanics are robust against the strong wind and the motion of balloon are stable for all wind direction and the change of wind direction. In this paper, a compact captive balloon (about 2m diam.) for flow measurement is proposed and the preservation of balloon height level and the stabilization of its motion are challenged by using a kite. The relation between force balances acted on the balloon and the balloon height or position was estimated and confirmed in experiments. Although the lift force of single kite worked successfully, it is found that the performance of plural kites is less in the traction of balloon since the interaction of their tensions. The compact balloon supported by the kite enabled the over 300m floating by virtue of the small size causing only low air resistance.

  6. Balloon dilatation of benign and malignant esophageal strictures. Blind retrograde balloon dilatation.

    PubMed

    Graham, D Y; Smith, J L

    1985-06-01

    Balloon esophageal dilatation offers many theoretical advantages (safety, speed, and patient comfort) over dilatation with mercury-filled bougies or with the Eder-Puestow system. The authors used balloon dilators in 22 patients with dysphagia secondary to benign or malignant strictures. Dilatation was performed with fluoroscopic guidance, blindly, or by a combination of these techniques. For "blind" stricture dilatation, an Eder-Puestow spring-tipped guide wire is placed into the stomach using a fiberoptic endoscope. The distance from the incisor teeth to the stricture is measured, and the balloon shaft is marked to indicate when the middle of the balloon is within the stricture. Dilatation is then performed using the antegrade or, the preferred, retrograde technique. Finally, the dilated stricture is calibrated by pulling an inflated balloon through the previously strictured area without difficulty. An attempt was made to achieve an esophageal diameter of 15 mm at the initial dilatation episode, and patient discomfort was used as a guide as to the final diameter. The balloon dilatation technique was highly successful, and a stricture diameter of 15 mm (45-47 French) was achieved at the initial dilatation in most instances. Malignant strictures were easily dilated. Balloon dilatation is convenient, effective, quick, and potentially safer than the previous Eder-Puestow or mercury-filled bougie techniques.

  7. 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.

  8. Effects of supramaximal balloon dilatation pressures on adult cricoid and tracheal cartilage: A cadaveric study.

    PubMed

    Durvasula, Venkata S P B; Shalin, Sara C; Tulunay-Ugur, Ozlem E; Suen, James Y; Richter, Gresham T

    2018-06-01

    Cricoid fracture is a serious concern for balloon dilatation in airway stenosis. Furthermore, there are no studies examining tracheal rupture in balloon dilatation of stenotic segments. The aim of this study was to evaluate the effect of supramaximal pressures of balloons on the cricoid and tracheal rings. Prospective cadaveric study. Seven cadaveric laryngotracheal complexes of normal adults with intact cricothyroid membranes were acquired. Noncompliant vascular angioplasty balloons (BARD-VIDA) were used for dilatation. The subglottis and trachea were subjected to supramaximal dilatation pressures graduated to nominal burst pressure (NBP) and, if necessary, rated burst pressure (RBP). Larger-diameter balloons, starting from 18 mm size to 24 mm, were used. Dilatations were maintained for 3 minutes. The cricoid ring was disrupted by larger-diameter balloons (22 mm and 24 mm) even at lower pressures (less than NBP) in six cases. Tracheal cartilages were very distensible, and external examination after supramaximal dilatation (24 mm close to RBP) revealed no obvious cartilage fractures or trachealis tears. Histopathological examination revealed sloughing of mucosa in the areas corresponding to balloon placement, but no microfractures or disruption of the perichondrium of tracheal ring cartilages. These results indicate that the cricoid is vulnerable to injury from larger balloons even at lower dilatation pressures. The tracheal cartilages and the membranous wall of the trachea remained resilient to supramaximal dilatation and larger balloons. NA. Laryngoscope, 128:1304-1309, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Usefulness of cutting balloon angioplasty for the treatment of congenital heart defects.

    PubMed

    Kusa, Jacek; Mazurak, Magdalena; Skierska, Agnieszka; Szydlowski, Leslaw; Czesniewicz, Pawel; Manka, Lukasz

    2018-01-01

    Patients with complex congenital heart defects may have different hemodynamic prob-lems which require a variety of interventional procedures including angioplasty which involves using high-pressure balloons. After failure of conventional balloon angioplasty, cutting balloon angioplasty is the next treatment option available. The purpose of this study was to evaluate the safety and efficacy of cutting balloon angioplasty in children with different types of congenital heart defects. Cutting balloon angioplasty was performed in 28 children with different congenital heart defects. The indication for cutting balloon angioplasty was: pulmonary artery stenosis in 17 patients, creating or dilatation of interatrial communication in 10 patients, and stenosis of left subclavian artery in 1 patient. In the pulmonary arteries group there was a significant decrease in systolic blood pressure (SBP) in the proximal part of the artery from the average 74.33 ± 20.4 mm Hg to 55 ± 16.7 mm Hg (p < 0.001). Distal to the stenosis there was an increase in SBP from 19.8 ± 3.82 mm Hg to 30.3 ± ± 13.3 mm Hg (p = 0.04). This result remained constant in the follow-up. In atrial septal defect/fenestra-tion group, cutting balloon angioplasty was performed after an unsuccessful classic Rashkind procedure. After cutting balloon angioplasty there was a significant widening of the interatrial communication. Cutting balloon angioplasty is a feasible and effective treatment option in different con-genital heart defects.

  10. Comparing short versus standard-length balloon for intra-aortic counterpulsation: results from a porcine model of myocardial ischaemia-reperfusion.

    PubMed

    Gelsomino, Sandro; Lozekoot, Pieter W J; Lorusso, Roberto; de Jong, Monique M J; Parise, Orlando; Matteucci, Francesco; Lucà, Fabiana; La Meir, Mark; Gensini, Gian Franco; Maessen, Jos G

    2016-05-01

    We compare a short and a standard-size balloon with same filling volumes to verify the differences in terms of visceral flow, coronary circulation and haemodynamic performance during aortic counterpulsation in an animal model of myocardial ischaemia-reperfusion injury. Eighteen healthy pigs underwent 120-min ligation of the left anterior descending coronary artery followed by 6 h of reperfusion, and they were randomly assigned to have intra-aortic balloon counterpulsation (IABP) with a 40-ml short-balloon (n = 6) or a 40-ml standard-length balloon (n = 6), or to undergo no IABP implantation (controls, n = 6). Haemodynamics and visceral and coronary flows were measured at baseline (t0), at 2 h of ischaemia (t1) and every hour thereafter until 6 h of reperfusion (from tR1 to tR6), respectively. Mesenteric flows increased significantly at tR1 only in the short-balloon group (P < 0.001) and it was constantly higher than in the standard-balloon group regardless of mean arterial pressure, systemic vascular resistance and cardiac output (CO; all, P < 0.001). Renal blood flows were significantly increased during IABP treatment with values constantly and significantly higher in short balloons at any following experimental step (all, P < 0.05). IABP improved CO and coronary blood flow, and reduced afterload, myocardial resistances and myocardial oxygen consumption without differences between the short and the standard-length balloon (all, P > 0.05). The short balloon prevents visceral ischaemia and, compared with the standard-size balloon, it does not lose IABP beneficial cardiac and coronary-related effects. Further studies are warranted to confirm our findings. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  11. Effect of air removal with extracorporeal balloon inflation on incidence of asymptomatic cerebral embolism during cryoballoon ablation of atrial fibrillation.

    PubMed

    Tokuda, Michifumi; Matsuo, Seiichiro; Kato, Mika; Sato, Hidenori; Oseto, Hirotsuna; Okajima, Eri; Ikewaki, Hidetsugu; Isogai, Ryota; Tokutake, Kenichi; Yokoyama, Kenichi; Narui, Ryohsuke; Tanigawa, Shin-Ichi; Yamashita, Seigo; Inada, Keiichi; Yoshimura, Michihiro; Yamane, Teiichi

    2017-09-01

    Asymptomatic cerebral embolism (ACE) is sometimes detected after cryoballoon ablation of atrial fibrillation. The removal of air bubbles from the cryoballoon before utilization may reduce the rate of ACE. This study aims to compare the incidence of ACE between a conventional and a novel balloon massaging method during cryoballoon ablation. Of 175 consecutive patients undergoing initial cryoballoon ablation of paroxysmal atrial fibrillation, 60 (34.3%) patients underwent novel balloon massaging with extracorporeal balloon inflation in saline water (group N) before the cryoballoon was inserted into the body. The remaining 115 (65.7%) patients underwent conventional balloon massaging in saline water while the balloon remained folded (group C). Of those, 86 propensity score-matched patients were included. The baseline characteristics were similar between the 2 groups. In group N, even after balloon massaging in saline water was carefully performed, multiple air bubbles remained on the balloon surface when the cryoballoon was inflated in all cases. Postprocedural cerebral magnetic resonance imaging detected ACE in 14.0% of all patients. The incidence of ACE was significantly lower in group N than in group C (4.7% vs 23.3%; P = .01). According to multivariable analysis, the novel method was the sole factor associated with the presence of ACE (odds ratio 0.161; 95% confidence interval 0.033-0.736; P = .02). Preliminary removal of air bubbles in heparinized saline water with extracorporeal balloon inflation reduced the incidence of ACE. Since conventional balloon massaging failed to remove air bubbles completely, this novel balloon massaging method should be recommended before cryoballoon utilization. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  12. Balloon-augmented Onyx embolization of cerebral arteriovenous malformations using a dual-lumen balloon: a multicenter experience.

    PubMed

    Spiotta, Alejandro M; James, Robert F; Lowe, Stephen R; Vargas, Jan; Turk, Aquilla S; Chaudry, M Imran; Bhalla, Tarun; Janjua, Rashid M; Delaney, John J; Quintero-Wolfe, Stacey; Turner, Raymond D

    2015-10-01

    Conventional Onyx embolization of cerebral arteriovenous malformations (AVMs) requires lengthy procedure and fluoroscopy times to form an adequate 'proximal plug' which allows forward nidal penetration while preventing reflux and non-targeted embolization. We review our experience with balloon-augmented Onyx embolization of cerebral AVMs using a dual-lumen balloon catheter technique designed to minimize these challenges. Retrospectively acquired data for all balloon-augmented cerebral AVM embolizations performed between 2011 and 2014 were obtained from four tertiary care centers. For each procedure, at least one Scepter C balloon catheter was advanced into the AVM arterial pedicle of interest and Onyx embolization was performed through the inner lumen after balloon inflation via the outer lumen. Twenty patients underwent embolization with the balloon-augmented technique over 24 discreet treatment episodes. There were 37 total arterial pedicles embolized with the balloon-augmented technique, a mean of 1.9 per patient (range 1-5). The treated AVMs were heterogeneous in their location and size (mean 3.3±1.6 cm). Mean fluoroscopy time for each procedure was 48±26 min (28 min per embolized pedicle). Two Scepter C balloon catheter-related complications (8.3% of embolization sessions, 5.4% of pedicles embolized) were observed: an intraprocedural rupture of a feeding pedicle and fracture and retention of a catheter fragment. This multicenter experience represents the largest reported series of balloon-augmented Onyx embolization of cerebral AVMs. The technique appears safe and effective in the treatment of AVMs, allowing more efficient and controlled injection of Onyx with a decreased risk of reflux and decreased fluoroscopy times. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Tackling the Issue of High Postoperative Pacemaker Implantation Rates in Sutureless Aortic Valve Replacement: Should Balloon Inflation be Removed from the Implantation Method of the Perceval Prosthesis?

    PubMed

    Charles Blouin, Mathieu; Bouhout, Ismail; Demers, Philippe; Carrier, Michel; Perrault, Louis; Lamarche, Yoan; El-Hamamsy, Ismail; Bouchard, Denis

    2017-05-01

    Sutureless aortic valve replacement (AVR) is an emerging alternative to standard AVR in elderly and high-risk patients. This procedure is associated with a high rate of postoperative permanent pacemaker implantation (PPI). The study aim was to assess the impact on the rate of PPI of implanting the Perceval prosthesis without using balloon inflation. A total of 159 patients who underwent sutureless AVR using the Perceval prosthesis was included. Balloon inflation was used in 132 patients (Balloon group) and not used in the remaining 27 (No-Balloon group). Clinical, echocardiographic and electrocardiographic outcomes were assessed. There was no significant difference in PPI rate between the two groups (26% for Balloon group versus 22% in No-Balloon group; p = 0.700). Balloon inflation had no significant impact on the incidence of paravalvular leaks (p = 0.839), or on the need to return to cardiopulmonary bypass (CPB) intraoperatively due to paravalvular leak or unsatisfactory deployment (p >0.999). Mean and peak transaortic pressure gradients were similar between the two groups (p = 0.417 and p = 0.522, respectively). Cross-clamp and CPB times were shorter in the No-Balloon group (49.6 ± 15.9 min versus 61.1 ± 25.6 min and 64.1 ± 26.3 min versus 79.6 ± 35.4 min, respectively; p = 0.027 and p = 0.012, respectively). The two groups had similar postoperative PPI rates. Implanting the Perceval prosthesis without balloon inflation is safe and had no impact on paravalvular leaks, intraoperative complications or hemodynamic results. Reductions in aortic cross-clamp time and CPB time were observed when the balloon was not used.

  14. Safety and effectiveness of gastric balloons associated with hypocaloric diet for the treatment of obesity.

    PubMed

    de Castro, Maria Luisa; Morales, Maria Jose; Martínez-Olmos, Miguel A; Pineda, Juan R; Cid, Lucia; Estévez, Pamela; del-Campo, Victor; Rodríguez-Prada, J Ignacio

    2013-10-01

    intragastric balloons provide early satiety and thereby induce short-term weight loss. The aim of this study was to evaluate safety and short and medium-term effectiveness of gastric balloons associated to hypocaloric diet in obesity. from May 2004 to June 2011 91 obese patients, body mass index (BMI) 45.2 +/- 7.2 kg/m2 were prospectively followed after endoscopic implantation of a gastric balloon associated to restricted diet. Successful therapy was defined as percent loss of total weight (%LTW) > or = 5 % at six months after balloon placement and 6 and 12 months after their withdrawal. All analyses followed intention-to treat principles considering significant p-values < 0.05. we placed 73 fluid-filled balloons (80.2 %) and 18 air-filled ones (19.8 %). Compared to baseline values, at 6-month 73.7 % subjects succeeded, showing significant reductions in weight (13.3 +/- 8.8 kg), BMI (5 +/- 3.4 kg/m2) (p < 0.0001), with % LTW 11 +/- 7 %. Six and twelve months after retrieval 45.1 % and 28.6 % patients reached % LTW > or = 5 %. Short-term and medium-term effectiveness was negatively associated to obesity in first-grade relatives (p = 0.003 and p = 0.04). Higher weight loss 6 months after balloon placement independently predicted medium-term effectiveness (p = 0.0001). Mortality was absent but there were two spontaneous deflations of air-filled balloons and severe withdrawal difficulties in 8 patients, leading to surgery in one case. Retrieval complications associated to air-filled balloons (p = 0.0005). in obesity, effectiveness of gastric balloons associated to hypocaloric diet decreases over time.Complications occurred mainly in the retrieval endoscopic procedure and related to air-filled balloons.

  15. Application of Electrocautery Needle Knife Combined with Balloon Dilatation versus Balloon Dilatation in the Treatment of Tracheal Fibrotic Scar Stenosis.

    PubMed

    Bo, Liyan; Li, Congcong; Chen, Min; Mu, Deguang; Jin, Faguang

    Electrocautery needle knives can largely reduce scar and granulation tissue hyperplasia and play an important role in treating patients with benign stricture. The aim of this retrospective study was to evaluate the efficacy and safety of electrocautery needle knife combined with balloon dilatation versus balloon dilatation alone in the treatment of tracheal stenosis caused by tracheal intubation or tracheotomy. We retrospectively analysed the clinical data of 43 patients with tracheal stenosis caused by tracheotomy or tracheal intubation in our department from January 2013 to January 2016. Among these 43 patients, 23 had simple web-like stenosis and 20 had complex steno sis. All patients were treated under general anaesthesia, and the treatment methods were (1) balloon dilatation alone, (2) needle knife excision of fibrotic tissue combined with balloon dilatation, and (3) needle knife radial incision of fibrotic tissue combined with balloon dilatation. After treatment the symptoms, such as shortness of breath, were markedly improved immediately in all cases. The stenosis degree of patients who were treated with the elec-trocautery needle knife combined with balloon dilatation had better improvement compared with that of those treated with balloon dilatation treatment alone after 3 months (0.45 ± 0.04 vs. 0.67 ± 0.05, p < 0.01), and the proportion of restenosis occurrence that required further treatment was decreased at 6 months (46.9 vs. 81.8%), especially for the web-like stenosis patients, as most of their stenoses dilated with no obvious restenosis and achieved clinical cure. Electrocautery needle knife combined with balloon dilatation is an effective and safe treatment for tracheal fibrotic stenosis compared with balloon dilatation alone. © 2017 S. Karger AG, Basel.

  16. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

    PubMed

    Cho, Hee Young; Park, Yong Won; Kim, Young Han; Jung, Inkyung; Kwon, Ja-Young

    2015-01-01

    The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation. We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL. Sixty-four patients (46.7%) required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1%) had placenta previa totalis. The overall success rate was 75% (48/64) for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05). The drainage amount over 1 hour was 500 mL (20-1200 mL) in the balloon failure group and 60 mL (5-500 mL) in the balloon success group (p<0.01). Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

  17. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients

    PubMed Central

    Cho, Hee Young; Park, Yong Won; Kim, Young Han; Jung, Inkyung; Kwon, Ja-Young

    2015-01-01

    Purpose The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation. Methods We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL. Results Sixty-four patients (46.7%) required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1%) had placenta previa totalis. The overall success rate was 75% (48/64) for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05). The drainage amount over 1 hour was 500 mL (20–1200 mL) in the balloon failure group and 60 mL (5–500 mL) in the balloon success group (p<0.01). Conclusion Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance. PMID:26263014

  18. Dextran sulfate as a drug delivery platform for drug‐coated balloons: Preparation, characterization, in vitro drug elution, and smooth muscle cell response

    PubMed Central

    Lamichhane, Sujan; Anderson, Jordan; Remund, Tyler; Kelly, Patrick

    2015-01-01

    Abstract Drug‐coated balloons (DCBs) have now emerged as a promising approach to treat peripheral artery disease. However, a significant amount of drug from the balloon surface is lost during balloon tracking and results in delivering only a subtherapeutic dose of drug at the diseased site. Hence, in this study, the use of dextran sulfate (DS) polymer was investigated as a platform to control the drug release from balloons. An antiproliferative drug, paclitaxel (PAT), was incorporated into DS films (PAT‐DS). The characterizations using SEM, FT‐IR, and DSC showed that the films prepared were smooth and homogenous with PAT molecularly dispersed in the bulk of DS matrix in amorphous form. An investigation on the interaction of smooth muscle cells (SMCs) with control‐DS and PAT‐DS films showed that both films inhibited SMC growth, with a superior inhibitory effect observed for PAT‐DS films. PAT‐DS coatings were then produced on balloon catheters. The integrity of coatings was well‐maintained when the balloons were either deflated or inflated. In this study, up to 2.2 µg/mm2 of PAT was loaded on the balloons using the DS platform. Drug elution studies showed that only 10 to 20% of the total PAT loaded was released from the PAT‐DS coated balloons during the typical time period of balloon tracking (1 min) and then ∼80% of the total PAT loaded was released during the typical time period of balloon inflation and treatment (from 1 min to 4 min). Thus, this study demonstrated the use of DS as a platform to control drug delivery from balloons. © 2015 The Authors Journal of Biomedical Materials Research Part B: Applied Biomaterials Published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1416–1430, 2016. PMID:26227252

  19. Similar PDK1-AKT-mTOR pathway activation in balloon cells and dysmorphic neurons of type II focal cortical dysplasia with refractory epilepsy.

    PubMed

    Lin, Yuan-xiang; Lin, Kun; Kang, De-zhi; Liu, Xin-xiu; Wang, Xing-fu; Zheng, Shu-fa; Yu, Liang-hong; Lin, Zhang-ya

    2015-05-01

    Dysmorphic neurons and balloon cells constitute the neuropathological hallmarks of type II focal cortical dysplasias (FCDs) with refractory epilepsy. The genesis of these cells may be critical to the histological findings in type II FCD. Recent work has shown enhanced activation of the mTOR cascade in both balloon cells and dysmorphic neurons, suggesting a common pathogenesis for these two neuropathological hallmarks. A direct comparative analysis of balloon cells and dysmorphic neurons might identify a molecular link between balloon cells and dysmorphic neurons. Here, we addressed whether PDK1-AKT-mTOR activation differentiates balloon cells from dysmorphic neurons. We used immunohistochemistry with antibodies against phosphorylated (p)-PDK1 (Ser241), p-AKT (Thr308), p-AKT (Ser473), p-mTOR (Ser2448), p-P70S6K (Thr229), and p-p70S6 kinase (Thr389) in balloon cells compared with dysmorphic neurons. Strong or moderate staining for components of the PDK1-AKT-mTOR signaling pathway was observed in both balloon cells and dysmorphic neurons. However, only a few pyramidal neurons displayed weak staining in control group (perilesional neocortex and histologically normal neocortex). Additionally, p-PDK1 (Ser241) and p-AKT (Thr308) staining in balloon cells were stronger than in dysmorphic neurons, whereas p-P70S6K (Thr229) and p-p70S6 kinase (Thr389) staining in balloon cells was weaker than in dysmorphic neurons. In balloon cells, p-AKT (Ser473) and p-mTOR (Ser2448) staining was comparable with the staining in dysmorphic neurons. Our data support the previously suggested pathogenic relationship between balloon cells and dysmorphic neurons concerning activation of the PDK1-AKT-mTOR, which may play important roles in the pathogenesis of type II FCD. Differential expression of some components of the PDK1-AKT-mTOR pathway between balloon cells and dysmorphic neurons may result from cell-specific gene expression. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. High altitude flights in equatorial regions

    NASA Astrophysics Data System (ADS)

    Redkar, R. T.

    A thorough analysis of balloon flights made from Hyderabad, India (Latitude 17°28'N, Longitude 78°35'E), and other equatorial sites has been made. It has been shown that limited success is expected for flights made from equatorial latitudes with balloons made out of natural colour polyethylene film, since the best known balloon film in the world today viz. Winzen Stratofilm is tested for low temperature brittleness only at -80°C., whereas the tropopause temperatures over equatorial latitudes vary between -80°C and -90°C. The success becomes even more critical when flights are made with heavy payloads and larger balloons particularly at night when in the absence of solar radiation the balloon film becomes more susceptible to low temperature brittle failure. It is recommended that in case of capped balloons longer caps should be used to fully cover the inflated protion of the balloon at the higher level equatorial tropopause. It is also advised that the conditions such as wind shears in the tropopause should be critically studied before launching and a day with the tropopause temperature nearer to -80°C should be chosen. Special care also should be taken while handling the balloon on ground and during launching phase. Properties of Winzen Stratofilm have been critically studied and fresh mandates have been recommended on the basis of limiting values of film stresses which caused balloon failures in the equatorial tropopause. It is also emphasized that the data on such flights is still meagre especially for flights with heavy payloads and larger balloons. It has been also shown that it is safest to use balloons made out of grey coloured film which retains its flexibility with the absorption of solar radiation, the success obtained with such balloons so far being 100%. The drawback, however, is that these balloons cannot be used for night flights. Stratospheric wind regimes over Hyderabad are also discussed with a view to determine the period over which long duration flights can be made. The data available, however, is meagre and it is recommended that more frequent special wind ascents be made to collect adequate statistical data from which reliable conclusions could be drawn through critical analysis.

  1. The NASA super pressure balloon - A path to flight

    NASA Astrophysics Data System (ADS)

    Cathey, H. M.

    2009-07-01

    The National Aeronautics and Space Administration's Balloon Program Office has invested significant time and effort in extensive ground testing of model super pressure balloons. The testing path has been developed as an outgrowth of the results of the super pressure balloon test flight in 2006. Summary results of the June 2006 super pressure test flight from Kiruna, Sweden are presented including the balloon performance and "lessons learned". This balloons flight performance exceeded expectations, but did not fully deploy. The flight was safely terminated by command. The results of this test flight refocused the project's efforts toward additional ground testing and analysis; a path to flight. A series of small 4 m diameter models were made and tested to further explore the deployment and structural capabilities of the balloons and materials. A series of ˜27 m model balloons were successfully tested indoors. These balloons successfully replicated the cleft seen in the Sweden flight, explored the deployment trade space to help characterize better design approaches, and demonstrated an acceptable fix to the deployment issue. Photogrammetry was employed during these ˜27 m model tests to help characterize both the balloon and gore shape evolution under pressurization. A ˜8.5 m ground model was used to explore the design and materials performance. Results of these tests will be presented. A general overview of some of the other project advancements made related to demonstrating the strain arresting nature of the proposed design, materials and analysis work will also be presented. All of this work has prepared a clear path toward a renewed round of test flights. This paper will give an overview of the development approach pursued for this super pressure balloon development. A description of the balloon design, including the modifications made as a result of the lessons learned, is presented. A short deployment test flight of the National Aeronautics and Space Administration's super pressure balloon took place in June 2008. This flight was from Ft. Sumner, New Mexico. Preliminary results of this flight are presented. Future plans for both ground testing and additional test flights are also presented. Goals of the future test flights, which are staged in increments of increasing suspended load and altitude, are presented. This includes the projected balloon volumes, payload capabilities, test flight locations, and proposed flight schedule.

  2. An analysis of the deployment of a pumpkin balloon on mars

    NASA Astrophysics Data System (ADS)

    Rand, J.; Phillips, M.

    The design of large superpressure balloons has received significant attention in recent years due to the successful demonstration of various enabling technologies and materials. Of particular note is the "pumpkin" shaped balloon concept, which allows the stress in the envelope to be limited by the surface geometry. Unlike a sphere, which produces stress resultants determined by the volume of the system, the pumpkin utilizes a system of meridional tendons to react the loading in one direction, and form a number of lobes, which limit the stress in the circumferential direction. The application of this technology to very large systems is currently being demonstrated by NASA's Ultra Long Duration Balloon (ULDB) Program. However, this type of balloon has certain features that may be exploited to produce a system far more robust than a comparable sphere during deployment, inflation, and operation for long periods of time. When this concept is applied to a system designed to carry two kilograms in the atmosphere of Mars, the resulting balloon is small enough to alter the construction techniques and produce an envelope which is free of tucks and folds which may cause uncontrolled stress concentrations. A technique has been demonstrated where high strength tendons may be pretensioned prior to installation along the centerline of each gore. Since this position is the shortest distance between the apex and nadir of the balloon, the tendons will automatically resist the forces caused by deployment and inflation and thereby protect the thin film gas barrier from damage. A suitable balloon has been designed for this type of mission using five-micron Mylar Type C film for the gas barrier and P O braided cables for the meridionalB load carrying members. The deployment of this balloon is assumed to occur while falling on a decelerator suitably designed for the Mars atmosphere. The inflation is accomplished by a ten-kilogram system suspended at the nadir of the balloon. As the system falls toward the surface of the planet, helium gas is transferred to the balloon, forming a partially inflated system very similar to an ascending zero pressure balloon. This analysis incorporates the flow of the planetary gas around the inflating balloon, altering the pressure distribution and shape. As a result, stresses are seen to increase beyond the design margin of safety, requiring the balloon to be redesigned. In addition, several scale models of this balloon were dynamically deployed in the laboratory to demonstrate that the deployment forces are indeed carried by the tendons

  3. 75 FR 63086 - Great Mississippi Balloon Race and Fireworks Safety Zone; Lower Mississippi River, Mile Marker...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-14

    ... flying hot air balloons transiting across the Lower Mississippi River. Entry into this zone is prohibited... mariners from the safety hazards associated with a fireworks display and low flying hot air balloons... mariners from the safety hazards associated with a fireworks display and low flying hot air balloons...

  4. Lightweight Valve Closes Duct Quickly

    NASA Technical Reports Server (NTRS)

    Fournier, Walter L.; Burgy, N. Frank

    1991-01-01

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

  5. Retrieval of impacted broken balloon by balloon inflation in guiding catheter.

    PubMed

    Mehta, Vimal; Pandit, Bhagya Narayan; Yusuf, Jamal; Mukhopadhyay, Saibal; Trehan, Vijay; Tyagi, Sanjay

    2014-07-01

    Broken catheter fragment in a coronary artery during percutaneous coronary angioplasty is a rare complication. It can result in serious problems as a result of thrombus formation and embolization of broken fragment. We report an unusual complication of a broken balloon catheter during angioplasty, which was successfully retrieved by balloon inflation in guiding catheter technique.

  6. JACEE long duration balloon flights. [Japanese-American Cooperative Emulsion Experiment

    NASA Technical Reports Server (NTRS)

    Burnett, T.; Iwai, J.; Dake, S.; Derrickson, J.; Fountain, W.; Fuki, M.; Gregory, J.; Hayashi, T.; Holynski, R.; Jones, W. V.

    1989-01-01

    JACEE balloon-borne emulsion chamber detectors are used to observe the spectra and interactions of cosmic ray protons and nuclei in the energy range 1 to 100A TeV. Experiments with long duration mid-latitude balloon flights and characteristics of the detector system that make it ideal for planned Antarctic balloon flights are discussed.

  7. 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.

  8. Enlargement of basilar artery aneurysms following balloon occlusion--"water-hammer effect". Report of two cases.

    PubMed

    Kwan, E S; Heilman, C B; Shucart, W A; Klucznik, R P

    1991-12-01

    Two patients with distal basilar aneurysms were treated with intra-aneurysmal balloon occlusion. After apparently successful therapy, follow-up angiograms demonstrated aneurysm enlargement with balloon migration distally in the sac. Geometric mismatch between the base of the balloons and the aneurysm neck together with transmitted pulsation through the 2-hydroxyl-ethylmethacrylate (HEMA)-filled balloon directly contributed to aneurysm enlargement. In this report, the authors discuss the problems of progressive aneurysm enlargement due to a "water-hammer effect" and the possibility of hemorrhage following subtotal occlusion.

  9. 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.

  10. 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 vessel. 3. Update of the cameras for the observation. In this experiment, we heat air in the combustion vessel to 500K, before microgravity. And during microgravity, we conduct to the follows. (1) Generate five droplets on the droplets supporter. (2) Moving droplets into combustion vessel. (3) Ignition of an edge droplet of the array using igniter. And during combustion experiment, cameras take movies of combustion phenomena. We plan to conduct this experiment in May 2014.

  11. An international multicenter study comparing EUS-guided pancreatic duct drainage with enteroscopy-assisted endoscopic retrograde pancreatography after Whipple surgery.

    PubMed

    Chen, Yen-I; Levy, Michael J; Moreels, Tom G; Hajijeva, Gulara; Will, Uwe; Artifon, Everson L; Hara, Kazuo; Kitano, Masayuki; Topazian, Mark; Abu Dayyeh, Barham; Reichel, Andreas; Vilela, Tiago; Ngamruengphong, Saowanee; Haito-Chavez, Yamile; Bukhari, Majidah; Okolo, Patrick; Kumbhari, Vivek; Ismail, Amr; Khashab, Mouen A

    2017-01-01

    Endoscopic management of post-Whipple pancreatic adverse events (AEs) with enteroscopy-assisted endoscopic retrograde pancreatography (e-ERP) is associated with high failure rates. EUS-guided pancreatic duct drainage (EUS-PDD) has shown promising results; however, no comparative data have been done for these 2 modalities. The goal of this study is to compare EUS-PDD with e-ERP in terms of technical success (PDD through dilation/stent), clinical success (improvement/resolution of pancreatic-type symptoms), and AE rates in patients with post-Whipple anatomy. This is an international multicenter comparative retrospective study at 7 tertiary centers (2 United States, 2 European, 2 Asian, and 1 South American). All consecutive patients who underwent EUS-PDD or e-ERP between January 2010 and August 2015 were included. In total, 66 patients (mean age, 57 years; 48% women) and 75 procedures were identified with 40 in EUS-PDD and 35 in e-ERP. Technical success was achieved in 92.5% of procedures in the EUS-PDD group compared with 20% of procedures in the e-ERP group (OR, 49.3; P < .001). Clinical success (per patient) was attained in 87.5% of procedures in the EUS-PDD group compared with 23.1% in the e-ERP group (OR, 23.3; P < .001). AEs occurred more commonly in the EUS-PDD group (35% vs 2.9%, P < .001). However, all AEs were rated as mild or moderate. Procedure time and length of stay were not significantly different between the 2 groups. EUS-PDD is superior to e-ERP in post-Whipple anatomy in terms of efficacy with acceptable safety. As such, EUS-PDD should be considered as a potential first-line treatment in post-pancreaticoduodenectomy anatomy when necessary expertise is available. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  12. Positional calibrations of the germanium double sided strip detectors for the Compton spectrometer and imager

    NASA Astrophysics Data System (ADS)

    Lowell, A.; Boggs, S.; Chiu, J. L.; Kierans, C.; McBride, S.; Tseng, C. H.; Zoglauer, A.; Amman, M.; Chang, H. K.; Jean, P.; Lin, C. H.; Sleator, C.; Tomsick, J.; von Ballmoos, P.; Yang, C. Y.

    2016-08-01

    The Compton Spectrometer and Imager (COSI) is a medium energy gamma ray (0.2 - 10 MeV) imager designed to observe high-energy processes in the universe from a high altitude balloon platform. At its core, COSI is comprised of twelve high purity germanium double sided strip detectors which measure particle interaction energies and locations with high precision. This manuscript focuses on the positional calibrations of the COSI detectors. The interaction depth in a detector is inferred from the charge collection time difference between the two sides of the detector. We outline our previous approach to this depth calibration and also describe a new approach we have recently developed. Two dimensional localization of interactions along the faces of the detector (x and y) is straightforward, as the location of the triggering strips is simply used. However, we describe a possible technique to improve the x/y position resolution beyond the detector strip pitch of 2 mm. With the current positional calibrations, COSI achieves an angular resolution of 5.6 +/- 0.1 degrees at 662 keV, close to our expectations from simulations.

  13. Successful Kissing Balloon Expandable Stent Graft Treatment for a Right Common Carotid Pseudoaneurysm Caused by Tracheotomy.

    PubMed

    Agyei, Justice O; Alvarez, Cynthia; Iqbal, Azher; Fanous, Andrew A; Siddiqui, Adnan H

    2018-06-01

    A rare complication following tracheotomy is common carotid artery (CCA) pseudoaneurysm. Treatment modalities for CCA pseudoaneurysm include surgical repair and single-artery balloon-covered stent graft technique. We describe successful treatment of tracheotomy-related CCA pseudoaneurysm with the "kissing balloon" expandable stent graft technique. We successfully implemented the kissing balloon expandable stent graft technique for treatment of a large, narrow-necked, bilobed CCA pseudoaneurysm that arose owing to a tracheotomy complication. The pseudoaneurysm was detected while performing a diagnostic angiogram of the aortic arch and surrounding vessels. The stent was deployed while the 2 balloons were introduced in a kissing manner such that they faced one another to avoid occlusion of either branch of the innominate artery coming into contact; 1 balloon was inflated at the origin of the right subclavian artery, and the other was inflated at the right innominate artery simultaneously. The pseudoaneurysm was successfully contained; normal blood flow was restored in the CCA. The balloons were deflated and withdrawn. The patient remained neurologically intact after the procedure. The kissing balloon technique is a safe and effective alternative to surgical repair, as it prevents morbidities associated with the surgical procedure. Also, this technique decreases the risk of major side-branch occlusion associated with the single-artery balloon-covered stent graft technique. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. 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)

  15. Dutch Viking TROS Aktua Special

    NASA Technical Reports Server (NTRS)

    1986-01-01

    Footage shows the night vertical takeoff of the Viking Hollan hot air balloon. The crew is shown participating in survival technique training, boarding the plane to depart to Canada, and preparing for the vertical takeoff in the hot air balloon across the Atlantic Ocean. Scenes also include the making of the capsule for the balloon, some flight activities, and the landing of the balloon.

  16. 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.

  17. Mechanical properties of ANTRIX balloon film and fabrication of single cap large volume balloons

    NASA Astrophysics Data System (ADS)

    Suneel Kumar, B.; Sreenivasan, S.; Subba Rao, J. V.; Manchanda, R. K.

    2008-11-01

    The zero pressure plastic balloons used for high altitude studies are generally made from polyethylene material. Tensile properties of the thin film polymer are the key parameters for material selection due to extremely low temperature of -90 °C encountered by the balloons in the tropopause region during the ascent at equatorial latitudes. The physical and structural properties of the material determine the uniformity of the stress distribution over the entire shell. Load stresses from the suspended load propagate via load tapes heat sealed along with the gore seals as per the balloon design. A balance between this heat seal strength and the film strength is a desirable property of the basic resin in terms of the bubble strength, gauge uniformity, and long-term storage properties. In addition, the design of the top shell of the balloon and its stress distribution play an important role since only a fraction of the balloon is deployed during the filling operation and the ascent. In this paper we describe the mechanical properties of the 'ANTRIX' film developed by us and the optimized design of single cap balloons, which have been successfully used in our experiments over the past 5 years.

  18. Introduction (Special Issue on Scientific Balloon Capabilities and Instrumentation)

    NASA Technical Reports Server (NTRS)

    Gaskin, Jessica A.; Smith, I. S.; Jones, W. V.

    2014-01-01

    In 1783, the Montgolfier brothers ushered in a new era of transportation and exploration when they used hot air to drive an un-tethered balloon to an altitude of 2 km. Made of sackcloth and held together with cords, this balloon challenged the way we thought about human travel, and it has since evolved into a robust platform for performing novel science and testing new technologies. Today, high-altitude balloons regularly reach altitudes of 40 km, and they can support payloads that weigh more than 3,000 kg. Long-duration balloons can currently support mission durations lasting 55 days, and developing balloon technologies (i.e. Super-Pressure Balloons) are expected to extend that duration to 100 days or longer; competing with satellite payloads. This relatively inexpensive platform supports a broad range of science payloads, spanning multiple disciplines (astrophysics, heliophysics, planetary and earth science.) Applications extending beyond traditional science include testing new technologies for eventual space-based application and stratospheric airships for planetary applications.

  19. Fracture, inflation and floatation embolisation of PTCA balloon.

    PubMed

    O'Neill, Louisa; Sowbhaga, Vinay; Owens, Patrick

    2015-01-09

    This case outlines an unusual complication of coronary intervention, the likely mechanisms leading to this and possible retrieval options. It is the first case to the best of our knowledge reporting this complication. A 78-year-old Caucasian man underwent coronary stenting. During the procedure kinking and subsequent fracture of a non-compliant percutaneous transluminal coronary angioplasty (PTCA) balloon occurred. Injection of contrast down the guide to opacify the coronary arteries resulted in 'inflation' of the balloon with air, and embolisation of the inflated balloon into the proximal left anterior descending artery. The embolised balloon was retrieved by removal of the guide catheter and wire as a unit. The patient had a good angiographic outcome. This case highlights risks associated with usage of kinked balloons catheters, and describes for the first time to our knowledge, the inflation of a PTCA balloon with air from its shaft within the catheter, causing 'floatation' embolisation into the coronary artery. 2015 BMJ Publishing Group Ltd.

  20. Fracture, inflation and floatation embolisation of PTCA balloon

    PubMed Central

    O'Neill, Louisa; Sowbhaga, Vinay; Owens, Patrick

    2015-01-01

    This case outlines an unusual complication of coronary intervention, the likely mechanisms leading to this and possible retrieval options. It is the first case to the best of our knowledge reporting this complication. A 78-year-old Caucasian man underwent coronary stenting. During the procedure kinking and subsequent fracture of a non-compliant percutaneous transluminal coronary angioplasty (PTCA) balloon occurred. Injection of contrast down the guide to opacify the coronary arteries resulted in ‘inflation’ of the balloon with air, and embolisation of the inflated balloon into the proximal left anterior descending artery. The embolised balloon was retrieved by removal of the guide catheter and wire as a unit. The patient had a good angiographic outcome. This case highlights risks associated with usage of kinked balloons catheters, and describes for the first time to our knowledge, the inflation of a PTCA balloon with air from its shaft within the catheter, causing ‘floatation’ embolisation into the coronary artery. PMID:25576524

  1. THERMTRAJ: A FORTRAN program to compute the trajectory and gas film temperatures of zero pressure balloons

    NASA Technical Reports Server (NTRS)

    Horn, W. J.; Carlson, L. A.

    1983-01-01

    A FORTRAN computer program called THERMTRAJ is presented which can be used to compute the trajectory of high altitude scientific zero pressure balloons from launch through all subsequent phases of the balloon flight. In addition, balloon gas and film temperatures can be computed at every point of the flight. The program has the ability to account for ballasting, changes in cloud cover, variable atmospheric temperature profiles, and both unconditional valving and scheduled valving of the balloon gas. The program was verified for an extensive range of balloon sizes (from 0.5 to 41.47 million cubic feet). Instructions on program usage, listing of the program source deck, input data and printed and plotted output for a verification case are included.

  2. Upper limits to the quiet-time solar neutron flux from 10 to 100 MeV

    NASA Technical Reports Server (NTRS)

    Moon, S.; Simnett, G. M.; White, R. S.

    1975-01-01

    The UCR large area solid-angle double scatter neutron telescope was flown to search for solar neutrons on 3 balloon flights on September 26, 1971, May 14, 1972 and September 19, 1972. The first two flights were launched from Palestine, Texas and the third from Cape Girardeau, Missouri. The float altitude on each flight was at about 5 g/sq cm residual atmosphere. Neutrons from 10 to 100 MeV were measured. No solar flares occurred during the flights. Upper limits to the quiet time solar neutron fluxes at the 95% confidence level are .00028, .00046, .00096 and .00090 neutrons/sq cm-sec in the energy intervals of 10-30, 30-50, 50-100 and 10-100 MeV, respectively.

  3. Polar Research with Unmanned Aircraft and Tethered Balloons

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

    Ivey, M; Petty, R; Desilets, D

    2014-01-24

    The Arctic is experiencing rapid climate change, with nearly double the rate of surface warming observed elsewhere on the planet. While various positive feedback mechanisms have been suggested, the reasons for Arctic amplification are not well understood, nor are the impacts to the global carbon cycle well quantified. Additionally, there are uncertainties associated with the complex interactions between Earth’s surface and the atmosphere. Elucidating the causes and consequences of Arctic warming is one of the many goals of the Climate and Environmental Sciences Division (CESD) of the U.S. Department of Energy’s (DOE) Biological and Environmental Research (BER) program, and ismore » part of the larger CESD initiative to develop a robust predictive understanding of Earth’s climate system.« less

  4. Morphological characterization of selected balloon films and its effects on balloon performances

    NASA Technical Reports Server (NTRS)

    Said, Magdi A.

    1994-01-01

    Morphological characterization of several polyethylene balloon films have been studied using various techniques. The objective is to determine, if any, differentiating structural or morphological features that can be related to the performance of these balloon film materials. The results of the study indicate that the films are composed of either linear low denstiy polyethylene (LLDPE) or low density polyethylene (LDPE). A selective examination of these data imply that films limited degree of branching and larger crystallites size (same % crystallinity) showed good mechanical properties that appear to correlate with their high level of success in balloon flights.

  5. KSC-02pd1858

    NASA Image and Video Library

    2002-12-05

    KENNEDY SPACE CENTER, FLA. - Stephen Ezell, meteorological systems operator at Weather Station A, Cape Canaveral Air Force Station, gets ready to release a weather balloon. Such balloons are released twice a day. The package in Ezell's hand is a radio sonde that collects temperature and humidity data as the balloon rises. The data is released to agencies nationwide, including the 45th Space Wing, which uses the data for its daily weather reports. The weather station provides additional data to NASA for launches -- releasing 12 balloons in eight hours prior to liftoff - and landings - releasing 5 balloons in six and a half hours before expected touchdown.

  6. KSC-02pd1859

    NASA Image and Video Library

    2002-12-05

    KENNEDY SPACE CENTER, FLA. -- Stephen Ezell, meteorological systems operator at Weather Station A, Cape Canaveral Air Force Station, releases a weather balloon. Such balloons are released twice a day. The package at the bottom is a radio sonde that collects temperature and humidity data as the balloon rises. The data is released to agencies nationwide, including the 45th Space Wing, which uses the data for its daily weather reports. The weather station provides additional data to NASA for launches -- releasing 12 balloons in eight hours prior to liftoff - and landings - releasing 5 balloons in six and a half hours before expected touchdown.

  7. KSC-02pd1857

    NASA Image and Video Library

    2002-12-05

    KENNEDY SPACE CENTER, FLA. - Stephen Ezell, meteorological systems operator at Weather Station A, Cape Canaveral Air Force Station, gets ready to release a weather balloon. Such balloons are released twice a day. The package in Ezell's hand is a radio sonde that collects temperature and humidity data as the balloon rises. The data is released to agencies nationwide, including the 45th Space Wing, which uses the data for its daily weather reports. The weather station provides additional data to NASA for launches -- releasing 12 balloons in eight hours prior to liftoff - and landings - releasing 5 balloons in six and a half hours before expected touchdown.

  8. Sounding rocket and balloon flight safety philosophy and methodologies

    NASA Technical Reports Server (NTRS)

    Beyma, R. J.

    1986-01-01

    NASA's sounding rocket and balloon goal is to successfully and safely perform scientific research. This is reflected in the design, planning, and conduct of sounding rocket and balloon operations. The purpose of this paper is to acquaint the sounding rocket and balloon scientific community with flight safety philosophy and methodologies, and how range safety affects their programs. This paper presents the flight safety philosophy for protecting the public against the risk created by the conduct of sounding rocket and balloon operations. The flight safety criteria used to implement this philosophy are defined and the methodologies used to calculate mission risk are described.

  9. 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)

  10. 21 CFR 874.4100 - Epistaxis balloon.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    .... An epistaxis balloon is a device consisting of an inflatable balloon intended to control internal... (general controls). The device is exempt from the premarket notification procedures in subpart E of part...

  11. Atmospheric Electricity and Tethered Aerostats, Volume 2

    DTIC Science & Technology

    1976-05-11

    vs Altitude (Non- conducting or Conducting Tethers...Effect of Corona Charge Plume 15 3.1 Tether Current vs Balloon Altitude , BJ+3 - 25 Sep 73 20 3.2 Tether Current vs Balloon Altitude , Baldy - 17 Oct 73 21...3.3 Tether Current vs Balloon Altitude , Baldy - 31 Oct 73 22 3.4 Tether Current vs Balloon Altitude , Baldy - 2 Nov 73 23 3.5 Tether Current vs

  12. Image-guided method for TLD-based in vivo rectal dose verification with endorectal balloon in proton therapy for prostate cancer

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

    Hsi, Wen C.; Fagundes, Marcio; Zeidan, Omar

    Purpose: To present a practical image-guided method to position an endorectal balloon that improves in vivo thermoluminiscent dosimeter (TLD) measurements of rectal doses in proton therapy for prostate cancer. Methods: TLDs were combined with endorectal balloons to measure dose at the anterior rectal wall during daily proton treatment delivery. Radiopaque metallic markers were employed as surrogates for balloon position reproducibility in rotation and translation. The markers were utilized to guide the balloon orientation during daily treatment employing orthogonal x-ray image-guided patient positioning. TLDs were placed at the 12 o'clock position on the anterior balloon surface at the midprostatic plane. Markersmore » were placed at the 3 and 9 o'clock positions on the balloon to align it with respect to the planned orientation. The balloon rotation along its stem axis, referred to as roll, causes TLD displacement along the anterior-posterior direction. The magnitude of TLD displacement is revealed by the separation distance between markers at opposite sides of the balloon on sagittal x-ray images. Results: A total of 81 in vivo TLD measurements were performed on six patients. Eighty-three percent of all measurements (65 TLD readings) were within +5% and -10% of the planning dose with a mean of -2.1% and a standard deviation of 3.5%. Examination of marker positions with in-room x-ray images of measured doses between -10% and -20% of the planned dose revealed a strong correlation between balloon roll and TLD displacement posteriorly from the planned position. The magnitude of the roll was confirmed by separations of 10-20 mm between the markers which could be corrected by manually adjusting the balloon position and verified by a repeat x-ray image prior to proton delivery. This approach could properly correct the balloon roll, resulting in TLD positioning within 2 mm along the anterior-posterior direction. Conclusions: Our results show that image-guided TLD-based in vivo dosimetry for rectal dose verification can be perfomed reliably and reproducibly for proton therapy in prostate cancer.« less

  13. Image-guided method for TLD-based in vivo rectal dose verification with endorectal balloon in proton therapy for prostate cancer.

    PubMed

    Hsi, Wen C; Fagundes, Marcio; Zeidan, Omar; Hug, Eugen; Schreuder, Niek

    2013-05-01

    To present a practical image-guided method to position an endorectal balloon that improves in vivo thermoluminiscent dosimeter (TLD) measurements of rectal doses in proton therapy for prostate cancer. TLDs were combined with endorectal balloons to measure dose at the anterior rectal wall during daily proton treatment delivery. Radiopaque metallic markers were employed as surrogates for balloon position reproducibility in rotation and translation. The markers were utilized to guide the balloon orientation during daily treatment employing orthogonal x-ray image-guided patient positioning. TLDs were placed at the 12 o'clock position on the anterior balloon surface at the midprostatic plane. Markers were placed at the 3 and 9 o'clock positions on the balloon to align it with respect to the planned orientation. The balloon rotation along its stem axis, referred to as roll, causes TLD displacement along the anterior-posterior direction. The magnitude of TLD displacement is revealed by the separation distance between markers at opposite sides of the balloon on sagittal x-ray images. A total of 81 in vivo TLD measurements were performed on six patients. Eighty-three percent of all measurements (65 TLD readings) were within +5% and -10% of the planning dose with a mean of -2.1% and a standard deviation of 3.5%. Examination of marker positions with in-room x-ray images of measured doses between -10% and -20% of the planned dose revealed a strong correlation between balloon roll and TLD displacement posteriorly from the planned position. The magnitude of the roll was confirmed by separations of 10-20 mm between the markers which could be corrected by manually adjusting the balloon position and verified by a repeat x-ray image prior to proton delivery. This approach could properly correct the balloon roll, resulting in TLD positioning within 2 mm along the anterior-posterior direction. Our results show that image-guided TLD-based in vivo dosimetry for rectal dose verification can be perfomed reliably and reproducibly for proton therapy in prostate cancer.

  14. Gastric antral webs in adults: A case series characterizing their clinical presentation and management in the modern endoscopic era

    PubMed Central

    Morales, Shannon J; Nigam, Neha; Chalhoub, Walid M; Abdelaziz, Dalia I; Lewis, James H; Benjamin, Stanley B

    2017-01-01

    AIM To investigate the current management of gastric antral webs (GAWs) among adults and identify optimal endoscopic and/or surgical management for these patients. METHODS We reviewed our endoscopy database seeking to identify patients in whom a GAW was visualized among 24640 esophagogastroduodenoscopies (EGD) over a seven-year period (2006-2013) at a single tertiary care center. The diagnosis of GAW was suspected during EGD if aperture size of the antrum did not vary with peristalsis or if a “double bulb” sign was present on upper gastrointestinal series. Confirmation of the diagnosis was made by demonstrating a normal pylorus distal to the GAW. RESULTS We identified 34 patients who met our inclusion criteria (incidence 0.14%). Of these, five patients presented with gastric outlet obstruction (GOO), four of whom underwent repeated sequential balloon dilations and/or needle-knife incisions with steroid injection for alleviation of GOO. The other 29 patients were incidentally found to have a non-obstructing GAW. Age at diagnosis ranged from 30-87 years. Non-obstructing GAWs are mostly incidental findings. The most frequently observed symptom prompting endoscopic work-up was refractory gastroesophageal reflux (n = 24, 70.6%) followed by abdominal pain (n = 11, 33.4%), nausea and vomiting (n = 9, 26.5%), dysphagia (n = 6, 17.6%), unexplained weight loss, (n = 4, 11.8%), early satiety (n = 4, 11.8%), and melena of unclear etiology (n = 3, 8.82%). Four of five GOO patients were treated with balloon dilation (n = 4), four-quadrant needle-knife incision (n = 3), and triamcinolone injection (n = 2). Three of these patients required repeat intervention. One patient had a significant complication of perforation after needle-knife incision. CONCLUSION Endoscopic intervention for GAW using balloon dilation or needle-knife incision is generally safe and effective in relieving symptoms, however repeat treatment may be needed and a risk of perforation exists with thermal therapies. PMID:28101304

  15. Effect of intravenous TRO40303 as an adjunct to primary percutaneous coronary intervention for acute ST-elevation myocardial infarction: MITOCARE study results.

    PubMed

    Atar, Dan; Arheden, Håkan; Berdeaux, Alain; Bonnet, Jean-Louis; Carlsson, Marcus; Clemmensen, Peter; Cuvier, Valérie; Danchin, Nicolas; Dubois-Randé, Jean-Luc; Engblom, Henrik; Erlinge, David; Firat, Hüseyin; Halvorsen, Sigrun; Hansen, Henrik Steen; Hauke, Wilfried; Heiberg, Einar; Koul, Sasha; Larsen, Alf-Inge; Le Corvoisier, Philippe; Nordrehaug, Jan Erik; Paganelli, Franck; Pruss, Rebecca M; Rousseau, Hélène; Schaller, Sophie; Sonou, Giles; Tuseth, Vegard; Veys, Julien; Vicaut, Eric; Jensen, Svend Eggert

    2015-01-07

    The MITOCARE study evaluated the efficacy and safety of TRO40303 for the reduction of reperfusion injury in patients undergoing revascularization for ST-elevation myocardial infarction (STEMI). Patients presenting with STEMI within 6 h of the onset of pain randomly received TRO40303 (n = 83) or placebo (n = 80) via i.v. bolus injection prior to balloon inflation during primary percutaneous coronary intervention in a double-blind manner. The primary endpoint was infarct size expressed as area under the curve (AUC) for creatine kinase (CK) and for troponin I (TnI) over 3 days. Secondary endpoints included measures of infarct size using cardiac magnetic resonance (CMR) and safety outcomes. The median pain-to-balloon time was 180 min for both groups, and the median (mean) door-to-balloon time was 60 (38) min for all sites. Infarct size, as measured by CK and TnI AUCs at 3 days, was not significantly different between treatment groups. There were no significant differences in the CMR-assessed myocardial salvage index (1-infarct size/myocardium at risk) (mean 52 vs. 58% with placebo, P = 0.1000), mean CMR-assessed infarct size (21.9 g vs. 20.0 g, or 17 vs. 15% of LV-mass) or left ventricular ejection fraction (LVEF) (46 vs. 48%), or in the mean 30-day echocardiographic LVEF (51.5 vs. 52.2%) between TRO40303 and placebo. A greater number of adjudicated safety events occurred in the TRO40303 group for unexplained reasons. This study in STEMI patients treated with contemporary mechanical revascularization principles did not show any effect of TRO40303 in limiting reperfusion injury of the ischaemic myocardium. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  16. Radioactive 133-Xenon gas-filled balloon to prevent restenosis: dosimetry, efficacy, and safety considerations.

    PubMed

    Apple, Marc; Waksman, Ron; Chan, Rosanna C; Vodovotz, Yoram; Fournadjiev, Jana; Bass, Bill G

    2002-08-06

    Ionizing radiation administered intraluminally via catheter-based systems using solid beta and gamma sources or liquid-filled balloons has shown reduction in the neointima formation after injury in the porcine model. We propose a novel system that uses a 133-Xenon (133Xe) radioactive gas-filled balloon catheter system. Overstretch balloon injury was performed in the coronary arteries of 33 domestic pigs. A novel 133Xe radioactive gas-filled balloon (3.5/45 mm) was positioned to overlap the injured segment with margins. After vacuum was obtained in the balloon catheter, approximately 2.5 cc of 133Xe gas was injected to fill the balloon. Doses of 0, 7.5, 15, and 30 Gy were delivered to a distance of 0.25 mm from the balloon surface. The dwell time ranged from 1.0 to 4.0 minutes, depending on the dose. Localization of 133Xe in the balloon was verified by a gamma camera. The average activity in a 3.5/45-mm balloon was measured at 67.7+/-12.1 mCi, and the total diffusion loss of the injected dose was 0.26% per minute of the injected dose. Bedside radiation exposure measured between 2 and 6 mR/h, and the shallow dose equivalent was calculated as 0.037 mrem per treatment. Histomorphometric analysis at 2 weeks showed inhibition of the intimal area (intimal area corrected for medial fracture length [IA/FL]) in the irradiated segments of 0.26+/-0.08 with 30 Gy, 0.07+/-0.24 with 15 Gy, and 0.12+/-0.89 with 7.5 Gy versus 0.76+/-0.08 with control P<0.001. 133Xe gas-filled balloon is feasible and effective in the reduction of neointima formation in the porcine model and safe for use in coronary arteries.

  17. Hygroscopic dilators vs balloon catheter ripening of the cervix for induction of labor in nulliparous women at term: Retrospective study

    PubMed Central

    Shindo, Ryosuke; Yonemoto, Naohiro; Yamamoto, Yuriko; Kasai, Junko; Kasai, Michi; Miyagi, Etsuko

    2017-01-01

    Objective To compare the efficacy and safety of hygroscopic dilators and balloon catheters for ripening of the cervix in induction of labor. Study design This retrospective, observational study used data from the Successive Pregnancy Birth Registry System of the Japan Society of Obstetrics and Gynecology from 2012 to 2014. Nulliparous women in whom labor was induced by mechanical methods of cervical ripening at term were enrolled. The eligible women were divided into dilator, balloon <40 mL, balloon ≧40 mL, and overlapping groups. Results The groups included 4645, 4100, 6615, and 1992 women, respectively. In the overlapping group, which included the women in whom delivery was most difficult, the vaginal delivery rate was lower and the intrauterine infection and neonatal mortality rates were higher than those in the dilator group. No difference in the vaginal delivery rate was observed among the dilator, balloon <40 mL, and balloon ≧40 mL groups (74.6%, 72.3%, and 73.8%, respectively; p>0.05). The vaginal instrumental delivery rate was higher in the two-balloon groups than in the dilator group. The volume of intrapartum hemorrhage was lowest in the dilator group. No significant difference in the frequencies of uterine rupture and intrauterine infection were observed among the dilator and two-balloon groups. With regard to neonatal outcomes, the frequency of a low Apgar score was statistically significantly lower in the dilator group than in the two-balloon groups. Moreover, the frequency of neonatal death tended to be lower in the dilator group than in the two-balloon groups. Conclusion With regard to cervical ripening for labor induction in nulliparous women at term, the vaginal delivery rate on using a dilator and on using a balloon seems to be equivalent. Concerning maternal complications and neonatal outcomes, cervical ripening with hygroscopic dilators in labor induction might be safer. PMID:29272277

  18. A study of the dynamics of the equatorial lower stratosphere by use of ultra-long-duration balloons, 1. Planetary scales

    NASA Astrophysics Data System (ADS)

    Vial, F.; Hertzog, A.; Mechoso, C. R.; Basdevant, C.; Cocquerez, P.; Dubourg, V.; Nouel, F.

    2001-10-01

    In the late southern winter of 1998, Center National d'Études Spatiales (CNES), the French Space Agency, released six 10-m-diameter, superpressure balloons from a location near Quito, Ecuador. Three balloons collapsed soon after launching, but the remaining three drifted westward for a few weeks at altitudes between 19 and 20 km. Two of those balloons crossed the Pacific Ocean before falling above the ``maritime continent,'' while the other completed a revolution around the Earth and crossed the Pacific for a second time before its final fall. Despite the small number and the relatively short duration of the flights, the balloons provided a unique in situ data set for the lower equatorial stratosphere. This part 1 of a two-part paper describes this data set and analyzes outstanding features in the planetary scales. Part 2 focuses on gravity-wave scale. It is argued that balloon trajectories over the Pacific are primarily determined by the westward drift during the easterly phase of the equatorial quasi-biennial oscillation (QBO) and the meridional velocity field of a mixed Rossby-gravity (Yanai) wave with an apparent period of 4 days and zonal wave number 4. This wave appears to have two episodes of amplification during the balloon flights. It is also argued that the balloons show evidence of oscillations with periods between 2 and 4 days and of a Kelvin wave with an apparent period close to 10 days and zonal wave number 1. In this way, the balloon behavior provided a pictorial view of air parcel trajectory in the equatorial lower stratosphere. It is stated that larger balloon campaigns can provide excellent in situ data sets for studies on the dynamics and composition of the middle atmosphere.

  19. Evaluation of balloon withdrawal forces with bare-metal stents, compared with Taxus and Cypher drug-eluting coronary stents: balloon, stent and polymer interactions.

    PubMed

    Turk, Marvee; Gupta, Vishal; Fischell, Tim A

    2010-03-01

    There have been reports of serious complications related to difficulty removing the deflated Taxus stent delivery balloon after stent deployment. The purpose of this study was to determine whether the Taxus SIBS polymer was "sticky" and associated with an increase in the force required to remove the stent delivery balloon after stent deployment, using a quantitative, ex-vivo model. Balloon-polymer-stent interactions during balloon withdrawal were measured with the Taxus Liberté, Liberté bare-metal stent (BMS; no polymer = control), the Cordis Cypher drug-eluting stent (DES; PEVA/PBMA polymer) and the BX Velocity (no polymer). We quantitatively measured the force required to remove the deflated stent delivery balloon from each of these stents in simulated vessels at 37 degrees C in a water bath. Balloon withdrawal forces were measured in straight (0 degree curve), mildly curved (20 degree curve) and moderately curved (40 degree curve) simulated vessel segments. The average peak force required to remove the deflated balloon catheter from the Taxus Liberté DES, the Liberté BMS, the Cypher DES, and the Bx Velocity BMS were similar in straight segments, but were much greater for the Taxus Liberté in the moderately curved segments (1.4 lbs vs. 0.11 lbs, 0.11 lbs and 0.12 lbs, respectively; p < 0.0001). The SIBS polymer of the Taxus Liberté DES appears to be "sticky" and is associated with high forces required to withdraw the deflated balloon from the deployed stent in curved segments. This withdrawal issue may help to explain the clinical complications that have been reported with this device.

  20. Balloon dilation of the eustachian tube for dilatory dysfunction: A randomized controlled trial.

    PubMed

    Poe, Dennis; Anand, Vijay; Dean, Marc; Roberts, William H; Stolovitzky, Jose Pablo; Hoffmann, Karen; Nachlas, Nathan E; Light, Joshua P; Widick, Mark H; Sugrue, John P; Elliott, C Layton; Rosenberg, Seth I; Guillory, Paul; Brown, Neil; Syms, Charles A; Hilton, Christopher W; McElveen, John T; Singh, Ameet; Weiss, Raymond L; Arriaga, Moises A; Leopold, John P

    2018-05-01

    To assess balloon dilation of the Eustachian tube with Eustachian tube balloon catheter in conjunction with medical management as treatment for Eustachian tube dilatory dysfunction. In this prospective, multicenter, randomized, controlled trial, we assigned, in a 2:1 ratio, patients age 22 years and older with Eustachian tube dilatory dysfunction refractory to medical therapy to undergo balloon dilation of the Eustachian tube with balloon catheter in conjunction with medical management or medical management alone. The primary endpoint was normalization of tympanogram at 6 weeks. Additional endpoints were normalization of Eustachian Tube Dysfunction Questionaire-7 symptom scores, positive Valsalva maneuver, mucosal inflammation, and safety. Primary efficacy results demonstrated superiority of balloon dilation of the Eustachian tube with balloon catheter + medical management compared to medical management alone. Tympanogram normalization at 6-week follow-up was observed in 51.8% (72/139) of investigational patients versus 13.9% (10/72) of controls (P < .0001). Tympanogram normalization in the treatment group was 62.2% after 24 weeks. Normalization of Eustachian Tube Dysfunction Questionaire-7 Symptom scores at 6-week follow-up was observed in 56.2% (77/137) of investigational patients versus 8.5% (6/71) controls (P < .001). The investigational group also demonstrated substantial improvement in both mucosal inflammation and Valsalva maneuver at 6-week follow-up compared to controls. No device- or procedure-related serious adverse events were reported for those who underwent balloon dilation of the Eustachian tube. This study demonstrated superiority of balloon dilation of the Eustachian tube with balloon catheter + medical management compared to medical management alone to treat Eustachian tube dilatory dysfunction in adults. 1b. Laryngoscope, 128:1200-1206, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  1. Multimodality Intra-Arterial Imaging Assessment of the Vascular Trauma Induced by Balloon-Based and Nonballoon-Based Renal Denervation Systems.

    PubMed

    Karanasos, Antonios; Van Mieghem, Nicolas; Bergmann, Martin W; Hartman, Eline; Ligthart, Jurgen; van der Heide, Elco; Heeger, Christian-H; Ouhlous, Mohamed; Zijlstra, Felix; Regar, Evelyn; Daemen, Joost

    2015-07-01

    Renal denervation is a new treatment considered for several possible indications. As new systems are introduced, the incidence of acute renal artery wall injury with relation to the denervation method is unknown. We investigated the acute repercussion of renal denervation on the renal arteries of patients treated with balloon-based and nonballoon-based denervation systems by quantitative angiography, intravascular ultrasound, and optical coherence tomography (OCT). Twenty-five patients (50 renal arteries) underwent bilateral renal denervation with 5 different systems, 3 of which balloon-based (Paradise [n=5], Oneshot [n=6], and Vessix V2 [n=5)]) and 2 nonballoon-based (Symplicity [n=6] and EnligHTN [n=3]). Analysis included quantitative angiography and morphometric intravascular ultrasound measurements pre and post procedure and assessment of vascular trauma (dissection, edema, or thrombus) by OCT after denervation. A significant reduction in lumen size by quantitative angiography and intravascular ultrasound was observed in nonballoon denervation but not in balloon denervation. By postdenervation OCT, dissection was seen in 14 arteries (32.6%). The percentage of frames with dissection was higher in balloon-based denervation catheters. Thrombus and edema were detected in 35 (81.4%) and 32 (74.4%) arteries, respectively. In arteries treated with balloon-based denervation that had dissection by OCT, the balloon/artery ratio was higher (1.24 [1.17-1.32] versus 1.10 [1.04-1.18]; P<0.01). A varying extent of vascular injury was observed after renal denervation in all systems; however, different patterns were identified in balloon-based and in nonballoon-based denervation systems. In balloon denervation, the presence of dissections by OCT was associated with a higher balloon/artery ratio. © 2015 American Heart Association, Inc.

  2. Static and quasi-static analysis of lobed-pumpkin balloon

    NASA Astrophysics Data System (ADS)

    Nakashino, Kyoichi; Sasaki, Makoto; Hashimoto, Satoshi; Saito, Yoshitaka; Izutsu, Naoki

    The present study is motivated by the need to improve design methodology for super pressure balloon with 3D gore design concept, currently being developed at the Scientific Balloon Center of ISAS/JAXA. The distinctive feature of the 3-D gore design is that the balloon film has excess materials not only in the circumferential direction but also in the meridional direction; the meridional excess is gained by attaching the film boundaries to the corresponding tendons of a shorter length with a controlled shortening rate. The resulting balloon shape is a pumpkin-like shape with large bulges formed between adjacent tendons. The balloon film, when fully inflated, develops wrinkles in the circumferential direction over its entire region, so that the stresses in the film are limited to a small amount of uniaxial tension in the circumferential direction while the high meridional loads are carried by re-enforced tendons. Naturally, the amount of wrinkling in the film is dominated by the shortening rate between the film boundaries and the tendon curve. In the 3-D gore design, as a consequence, the shortening rate becomes a fundamental design parameter along with the geometric parameters of the gore. In view of this, we have carried out a series of numerical study of the lobed-pumpkin balloon with varying gore geometry as well as with varying shortening rate. The numerical simula-tions were carried out with a nonlinear finite element code incorporating the wrinkling effect. Numerical results show that there is a threshold value for the shortening rate beyond which the stresses in the balloon film increases disproportionately. We have also carried out quasi-static simulations of the inflation process of the lobed-pumpkin balloon, and have obtained asymmetric deformations when the balloon films are in uniaxial tension state.

  3. Tube Feeding Troubleshooting Guide

    MedlinePlus

    ... in place. (For example, does it have a balloon, a mushroom bumper, or other internal device, or ... Frequent vomiting. • See “Nausea and Vomiting” page 3. Balloon deflates or bursts. • Be sure the balloon under ...

  4. 14 CFR 101.5 - Operations in prohibited or restricted areas.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND... a moored balloon, kite, amateur rocket, or unmanned free balloon in a prohibited or restricted area...

  5. 14 CFR 101.5 - Operations in prohibited or restricted areas.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND... a moored balloon, kite, amateur rocket, or unmanned free balloon in a prohibited or restricted area...

  6. 14 CFR 101.5 - Operations in prohibited or restricted areas.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND... a moored balloon, kite, amateur rocket, or unmanned free balloon in a prohibited or restricted area...

  7. 14 CFR 101.5 - Operations in prohibited or restricted areas.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND... a moored balloon, kite, amateur rocket, or unmanned free balloon in a prohibited or restricted area...

  8. 14 CFR 101.5 - Operations in prohibited or restricted areas.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND... a moored balloon, kite, amateur rocket, or unmanned free balloon in a prohibited or restricted area...

  9. Endovascular balloon-assisted embolization of high-flow peripheral vascular lesions using dual-lumen coaxial balloon microcatheter and Onyx: initial experience.

    PubMed

    Jagadeesan, Bharathi D; Mortazavi, Shabnam; Hunter, David W; Duran-Castro, Olga L; Snyder, Gregory B; Siedel, Glen F; Golzarian, Jafar

    2014-04-01

    Balloon-assisted embolization performed by delivering Onyx ethylene vinyl alcohol copolymer through a dual-lumen coaxial balloon microcatheter is a new technique for the management of peripheral vascular lesions. This technique does not require an initial reflux of Onyx to form around the tip of the microcatheter before antegrade flow of Onyx can commence. In a series of four patients who were treated with the use of this technique, the absence of significant reflux of Onyx was noted, as were excellent navigability and easy retrieval of the balloon microcatheter. However, in one patient, there was inadvertent adverse embolization of a digital artery, which was not caused by reflux of Onyx but could still be related to balloon inflation. © 2013 SIR Published by SIR All rights reserved.

  10. Detection of Artificially Generated Seismic Signals Using Balloon-Borne Infrasound Sensors

    NASA Astrophysics Data System (ADS)

    Krishnamoorthy, Siddharth; Komjathy, Attila; Pauken, Michael T.; Cutts, James A.; Garcia, Raphael F.; Mimoun, David; Cadu, Alexandre; Sournac, Anthony; Jackson, Jennifer M.; Lai, Voon Hui; Bowman, Daniel C.

    2018-04-01

    We conducted an experiment in Pahrump, Nevada, in June 2017, where artificial seismic signals were created using a seismic hammer, and the possibility of detecting them from their acoustic signature was examined. In this work, we analyze the pressure signals recorded by highly sensitive barometers deployed on the ground and on tethers suspended from balloons. Our signal processing results show that wind noise experienced by a barometer on a free-flying balloon is lower compared to one on a moored balloon. This has never been experimentally demonstrated in the lower troposphere. While seismoacoustic signals were not recorded on the hot air balloon platform owing to operational challenges, we demonstrate the detection of seismoacoustic signals on our moored balloon platform. Our results have important implications for performing seismology in harsh surface environments such as Venus through atmospheric remote sensing.

  11. Exhaled nitric oxide in mylar balloons: influence of storage time, humidity and temperature.

    PubMed Central

    Bodini, Alessandro; Pijnenburg, Mariëlle W H; Boner, Atillio L; de Jongste, Johan C

    2003-01-01

    BACKGROUND: Mylar balloons are used to collect exhaled air for analysis of fractional nitric oxide concentration (FENO). AIM: We studied the effect of storage conditions on the stability of nitric oxide (NO) in mylar balloons. METHODS: Exhaled air samples and calibration gases were stored in mylar balloons at 4, 21 and 37 degrees C, with or without silica gel. NO was measured after 0, 6, 9, 24 and 48 h. Scheffe F-tests were used to compare NO values. RESULTS: NO remained stable in balloons for 9 h at all temperatures, without silica gel. NO increased between 9 and 48 h, but only with low initial FENO. Silica gel increased variability. CONCLUSIONS: FENO in mylar balloons is stable for at least 9 h. The storage temperature is not critical, but silica gel increases variability. PMID:12745548

  12. A verified technique for calibrating space solar cells

    NASA Technical Reports Server (NTRS)

    Anspaugh, Bruce

    1987-01-01

    Solar cells have been flown on high-altitude balloons for over 24 years, to produce solar cell standards that can be used to set the intensity of solar simulators. The events of a typical balloon calibration flight are reported. These are: the preflight events, including the preflight cell measurements and the assembly of the flight cells onto the solar tracker; the activities at the National Scientific Balloon Facility in Palestine, Texas, including the preflight calibrations, the mating of the tracker and cells onto the balloon, preparations for launch, and the launch; the payload recovery, which includes tracking the balloon by aircraft, terminating the flight, and retrieving the payload. In 1985, the cells flow on the balloon were also flown on a shuttle flight and measured independently. The two measurement methods are compared and shown to agree within 1 percent.

  13. Balloon-Assisted Chemoembolization Using a Micro-Balloon Catheter Alongside a Microcatheter for a Hepatocellular Carcinoma with a Prominent Arterioportal Shunt: A Case Report

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

    Hoshiai, Sodai, E-mail: hoshiai@sb4.so-net.ne.jp; Mori, Kensaku; Ishiguro, Toshitaka

    Although transcatheter arterial chemoembolization is one of the established treatments for hepatocellular carcinoma (HCC), it is difficult to treat HCCs with prominent arterioportal (AP) shunts because anticancer drugs and embolic materials migrate into the non-tumorous liver through the AP shunts and may cause liver infarction. We developed a novel method of balloon-assisted chemoembolization using a micro-balloon catheter alongside a microcatheter simultaneously inserted through a single 4.5-Fr guiding sheath, comprising proximal chemoembolization with distal arterial balloon occlusion. We applied this method to treat an HCC with a prominent distal AP shunt induced by previous proton beam therapy and achieved successful chemoembolizationmore » without non-tumorous liver infarction under temporal balloon occlusion of a distal AP shunt.« less

  14. An Overview of the NASA Sounding Rocket and Balloon Programs

    NASA Technical Reports Server (NTRS)

    Eberspeaker, Philip J.; Smith, Ira S.

    2003-01-01

    The U.S. National Aeronautics and Space Administration (NASA) Sounding Rockets and Balloon Programs conduct a total of 50 to 60 missions per year in support of the NASA scientific community. These missions support investigations sponsored by NASA's Offices of Space Science, Life and Microgravity Sciences & Applications, and Earth Science. The Goddard Space Flight Center has management and implementation responsibility for these programs. The NASA Sounding Rockets Program provides the science community with payload development support, environmental testing, launch vehicles, and launch operations from fixed and mobile launch ranges. Sounding rockets continue to provide a cost-effective way to make in situ observations from 50 to 1500 km in the near-earth environment and to uniquely cover the altitude regime between 50 km and 130 km above the Earth's surface. New technology efforts include GPS payload event triggering, tailored trajectories, new vehicle configuration development to expand current capabilities, and the feasibility assessment of an ultra high altitude sounding rocket vehicle. The NASA Balloon Program continues to make advancements and developments in its capabilities for support of the scientific ballooning community. The Long Duration Balloon (LDB) is capable of providing flight durations in excess of two weeks and has had many successful flights since its development. The NASA Balloon Program is currently engaged in the development of the Ultra Long Duration Balloon (ULDB), which will be capable of providing flight times up to 100-days. Additional development efforts are focusing on ultra high altitude balloons, station keeping techniques and planetary balloon technologies.

  15. Histopathology of balloon-dilation Eustachian tuboplasty.

    PubMed

    Kivekäs, Ilkka; Chao, Wei-Chieh; Faquin, William; Hollowell, Monica; Silvola, Juha; Rasooly, Tali; Poe, Dennis

    2015-02-01

    Surgical intervention of the Eustachian tube (ET) has become increasingly common in the past decade, and balloon dilation has shown promising results in recent studies. It is unclear how balloon dilation enhances ET function. Our aim was to evaluate histological changes in the ET's mucosal lumen comparing before balloon dilation, immediately after, and postoperatively. Case series. Thirteen patients with bilateral ET dysfunction were enrolled. Biopsies of the ET mucosa were obtained just before balloon dilation; immediately after; and in three cases, 5 to 12 weeks postoperatively. Specimens were retrospectively examined under light microscopy by two pathologists blinded to the clinical information and whether specimens were pre- or postballoon dilation. Preoperative biopsies were characterized by inflammatory changes within the epithelium and submucosal layer. Immediate response to balloon dilation was thinning of the mucosa, shearing of epithelium and crush injury to the submucosa, especially to lymphocytic infiltrates. Postoperative biopsies demonstrated healthy pseudocolumnar epithelium and replacement of lymphocytic infiltrate with a thinner layer of fibrous tissue. Reduction of inflammatory epithelial changes and submucosal inflammatory infiltrate appeared to be the principal result of balloon dilation. The balloon may shear or crush portions of inflamed epithelium but usually spared the basal layer, allowing for rapid healing. Additionally, it appeared to effectively crush lymphocytes and lymphocytic follicles that may become replaced with thinner fibrous scar. Histopathology of the ET undergoing balloon dilation demonstrated effects that could reduce the overall inflammatory burden and may contribute to clinical improvement in ET function. 4. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  16. The glider balloon: a useful device for the treatment of bifurcation lesions.

    PubMed

    Briguori, Carlo; Visconti, Gabriella; Donahue, Michael; Chiariello, Giovanni Alfonso; Focaccio, Amelia

    2013-10-09

    Final kissing balloon dilatation (FKBD) is a recommended final step in case of treatment of bifurcation lesions by two stents approaches. Furthermore, dilatation of the side branch (SB) may be necessary following main vessel (MV) stenting. Occasionally, recrossing the stent struts with a balloon is hampered because the tip hits a stent strut. The Glider (TriReme Medical, Pleasanton, CA) is a dedicated balloon designed for crossing through struts of deployed stents toward a SB. From October 2010 to January 2012, FKBD was attempted in 236 consecutive bifurcation lesions treated in our Institution. FKBD was successfully performed by conventional balloon catheters in 221 (93.5%) lesions (Conventional group). In the remaining 15 (6.5%) lesions, where a conventional balloon failed to cross the stent strut, the Glider balloon was attempted (Glider group). The angle beta (between the axis of the MV after the branch point and the SB axis at the point of divergence) was wider in the Glider group (83±17° versus 65±27°; p=0.032). A trend toward an higher rate of the true bifurcation lesions was observed in the Glider group (93% versus 70.5%; p=0.07). The Glider balloon successfully crossed through MV stent struts toward a SB in 12 patients (80%), whereas failed in the remaining 3 patients. The Glider balloon represents an unique bail-out device which offers an effective rescue strategy for recrossing stent struts during complex bifurcation stenting. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Is non‐steroidal anti‐inflammaory drug (NSAID) enteropathy clinically more important than NSAID gastropathy?

    PubMed Central

    Adebayo, D; Bjarnason, I

    2006-01-01

    The side effects of conventional non‐steroidal anti‐inflammatory drugs (NSAIDs) on the stomach is undoubtedly a serious public health problem contributing significantly to the morbidity and mortality of patients receiving these drugs. However, the damage of NSAIDs is not confined to the stomach. Indeed the short term and long term damage of NSAIDs on the small bowel (NSAID enteropathy) is more frequent than NSAID gastropathy. Furthermore, NSAID enteropathy is associated with complications (bleeding and protein loss). While many of these are mild, the serious events (significant bleeding, perforation, obstruction, and sudden death) are frequent as that reported for NSAID gastropathy. The diagnosis of NSAID enteropathy has been greatly aided by the introduction of wireless capsule enteroscopy. PMID:16517800

  18. Is non-steroidal anti-inflammaory drug (NSAID) enteropathy clinically more important than NSAID gastropathy?

    PubMed

    Adebayo, D; Bjarnason, I

    2006-03-01

    The side effects of conventional non-steroidal anti-inflammatory drugs (NSAIDs) on the stomach is undoubtedly a serious public health problem contributing significantly to the morbidity and mortality of patients receiving these drugs. However, the damage of NSAIDs is not confined to the stomach. Indeed the short term and long term damage of NSAIDs on the small bowel (NSAID enteropathy) is more frequent than NSAID gastropathy. Furthermore, NSAID enteropathy is associated with complications (bleeding and protein loss). While many of these are mild, the serious events (significant bleeding, perforation, obstruction, and sudden death) are frequent as that reported for NSAID gastropathy. The diagnosis of NSAID enteropathy has been greatly aided by the introduction of wireless capsule enteroscopy.

  19. JBFA - buoyant flight

    NASA Technical Reports Server (NTRS)

    Ohari, T.

    1982-01-01

    A method was developed whereby a balloon was used to carry lumber out of a forest in order to continue lumber production without destroying the natural environment and view of the forest. Emphasis was on the best shape for a logging balloon, development of a balloon logging system suitable for cutting lumber and safety plans, tests on balloon construction and development of netting, and weather of mountainous areas, especially solutions to problems caused by winds.

  20. Assessing the Potential of Societal Verification by Means of New Media

    DTIC Science & Technology

    2014-01-01

    the Defense Advanced Research Projects Agency (DARPA) “Red Balloon Challenge” in 2009 by finding 10 tethered weather balloons scattered across the...Institute of Technology (MIT) managed to locate 10 weather balloons tethered at undisclosed locations across the continental United States in less than...suited for complex problem solving, and the 2009 Defense Advanced Research Projects Agency’s (DARPA) “Red Balloon Challenge” has already demonstrated

  1. Applying Chemical Potential and Partial Pressure Concepts to Understand the Spontaneous Mixing of Helium and Air in a Helium-Inflated Balloon

    ERIC Educational Resources Information Center

    Jee-Yon Lee; Hee-Soo Yoo; Jong Sook Park; Kwang-Jin Hwang; Jin Seog Kim

    2005-01-01

    The spontaneous mixing of helium and air in a helium-inflated balloon is described in an experiment in which the partial pressure of the gases in the balloon are determined from the mole factions and the total pressure measured in the balloon. The results described provide a model for teaching concepts of partial pressure, chemical potential, and…

  2. 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.

  3. LISA: a java API for performing simulations of trajectories for all types of balloons

    NASA Astrophysics Data System (ADS)

    Conessa, Huguette

    2016-07-01

    LISA (LIbrarie de Simulation pour les Aerostats) is a java API for performing simulations of trajectories for all types of balloons (Zero Pressure Balloons, Pressurized Balloons, Infrared Montgolfier), and for all phases of flight (ascent, ceiling, descent). This library has for goals to establish a reliable repository of Balloons flight physics models, to capitalize developments and control models used in different tools. It is already used for flight physics study software in CNES, to understand and reproduce the behavior of balloons, observed during real flights. It will be used operationally for the ground segment of the STRATEOLE2 mission. It was developed with quality rules of "critical software." It is based on fundamental generic concepts, linking the simulation state variables to interchangeable calculation models. Each LISA model defines how to calculate a consistent set of state variables combining validity checks. To perform a simulation for a type of balloon and a phase of flight, it is necessary to select or create a macro-model that is to say, a consistent set of models to choose from among those offered by LISA, defining the behavior of the environment and the balloon. The purpose of this presentation is to introduce the main concepts of LISA, and the new perspectives offered by this library.

  4. A balloon-borne experiment to investigate the Martian magnetic field

    NASA Astrophysics Data System (ADS)

    Schwingenschuh, K.; Feldhofer, H.; Koren, W.; Jernej, I.; Stachel, M.; Riedler, W.; Slamanig, H.; Auster, H.-U.; Rustenbach, J.; Fornacon, H. K.; Schenk, H. J.; Hillenmaier, O.; Haerendel, G.; Yeroshenko, Ye.; Styashkin, V.; Zaroutzky, A.; Best, A.; Scholz, G.; Russell, C. T.; Means, J.; Pierce, D.; Luhmann, J. G.

    1996-03-01

    The Space Research Institute of the Austrian Academy, of Sciences (Graz, Austria) in cooperation with MPE (Berlin, Germany), GFZ Potsdam (Obs. Niemegk, Germany) IZMIRAN/IOFAN (Moscow, Russian) and IGPP/UCLA (Los Angeles, USA) is designing the magnetic field experiment MAGIBAL (MAGnetic field experiment aboard a martian BALloon) to investigate the magnetic field on the surface of Mars. The dual sensor fluxgate magnetometer is part of the MARS-98/MARS-TOGETHER balloon payload. During a ten days period the balloon will float over a distance of about 2000 km at altitudes between 0 and 4 km. Due to the limited power and telemetry allocation the magnetometer can transmit only one vector per ten seconds and spectral information in the frequency range from 2 - 25 Hz. The dynamic range is +/- 2000 nT. The main scientific objectives of the experiment are: • Determination of the magnetism of the Martian rocks • Investigation of the leakage of the solar wind induced magnetosphere using the correlation between orbiter and balloon observations • Measurement of the magnetic field profile between the orbiter and the surface of Mars during the descent phase of the balloon. Terrestrial test flights with a hot air balloon were performed in order to test the original MAGIBAL equipment under balloon flight conditions.

  5. Review of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography using several endoscopic methods in patients with surgically altered gastrointestinal anatomy

    PubMed Central

    Shimatani, Masaaki; Takaoka, Makoto; Tokuhara, Mitsuo; Miyoshi, Hideaki; Ikeura, Tsukasa; Okazaki, Kazuichi

    2015-01-01

    The endoscopic approach for biliary diseases in patients with surgically altered gastrointestinal anatomy (SAGA) had been generally deemed impractical. However, it was radically made feasible by the introduction of double balloon endoscopy (DBE) that was originally developed for diagnosis and treatments for small-bowel diseases. Followed by the subsequent development of single-balloon endoscopy (SBE) and spiral endoscopy (SE), interventions using several endoscopes for biliary disease in patients with SAGA widely gained an acceptance as a new modality. Many studies have been made on this new technique. Yet, some problems are to be solved. For instance, the mutual unavailability among devices due to different working lengths and channels, and unestablished standardization of procedural techniques can be raised. Additionally, in an attempt to standardize endoscopic procedures, it is important to evaluate biliary cannulating methods by case with existence of papilla or not. A full comprehension of the features of respective scope types is also required. However there are not many papers written as a review. In our manuscript, we would like to evaluate and make a review of the present status of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography applying DBE, SBE and SE for biliary diseases in patients with SAGA for establishment of these modalities as a new technology and further improvement of the scopes and devices. PMID:26078830

  6. Simulation of the energy distribution of relativistic electron precipitation caused by quasi-linear interactions with EMIC waves.

    PubMed

    Li, Zan; Millan, Robyn M; Hudson, Mary K

    2013-12-01

    [1]Previous studies on electromagnetic ion cyclotron (EMIC) waves as a possible cause of relativistic electron precipitation (REP) mainly focus on the time evolution of the trapped electron flux. However, directly measured by balloons and many satellites is the precipitating flux as well as its dependence on both time and energy. Therefore, to better understand whether pitch angle scattering by EMIC waves is an important radiation belt electron loss mechanism and whether quasi-linear theory is a sufficient theoretical treatment, we simulate the quasi-linear wave-particle interactions for a range of parameters and generate energy spectra, laying the foundation for modeling specific events that can be compared with balloon and spacecraft observations. We show that the REP energy spectrum has a peaked structure, with a lower cutoff at the minimum resonant energy. The peak moves with time toward higher energies and the spectrum flattens. The precipitating flux, on the other hand, first rapidly increases and then gradually decreases. We also show that increasing wave frequency can lead to the occurrence of a second peak. In both single- and double-peak cases, increasing wave frequency, cold plasma density or decreasing background magnetic field strength lowers the energies of the peak(s) and causes the precipitation to increase at low energies and decrease at high energies at the start of the precipitation.

  7. Curie-Montgolfiere Planetary Explorers

    NASA Astrophysics Data System (ADS)

    Taylor, Chris Y.; Hansen, Jeremiah

    2007-01-01

    Hot-air balloons, also known as Montgolfiere balloons, powered by heat from radioisotope decay are a potentially useful tool for exploring planetary atmospheres and augmenting the capabilities of other exploration technologies. This paper describes the physical equations and identifies the key engineering parameters that drive radioisotope-powered balloon performance. These parameters include envelope strength-to-weight, envelope thermal conductivity, heater power-to-weight, heater temperature, and balloon shape. The design space for these parameters are shown for varying atmospheric compositions to illustrate the performance needed to build functioning ``Curie-Montgolfiere'' balloons for various planetary atmospheres. Methods to ease the process of Curie-Montgolfiere conceptual design and sizing of are also introduced.

  8. Development of optical laser balloon and drainage from radiation vulcanized natural rubber latex

    NASA Astrophysics Data System (ADS)

    Shimamura, Yoshiyuki

    Rubber film made of radiation vulcanized natural rubber latex (RVNRL) has better transparency and lower toxicity compared with sulfur-vulcanized latex film. Optical laser balloon (optical endoscopical balloon) and drainage were developed by using RVNRL. An endoscope was equipped with a saline-filled latex rubber balloon at its tip to displace contaminating blood, bile, or gastric contents during operative portoscopy, biliary endoscopy, or upper gastrointestinal endoscopy. The transmission of Nd-Yag laser through the balloon is 98%, higher than the sulfur-vulcanized latex rubber (75%). High transparency of the drainage bag facilitated easy observation of discharged fluids without detaching the bag from the tube.

  9. On the feasibility of closed-loop control of intra-aortic balloon pumping

    NASA Technical Reports Server (NTRS)

    Clark, J. W., Jr.; Bourland, H. M.; Kane, G. R.

    1973-01-01

    A closed-loop control scheme for the control of intra-aortic balloon pumping has been developed and tested in dog experiments. A performance index reflecting the general objectives of balloon-assist pumping is developed and a modified steepest ascent control algorithm is utilized for the selection of a proper operating point for the balloon during its pumping cycle. This paper attempts to indicate the feasibility of closed-loop control of balloon pumping, and particularly its flexibility in achieving both diastolic augmentation of mean aortic pressure and control of the level of end-diastolic pressure (EDP) an important factor in reducing heart work.

  10. 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.

  11. KSC-02pd1856

    NASA Image and Video Library

    2002-12-05

    KENNEDY SPACE CENTER, FLA. - Stephen Ezell, meteorological systems operator at Weather Station A, Cape Canaveral Air Force Station, walks out with a weather balloon that he will release. Such balloons are released twice a day. The package in Ezell's hand is a radio sonde that collects temperature and humidity data as the balloon rises. The data is released to agencies nationwide, including the 45th Space Wing which uses the data for its daily weather reports. The weather station provides additional data to NASA for launches - releasing 12 balloons in eight hours prior to liftoff - and landings - releasing 5 balloons in six and a half hours before expected touchdown.

  12. KSC-02pd1860

    NASA Image and Video Library

    2002-12-05

    KENNEDY SPACE CENTER, FLA. - At Weather Station A, Cape Canaveral Air Force Station, Judy Kelley, supervisor of Meteorology Operations, and Stephen Ezell, meteorological systems operator, get ready to release a weather balloon. Such balloons are released twice a day. The package at the bottom is a radio sonde that collects temperature and humidity data as the balloon rises. The data is released to agencies nationwide, including the 45th Space Wing, which uses the data for its daily weather reports. The weather station provides additional data to NASA for launches -- releasing 12 balloons in eight hours prior to liftoff - and landings - releasing 5 balloons in six and a half hours before expected touchdown.

  13. Improvement in intra-aortic balloon pumping and evaluation of its efficacy by electrode methods of control.

    PubMed

    Ioseliani, G D; Chilaia, S M

    1983-02-01

    A basically new design for the reversing balloon pump has been proposed for increasing the efficacy of intra-aortic balloon pumping (IABP). The device not only causes a significant increase in discharge, but also permits control of the central and peripheral circulation within the desired limits owing to back-and-forth movements (like a piston) of the balloon pump. Standard one- and two-chamber balloon pumps were compared. In addition to traditional hemodynamic and biochemical indexes, the efficacy of IABP was assessed based on electrode monitor control of PO2 and pH in the myocardium, peripheral tissues, and circulating blood. Based on 54 experiments on dogs, it was found that IABP with reversing balloon pumps in synchronous pulsation resulted in survival of 69% of the cases; PO2 and pH levels in the myocardium, tissues, and blood in the coronary sinus were close to normal, and coronary blood flow and peripheral circulation were increased. With standard one-chamber balloon pumps, the survival rate did not exceed 33.4%; PO2 and pH in the peripheral tissues reached critical levels.

  14. [Interventional catheter treatment of bypass graft stenosis: comparison of intracoronary stent implantation and balloon angioplasty].

    PubMed

    Heidland, U E; Heintzen, M P; Schoppmann, D; Michel, C J; Strauer, B E

    2000-02-25

    Balloon angioplasty of a stenosed bypass graft has a much higher risk of recurrent stenosis than dilatation of a stenosed native coronary artery. Intracoronary stent implantation has established itself as the better treatment of native coronary artery stenosis than conventional balloon angioplasty. However, there is still uncertainty whether intracoronary stent implantation in stenosed bypass vessels gives better long-term results than conventional balloon angioplasty. Results were retrospectively analyzed of unrandomized 224 primarily successful interventions--122 balloon dilatations and 102 stent implantations--performed between January 1996 and June 1998 on stenosed coronary bypass grafts, re-examined by coronary angiography an average of 6 months later. All but 11 patients were on combined aspirin and ticlopidine antiplatelet aggregation treatment. There was a significantly lower 6-month restenosis rate (30.4%) after stent implantation than after balloon dilatation (51.6%). The re-intervention rate was also significantly lower after stent implantation. These data suggest that stent implantation of stenosed coronary bypass grafts under cover of platelet-aggregation inhibition with aspirin and ticlopidine provides a lower restenosis and thus higher revascularization rate than conventional balloon dilatation.

  15. The effect of pressure anisotropy on ballooning modes in tokamak plasmas

    NASA Astrophysics Data System (ADS)

    Johnston, A.; Hole, M. J.; Qu, Z. S.; Hezaveh, H.

    2018-06-01

    Edge Localised Modes are thought to be caused by a spectrum of magnetohydrodynamic instabilities, including the ballooning mode. While ballooning modes have been studied extensively both theoretically and experimentally, the focus of the vast majority of this research has been on isotropic plasmas. The prevalence of pressure anisotropy in modern tokamaks thus motivates further study of these modes. This paper presents a numerical analysis of ballooning modes in anisotropic equilibria. The investigation was conducted using the newly-developed codes HELENA+ATF and MISHKA-A, which adds anisotropic physics to equilibria and stability analysis. We have examined the impact of anisotropy on the stability of an n = 30 ballooning mode, confirming results conform to previous calculations in the isotropic limit. Growth rates of ballooning modes in equilibria with different levels of anisotropy were then calculated using the stability code MISHKA-A. The key finding was that the level of anisotropy had a significant impact on ballooning mode growth rates. For {T}\\perp > {T}| | , typical of ICRH heating, the growth rate increases, while for {T}\\perp < {T}| | , typical of neutral beam heating, the growth rate decreases.

  16. 16 CFR 1117.4 - Time for filing a report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REPORTING OF CHOKING INCIDENTS INVOLVING MARBLES, SMALL BALLS, LATEX BALLOONS AND OTHER SMALL PARTS § 1117.4... marble, small ball, or latex balloon or on a marble, small ball, latex balloon, or other small part...

  17. Ignition of Hydrogen Balloons by Model-Rocket-Engine Igniters.

    ERIC Educational Resources Information Center

    Hartman, Nicholas T.

    2003-01-01

    Describes an alternative method for exploding hydrogen balloons as a classroom demonstration. Uses the method of igniting the balloons via an electronic match. Includes necessary materials to conduct the demonstration and discusses potential hazards. (SOE)

  18. Introduction

    NASA Astrophysics Data System (ADS)

    Gaskin, J. A.; Smith, I. S.; Jones, W. V.

    In 1783, the Montgolfier brothers ushered in a new era of transportation and exploration when they used hot air to drive an un-tethered balloon to an altitude of 2 km. Made of sackcloth and held together with cords, this balloon challenged the way we thought about human travel, and it has since evolved into a robust platform for performing novel science and testing new technologies. Today, high-altitude balloons regularly reach altitudes of 40 km, and they can support payloads that weigh more than 3000 kg. Long-duration balloons can currently support mission durations lasting 55 days, and developing balloon technologies (i.e. Super-Pressure Balloons) are expected to extend that duration to 100 days or longer; competing with satellite payloads. This relatively inexpensive platform supports a broad range of science payloads, spanning multiple disciplines (astrophysics, heliophysics, planetary and earth science). Applications extending beyond traditional science include testing new technologies for eventual space-based application and stratospheric airships for planetary applications.

  19. Balloon Ascent: 3-D Simulation Tool for the Ascent and Float of High-Altitude Balloons

    NASA Technical Reports Server (NTRS)

    Farley, Rodger E.

    2005-01-01

    The BalloonAscent balloon flight simulation code represents a from-scratch development using Visual Basic 5 as the software platform. The simulation code is a transient analysis of balloon flight, predicting the skin and gas temperatures along with the 3-D position and velocity in a time and spatially varying environment. There are manual and automated controls for gas valving and the dropping of ballast. Also, there are many handy calculators, such as appropriate free lift, and steady-state thermal solutions with temperature gradients. The strength of this simulation model over others in the past is that the infrared environment is deterministic rather than guessed at. The ground temperature is specified along with the emissivity, which creates a ground level IR environment that is then partially absorbed as it travels upward through the atmosphere to the altitude of the balloon.

  20. [Effect of hot-air balloon crossings on animals in the open air].

    PubMed

    Stephan, E

    1997-02-01

    Since the middle of the eighties owners of animals increasingly claimed compensation from balloon pilots. They asserted, that their animals got restless due to strange optical and acoustical stimuli caused by low altitude crossing of hot-air balloons and were damaged while trying to get out of the way or to escape. Very low altitude "Contour crossing" of hot-air balloons, mainly forming the basis of complaints, is only left possible in a limited degree in Germany since the air traffic regulations were changed to a higher minimum safety altitude (Air Traffic Act, LuftVO, version of March 21, 1995) and the violating balloon pilot may be disciplined. The paper is dealing with the principle of hot-air ballooning, with the feasibility of the pilot to avoid and restrict damages, with the possibilities to assign damages to a potential cause and with the legal basis.

  1. Solar Hot Air Balloons: A Low Cost, Multi-hour Flight System for Lightweight Scientific Instrumentation Packages

    NASA Astrophysics Data System (ADS)

    Bowman, D. C.; Albert, S.; Dexheimer, D.; Murphy, S.; Mullen, M.

    2017-12-01

    Existing scientific ballooning solutions for multi hour flights in the upper troposphere/lower stratosphere are expensive and/or technically challenging. In contrast, solar hot air balloons are inexpensive and simple to construct. These balloons, which rely solely on sunlight striking a darkened envelope, can deliver payloads to 22 km altitude and maintain level flight until sunset. We describe an experimental campaign in which five solar hot air balloons launched in 45 minutes created a free flying infrasound (low frequency sound) microphone network that remained in the air for over 12 hours. We discuss the balloons' trajectory, maximum altitude, and stability as well as present results from the infrasound observations. We assess the performance and limitations of this design for lightweight atmospheric instrumentation deployments that require multi-hour flight times. Finally, we address the possibilities of multi day flights during the polar summer and on other planets.

  2. Wind Tunnel Investigation of a Balloon as Decelerator at Mach Numbers from 1.47 to 2.50

    NASA Technical Reports Server (NTRS)

    McShera, John T.; Keyes, J. Wayne

    1961-01-01

    A wind-tunnel investigation was conducted to study the characteristics of a towed spherical balloon as a drag device at Mach numbers from 1.47 to 2.50, Reynolds numbers from 0.36 x 10(exp 6) to 1.0 x 10(exp 6) , and angles of attack from -15 to 15 degrees. Tow-cable length was approximately 24 inches from asymmetric body to cone on the upstream side of the balloon. As the tow cable was lengthened the balloon reached a point in the test section where wall-reflected shocks intersected the balloon and caused severe oscillations. As a result, the tow cable broke and the inflatable balloon model was destroyed. Further tests used a model rigid plastic sphere 6.75 inches in diameter. Tow cable length was approximately 24 inches from asymmetric body to the upstream side of the sphere.

  3. Detection of Artificially Generated Seismic Signals Using Balloon-Borne Infrasound Sensors

    DOE PAGES

    Krishnamoorthy, Siddharth; Komjathy, Attila; Pauken, Michael T.; ...

    2018-04-24

    Here, we conducted an experiment in Pahrump, Nevada, in June 2017, where artificial seismic signals were created using a seismic hammer, and the possibility of detecting them from their acoustic signature was examined. In this work, we analyze the pressure signals recorded by highly sensitive barometers deployed on the ground and on tethers suspended from balloons. Our signal processing results show that wind noise experienced by a barometer on a free-flying balloon is lower compared to one on a moored balloon. This has never been experimentally demonstrated in the lower troposphere. While seismoacoustic signals were not recorded on the hotmore » air balloon platform owing to operational challenges, we demonstrate the detection of seismoacoustic signals on our moored balloon platform. Our results have important implications for performing seismology in harsh surface environments such as Venus through atmospheric remote sensing.« less

  4. Initial experience with the Europass: a new ultra-low profile monorail balloon catheter.

    PubMed

    Zimarino, M; Corcos, T; Favereau, X; Tamburino, C; Toussaint, M; Spaulding, C; Guérin, Y

    1994-09-01

    One of the causes for percutaneous transluminal coronary angioplasty (PTCA) failure is the inability to cross the lesion with the balloon catheter after guidewire positioning. The Europass coronary angioplasty catheter is a monorail Duralyn balloon catheter developed to enhance lesion crossability and to overcome this limitation. This system was evaluated in 50 patients in which target lesions were chronic total coronary occlusions (12 cases) or stenoses that could not be reached or crossed by other new monorail balloon catheters. Overall procedural success was obtained in 49/50 patients (98%), using a single Europass balloon catheter in 46/50 patients (92%), with no in-hospital complications. Its low profile, small distal shaft, and excellent trackability allowed successful angioplasty in cases where other catheters failed. This balloon catheter represents a significant advance in angioplasty technology and can be considered as a first-choice device for a safe and expeditious single-operator procedure.

  5. A balloon-borne prototype for demonstrating the concept of JEM-EUSO

    NASA Astrophysics Data System (ADS)

    von Ballmoos, P.; Santangelo, A.; Adams, J. H.; Barrillon, P.; Bayer, J.; Bertaina, M.; Cafagna, F.; Casolino, M.; Dagoret, S.; Danto, P.; Distratis, G.; Dupieux, M.; Ebersoldt, A.; Ebisuzaki, T.; Evrard, J.; Gorodetzky, Ph.; Haungs, A.; Jung, A.; Kawasaki, Y.; Medina-Tanco, G.; Mot, B.; Osteria, G.; Parizot, E.; Park, I. H.; Picozza, P.; Prévôt, G.; Prieto, H.; Ricci, M.; Rodríguez Frías, M. D.; Roudil, G.; Scotti, V.; Szabelski, J.; Takizawa, Y.; Tusno, K.

    2014-05-01

    EUSO-BALLOON has been conceived as a pathfinder for JEM-EUSO, a mission concept for a space-borne wide-field telescope monitoring the Earth's nighttime atmosphere with the objective of recording the ultraviolet light from tracks initiated by ultra-high energy cosmic rays. Through a series of stratospheric balloon flights performed by the French Space Agency CNES, EUSO-BALLOON will serve as a test-bench for the key technologies of JEM-EUSO. EUSO-BALLOON shall perform an end-to-end test of all subsystems and components, and prove the global detection chain while improving our knowledge of the atmospheric and terrestrial ultraviolet background. The balloon-instrument also has the potential to detect for the first time UV-light generated by atmospheric air-shower from above, marking a milestone in the development of UHECR science, and paving the way for any future large scale, space-based ultra-high energy cosmic ray observatory.

  6. Detection of Artificially Generated Seismic Signals Using Balloon-Borne Infrasound Sensors

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

    Krishnamoorthy, Siddharth; Komjathy, Attila; Pauken, Michael T.

    Here, we conducted an experiment in Pahrump, Nevada, in June 2017, where artificial seismic signals were created using a seismic hammer, and the possibility of detecting them from their acoustic signature was examined. In this work, we analyze the pressure signals recorded by highly sensitive barometers deployed on the ground and on tethers suspended from balloons. Our signal processing results show that wind noise experienced by a barometer on a free-flying balloon is lower compared to one on a moored balloon. This has never been experimentally demonstrated in the lower troposphere. While seismoacoustic signals were not recorded on the hotmore » air balloon platform owing to operational challenges, we demonstrate the detection of seismoacoustic signals on our moored balloon platform. Our results have important implications for performing seismology in harsh surface environments such as Venus through atmospheric remote sensing.« less

  7. The Latest Developments in NASA's Long Duration Balloon Systems

    NASA Astrophysics Data System (ADS)

    Stilwell, Bryan D.

    The Latest Developments in NASA’s Long Duration Balloon Systems Bryan D. Stilwell, bryan.stilwell@csbf.nasa.gov Columbia Scientific Balloon Facility, Palestine, Texas, USA The Columbia Scientific Balloon Facility, located in Palestine, Texas offers the scientific community a high altitude balloon based communications platform. Scientific payload mass can exceed 2722 kg with balloon float altitudes on average of 40000 km and flight duration of up to 100 days. Many developments in electrical systems have occurred over the more than 25 years of long duration flights. This paper will discuss the latest developments in electronic systems related to long duration flights. Over the years, the long duration flights have increased in durations exceeding 56 days. In order to support these longer flights, the systems have had to increase in complexity and reliability. Several different systems that have been upgraded and/or enhanced will be discussed.

  8. Preparation, characterization, in vitro drug release, and cellular interactions of tailored paclitaxel releasing polyethylene oxide films for drug-coated balloons.

    PubMed

    Anderson, Jordan A; Lamichhane, Sujan; Remund, Tyler; Kelly, Patrick; Mani, Gopinath

    2016-01-01

    Drug-coated balloons (DCBs) are used to treat various cardiovascular diseases. Currently available DCBs carry drug on the balloon surface either solely or using different carriers. Several studies have shown that a significant amount of drug is lost in the blood stream during balloon tracking to deliver only a sub-therapeutic level of drug at the treatment site. This research is focused on developing paclitaxel (PAT) loaded polyethylene oxide (PEO) films (PAT-PEO) as a controlled drug delivery carrier for DCBs. An array of PAT-PEO films were developed in this study to provide tailored release of >90% of drug only at specific time intervals, which is the time frame required for carrying out balloon-based therapy. The characterizations of PAT-PEO films using SEM, FTIR, and DSC showed that the films developed were homogenous and the PAT was molecularly dispersed in the PEO matrix. Mechanical tests showed that most PAT-PEO films developed were flexible and ductile, with yield and tensile strengths not affected after PAT incorporation. The viability, proliferation, morphology, and phenotype of smooth muscle cells (SMCs) interacted with control-PEO and PAT-PEO films were investigated. All control-PEO and PAT-PEO films showed a significant inhibitory effect on the growth of SMCs, with the degree of inhibition strongly dependent on the w/v% of the polymer used. The PAT-PEO coating was produced on the balloons. The integrity of PAT-PEO coating was well maintained without any mechanical defects occurring during balloon inflation or deflation. The drug release studies showed that only 15% of the total PAT loaded was released from the balloons within the initial 1min (typical balloon tracking time), whereas 80% of the PAT was released between 1min and 4min (typical balloon treatment time). Thus, this study demonstrated the use of PEO as an alternate drug delivery system for the balloons. Atherosclerosis is primarily responsible for cardiovascular diseases (CVDs) in millions of patients every year. Drug-coated balloons (DCBs) are commonly used to treat various CVDs. However, in several currently used DCBs, a significant amount of drug is lost in the blood stream during balloon tracking to deliver only a sub-therapeutic level of drug at the treatment site. In this study, paclitaxel containing polyethylene oxide (PEO) films were developed to provide unique advantages including drug release profiles specifically tailored for balloon-based therapy, homogeneous films with molecularly dispersed drug, flexible and ductile films, and exhibits significant inhibitory effect on smooth muscle cell growth. Thus, this study demonstrated the use of PEO as an alternate drug delivery platform for DCBs to improve its efficacy. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  9. NASA Scientific Balloon Team Hopes to Break Flight Duration Record with New Zealand Launch

    NASA Image and Video Library

    2017-12-08

    After years of tests and development, NASA’s Balloon Program team is on the cusp of expanding the envelope in high-altitude, heavy-lift ballooning with its super pressure balloon (SPB) technology. NASA’s scientific balloon experts are in Wanaka, New Zealand, prepping for the fourth flight of an 18.8 million-cubic-foot (532,000 cubic-meter) balloon, with the ambitious goal of achieving an ultra-long-duration flight of up to 100 days at mid-latitudes. Launch of the pumpkin-shaped, football stadium-size balloon is scheduled for sometime after April 1, 2016, from Wanaka Airport, pending final checkouts and flight readiness of the balloon and supporting systems. Once launched, the SPB, which is made from 22-acres of polyethylene film – similar to a sandwich bag, but stronger and more durable – will ascend to a nearly constant float altitude of 110,000 feet (33.5 km). The balloon will travel eastward carrying a 2,260-pound (1,025 kg) payload consisting of tracking, communications and scientific instruments. NASA expects the SPB to circumnavigate the globe once every one to three weeks, depending on wind speeds in the stratosphere. Read more: go.nasa.gov/1p56xKR 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

  10. An observational study of ballooning in large spiders: Nanoscale multifibers enable large spiders' soaring flight.

    PubMed

    Cho, Moonsung; Neubauer, Peter; Fahrenson, Christoph; Rechenberg, Ingo

    2018-06-01

    The physical mechanism of aerial dispersal of spiders, "ballooning behavior," is still unclear because of the lack of serious scientific observations and experiments. Therefore, as a first step in clarifying the phenomenon, we studied the ballooning behavior of relatively large spiders (heavier than 5 mg) in nature. Additional wind tunnel tests to identify ballooning silks were implemented in the laboratory. From our observation, it seems obvious that spiders actively evaluate the condition of the wind with their front leg (leg I) and wait for the preferable wind condition for their ballooning takeoff. In the wind tunnel tests, as-yet-unknown physical properties of ballooning fibers (length, thickness, and number of fibers) were identified. Large spiders, 16-20 mg Xysticus spp., spun 50-60 nanoscale fibers, with a diameter of 121-323 nm. The length of these threads was 3.22 ± 1.31 m (N = 22). These physical properties of ballooning fibers can explain the ballooning of large spiders with relatively light updrafts, 0.1-0.5 m s-1, which exist in a light breeze of 1.5-3.3 m s-1. Additionally, in line with previous research on turbulence in atmospheric boundary layers and from our wind measurements, it is hypothesized that spiders use the ascending air current for their aerial dispersal, the "ejection" regime, which is induced by hairpin vortices in the atmospheric boundary layer turbulence. This regime is highly correlated with lower wind speeds. This coincides well with the fact that spiders usually balloon when the wind speed is lower than 3 m s-1.

  11. Delivery of Plasmid DNA to Vascular Tissue in vivo using Catheter Balloons Coated with Polyelectrolyte Multilayers

    PubMed Central

    Saurer, Eric M.; Yamanouchi, Dai; Liu, Bo; Lynn, David M.

    2010-01-01

    We report an approach for the localized delivery of plasmid DNA to vascular tissue from the surfaces of inflatable embolectomy catheter balloons. Using a layer-by-layer approach, ultrathin multilayered polyelectrolyte films were fabricated on embolectomy catheter balloons by alternately adsorbing layers of a hydrolytically degradable poly(β-amino ester) and plasmid DNA. Fluorescence microscopy revealed that the films coated the surfaces of the balloons uniformly. Coated balloons that were incubated in phosphate-buffered saline at 37 °C released ~25 μg DNA/cm2 over 24 hours. Analysis of the DNA by gel electrophoresis showed that the DNA was released in open-circular (‘nicked’) and supercoiled conformations, and in vitro cell transfection assays confirmed that the released DNA was transcriptionally active. Arterial injury was induced in the internal carotid arteries of Sprague-Dawley rats using uncoated balloons, followed by treatment with film-coated balloons for 20 minutes. X-gal, immunohistochemical, and immunofluorescence staining of sectioned arteries indicated high levels of β-galactosidase or enhanced green fluorescent protein (EGFP) expression in arteries treated with film-coated balloons. β-galactosidase and EGFP expression were observed throughout the medial layers of arterial tissue, and around approximately two-thirds of the circumference of the treated arteries. The layer-by-layer approach reported here provides a general platform for the balloon-mediated delivery of DNA to vascular tissue. Our results suggest the potential of this approach to deliver therapeutically relevant DNA to prevent complications such as intimal hyperplasia that arise after vascular interventions. PMID:20933275

  12. Ballooning for Biologists: Mission Essentials for Flying Experiments on Large NASA Balloons

    NASA Technical Reports Server (NTRS)

    Smith, David J.; Sowa, Marianne

    2017-01-01

    Despite centuries of scientific balloon flights, only a handful of experiments have produced biologically-relevant results. Yet unlike orbital spaceflight, it is much faster and cheaper to conduct biology research with balloons, sending specimens to the near space environment of Earths stratosphere. Samples can be loaded the morning of a launch and sometimes returned to the laboratory within one day after flying. The National Aeronautics and Space Administration (NASA) flies large, unmanned scientific balloons from all over the globe, with missions ranging from hours to weeks in duration. A payload in the middle portion of the stratosphere (approx. 35 km above sea level) will be exposed to an environment similar to the surface of Mars: temperatures generally around -36 C, atmospheric pressure at a thin 1 kPa, relative humidity levels <1%, and a harsh illumination of ultraviolet (UV) and cosmic radiation levels (about 100 W/sq m and 0.1 mGy/d, respectively) that can be obtained nowhere else on the surface of the Earth, including environmental chambers and particle accelerator facilities attempting to simulate space radiation effects. Considering the operational advantages of ballooning and the fidelity of space-like stressors in the stratosphere, researchers in aerobiology, astrobiology, and space biology can benefit from balloon flight experiments as an intermediary step on the extraterrestrial continuum (ground, low Earth orbit, and deep space studies). Our presentation targets biologists with no background or experience in scientific ballooning. We will provide an overview of large balloon operations, biology topics that can be uniquely addressed in the stratosphere, and a roadmap for developing payloads to fly with NASA.

  13. High submuscular placement of urologic prosthetic balloons and reservoirs via transscrotal approach.

    PubMed

    Morey, Allen F; Cefalu, Christopher A; Hudak, Steven J

    2013-02-01

    Traditional placement of inflatable penile prosthesis (IPP) reservoirs and/or artificial urinary sphincter (AUS) balloons into the space of Retzius may be challenging following major pelvic surgery. The aim of this study is to report our 1-year experience using a novel technique for high balloon/reservoir placement beneath the rectus abdominus muscle, thus completely obviating deep pelvic dissection during prosthetic urologic surgery. A retrospective review of all patients who underwent IPP and/or AUS placement between June 2011 and June 2012 was performed. All had AUS balloons and/or IPP reservoirs placed in a submuscular location by bluntly tunneling through the external inguinal ring into a potential space between the transversalis fascia and the rectus abdominus muscle using a long, angled, lung grasping clamp. Patient demographics, perioperative outcomes, and initial follow-up patient-reported outcomes were reviewed. During the study period, 120 submuscular balloons/reservoirs were inserted in 107 consecutive patients who underwent placement of an IPP (61 patients), AUS (33 patients), or both (13 patients). Among our 48 most recent patients, 41 (85%) reported they were totally unable to feel their balloon/reservoir, and all but two patients reported no bother from the submuscular balloon/reservoir placement. Of the 120 total submuscular balloons and reservoirs, surgical time and outcomes of the prosthetic procedures appeared similar to those placed using traditional methods; two reservoirs required revision surgery for repositioning. High submuscular placement of genitourinary prosthetic balloons and reservoirs via a transscrotal approach is both safely and effective, while avoiding deep retropubic dissection. © 2012 International Society for Sexual Medicine.

  14. Influence of Contrast Agent Dilution on Ballon Deflation Time and Visibility During Tracheal Balloon Dilation: A 3D Printed Phantom Study

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

    Kim, Min Tae; Park, Jung-Hoon; Shin, Ji Hoon, E-mail: jhshin@amc.seoul.kr

    PurposeTo determine the effect of contrast medium dilution during tracheal balloon dilation on balloon deflation time and visibility using a 3-dimensional (3D) printed airway phantom.Materials and MethodsA comparison study to investigate balloon deflation times and image quality was performed using two contrast agents with different viscosities, i.e., iohexol and ioxithalamate, and six contrast dilutions with a 3D printed airway phantom.ResultsCompared to 1:0 concentration, 3:1, 2:1, 1:1, 1:2, and 1:3, contrast/saline ratios resulted in a 46% (56.2 s), 59.8% (73.1 s), 74.9% (91.6 s), 81.7% (99.8 s), and 83.5% (102 s) reduction for iohexol, respectively, and a 51.8% (54.7 s), 63.8% (67.6 s), 74.7% (79.2 s), 80.5% (85.3 s), andmore » 82.4% (87.4 s) reduction for ioxithalamate, respectively, in the mean balloon deflation time, although at the expense of decreased balloon opacity (3.5, 6.9, 11.1, 12.4, and 13.9%, for iohexol, respectively, and 3.2, 6, 9.6, 10.8, and 12.4%, for ioxithalamate, respectively).ConclusionsUse of a lower viscosity contrast agent and higher contrast dilution is considered to be able to reduce balloon deflation times and then simultaneously decrease visualization of balloons. The rapid balloon deflation time is likely to improve the safe performance of interventional procedures.« less

  15. 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)

  16. Crash in Australian outback ends NASA ballooning season

    NASA Astrophysics Data System (ADS)

    Harris, Margaret

    2010-06-01

    NASA has temporarily suspended all its scientific balloon launches after the balloon-borne Nuclear Compton Tele scope (NCT) crashed during take-off, scattering a trail of debris across the remote launch site and overturning a nearby parked car.

  17. 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)

  18. An Overview of the NASA Sounding Rockets and Balloon Programs

    NASA Technical Reports Server (NTRS)

    Flowers, Bobby J.; Needleman, Harvey C.

    1999-01-01

    The U.S. National Aeronautics and Space Administration (NASA) Sounding Rockets and Balloon Programs conduct a combined total of approximately fifty to sixty missions per year in support of the NASA scientific community. These missions are provided in support of investigations sponsored by NASA'S Offices of Space Science, Life and Microgravity Sciences & Applications, and Earth Science. The Goddard Space Flight Center has management and implementation responsibility for these programs. The NASA Sounding Rockets Program has continued to su,pport the science community by integrating their experiments into the sounding rocket payload and providing the rocket vehicle and launch operations necessary to provide the altitude/time required obtain the science objectives. The sounding rockets continue to provide a cost-effective way to make in situ observations from 50 to 1500 km in the near-earth environment and to uniquely cover the altitude regime between 50 km and 130 km above the Earth's surface, which is physically inaccessible to either balloons or satellites. A new architecture for providing this support has been introduced this year with the establishment of the NASA Sounding Rockets Contract. The Program has continued to introduce improvements into their operations and ground and flight systems. An overview of the NASA Sounding Rockets Program with special emphasis on the new support contract will be presented. The NASA Balloon Program continues to make advancements and developments in its capabilities for support of the scientific ballooning community. Long duration balloon (LDB) is a prominent aspect of the program with two campaigns scheduled for this calendar year. Two flights are scheduled in the Northern Hemisphere from Fairbanks, Alaska, in June and two flights are scheduled from McMurdo, Antarctica, in the Southern Hemisphere in December. The comprehensive balloon research and development (R&D) effort has continued with advances being made across the spectrum of balloon related disciplines. As a result of these technology advancements a new ultra long duration balloon project (ULDB) for the development of a 100- day duration balloon capability has been initiated. The ULDB will rely upon new balloon materials and designs to accomplish its goals. The Program has also continued to introduce new technology and improvements into flights systems, ground systems and operational techniques. An overview of the various aspects of the NASA Balloon Program will be presented.

  19. Overview of the Scientific Balloon Activity in Sweden

    NASA Astrophysics Data System (ADS)

    Abrahamsson, Mattias; Kemi, Stig; Lockowandt, Christian; Andersson, Kent

    SSC, formerly known as Swedish Space Corporation, is a Swedish state-owned company working in several different space related fields, including scientific stratospheric balloon launches. Esrange Space Centre (Esrange in short) located in the north of Sweden is the launch facility of SSC, where both sounding rocket launches and stratospheric balloon launches are conducted. At Esrange there are also facilities for satellite communication, including one of the largest civilian satellite data reception stations in the world. Stratospheric balloons have been launched from Esrange since 1974, when the first flights were performed together with the French space agency CNES. These balloon flights have normally flown eastward either only over Sweden or into Finland. Some flights have also had permission to fly into Russia, as far as the Ural Mountains. Normal flight times are from 4 to 12 hours. These eastward flights are conducted during the winter months (September to May). Long duration flights have been flown from ESC since 2005, when NASA flew the BLAST payload from Sweden to north Canada. The prevailing westerly wind pattern is very advantageous for trans-Atlantic flights during summer (late May to late July). The long flight times are very beneficial for astronomical payloads, such as telescopes that need long observation times. In 2013 two such payloads were flown, the first called SUNRISE was a German/US solar telescope, and the other called PoGOLite with a Swedish gamma-ray telescope. In 14 days PoGOLite, which had permission to fly over Russia, made an almost complete circumpolar flight. Typical scientific balloon payload fields include atmospheric research, including research on ozone depletion, astronomical and cosmological research, and research in technical fields such as aerodynamics. University students from all over Europe are involved in flights from Esrange under a Swedish/German programme called BEXUS. Two stratospheric balloons are flown with student payloads yearly, with the goal to introduce students in ballooning. Over the next couple of years the plan is to make a re-flight of the PoGOLite payload, fly two Japanese balloon payloads for planetary science missions, fly four student balloons, three balloons for technical studies of re-entry vehicles, and a balloon with a payload studying aerodynamic behaviour of a falling body.

  20. 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.

  1. Balloon Program Wraps up in Antarctica, Heading to New Zealand

    NASA Image and Video Library

    2015-02-02

    Caption: A NASA Super Pressure Balloon with the COSI payload is ready for launch from McMurdo, Antarctica. Credit: NASA More info: NASA’s globetrotting Balloon Program Office is wrapping up its 2014-2015 Antarctic campaign while prepping for an around-the-world flight launching out of Wanaka, New Zealand, in March. After 16 days, 12 hours, and 56 minutes of flight, operators successfully conducted a planned flight termination of the Suborbital Polarimeter for Inflation Dust and the Epoch of Reionization (SPIDER) mission Saturday, Jan. 18, the final mission of the campaign. Other flights in the 2014-2015 Antarctic campaign included the Antarctic Impulsive Transient Antenna (ANITA-III) mission as well as the Compton Spectrometer and Imager (COSI) payload flown on the developmental Super Pressure Balloon (SPB). ANITA-III successfully wrapped up Jan. 9 after 22 days, 9 hours, and 14 minutes of flight. Flight controllers terminated the COSI flight 43 hours into the mission after detecting a small gas leak in the balloon. Crews are now working to recover all three instruments from different locations across the continent. The 6,480-pound SPIDER payload is stationary at a position about 290 miles from the United Kingdom’s Sky Blu Logistics Facility in Antarctica. The 4,601 pound ANITA-III payload, located about 100 miles from Australia’s Davis Station, and the 2,866 pound COSI payload, located about 340 miles from the United States McMurdo Station both had numerous key components recovered in the past few days. Beginning in late January, the Balloon Program Office will deploy a team to Wanaka, New Zealand, to begin preparations for an SPB flight, scheduled to launch in March. The Program Office seeks to fly the SPB more than 100 days, which would shatter the current flight duration record of 55 days, 1 hour, and 34 minutes for a large scientific balloon. “We’re looking forward to the New Zealand campaign and hopefully a history-making flight with the Super Pressure Balloon,” said Debbie Fairbrother, NASA’s Balloon Program Office Chief. Most scientific balloons see altitude variances based on temperature changes in the atmosphere at night and during the day. The SPB is capable of missions on the order of 100 days or more at constant float altitudes due to the pressurization of the balloon. “Stable, long-duration flights at near-space altitudes above more than 99 percent of the atmosphere are highly desirable in the science community, and we’re ready to deliver,” said Fairbrother. In addition to the SPB flight in March, the Balloon Program Office has 10 more balloon missions planned through September 2015 to include scheduled test flights of the Low-Density Supersonic Decelerator, which is testing new technologies for landing larger, heavier payloads on Mars. NASA’s Wallops Flight Facility manages the agency’s Scientific Balloon Program with 10 to 15 flights each year from launch sites worldwide. The balloons are massive in volume; the average-sized balloon could hold the volume of nearly 200 blimps. Previous work on balloons have contributed to confirming the Big Bang Theory. For more information on NASA’s Scientific Balloon Program, see: sites.wff.nasa.gov/code820/index.html 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

  2. 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.

  3. Some special sub-systems for stratospheric balloon flights in India

    NASA Astrophysics Data System (ADS)

    Damle, S. V.; Gokhale, G. S.; Kundapurkar, R. U.

    During last few years several new sub-systems for balloon were developed and are being regularly used in the balloon flights. Some of these sub-systems are i) positive monitor for magnetic ballast release using an opto-electronic device ii) one-way pressure switch to terminate flight for runaway balloon iii) in-flight payload reel down system for atmospheric science experiment. The design, usage and performance of these and other sub-systems will be presented.

  4. Hot air balloons fill gap in atmospheric and sensing platforms

    NASA Astrophysics Data System (ADS)

    Watson, Steven M.; Price, Russ

    Eric Edgerton was having a problem he could not solve: how to noninvasively collect in situ incinerator plume data. So he called in the Air Force and learned about its Atmospheric and Sensor Test Platform program; its platform is a manned hot air balloon. Many investigators are discovering the advantages of hot air balloons as stable, inexpensive platforms for performing in situ atmospheric measurements. Some are also using remote sensing capabilities on the balloon platforms.

  5. Location and data collection for long stratospheric balloon flights

    NASA Astrophysics Data System (ADS)

    Malaterre, P.

    Stratospheric balloons capable of taking a 30 kg scientific payload to an altitude of 22 to 30 km for 1 month or more were developed. In-flight experiments were used to qualify the designs of a pumpkin shaped superpressure balloon and an infrared hot air balloon. Tracking of the flights (location and transmission of the parameters measured on board) was achieved using a telemetry gondola including an ARGOS beacon adapted for operation in the low temperatures encountered.

  6. Pulling Teeth: Why Humans Are More Important Than Hardware in Airborne Intelligence, Surveillance, and Reconnaissance

    DTIC Science & Technology

    2015-06-12

    soldiers aloft in tethered hot air balloons to observe enemy positions on the battlefield. The Union Army even established a separate Balloon Corps from...December 20, 2014). 1 describe man-lifting kites in the Far East while eighteenth and nineteenth century manned balloons and piloted fixed wing aircraft...in the twentieth and twenty-first centuries provided this capability. One of the first recorded Western uses of manned balloons for ISR purposes

  7. Balloon crash damage and injuries: an analysis of 86 accidents, 2000-2004.

    PubMed

    de Voogt, Alexander J; van Doorn, Robert R A

    2006-05-01

    General aviation accounts for the majority of aviation crashes and casualties in the United States. The role of ballooning in these statistics is not regularly studied. Since 2001, the National Transportation and Safety Board has made its accident reports more readily available, which presents opportunities for further study. This study analyzes and compares a 5-yr period of accident reports and includes an analysis of injuries and balloon damage in hot-air and gas balloon accidents. Balloon crash 2-page briefs and 5-page accident reports published by the National Transportation and Safety Board for the 5-yr time period 2000-2004 were examined. Data collected in the investigation of these crashes were analyzed and compared with the epidemiological data collected in earlier research. In 86 crashes during a 5-yr period, there were 4 fatalities and 75 people were seriously injured. Only one accident was reported involving a student pilot. Broken ankles and legs have been the most commonly recorded serious injury, but could not be linked to the severity of damage to the balloon. The absence of student pilot accidents may be explained by possible stricter supervision. Balloon basket and envelopes appear of sufficient quality to withstand crashes, but improving the protection of passengers during hard landings should help to decrease the number of serious injuries in ballooning.

  8. Comparison of self-expandable and balloon-expanding stents for hybrid ductal stenting in hypoplastic left heart complex.

    PubMed

    Goreczny, Sebastian; Qureshi, Shakeel A; Rosenthal, Eric; Krasemann, Thomas; Nassar, Mohamed S; Anderson, David R; Morgan, Gareth J

    2017-07-01

    We aimed to compare the procedural and mid-term performance of a specifically designed self-expanding stent with balloon-expandable stents in patients undergoing hybrid palliation for hypoplastic left heart syndrome and its variants. The lack of specifically designed stents has led to off-label use of coronary, biliary, or peripheral stents in the neonatal ductus arteriosus. Recently, a self-expanding stent, specifically designed for use in hypoplastic left heart syndrome, has become available. We carried out a retrospective cohort comparison of 69 neonates who underwent hybrid ductal stenting with balloon-expandable and self-expanding stents from December, 2005 to July, 2014. In total, 43 balloon-expandable stents were implanted in 41 neonates and more recently 47 self-expanding stents in 28 neonates. In the balloon-expandable stents group, stent-related complications occurred in nine patients (22%), compared with one patient in the self-expanding stent group (4%). During follow-up, percutaneous re-intervention related to the ductal stent was performed in five patients (17%) in the balloon-expandable stent group and seven patients (28%) in self-expanding stents group. Hybrid ductal stenting with self-expanding stents produced favourable results when compared with the results obtained with balloon-expandable stents. Immediate additional interventions and follow-up re-interventions were similar in both groups with complications more common in those with balloon-expandable stents.

  9. The financial impact of flipping the coin.

    PubMed

    Gonzalez, Katherine W; Reddy, Shiva R; Mundakkal, Angela A; St Peter, Shawn D

    2017-01-01

    Esophageal foreign body retrieval is typically performed by rigid or flexible esophagoscopy. Despite evidence supporting the efficacy and safety of balloon extraction, it is rarely performed. We sought to establish the financial benefits of this minimally invasive approach. A retrospective review of 241 children with esophageal coins between 2011 and 2013 was performed. Coins were removed via endoscopy or fluoroscopic-guided balloon retrieval. Timing, symptoms, facility cost, and patient charges were compared. Two hundred patients had attempted balloon retrieval with 80% success. Forty-one patients went directly for operative removal. Patients with respiratory difficulty (p=0.05), wheezing (p<0.01), or fever (p=0.03) were more often taken directly for endoscopic retrieval. The median cost and charges for attempted balloon extraction were $484 and $1647. The median cost and charges for primary endoscopy were $1834 and $6746. The median total cost and charges of attempted balloon extraction including ED, OR, transport, admission, and balloon retrieval were $1231 and $3539 versus $3615 and $12,204 in the primary endoscopy group (p<0.001, p<0.001). Seventeen percent of patients who underwent attempted balloon retrieval were admitted prior to removal compared to 76% who underwent primary endoscopy (p<0.001). Fluoroscopic guided balloon extraction of esophageal coins is a financially prudent choice which shortens hospital stay. III. Retrospective treatment and economic study. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Development Overview of the Revised NASA Ultra Long Duration Balloon

    NASA Technical Reports Server (NTRS)

    Cathey, H. M.; Gregory, D; Young, L.; Pierce, D.

    2006-01-01

    The development of the National Aeronautics and Space Administration s (NASA) Ultra Long Duration Balloon (ULDB) has made significant strides in addressing the deployment issues experienced in the scaling up of the balloon structure. This paper concentrates on the super-pressure balloon developments that have been, and are currently being planned by the NASA Balloon Program Office at Goddard Space Flight Center s Wallops Flight Facility. The goal of the NASA ULDB development project is to attempt to extend the potential flight durations for large scientific balloon payloads. A summary of the February 2005 test flight from Ft. Sumner, New Mexico will be presented. This test flight spurred a number of investigations and advancements for this project. The development path has pursued some new approaches in the design, analysis, and testing of the balloons. New issues have been ideEti6ed throu& both analysis md testing. These have been addressed in the design stage before the next balloon construction was begun. This paper will give an overview of the recent history for this effort and the development approach pursued for ULDB. A description of the balloon design, including the modifications made as a result of the lessons learned, will be presented. Areas to be presented include the design approach, deployment issues that have been encountered and the proposed solutions, ground testing, photogrammetry, and an analysis overview. Test flight planning and considerations will be presented including test flight safety. An extended duration test flight of the National Aeronautics and Space Administration s Ultra Long Duration Balloon is planned for the May/June 2006 time frame. This flight is expected to fly from Sweden to either Canada or Alaska. Preliminary results of this flight will be presented as available. Future plans for both ground testing and additional test flights will also be presented. Goals of the future test flights, which are staged in increments of increasing suspended load and altitude, will be presented. This will include the projected balloon volumes, payload capabilities, test flight locations, and proposed flight schedule.

  11. 75 FR 77673 - National Environmental Policy Act: Scientific Balloon Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-13

    ... implementation of the Proposed Action are summarized below. Airspace and Balloon Operations: No adverse impacts to airspace management or balloon operations are anticipated under this proposal. CSBF would continue... minimal. Air emissions would not be perceptibly [[Page 77674

  12. 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)

  13. 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 (over the line of sight) than with dedicated RF system, which requires balloon visibility from the ground station. For long duration flights (3 months) of Infra Red Montgolfieres, a house keeping gondola has been developed, using the Inmarsat C standard to have communication all around the world (up to N or S 80 ° latitude) with an automatic switching between the 4 geostationnary Inmarsat satellites. After validation flights performed from Bauru / Brazil. (2000 & 2001) and Kiruna/Sweden (2002), the first operational flights took place from Bauru in February 2003 during ENVISAT validation campaign. The next flights will be realized in the framework of the Hibiscus campaign planned in February 2004 in Bauru.. The Balloon Division was involved in the Franco / Japanese HSFD II project which consists to drop a mock-up of the Japanese HOPE-X space shuttle from a stratospheric balloon to validate its flight from the altitude of 30 km. We developed a specific gondola as a service module for the HOPE-X shuttle, providing power and GPS radio-frequency signal during the balloon flight phase, telemetry end remote control radio frequency links and separation system with pyrotechnic cutters for the drop of the shuttle. A successful flight was performed at Kiruna in July 2003. Concerning gondola with pointing system, the study of a big g-ray telescope (8 m of focal length), started by the end of 2002. For this 1 ton gondola, the telescope stabilization system will be based on control moment gyro (CMG). The CMG system has been designed and will be manufactured and validated during 2004. The first flight of this g-ray gondola is planned for 2006. The progress, status and future plans concerning these gondola developments will be presented.

  14. Modeling the ascent of sounding balloons: derivation of the vertical air motion

    NASA Astrophysics Data System (ADS)

    Gallice, A.; Wienhold, F. G.; Hoyle, C. R.; Immler, F.; Peter, T.

    2011-10-01

    A new model to describe the ascent of sounding balloons in the troposphere and lower stratosphere (up to ∼30-35 km altitude) is presented. Contrary to previous models, detailed account is taken of both the variation of the drag coefficient with altitude and the heat imbalance between the balloon and the atmosphere. To compensate for the lack of data on the drag coefficient of sounding balloons, a reference curve for the relationship between drag coefficient and Reynolds number is derived from a dataset of flights launched during the Lindenberg Upper Air Methods Intercomparisons (LUAMI) campaign. The transfer of heat from the surrounding air into the balloon is accounted for by solving the radial heat diffusion equation inside the balloon. In its present state, the model does not account for solar radiation, i.e. it is only able to describe the ascent of balloons during the night. It could however be adapted to also represent daytime soundings, with solar radiation modeled as a diffusive process. The potential applications of the model include the forecast of the trajectory of sounding balloons, which can be used to increase the accuracy of the match technique, and the derivation of the air vertical velocity. The latter is obtained by subtracting the ascent rate of the balloon in still air calculated by the model from the actual ascent rate. This technique is shown to provide an approximation for the vertical air motion with an uncertainty error of 0.5 m s-1 in the troposphere and 0.2 m s-1 in the stratosphere. An example of extraction of the air vertical velocity is provided in this paper. We show that the air vertical velocities derived from the balloon soundings in this paper are in general agreement with small-scale atmospheric velocity fluctuations related to gravity waves, mechanical turbulence, or other small-scale air motions measured during the SUCCESS campaign (Subsonic Aircraft: Contrail and Cloud Effects Special Study) in the orographically unperturbed mid-latitude middle troposphere.

  15. Use of mechanical devices for distal hemoperfusion during balloon catheter coronary angioplasty.

    PubMed

    Heibig, J; Angelini, P; Leachman, D R; Beall, M M; Beall, A C

    1988-01-01

    Previous attempts to protect the dependent myocardium during balloon catheter coronary angioplasty in animals and humans have had generally unsatisfactory results. This paper summarizes the authors' experience in investigating commercially available mechanical pumps for distal coronary hemoperfusion during balloon angioplasty. Both roller and piston pumps can attain adequate distal perfusion without significant side effects in the majority of patients. Our goal was to suppress angina for at least 5 min to prolong balloon inflation in awake patients. Minor T-wave changes without concomitant angina pectoris can be expected when the distal coronary bed is perfused with hypothermic blood. Side branch occlusion by the inflated balloon prevents effective protection of the corresponding part of the dependent myocardium during distal hemoperfusion, which may result in persistent angina and ST-T changes uncorrected by increasing the hemoperfusion rate. Distal coronary diffuse spasm, rare and transient, was the only immediate complication of this procedure. It is suggested that intense local wall stimulation could occur with a higher flow rate (jet effect). Improved balloon catheter pressure/flow characteristics and on-line continuous mechanical pumps should soon make distal coronary hemoperfusion through balloon catheters an accepted clinical technique.

  16. Selection of extreme environmental conditions, albedo coefficient and Earth infrared radiation, for polar summer Long Duration Balloon missions

    NASA Astrophysics Data System (ADS)

    González-Llana, Arturo; González-Bárcena, David; Pérez-Grande, Isabel; Sanz-Andrés, Ángel

    2018-07-01

    The selection of the extreme thermal environmental conditions -albedo coefficient and Earth infrared radiation- for the thermal design of stratospheric balloon missions is usually based on the methodologies applied in space missions. However, the particularities of stratospheric balloon missions, such as the much higher residence time of the balloon payload over a determined area, make necessary an approach centered in the actual environment the balloon is going to find, in terms of geographic area and season of flight. In this sense, this work is focussed on stratospheric balloon missions circumnavigating the North Pole during the summer period. Pairs of albedo and Earth infrared radiation satellite data restricted to this area and season of interest have been treated statistically. Furthermore, the environmental conditions leading to the extreme temperatures of the payload depend in turn on the surface finish, and more particularly on the ratio between the solar absorptance and the infrared emissivity α/ε. A simple but representative thermal model of a balloon and its payload has been set up in order to identify the pairs of albedo coefficient and Earth infrared radiation leading to extreme temperatures for each value of α/ε.

  17. Endoscopic minor papilla balloon dilation for the treatment of symptomatic pancreas divisum.

    PubMed

    Yamamoto, Natsuyo; Isayama, Hiroyuki; Sasahira, Naoki; Tsujino, Takeshi; Nakai, Yousuke; Miyabayashi, Koji; Mizuno, Suguru; Kogure, Hirofumi; Sasaki, Takashi; Hirano, Kenji; Tada, Minoru; Koike, Kazuhiko

    2014-08-01

    A subpopulation of patients with pancreas divisum experience symptomatic events such as recurrent acute pancreatitis and chronic pancreatitis. Minor papilla sphincterotomy has been reported as being an effective treatment. The aim of this study was to evaluate the safety and efficacy of endoscopic balloon dilation for the minor papilla. Between 2000 and 2012, 16 patients were retrospectively included in this study. After endoscopic balloon dilation for the minor papilla was received, a pancreatic stent or a nasal pancreatic drainage catheter was placed for 1 week. If a stricture or obstruction was evident, it was treated with balloon dilation followed by long-term stent placement (1 year). When an outflow of pancreatic juice was disturbed by a pancreatic stone, endoscopic stone extraction was performed. Balloon dilation and stent placement were achieved and were successful in all the cases (16/16; 100%). Clinical improvement was achieved in 7 (84.7%) of the 9 patients with recurrent acute pancreatitis and in 6 (85.7%) of the 7 patients with chronic pancreatitis. Early complications were observed in 1 (6.3%) patient. Pancreatitis or bleeding related to balloon dilation was not observed. Endoscopic balloon dilation for the minor papilla is feasible for the management of symptomatic pancreas divisum.

  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. 14 CFR 101.39 - Balloon position reports.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Balloon position reports. 101.39 Section 101.39 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE...

  20. 14 CFR 101.39 - Balloon position reports.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Balloon position reports. 101.39 Section 101.39 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE...

  1. 14 CFR 101.39 - Balloon position reports.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Balloon position reports. 101.39 Section 101.39 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE...

  2. 14 CFR 101.39 - Balloon position reports.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Balloon position reports. 101.39 Section 101.39 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE...

  3. 14 CFR 101.39 - Balloon position reports.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Balloon position reports. 101.39 Section 101.39 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES MOORED BALLOONS, KITES, AMATEUR ROCKETS AND UNMANNED FREE...

  4. The Balloon Effect and Mexican Homeland Security: What it Means to be the Weakest Link in the Americas’ Security Chain

    DTIC Science & Technology

    2011-12-01

    in the Social Sciences (George & Bennett, 2005), the main challenges of this thesis are: 9  To test the hypothesis of whether the implications of...Americas´ security chain;  To test whether the new concept of balloon-effect counter-pressure coming from the Mexican strategy is influencing latent...balloon effects against U.S. homeland security;  To test whether those balloon effects created by the Mexican strategy inside Mexico are a

  5. Clinical Study of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Severe Pelvic Fracture and Intra Abdominal Hemorrhagic Shock using Continuous Vital Signs

    DTIC Science & Technology

    2016-03-01

    AWARD NUMBER: W81XWH-15-1-0025 TITLE: Clinical Study of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Severe Pelvic...Intra-Abdominal Hemorrhagic Shock 5b. GRANT NUMBER W81XWH-15-1-0025 Clinical Study of Resuscitative Endovascular Balloon Occlusion of the Aorta ...sites. Resuscitative balloon occlusion of the aorta (REBOA) has been clinically demonstrated to stop bleeding below the diaphragm. It has the potential

  6. A method of exploration of the atmosphere of Titan. [hot air balloon heated by solar radiation or planetary thermal flux

    NASA Technical Reports Server (NTRS)

    Blamont, J.

    1978-01-01

    A hot-air balloon, with the air heated by natural sources, is described. Buoyancy is accomplished by either solar heating or by utilizing the IR thermal flux of the planet to heat the gas in the balloon. Altitude control is provided by a valve which is opened and closed by a barometer. The balloon is made of an organic material which has to absorb radiant energy and to emit as little as possible.

  7. Vertical sounding balloons for stratospheric photochemistry

    NASA Astrophysics Data System (ADS)

    Pommereau, J. P.

    The use of vertical sounding balloons for stratospheric photochemistry studies is illustrated by the use of a vertical piloted gas balloon for the search of NO2 diurnal variations. It is shown that the use of montgolfieres (hot air balloons) can enhance the vertical sounding technique. Particular attention is given to a sun-heated montgolfiere and to the more sophisticated infrared montgolfiere that is able to perform three to four vertical excursions per day and to remain aloft for weeks or months.

  8. Strengths of balloon films with flaws and repairs

    NASA Technical Reports Server (NTRS)

    Portanova, M. A.

    1989-01-01

    The effects of manufacture flaws and repairs in high altitude scientific balloons was examined. A right circular cylinder was used to induce a biaxial tension-tension stress field in the polyethlene film used to manufacture these balloons. A preliminary investigation of the effect that cylinder geometry has on stress rate as a function of inflation rate was conducted. The ultimate goal was to rank, by order of degrading effects, the flaws and repairs commonly found in current high altitude balloons.

  9. Analysis of Flight of Near-Space Balloon

    NASA Astrophysics Data System (ADS)

    Miller, Zech; Evans, Austin; Seyfert, James; Leadlove, Kyle; Gumina, Kaitlyn; Martell, Eric

    2015-04-01

    In December 2014, the Electronics class at Millikin University launched a balloon designed to travel into the near-space region of the atmosphere. The balloon was equipped with an instrumentation package including a camera, accelerometer, barometric pressure sensor, temperature probes, as well as a system for tracking using an Automatic Packet Reporting System (APRS). The balloon was launched from Decatur, IL, and landed in Marysville, OH, nearly 320 miles away. The students then analyzed the data from the flight and compared results to expectations.

  10. Modeling the ascent of sounding balloons: derivation of the vertical air motion

    NASA Astrophysics Data System (ADS)

    Gallice, A.; Wienhold, F. G.; Hoyle, C. R.; Immler, F.; Peter, T.

    2011-06-01

    A new model to describe the ascent of sounding balloons in the troposphere and lower stratosphere (up to ~30-35 km altitude) is presented. Contrary to previous models, detailed account is taken of both the variation of the drag coefficient with altitude and the heat imbalance between the balloon and the atmosphere. To compensate for the lack of data on the drag coefficient of sounding balloons, a reference curve for the relationship between drag coefficient and Reynolds number is derived from a dataset of flights launched during the Lindenberg Upper Air Methods Intercomparisons (LUAMI) campaign. The transfer of heat from the surrounding air into the balloon is accounted for by solving the radial heat diffusion equation inside the balloon. The potential applications of the model include the forecast of the trajectory of sounding balloons, which can be used to increase the accuracy of the match technique, and the derivation of the air vertical velocity. The latter is obtained by subtracting the ascent rate of the balloon in still air calculated by the model from the actual ascent rate. This technique is shown to provide an approximation for the vertical air motion with an uncertainty error of 0.5 m s-1 in the troposphere and 0.2 m s-1 in the stratosphere. An example of extraction of the air vertical velocity is provided in this paper. We show that the air vertical velocities derived from the balloon soundings in this paper are in general agreement with small-scale atmospheric velocity fluctuations related to gravity waves, mechanical turbulence, or other small-scale air motions measured during the SUCCESS campaign (Subsonic Aircraft: Contrail and Cloud Effects Special Study) in the orographically unperturbed mid-latitude middle troposphere.

  11. A New Type of Captive Balloon for Vertical Meteorological Observation in Urban Area

    NASA Astrophysics Data System (ADS)

    Nakamura, M.; Sakai, S.; Ono, K.

    2010-12-01

    Many meteorological observations in urban area have been made in recent years in order to investigate the mechanism of heat island. However, there are few data of cooling process in urban area. For this purpose, high density observations in both space and time are required. Generally vertical meteorological observations can be made by towers, radars, balloons. These methods are limited by urban area conditions. Among these methods, a captive balloon is mainly used to about a hundred meter from ground in a vertical meteorological observation. Small airships called kytoons or advertising balloons, for example. Conventional balloons are, however, influenced by the wind and difficult to keep the specified position. Moreover, it can be dangerous to conduct such observations in the highly build-up area. To overcome these difficulties, we are developing a new type of captive balloon. It has a wing form to gain lift and keep its position. It is also designed small to be kept in a carport. It is made of aluminum film and polyester cloth in order to attain lightweight solution. We have tried floating a balloon like NACA4424 for several years. It was difficult to keep a wing form floating up over 100 meters from ground because internal pressure was decreased by different temperature. The design is changed in this year. The balloon that has wing form NACA4415 is similar in composition to an airplane. It has a big gasbag with airship form and two wing form. It is able to keep form of a wing by high internal pressure. We will report a plan for the balloon and instances of some observations.

  12. SU-E-T-257: Development of a New Endorectal Balloon with An Unfoldable Radiochromic Film for In-Vivo Rectal Dosimetry During Prostate Cancer Radiotherapy

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

    Jeang, E; Lim, Y; Cho, K

    Purpose: We developed an endorectal balloon for in-vivo rectal dosimetry in two-dimensions, and evaluated its dosimetric properties for the radiation treatment of prostate cancer. Methods: The endorectal balloon for in-vivo rectal dosimetry is equipped with a radiochromic film so that two-dimensional dose distribution can be measured in the rectal wall. The film is unrolled as the balloon is inflated, and it is rolled as the balloon is deflated. The outer diameter of the balloon is about 14 mm before inflating it, but its outer diameter can be increased up to about 50 mm after inflating it with 80 ml distilledmore » water. The size of the film is 80(L) x 64(W) mm2, so large as to measure a dose distribution of an anterior half of the rectal wall. After it was inserted into a fabricated rectal phantom, the phantom was scanned by a CT scanner and 5 Gy was delivered to a target inside the phantom with a 15 MV photon beam in AP direction. Finally, the dose distribution measured in the endorectal balloon was compared with that of the treatment plan. Results: The two dose distributions were compared each other in the parallel and the perpendicular directions along an axis of the balloon. The two dose profiles analyzed from the radiochromic film agreed well with the plan within 3% for 15 MV photon beam. Conclusion: An endorectal balloon for two-dimensional in-vivo rectal dosimetry was developed and its dosimetric effectiveness was evaluated for the radiation treatment of prostate cancer. The measured dose distributions showed good agreement with the plans.« less

  13. Prospects for infrasound bolide detections from balloon-borne platforms

    NASA Astrophysics Data System (ADS)

    Young, Eliot; Bowman, Daniel; Arrowsmith, Stephen; Boslough, Marc; Klein, Viliam; Ballard, Courtney; Lees, Jonathan

    2017-04-01

    We report on an experiment to assess whether balloon-borne instruments can improve sensitivities to bolides exploding in the Earth's atmosphere (essentially using the atmosphere as a witness plate to characterize the small end of the NEO (Near Earth Object) population). The CTBTO's infrasound network regularly detects infrasound disturbances caused by bolides, including the 15-FEB-2013 Chelybinsk impact. Balloon-borne infrasound sensors should have two important advantages over ground-based infrasound stations: there should be virtually no wind noise on a free-floating platform, and a sensor in the stratosphere should benefit from its location within the stratospheric duct. Balloon-borne sensors also have the disadvantage that the amplitude of infrasound waves will decrease as they ascend with altitude. To test the performance of balloon-borne sensors, we conducted an experiment on a NASA high altitude (35 km) balloon launched from Ft Sumner, NM on 28-SEP-2016. We were able to put two independent infrasound payloads on this flight. We arranged for three 3000-lb ANFO explosions to be detonated from Socorro, NM at 12:00, 14:00 and 16:29:59 MST. The first two explosions were detected from the NASA balloon, with the first explosion showing three separate waveforms arriving within a 25-s span. The peak-to-peak amplitude of the waveforms was about 0.06 Pa, and the cleanest microphone channel detected this waveform with an SNR greater than 20. A second balloon at 15 km altitude also detected the second explosion. We have signals from a dozen ground stations at various positions from Socorro to Ft Sumner. We will report on wave propagation models and how they compare with observations from the two balloons and the various ground-stations.

  14. Water-filled balloon in the postoperative resection cavity improves dose distribution to target volumes in radiotherapy of maxillary sinus carcinoma.

    PubMed

    Zhang, Qun; Lin, Shi-Rong; He, Fang; Kang, De-Hua; Chen, Guo-Zhang; Luo, Wei

    2011-11-01

    Postoperative radiotherapy is a major treatment for patients with maxillary sinus carcinoma. However, the irregular resection cavity poses a technical difficulty for this treatment, causing uneven dose distribution to target volumes. In this study, we evaluated the dose distribution to target volumes and normal tissues in postoperative intensity-modulated radiotherapy (IMRT) after placing a water-filled balloon into the resection cavity. Three postoperative patients with advanced maxillary sinus carcinoma were selected in this trial. Water-filled balloons and supporting dental stents were fabricated according to the size of the maxillary resection cavity. Simulation CT scans were performed with or without water-filled balloons, IMRT treatment plans were established, and dose distribution to target volumes and organs at risk were evaluated. Compared to those in the treatment plan without balloons, the dose (D98) delivered to 98% of the gross tumor volume (GTV) increased by 2.1 Gy (P = 0.009), homogeneity index (HI) improved by 2.3% (P = 0.001), and target volume conformity index (TCI) of 68 Gy increased by 18.5% (P = 0.011) in the plan with balloons. Dosimetry endpoints of normal tissues around target regions in both plans were not significantly different (P > 0.05) except for the optic chiasm. In the plan without balloons, 68 Gy high-dose regions did not entirely cover target volumes in the ethmoid sinus, posteromedial wall of the maxillary sinus, or surgical margin of the hard palate. In contrast, 68 Gy high-dose regions entirely covered the GTV in the plan with balloons. These results suggest that placing a water-filled balloon in the resection cavity for postoperative IMRT of maxillary sinus carcinoma can reduce low-dose regions and markedly and simultaneously increase dose homogeneity and conformity of target volumes.

  15. 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.

  16. An observational study of ballooning in large spiders: Nanoscale multifibers enable large spiders’ soaring flight

    PubMed Central

    Neubauer, Peter; Fahrenson, Christoph; Rechenberg, Ingo

    2018-01-01

    The physical mechanism of aerial dispersal of spiders, “ballooning behavior,” is still unclear because of the lack of serious scientific observations and experiments. Therefore, as a first step in clarifying the phenomenon, we studied the ballooning behavior of relatively large spiders (heavier than 5 mg) in nature. Additional wind tunnel tests to identify ballooning silks were implemented in the laboratory. From our observation, it seems obvious that spiders actively evaluate the condition of the wind with their front leg (leg I) and wait for the preferable wind condition for their ballooning takeoff. In the wind tunnel tests, as-yet-unknown physical properties of ballooning fibers (length, thickness, and number of fibers) were identified. Large spiders, 16–20 mg Xysticus spp., spun 50–60 nanoscale fibers, with a diameter of 121–323 nm. The length of these threads was 3.22 ± 1.31 m (N = 22). These physical properties of ballooning fibers can explain the ballooning of large spiders with relatively light updrafts, 0.1–0.5 m s−1, which exist in a light breeze of 1.5–3.3 m s−1. Additionally, in line with previous research on turbulence in atmospheric boundary layers and from our wind measurements, it is hypothesized that spiders use the ascending air current for their aerial dispersal, the “ejection” regime, which is induced by hairpin vortices in the atmospheric boundary layer turbulence. This regime is highly correlated with lower wind speeds. This coincides well with the fact that spiders usually balloon when the wind speed is lower than 3 m s−1. PMID:29902191

  17. Ballooning in the constant sun of the South Pole summer

    NASA Image and Video Library

    2017-12-08

    BARREL researchers get ready to release the top part of the balloon, called the bubble, as it fills with enough helium to support itself. Only the top part of the balloon is inflated before launch since the helium expands as the balloon ascends. Credit: NASA/Goddard/BARREL/Nicky Knox Read more: www.nasa.gov/content/goddard/nasas-barrel-returns-success... -- Three months, 20 balloons, and one very successful campaign. The team for NASA's BARREL – short for Balloon Array for Radiation belt Relativistic Electron Losses -- mission returned from Antarctica in March 2014. BARREL's job is to help unravel the mysterious Van Allen belts, two gigantic donuts of radiation that surround Earth, which can shrink and swell in response to incoming energy and particles from the sun and sometimes expose satellites to harsh radiation. While in Antarctica, the team launched 20 balloons carrying instruments that sense charged particles that are scattered into the atmosphere from the belts, spiraling down the magnetic fields near the South Pole. Each balloon traveled around the pole for up to three weeks. The team will coordinate the BARREL data with observations from NASA's two Van Allen Probes to better understand how occurrences in the belts relate to bursts of particles funneling down toward Earth. BARREL team members will be on hand at the USA Science and Engineering Festival in DC on April 26 and 27, 2014 for the exhibit Space Balloons: Exploring the Extremes of Space Weather. 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

  18. 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.

  19. [The Application of Internal Iliac Artery Balloon Occlusion in Pernicious Placenta Previa].

    PubMed

    Qi, Xiao-Rong; Liu, Xing-Hui; You, Yong; Wang, Xiao-Dong; Zhou, Rong; Xing, Ai-Yun; Zhang, Li; Ning, Gang; Zhao, Fu-Min; Li, Kai-Ming

    2016-07-01

    To evaluate the clinical application value of internal iliac artery balloon occlusion in pernicious placenta previa. We retrospectively reviewed the medical records of the patients of pernicious placenta previa in a single center from Jan, 2010 to Jan, 2015. The patients were divided into two groups, internal iliac artery balloon occlusion group and the control group without endovascular intervention. Blood loss in operation, volume of transfused blood products, caesarean hysterectomy, operating time, hospital days after operation and postoperative morbidity were compared between the two groups. The balloon occlusion group had significantly less blood loss, the volume of transfused blood products, caesarean hysterectomy, hospital day after operation than the control group had. There was no statistical difference in operating time, intensive care units (ICU), hypotension, infection, hypoxemia, bladder injury, bowel obstruction, neonatal asphyxia between the two groups. The balloon occlusion group had significantly higher rate in coagulopathy, hypoalbuminemia, electrolyte imbalance. Among the patients whose uterus were preserved, the blood loss was not significantly difference between the two groups. Among the patients with the complication of placenta accreta, caesarean hysterectomy was less in balloon group, and blood loss between the two groups was not significantly different. Among the patients without placenta accrete, the blood loss was less in balloon group, and caesarean hysterectomy between the two groups was not significantly different. The risk of hysterectomy in balloon group was related to placenta accreta, uterine arteries engorgement, placental invasive serosa, taking placenta by hand, placental invasive bladder, barrel-shaped thickening of lower uterine segment, unable to remove placenta. Internal iliac artery balloon occlusion is an effective treatment for pernicious placenta previa.

  20. Design Evolution and Methodology for Pumpkin Super-Pressure Balloons

    NASA Astrophysics Data System (ADS)

    Farley, Rodger

    The NASA Ultra Long Duration Balloon (ULDB) program has had many technical development issues discovered and solved along its road to success as a new vehicle. It has the promise of being a sub-satellite, a means to launch up to 2700 kg to 33.5 km altitude for 100 days from a comfortable mid-latitude launch point. Current high-lift long duration ballooning is accomplished out of Antarctica with zero-pressure balloons, which cannot cope with the rigors of diurnal cycles. The ULDB design is still evolving, the product of intense analytical effort, scaled testing, improved manufacturing, and engineering intuition. The past technical problems, in particular the s-cleft deformation, their solutions, future challenges, and the methodology of pumpkin balloon design will generally be described.

  1. Balloon-Borne, High-Energy Astrophysics: Experiences from the 1960s to the 1980s

    NASA Technical Reports Server (NTRS)

    Fishman, Gerald J.

    2008-01-01

    Observational high-energy astrophysics in the hard-x-ray and gamma-ray regions owes its development and initial successes to the balloon-borne development of detector systems, as well as pioneering observations, primarily in the timeframe from the 1960s to the 1990s. I will describe some of the first observations made by the Rice University balloon group in the 1960s, including the impetus for these observations. The appearance of SN 1987a led to several balloon-flight campaigns, sponsored by NASA, from Alice Springs, Australia in 1987 and 1988. During the 1980s, prototypes of instruments for the Compton Gamma Ray Observatory were flown on many balloon flights, which greatly enhanced the success of that mission.

  2. Incorporation of Scientific Ballooning into Science Education

    NASA Astrophysics Data System (ADS)

    Chanover, N.; Stochaj, S.; Petty, C.

    1999-12-01

    We are augmenting the science curriculum of the Roswell Independent School District in Roswell, NM, to take advantage of the proximity of a NASA scientific balloon base. The basic science related to balloon experimentation is being incorporated into the K-12 science curriculum via the discussion of topics such as atmospheric properties, weather, phases of matter, plotting skills, and communications in the context of a high-altitude balloon flight. These efforts will culminate in the construction of balloon-borne instruments by high school students, which will be launched during the spring of 2000. A demonstration flight, launched in the spring of 1999, was used to build student enthusiasm and community support for this program, which is funded by the NASA/IDEAS program.

  3. Nimbus 4/IRLS Balloon Interrogation Package (BIP)

    NASA Technical Reports Server (NTRS)

    1971-01-01

    The balloon interrogation package (BIP), an integral part of the overall interrogation, recording, and location subsystems (IRLS) for the Nimbus 4 program, is described. The BIP is a self-contained, integrated transponder designed to be carried aloft by a constant altitude, superpressure balloon to an altitude of 67,000 or 78,000 feet. After launch the BIP senses high-altitude balloon overpressure and temperature, and upon receipt of an interrogated command from the IRLS aboard the Nimbus 4 satellite, the BIP enodes the data on a real-time basis into a pulse-code modulation (PCM) format and transmits this data to the satellite. A summary of the program activity to produce 30 BIP systems and to support balloon launches from Ascension Island is presented.

  4. Determination of constant-volume balloon capabilities for aeronautical research. [specifically measurement of atmospheric phenomena

    NASA Technical Reports Server (NTRS)

    Tatom, F. B.; King, R. L.

    1977-01-01

    The proper application of constant-volume balloons (CVB) for measurement of atmospheric phenomena was determined. And with the proper interpretation of the resulting data. A literature survey covering 176 references is included. the governing equations describing the three-dimensional motion of a CVB immersed in a flow field are developed. The flowfield model is periodic, three-dimensional, and nonhomogeneous, with mean translational motion. The balloon motion and flow field equations are cast into dimensionless form for greater generality, and certain significant dimensionless groups are identified. An alternate treatment of the balloon motion, based on first-order perturbation analysis, is also presented. A description of the digital computer program, BALLOON, used for numerically integrating the governing equations is provided.

  5. Endovascular techniques in limb salvage: cutting, cryo, brachy, and drug-eluting balloons.

    PubMed

    Davies, Mark G; Anaya-Ayala, Javier E

    2013-04-01

    The complex pathophysiology response to injury of the lower-extremity arteries has prompted the development of several unique balloon technologies to overcome initial technical failures and short-term intimal hyperplasia. Cryoplasty alters the cellular and mechanical properties of the vessel wall during angioplasty. Cutting balloons incise the wall, preventing elastic recoil and allowing expansion of the lumen at a lower pressure, thus limiting barotrauma. Drug-eluting balloons actively transfer inhibitory compounds to the wall during the initial therapy, while brachytherapy balloons allow for localized delivery of radiation to inhibit the proliferative response seen after angioplasty. These platforms provide unique means to enhance immediate and short-term results and also reduce stent usage in the lower extremity.

  6. Transthoracic ultrasound guided balloon dilation of cor triatriatum dexter in 2 Rottweiler puppies.

    PubMed

    Birettoni, F; Caivano, D; Bufalari, A; Giorgi, M E; Miglio, A; Paradies, P; Porciello, F

    2016-12-01

    Balloon dilation was performed in two Rottweiler puppies with cor triatriatum dexter and clinical signs of ascites using transthoracic echocardiographic guidance. The dogs were positioned on a standard echocardiography table in right lateral recumbency, and guide wires and balloon catheters were imaged by echocardiographic views optimized to allow visualization of the defect. The procedures were performed successfully without complications and clinical signs were resolved completely in both cases. Guide wires and balloon catheters appeared hyperechoic on transthoracic echocardiography image and could be clearly monitored and guided in real-time. These two cases demonstrate that it is possible to perform balloon catheter dilation of cor triatriatum dexter under transthoracic guidance alone. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Upper limits to the quiet-time solar neutron flux from 10 to 100 MeV

    NASA Technical Reports Server (NTRS)

    Moon, S.; Simnett, G. M.; White, R. S.

    1976-01-01

    A large-area solid-angle double-scatter neutron telescope was flown to search for solar neutrons on three balloon flights in 1971 and 1972. The first two flights were launched from Palestine, Texas, and the third from Cape Girardeau, Missouri. The float altitude on each flight was at about 5 g/sq cm residual atmosphere. Neutrons from 10 to 100 MeV were measured. No solar flares occurred during the flights. Upper limits to the quiet-time solar neutron fluxes at the 95-per cent confidence level are 2.8, 4.6, 9.6, and 9.0 x 10 to the -4th power neutron/sq cm/sec in the energy intervals of 10-30, 30-50, 50-100, and 10-100 MeV, respectively.

  8. Hurricane Balloon Observations in the Hurricane Inflow Layer

    NASA Astrophysics Data System (ADS)

    Businger, S.; Johnson, R.; Ellis, R.; Talbot, R.

    2005-12-01

    Four autonomous NOAA smart balloons have been prepared at NOAA's Air Resources Lab Field Research Division. The balloons will be released from the northwest corner of Puerto Rico during August and September 2005 into the inflow of tropical cyclones passing just to the north or south of the island. Ballast control allows the balloons to be positioned low in the atmosphere in the inflow of the storms. Observations will include aspirated temperature and humidity, barometric pressure, GPS position, rain rate, ozone, downward IR temperature, and solar radiation. The observations will be transmitted in real time via satellite cellular telephone and posted to the web. Preliminary results of the analysis of the balloon data sets will be presented, including energy content of the inflow air, estimates of surface fluxes, and evidence of organized eddies. Solar cells will help prolong battery life. If a balloon survives an eye-wall penetration, data on the energy content and ozone concentrations of the boundary layer air in the eye will be presented.

  9. Stratospheric Balloons for Planetary Science and the Balloon Observation Platform for Planetary Science (BOPPS) Mission Summary

    NASA Technical Reports Server (NTRS)

    Kremic, Tibor; Cheng, Andrew F.; Hibbitts, Karl; Young, Eliot F.; Ansari, Rafat R.; Dolloff, Matthew D.; Landis, Rob R.

    2015-01-01

    NASA and the planetary science community have been exploring the potential contributions approximately 200 questions raised in the Decadal Survey have identified about 45 topics that are potentially suitable for addressing by stratospheric balloon platforms. A stratospheric balloon mission was flown in the fall of 2014 called BOPPS, Balloon Observation Platform for Planetary Science. This mission observed a number of planetary targets including two Oort cloud comets. The optical system and instrumentation payload was able to provide unique measurements of the intended targets and increase our understanding of these primitive bodies and their implications for us here on Earth. This paper will discuss the mission, instrumentation and initial results and how these may contribute to the broader planetary science objectives of NASA and the scientific community. This paper will also identify how the instrument platform on BOPPS may be able to contribute to future balloon-based science. Finally the paper will address potential future enhancements and the expected science impacts should those enhancements be implemented.

  10. Astrobiology Exploration Strategies for the Mars Polar Regions Using Balloon Platforms

    NASA Technical Reports Server (NTRS)

    Mahaffy, P. R.; Atreya, S. A.; Fairbrother, D. A.; Farrell, W. M.; Gorevan, S.; Jones, J.; Mitrofanov, I.; Scott, J.

    2003-01-01

    Montgolfiere balloons can provide a unique near-surface platform for an extended traverse over the polar regions of Mars. During the polar summer, such solar powered balloons would remain in the constant sun of the polar summer and could remain airborne for many weeks or even months as the atmospheric circulation would drive the balloons around the polar region many times before the balloon would cross the terminator. Such a platform for scientific measurements could provide in situ sampling of the atmosphere for trace disequilibrium species that might be indicators of present geological or biological activity in this region. It could furthermore provide high resolution imaging, deep electromagnetic (EM) sounding for subsurface stratigraphy and liquid water, and high spatial resolution neutron measurements of subsurface ice. Technologies for robust balloon deployment on entry and controlled encounters with the surface and near subsurface for sample acquisition in otherwise inaccessible regions are presently being studied and developed with support from NASA.

  11. Astrobiology Exploration Strategies for the Mars Polar Regions Using Balloon Platforms

    NASA Technical Reports Server (NTRS)

    Mahaffy, P. R.; Atreya, S. A.; Fairbrother, D. A.; Farrell, W. M.; Gorevan, S.; Jones, J.; Mitrofanov, I.; Scott, J.

    2003-01-01

    Montgolfiere balloons can provide a unique near-surface platform for an extended traverse over the polar regions of Mars. During the polar summer, such solar powered balloons would remain in the constant sun of the polar summer and could remain airborne for many weeks or even months as the atmospheric circulation would drive the balloons around the polar region many times before the balloon would cross the terminator. Such a platform for scientific measurements could provide in situ sampling of the atmosphere for trace disequilibrium species that might be indicators of present geological or biological activity in this regon. It could furthermore provide high resolution imaging, deep electromagnetic (EM) sounding for subsurface stratigraphy and liquid water, and high spatial resolution neutron measurements of subsurface ice. Technologies for robust balloon deployment on entry and controlled encounters with the surface and near subsurface for sample acquisition in otherwise inaccessible regions are presently being studied and developed with support from NASA.

  12. Aerial Deployment and Inflation System for Mars Helium Balloons

    NASA Technical Reports Server (NTRS)

    Lachenmeler, Tim; Fairbrother, Debora; Shreves, Chris; Hall, Jeffery, L.; Kerzhanovich, Viktor V.; Pauken, Michael T.; Walsh, Gerald J.; White, Christopher V.

    2009-01-01

    A method is examined for safely deploying and inflating helium balloons for missions at Mars. The key for making it possible to deploy balloons that are light enough to be buoyant in the thin, Martian atmosphere is to mitigate the transient forces on the balloon that might tear it. A fully inflated Mars balloon has a diameter of 10 m, so it must be folded up for the trip to Mars, unfolded upon arrival, and then inflated with helium gas in the atmosphere. Safe entry into the Martian atmosphere requires the use of an aeroshell vehicle, which protects against severe heating and pressure loads associated with the hypersonic entry flight. Drag decelerates the aeroshell to supersonic speeds, then two parachutes deploy to slow the vehicle down to the needed safe speed of 25 to 35 m/s for balloon deployment. The parachute system descent dynamic pressure must be approximately 5 Pa or lower at an altitude of 4 km or more above the surface.

  13. Dislodgement of variceal bands after esophageal balloon tamponade for variceal bleeding.

    PubMed

    Mogrovejo, Estela; Manickam, Palaniappan; Polidori, Gregg; Cappell, Mitchell S

    2014-01-01

    A 43-year-old male with alcoholic cirrhosis underwent EGD for hematemesis which revealed bleeding, grade II, lower esophageal varices that were endoscopically ligated with 6 bands. All the bands remained attached to varices at the completion of EGD. Despite apparent initial hemostasis, balloon tamponade was performed one hour later for suspected continued bleeding. Due to suspected continuing bleeding, EGD was repeated 4 h after initial EGD, and 3 h after balloon tamponade. This EGD revealed the esophageal varices; none of the bands remaining on esophageal mucosa; multiple mucosal stigmata likely from trauma at initial site of variceal bands before dislodgement; and 3 dislodged bands in gastric body, duodenal bulb, or descending duodenum. The patient expired 17 h thereafter from hypovolemic shock. This single report may suggest an apparently novel, balloon tamponade complication: dislodgement of previously placed, endoscopic bands. The proposed pathophysiology is release of bands by stretching entrapped, esophageal mucosa during esophageal balloon tamponade. This complication, if confirmed, might render balloon tamponade a less desirable option very soon after band ligation.

  14. Rupture of the Renal Artery After Cutting Balloon Angioplasty in a Young Woman With Fibromuscular Dysplasia

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

    Oguzkurt, Levent, E-mail: loguzkurt@yahoo.com; Tercan, Fahri; Gulcan, Oner

    2005-04-15

    A 24-year-old woman with uncontrollable high blood pressure for 3 months had significant stenosis of the left renal artery caused by fibromuscular dysplasia (FMD). The lesion was resistant to percutaneous transluminal angioplasty at 18 atm with a semicompliant balloon. Angioplasy with a 6 x 10 mm cutting balloon (CB) caused rupture of the artery. Low-pressure balloon inflation decreased but did not stop the leak. An attempt to place a stent-graft (Jostent; Jomed, Rangendingen, Germany) failed, and a bare, 6-mm balloon-expandable stent (Express SD; Boston Scientific, MN) was deployed to seal the leak, which had decreased considerably after long-duration balloon inflation.more » The bleeding continued, and the patient underwent emergent surgical revascularization of the renal artery with successful placement of a 6-mm polytetrafluoroethylene bypass graft. CBs should be used very carefully in the treatment of renal artery stenosis, particularly in patients with FMD.« less

  15. Meeting the Challenge to Balloon Science

    NASA Astrophysics Data System (ADS)

    Jones, W. Vernon

    The promise of superpressure ballooning is helping the balloon program evolve toward a cost-effective means for frequent access to near-space. Superpressure balloons fabricated from strong, light-weight composite materials have the potential for increasing flight times of ton-class payloads to 100 days or more at altitudes above 5 mbars at essentially any geographic latitude. Although this new capability is still in an embryonic stage, its potential has already had an impact. Specifically, a new NASA Office of Space Science policy for University-class Explorer missions allows balloon investigations to compete on an equal basis with other low-cost missions requiring expendable launch vehicles. The new challenge for the science community is to design winning payloads that can be built within the cost cap of $13 M, including launch costs, and be developed within two to three years from selection to launch. Defining the international trajectories and getting the overflight agreements for balloon flights that make several circumnavigations of Earth will also be a challenge

  16. How to perform combined cutting balloon and high pressure balloon valvuloplasty for dogs with subaortic stenosis.

    PubMed

    Kleman, Mandi E; Estrada, Amara H; Maisenbacher, Herbert W; Prošek, Robert; Pogue, Brandon; Shih, Andre; Paolillo, Joseph A

    2012-01-01

    Subvalvular aortic stenosis (SAS) is one of the most common congenital cardiac malformations in dogs. Unfortunately, the long term success rate and survival data following either open heart surgery or catheter based intervention has been disappointing in dogs with severe subaortic stenosis. Medical therapy is currently the only standard recommended treatment option. A cutting balloon dilation catheter has been used successfully for resistant coronary artery and peripheral pulmonary arterial stenoses in humans. This catheter is unique in that it has the ability to cut, or score, the stenotic region prior to balloon dilatation of the stenosis. The use of cutting balloon valvuloplasty combined with high pressure valvuloplasty for dogs with severe subaortic stenosis has recently been reported to be a safe and feasible alternative therapeutic option. The following report describes this technique, outlines the materials required, and provides some 'tips' for successful percutaneous subaortic balloon valvuloplasty. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Balloon cell nevus of the iris.

    PubMed

    Morcos, Mohib W; Odashiro, Alexandre; Bazin, Richard; Pereira, Patricia Rusa; O'Meara, Aisling; Burnier, Miguel N

    2014-12-01

    Balloon cell nevus is a rare histopathological lesion characterized by a predominance of large, vesicular and clear cells, called balloon cells. There is only 1 case of balloon cell nevus of the iris reported in the literature. A 55 year-old man presented a pigmented elevated lesion in the right iris since the age of 12 years old. The lesion had been growing for the past 2 years and excision was performed. Histopathological examination showed a balloon cell nevus composed of clear and vacuolated cells without atypia. A typical spindle cell nevus of the iris was also observed. The differential diagnosis included xanthomatous lesions, brown adipocyte or other adipocytic lesions, clear cell hidradenoma, metastatic clear cell carcinoma of the kidney and clear cell sarcoma. The tumor was positive for Melan A, S100 protein and HMB45. Balloon cell nevus of the iris is rare but should be considered in the differential diagnosis of melanocytic lesions of the iris. Copyright © 2014 Elsevier GmbH. All rights reserved.

  18. Iridium: Global OTH data communications for high altitude scientific ballooning

    NASA Astrophysics Data System (ADS)

    Denney, A.

    While the scientific community is no stranger to embracing commercially available technologies, the growth and availability of truly affordable cutting edge technologies is opening the door to an entirely new means of global communications. For many years high altitude ballooning has provided science an alternative to costly satellite based experimental platforms. As with any project, evolution becomes an integral part of development. Specifically in the NSBF ballooning program, where flight durations have evolved from the earlier days of hours to several weeks and plans are underway to provide missions up to 100 days. Addressing increased flight durations, the harsh operational environment, along with cumbersome and outdated systems used on existing systems, such as the balloon vehicles Support Instrumentation Package (SIP) and ground-based systems, a new Over-The-Horizon (OTH) communications medium is sought. Current OTH equipment planning to be phased-out include: HF commanding systems, ARGOS PTT telemetry downlinks and INMARSAT data terminals. Other aspects up for review in addition to the SIP to utilize this communications medium include pathfinder balloon platforms - thereby, adding commanding abilities and increased data rates, plus providing a package for ultra-small experiments to ride aloft. Existing communication systems employed by the National Scientific Balloon Facility ballooning program have been limited not only by increased cost, slow data rates and "special government use only" services such as TDRSS (Tracking and Data Relay Satellite System), but have had to make special provisions to geographical flight location. Development of the Support Instrumentation Packages whether LDB (Long Duration Balloon), ULDB (Ultra Long Duration Balloon) or conventional ballooning have been plagued by non-standard systems configurations requiring additional support equipment for different regions and missions along with a myriad of backup for redundancy. Several beneficial points provided by the Iridium platform include pure global accessibility (as well as polar), cost effectiveness because it is available as a COTS (Commercially Off The Shelf) technology, reliability in that the equipment must operate in extreme conditions (near space), integration and development time into current systems must be minimized. As a bonus Motorola and NAL Research Corporation are developing SBD (Short Burst Data) into the Iridium network. This may lead the way to a global IP (Internet Protocol) node based ballooning platform. The Iridium satellite data modems employ the Iridium Low-Earth Orbit (LEO) satellite network. The scope of this paper is to introduce an OTH communications alternative, albeit not necessarily a primary one, to existing ballooning platforms using COTS based emerging technologies. Design aspects, characteristics, actual flight testing statistics, principles of the Iridium modems and communication paths are described including payload and support instrumentation interfacing. Not limited to high altitude ballooning, the Iridium communications platform opens a new era in remote commanding and data retrieval.

  19. An Onyx tunnel: reconstructive transvenous balloon-assisted Onyx embolization for dural arteriovenous fistula of the transverse-sigmoid sinus.

    PubMed

    Kerolus, Mena G; Chung, Joonho; Munich, Stephen A; Matsuda, Yoshikazu; Okada, Hideo; Lopes, Demetrius K

    2017-11-17

    Transvenous embolization is an effective method for treating dural arteriovenous fistulas (DAVFs) of the transverse-sigmoid sinus (TSS). However, in cases of complicated DAVFs, it is difficult to preserve the patency of the dural sinus. The authors describe the technical details of a new reconstructive technique using transvenous balloon-assisted Onyx embolization as another treatment option in a patient with an extensive and complex DAVF of the left TSS. A microcatheter and compliant balloon catheter were navigated into the left internal jugular vein and placed at the distal end of the DAVF in the transverse sinus. The microcatheter was placed between the vessel wall of the TSS and the balloon. After the balloon was fully inflated, Onyx-18 was injected at the periphery of the balloon in a slow, controlled, progressive, stepwise manner; the balloon and microcatheter were simultaneously withdrawn toward the sigmoid sinus, with Onyx encompassing the entirety of the complex DAVF. The Onyx refluxed into multiple arterial feeders in a distal-to-proximal step-by-step manner, ultimately resulting in an Onyx tunnel. The final angiography study revealed complete obliteration of the DAVF and patency of the TSS. The Onyx tunnel, or reconstructive transvenous balloon-assisted Onyx embolization technique, may be an effective treatment option for large, complex DAVFs of the TSS. This technique may provide another option to facilitate the complete obliteration of the DAVF while preserving the functional sinus.

  20. Inquiry-Based Early Undergraduate Research Using High-Altitude Ballooning

    NASA Astrophysics Data System (ADS)

    Sibbernsen, K.; Sibbernsen, M.

    2012-12-01

    One common objective for undergraduate science classes is to have students learn how to do scientific inquiry. However, often in science laboratory classes, students learn to take data, analyze the data, and come to conclusions, but they are told what to study and do not have the opportunity to ask their own research questions, a crucial part of scientific inquiry. A special topics class in high-altitude ballooning (HAB) was offered at Metropolitan Community College, a large metropolitan two-year college in Omaha, Nebraska to focus on scientific inquiry for the participants through support of NASA Nebraska Space Grant. A weather balloon with payloads attached (balloonSAT) was launched to near space where the balloon burst and fell back to the ground with a parachute. Students worked in small groups to ask their research questions, they designed their payloads, participated in the launch and retrieval of equipment, analyzed data, and presented the results of their research. This type of experience has potential uses in physics, physical science, engineering, electronics, computer programming, meteorology, astronomy, and chemistry classes. The balloonSAT experience can act as a stepping-stone to designing sounding rocket payloads and it can allow students the opportunity to participate in regional competitions and present at HAB conferences. Results from the workshop are shared, as well as student responses to the experience and suggestions for administering a high-altitude ballooning program for undergraduates or extending inquiry-based ballooning experiences into high-school or middle-school.

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