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Sample records for ecc direct bypass

  1. ECC Water Film Spreading, ECC Water Bypass and Sweep-out Phenomena in the Downcomer with DVI of APR1400 under LBLOCA

    SciTech Connect

    Lee, Dong Won; No, Hee Cheon; Kim, Han Kon; Oh, Seung Jong

    2002-07-01

    In the present study, several experiments related to the thermal-hydraulic phenomena in downcomer with DVI under LBLOCA (Large Break Loss of Coolant Accident) were carried out using the experimental facility of plane-channel type scaled down as 1/7 ratio of prototype reactor (APR1400). Especially, phenomena such as ECC (Emergency Core Cooling) water entrainment and mixing in the downcomer were focused in the present study. Water film spreading was studied and compared with the full-scaled experiment and the experiment with a 1/7 scaled cylindrical-type test section to see the scaling effect and its curvature effect. It turns out that the curvature effect is negligible and the present modified linear scaling law is more appropriate than the linear scaling law. The water height and the amount of ECC water bypass by onset of sweep-out were measured from the visual observation of sweep-out in the downcomer. From this test, the onset of continuous sweep-out was used to analyze the water height in the downcomer. The amount of ECC water bypass by sweep-out was measured and compared with the UCB and KfK correlations. It is found that the best fit of the data from the present experiment lies between the predictions by the two correlations. ECC water mixing phenomena in downcomer were observed focusing on the ECC water film behavior. From the air and water mixing tests, it is concluded that ECC water bypass fraction is highly dependent on DVI position rather than gas flow rates and ECC water bypass fraction is less than 10% of injection ECC water. From the steam and water mixing tests, it is concluded that ECC bypass fraction with steam injection is under 1.5% and much less than that with an air injection because of the condensation in the downcomer. (authors)

  2. Direct visualization of leukocyte/endothelial cell interaction during extracorporeal circulation (ECC) in a new animal model.

    PubMed

    Kamler, M; Jakob, H; Lehr, H A; Gebhard, M M; Hagl, S

    1997-05-01

    The clinical complications of extracorporeal circulation (ECC) have been linked to a systemic activation of cellular and humoral components and to a dysregulation of the microcirculatory compartment. Since to date only in vitro methods exist for evaluation, we developed an animal model to study the effects of ECC on the microcirculation. To establish the model, we assessed whether these effects are dependent on the duration of ECC. Intravital fluorescence microscopy was used on the dorsal skinfold chamber preparation in chronically instrumented, awake Syrian golden hamsters. ECC was realized using a micro-rollerpump and a silicon tube shunting blood between the carotid artery and the jugular vein. ECC was performed in three groups for various times (2, 10 and 20 min) after application of heparin at 300 IU/kg body wt. In hamsters, the application of high-dose heparin releases endothelial bound superoxide dismutase (SOD), a natural scavenger of oxygen-derived free radicals. Protocol II assigned two groups receiving heparin at different doses of 50 and 2000 IU/kg body wt. ECC for 2 min served as control to exclude effects from hemodilution and resulted in a minimal induction of leukocyte/endothelial cell interaction. Isovolemic ECC for 20 min resulted in an increase in rolling (from 11 +/- 3 to 38 +/- 20%, mean +/- S.D., P < 0.05) and adherent leukocytes (from 19 +/- 16 to 215 +/- 145 cells/mm2, mean +/- S.D., P < 0.05) in postcapillary venules. Microhemodynamic parameters and functional capillary density were not significantly affected. Arterial blood pressure and heart rate were stable. Heparin at 2000 IU/kg inhibited post-ECC leukocyte adhesion following ECC, whereas 50 IU/kg showed no protective effects. Leukocyte/endothelial cell interaction, induced by blood contact with synthetic surfaces, was directly visualized in vivo. The number of adherent leukocytes was dependent on the duration of ECC. The application of high-dose heparin followed by release of SOD

  3. Progress on Complications of Direct Bypass for Moyamoya Disease

    PubMed Central

    Yu, Jinlu; Shi, Lei; Guo, Yunbao; Xu, Baofeng; Xu, Kan

    2016-01-01

    Moyamoya disease (MMD) involves progressive occlusion of the intracranial internal carotid artery resulting in formation of moyamoya-like vessels at the base of the brain. It can be characterized by hemorrhage or ischemia. Direct vascular bypass is the main and most effective treatment of MMD. However, patients with MMD differ from those with normal cerebral vessels. MMD patients have unstable intracranial artery hemodynamics and a poor blood flow reserve; therefore, during the direct bypass of superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis, perioperative risk factors and anesthesia can affect the hemodynamics of these patients. When brain tissue cannot tolerate a high blood flow rate, it becomes prone to hyperperfusion syndrome, which leads to neurological function defects and can even cause intracranial hemorrhage in severe cases. The brain tissue is prone to infarction when hemodynamic equilibrium is affected. In addition, bypass vessels become susceptible to occlusion or atrophy when blood resistance increases. Even compression of the temporalis affects bypass vessels. Because the STA is used in MMD surgery, the scalp becomes ischemic and is likely to develop necrosis and infection. These complications of MMD surgery are difficult to manage and are not well understood. To date, no systematic studies of the complications that occur after direct bypass in MMD have been performed, and reported complications are hidden among various case studies; therefore, this paper presents a review and summary of the literature in PubMed on the complications of direct bypass in MMD. PMID:27499690

  4. Bias in peak clad temperature predictions due to uncertainties in modeling of ECC bypass and dissolved non-condensable gas phenomena

    SciTech Connect

    Rohatgi, U.S.; Neymotin, L.Y.; Jo, J.; Wulff, W. )

    1990-09-01

    This report describes a general method for estimating the effect on the Reflood Phase PCT from systematic errors (biases) associated with the modelling of the ECCS and dissolved nitrogen, and the application of this method in estimating biases in the Reflood Phase PCT (second PCT) predicted by the TRAC/PF1/MOD1, Version 14.3. The bias in the second PCT due to the uncertainty in the existing code models for ECCS related phenomena is {minus}19{degree}K ({minus}34{degree}F). The negative bias implies that the code models for this phenomena are conservative. The bias in the second PCT due to the lack of modelling of dissolved N{sub 2} in the code is estimated to be 9.9{degree}K (17.8{degree}F). The positive bias implies that the absence of dissolved N{sub 2} model makes the code prediction of PCT non-conservative. The bias estimation in this report is a major exception among all other uncertainty and bias assessments performed in conjunction with the CSAU methodology demonstration, because this bias estimation benefitted from using full-scale test data from the full-scale Upper Plenum Test Facility (UPTF). Thus, the bias estimates presented here are unaffected by scale distortions in test facilities. Data from small size facilities were also available and an estimate of bias based on these data will be conservative. 35 refs., 18 figs., 5 tabs.

  5. To ECC or not to ECC: the question remains.

    PubMed

    Driggers, Rita W; Zahn, Christopher M

    2008-12-01

    The usefulness of endocervical curettage (ECC) in evaluating women who have abnormal cervical cytology and histopathology has been debated for years; data regarding performance of ECC in the diagnostic evaluations of squamous and glandular lesions are mixed. There are no well-done randomized trials or systematic reviews regarding the usefulness of ECC. The yield on ECC increases in the setting of unsatisfactory colposcopy; in this situation, there seems less controversy regarding performance of an ECC. Reproducibility of ECC-rendered diagnosis is a concern. Data are needed to further define the role of ECC in evaluating women who have cervical disease.

  6. Perfusion and Aortic Surgery: Patient Directed Cardiopulmonary Bypass and Quality Improvement

    PubMed Central

    Poullis, Mike

    2011-01-01

    Abstract: Aortic surgery frequently extends the boundaries of perfusion knowledge learned from non aortic cardiac surgery. This is due to the extremes of temperature, prolonged bypass times, hypothermic arrest, and selective organ(s) perfusion. Suboptimal perfusion can potentially affect outcomes even after technically successful aortic surgery. We present the concepts of patient directed bypass with regard to blood pressure, flow during cardiopulmonary bypass (CPB), oxygen delivery, cooling, and carbon dioxide levels on bypass. Quality of perfusion during aortic surgery is then addressed in the context of Perfusion Standards of Reporting Trials (PERFSORT, www.perfsort.net). PERFSORT analyses these variables during bypass: blood pressure, hematocrit, lactate, glucose, and temperature, all of which are known to affect outcomes. PERFSORT can be applied to individual cases or a series, and although primarily designed for research publications, is equally useful in a purely clinical setting. A new concept from engineering called Lissajous figures is then discussed to potentially retrospectively assess the effects of ischemia during aortic surgery. This may help identify why some patients despite flawless surgery, anesthesia, and perfusion, in the absence of bleeding, stroke, and obvious causes of organ damage at the time of aortic surgery develop multi organ dysfunction. PMID:21449244

  7. ECC's Future: Picturing the Possible.

    ERIC Educational Resources Information Center

    Willett, Lynn H.; Youngren, Tom

    This report by the President's Planning Commission at Elgin Community College (ECC) presents two visions of the college's future based on community and staff views of how the college should develop and provides goals to help realize these visions. First, the report presents the basic planning assumptions, or megatrends, on which the scenarios for…

  8. Bypassing primary sensory cortices--a direct thalamocortical pathway for transmitting salient sensory information.

    PubMed

    Liang, M; Mouraux, A; Iannetti, G D

    2013-01-01

    Detection and appropriate reaction to sudden and intense events happening in the sensory environment is crucial for survival. By combining Bayesian model selection with dynamic causal modeling of functional magnetic resonance imaging data, a novel analysis approach that allows inferring the causality between neural activities in different brain areas, we demonstrate that salient sensory information reaches the multimodal cortical areas responsible for its detection directly from the thalamus, without being first processed in primary and secondary sensory-specific areas. This direct thalamocortical transmission of multimodal salient information is parallel to the processing of finer stimulus attributes, which are transmitted in a modality-specific fashion from the thalamus to the relevant primary sensory areas. Such direct thalamocortical connections bypassing primary sensory cortices provide a fast and efficient way for transmitting information from subcortical structures to multimodal cortical areas, to allow the early detection of salient events and, thereby, trigger immediate and appropriate behavior.

  9. Clinical Effect and Prognosis of Off-Pump Minimally Invasive Direct Coronary Artery Bypass

    PubMed Central

    Yang, Ming; Xiao, Lian-Bo; Gao, Zhi-Sheng; Zhou, Ji-Wu

    2017-01-01

    Background Coronary artery bypass grafting (CABG) is a common procedure to circumvent the obstruction of coronary arteries when stents are unsuitable. CABG is a very traumatic surgery that requires redirecting blood flow to an external pump. Thus, this procedure has many risks during and after surgery, and minimizing these risks would greatly benefit the patients. Material/Methods We selected 126 patients with coronary artery syndrome and who were unsuitable for stent percutaneous coronary intervention. The observation group received minimally invasive direct coronary artery bypass (MIDCAB), while the control group was treated with off-pump CABG. Results Blood markers and echocardiography before and after treatment improved equally in both groups. Neither group exhibited obvious adverse reactions, or liver and kidney function damage. However, surgical bleeding and postoperative observation days were significantly reduced in the MIDCAB group. Death and cardiac shock at the end of follow-up were significantly lower in the MIDCAB group. Conclusions Overall, the clinical benefits of MIDCAB and OP-CABG were similar, but MIDCAB significantly reduced postoperative hospital stay and intraoperative blood transfusion, and improved clinical prognosis. PMID:28257412

  10. The ESX-5 associated eccB-EccC locus is essential for Mycobacterium tuberculosis viability.

    PubMed

    Di Luca, Mariagrazia; Bottai, Daria; Batoni, Giovanna; Orgeur, Mickael; Aulicino, Anna; Counoupas, Claudio; Campa, Mario; Brosch, Roland; Esin, Semih

    2012-01-01

    The recently described ESX-5 secretion system of Mycobacterium tuberculosis is one of the most important modulators of host-pathogen interactions due to its crucial impact on PPE protein secretion, cell wall stability and virulence. Although various components of the ESX-5 secretion machinery have been defined, other ESX-5 core components still remain to be characterized. In this study, we focused on EccB(5) and EccC(5), a transmembrane protein (EccB(5)) and a membrane-bound ATPase (EccC(5)), both predicted to be building blocks of the M. tuberculosis ESX-5 membrane-associated complex. In vitro expression studies demonstrated that EccB(5) and EccC(5) encoding genes constitute an operon. The expression of this operon is essential for M. tuberculosis, since the deletion of the eccB(5)-eccC(5) genomic segment at the ESX-5 locus is possible only after the integration of a second functional copy of eccB(5)-eccC(5) genes into the M. tuberculosis chromosome. The characterization of two M. tuberculosis conditional mutant strains (Mtb(Pptr)eccB(5) and Mtb(Pptr)eccC(5)), in which the eccB(5)-eccC(5) operon or the eccC(5) gene, respectively, were expressed under the control of an anhydrotetracycline-repressible promoter, confirmed that the repression of eccB(5)-eccC(5) genes is detrimental for growth of M. tuberculosis both in vitro and in THP-1 human macrophage cell line. Moreover, analysis of the secretome of Mtb(Pptr)eccB(5)-eccC(5) and Mtb(Pptr)eccC(5) strains revealed that both EccB(5) and EccC(5) are required for secretion of ESX-5 specific substrates, thus confirming that they are indeed components of the ESX-5 secretion machinery. Taken together these findings demonstrate the importance of an intact and functional ESX-5 system for viability of M. tuberculosis, thus opening new interesting options for alternative antimycobacterial control strategies.

  11. Osborne Reynolds' pipe flow: Direct computation from laminar through bypass transition to fully-developed turbulence

    NASA Astrophysics Data System (ADS)

    Wu, Xiaohua; Moin, Parviz; Adrian, Ronald; Baltzer, Jon; Hickey, Jean-Pierre

    2012-11-01

    The most fundamental internal flow, smooth pipe from a slightly perturbed laminar inlet state continuously through bypass transition to fully-developed turbulence, has been computed using DNS over an axial domain length of 250 pipe radii. In the fully-developed turbulent region, mean and second-order turbulent statistics including the rate of viscous dissipation show excellent agreement with those obtained from an additional simulation using the conventional streamwise periodic boundary condition over an axial domain length of 30 pipe radii. Friction factor follows analytical solution prior to breakdown, and agrees with Moody's correlation after the completion of transition. During transition it exhibits an overshoot. Breakdown of the laminar pipe flow is characterized by the formation of large Lambda-shaped vortices pointing upstream, followed by their subsequent generation of small hairpin packets inclined towards the downstream direction.

  12. [A successful case of minimally invasive direct coronary artery bypass (MIDCAB) followed by PTCA].

    PubMed

    Nishina, T; Matsuda, K; Nomoto, S; Nishimura, K; Koshiji, T; Sato, T; Ueyama, K; Nonaka, M; Ban, T

    1998-02-01

    A 70-year-old man who developed angina pectoris underwent cardiac catheterization, which showed total occlusion of the left anterior descending coronary artery (LAD), associated with 75% stenosis of the right coronary artery (RCA) and 90% stenosis of the small circumflex coronary artery (CX). The LAD received good collateral flow from the RCA. The patient was scheduled to undergo the MIDCAB for the LAD using the internal thoracic artery (ITA), combined with percutaneous transluminal coronary angioplasty (PTCA) for the RCA subsequently. A left anterior submammarian skin incision of 10 cm in length was made. The fifth costal cartilage was removed. The left ITA was directly harvested from the chest wall from the 4th to 7th intercostal space, and was anastomosed to the midportion of the LAD without cardiopulmonary bypass. The patient was quickly recovered after the operation. On the 8th postoperative day, the patient successfully underwent the PTCA for the RCA after the ITA-LAD graft had been verified to be patent. The MIDCAB could be indicated for multivessel coronary disease in conjunction with the PTCA.

  13. Bypass of an anesthesiologist-directed preoperative evaluation clinic results in greater first-case tardiness and turnover times.

    PubMed

    Epstein, Richard H; Dexter, Franklin; Schwenk, Eric S; Witkowski, Thomas A

    2017-09-01

    We evaluated 4 hypotheses related to bypass of an anesthesiologist-directed preoperative evaluation clinics (APEC): 1) first-case tardiness and turnover times increased; 2) turnover times increased more than first-case tardiness; and higher American Society of Anesthesiologists Physical Status (ASA PS) resulted in both an ordered increase among ASA PS and within ASA PS in 3) first-case tardiness; and 4) turnover times. Retrospective observational study using electronic health records. One large, teaching hospital. An average of 14,310 patients per year undergoing elective surgery in the hospital's main opera rating rooms who were not inpatients preoperatively between 2006 and 2016. None. Average increases in first-case tardiness and turnover times between patients seen or not seen preoperatively in the APEC. APEC bypass increased first-case tardiness 2.58 min per case (CI 1.55-3.61; P<0.0001) and turnover times by 7.49 min (CI 6.79-8.19; P<0.0001). The increase in mean turnover time was greater than mean first-case tardiness (difference=4.91 min; CI 3.76-6.06; P<0.0001). Had all patients bypassed the APEC, the increase in total minutes OR- 1 workday- 1 for turnover times would have been larger than the increase in first-case tardiness (difference=5.71, CI 3.17-4.72; P<0.0001). There was an ordered increase with APEC bypass for both first-case tardiness and turnover times with increasing ASA PS (P<0.0001). Within ASA PS, first-case tardiness (all P-values<0.003) and turnover times (all P-values<0.0001) also increased with APEC bypass. All 4 hypotheses were accepted. Overall and with control for ASA PS, APEC bypass increases first-case tardiness and turnover times. A strategy of selective bypass of ASA PS 1-2 patients would not be effective economically because of substantial delays from ASA PS 2 patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Off-Pump Minimally Invasive Coronary Artery Bypass Grafting With a Heart Positioner: Direct Retraction for a Better Exposure.

    PubMed

    Kikuchi, Keita; Une, Dai; Suzuki, Koutaro; Endo, Yoshiki; Matsuyama, Takayoshi; Osaka, Shin-Ichi; Kurata, Atsushi

    2015-01-01

    Lateral and inferior territories are difficult to expose during off-pump minimally invasive coronary artery bypass grafting (MICS CABG). The use of cardiopulmonary bypass is required at times. We initiated a direct retraction method by using a cardiac positioner for a better exposure, in order to complete off-pump, multivessel MICS CABG safely. We recently initiated multivessel MICS CABG, performed via a 6- to 9-cm left thoracotomy. For distal anastomoses, the lateral pericardial edge was pulled to the chest wall to optimize exposure of the lateral and inferior area. Next, a single- or multisuction cardiac positioner was put on the sides of the target vessel through the small thoracotomy and pulled directly toward the incision. Finally, a distal anastomosis was made with an epicardial stabilizer via the thoracotomy, as in standard off-pump CABG. There was no mortality or conversion to sternotomy. A total of 10 cases were targeted for off-pump multivessel MICS CABG with this approach. Nine were completed, while 1 still required pump assist. The average number of distal anastomoses was 2.8 ± 0.8. Two were successful off-pump quadruple bypass grafting with sequential anastomoses. All patients were discharged and remain well to this day. Most multivessel MICS CABG was feasible without pump assist even at the initiation period. This approach is easy and helpful in providing good exposure of target vessels without requirement of additional incisions.

  15. ECC Ozonesonde Calibration and Observations: Satellite Validation

    NASA Technical Reports Server (NTRS)

    Schmidlin, Francis J.; Zukor, Dorothy (Technical Monitor)

    2001-01-01

    The reliability of the Electrochemical Concentration Cell (ECC) ozonesonde depends on the care exercised in preparing the instrument for use. Although the ECC can be quickly prepared and flown, generally within less then one day if necessary, it is best to prepare the instrument at least one week prior to use, and as our tests have confirmed even 2-3 weeks prior to use may actually be better. There are a number of factors that must be considered when preparing an ECC. These basically are the pump efficiency, volumetric flow rate, temperature of the air entering the pump, and the background current. Also of importance is the concentration of the potassium iodide solution. Tests conducted at Wallops Island (38 N) has enabled us to identify potential problem areas and ways to avoid them. The calibration and pre-flight preparation methods will be discussed. The method of calibrating the ECC also is used at Ascension Island (8 S) and Natal, Brazil (5 S). Comparisons between vertical profiles of the ECC instrument and satellites will be reviewed as well as comparison with ground based instruments, such as, the Dobson Spectrophotometer and hand held Microtops photometers.

  16. ECC Ozonesonde Calibration and Observations: Satellite Validation

    NASA Technical Reports Server (NTRS)

    Schmidlin, Francis J.; Zukor, Dorothy (Technical Monitor)

    2001-01-01

    The reliability of the Electrochemical Concentration Cell (ECC) ozonesonde depends on the care exercised in preparing the instrument for use. Although the ECC can be quickly prepared and flown, generally within less then one day if necessary, it is best to prepare the instrument at least one week prior to use, and as our tests have confirmed even 2-3 weeks prior to use may actually be better. There are a number of factors that must be considered when preparing an ECC. These basically are the pump efficiency, volumetric flow rate, temperature of the air entering the pump, and the background current. Also of importance is the concentration of the potassium iodide solution. Tests conducted at Wallops Island (38 N) has enabled us to identify potential problem areas and ways to avoid them. The calibration and pre-flight preparation methods will be discussed. The method of calibrating the ECC also is used at Ascension Island (8 S) and Natal, Brazil (5 S). Comparisons between vertical profiles of the ECC instrument and satellites will be reviewed as well as comparison with ground based instruments, such as, the Dobson Spectrophotometer and hand held Microtops photometers.

  17. Direct Transaortic Balloon Valvuloplasty Under Cardiopulmonary Bypass for Neonatal Critical Aortic Stenosis

    SciTech Connect

    Nogi, Shunji; Teraguchi, Masayuki; Ikemoto, Yumiko; Otani, Hajime; Imamura, Hiroji; Kobayashi, Yohnosuke

    1996-09-15

    A 1-day-old male infant with critical aortic valvular stenosis underwent balloon aortic valvuloplasty (BAV) under echocardiographic guidance during cardiopulmonary bypass. Left ventricular function dramatically improved after BAV. This technique combined with a surgical approach was safe and efficient.

  18. Patient Directed Perfusion Pressure on Bypass, an Analogy from Electrical Engineering—A New Concept

    PubMed Central

    Warwick, Richard; Poole, Robert; Palmer, Kenneth; Johnson, Ian; Poullis, Michael

    2010-01-01

    Abstract: Organ ischemia, particularly mesenteric and renal, can occur despite a seemingly adequate perfusion flow and pressure during a period of cardiopulmonary bypass. The blood pressure to run bypass at remains a contentious issue. We present the concept that perfusion pressure during cardiopulmonary bypass should be patient specific, depending on an individual’s resting pre-procedural blood pressure. Four simulated arterial traces with variable morphology, but identical systolic and diastolic blood pressures, were analyzed to calculate the medical mean, arithmetic mean, and root mean square of the blood pressure tracing. Using the standard medical formula for calculation of mean blood pressure, you can potentially underestimate perfusion pressure by 12 mmHg in a normotensive subject. The root mean square pressure calculates the equivalent non pulsatile pressure that will deliver the same hydraulic power to the circulation as its pulsatile equivalent. Patient specific perfusion pressures, calculated via root mean square may potentially help reduce the incidence of organ ischemia during cardiopulmonary bypass. Clinical trials are needed to confirm or refute this concept. PMID:20437793

  19. Patient directed perfusion pressure on bypass, an analogy from electrical engineering--a new concept.

    PubMed

    Warwick, Richard; Poole, Robert; Palmer, Kenneth; Johnson, Ian; Poullis, Michael

    2010-03-01

    Organ ischemia, particularly mesenteric and renal, can occur despite a seemingly adequate perfusion flow and pressure during a period of cardiopulmonary bypass. The blood pressure to run bypass at remains a contentious issue. We present the concept that perfusion pressure during cardiopulmonary bypass should be patient specific, depending on an individual's resting pre-procedural blood pressure. Four simulated arterial traces with variable morphology, but identical systolic and diastolic blood pressures, were analyzed to calculate the medical mean, arithmetic mean, and root mean square of the blood pressure tracing. Using the standard medical formula for calculation of mean blood pressure, you can potentially underestimate perfusion pressure by 12 mmHg in a normotensive subject. The root mean square pressure calculates the equivalent non pulsatile pressure that will deliver the same hydraulic power to the circulation as its pulsatile equivalent. Patient specific perfusion pressures, calculated via root mean square may potentially help reduce the incidence of organ ischemia during cardiopulmonary bypass. Clinical trials are needed to confirm or refute this concept.

  20. Nanoscale characterization of engineered cementitious composites (ECC)

    SciTech Connect

    Sakulich, Aaron Richard Li, Victor C.

    2011-02-15

    Engineered cementitious composites (ECC) are ultra-ductile fiber-reinforced cementitious composites. The nanoscale chemical and mechanical properties of three ECC formulae (one standard formula, and two containing nanomaterial additives) were studied using nanoindentation, electron microscopy, and energy dispersive spectroscopy. Nanoindentation results highlight the difference in modulus between bulk matrix ({approx} 30 GPa) and matrix/fiber interfacial transition zones as well as between matrix and unreacted fly ash ({approx} 20 GPa). The addition of carbon black or carbon nanotubes produced little variation in moduli when compared to standard M45-ECC. The indents were observed by electron microscopy; no trace of the carbon black particles could be found, but nanotubes, including nanotubes bridging cracks, were easily located in ultrafine cracks near PVA fibers. Elemental analysis failed to show a correlation between modulus and chemical composition, implying that factors such as porosity have more of an effect on mechanical properties than elemental composition.

  1. New mini-extracorporeal circulation system (ECC.O) is a safe technique in coronary surgery.

    PubMed

    Valtonen, Mika; Vähäsilta, Tommi; Kaila-Keinänen, Tessa; Kuttila, Kari

    2007-10-01

    Cardiopulmonary bypass (CPB) is known to cause the systemic inflammatory reaction after cardiac surgery. New coated and closed loop circuit systems may reduce this inflammation response and improve the surgical outcome. This study was designed to evaluate the safety and efficacy of the mini-extracorporeal circulation system (ECC.O) in CABG patients. Forty patients undergoing elective coronary surgery were randomized into two groups, the ECC.O group and the standard CPB group. Routine hemodynamic monitoring and biochemical measurements were registered according to the hospital practice. The clinical outcome of the patients was similar in both groups. There were no significant differences between the groups in the duration of intubation following surgery, the length of intensive care unit-stay or the total hospital stay. The haemoglobin level was significantly higher (p=0.0069) during and after the perfusion in the ECC.O group. The ECC.O system can be safely used in CABG patients and it maintains haemoglobin level better than conventional CPB.

  2. Direct oxymetric peripheral tissue perfusion monitoring during open heart surgery with the use of cardiopulmonary bypass: preliminary experience.

    PubMed

    Lonsky, V; Svitek, V; Brzek, V; Kubicek, J; Volt, M; Horak, M; Mandak, J

    2011-11-01

    Regional hypoperfusion has been associated with the development of postoperative organ dysfunction in cardiac surgery involving cardiopulmonary bypass (CPB). Direct tissue oxymetry is a potentially new method for monitoring the quality of the peripheral tissue perfusion during CPB. The aim of this study was to assess the effects of CPB in skeletal muscle oxygenation when measured in the deltoid muscle by direct oxymetry during perioperative period. Seven patients underwent on-pump coronary artery bypass grafting. Direct oxymetry was performed by an optical cathether introduced into the deltoid muscle. Continuous measurement was made during the surgical procedure and the postoperative period. Mean arterial blood pressure, blood flow during CPB, laboratory markers of tissue hypoperfusion, blood gases and body temperature were also recorded. Interstitial muscle tissue oxygen tension (pO(2)) decreased after the introduction to anaesthesia and, more significantly, during CPB. After the disconnection from CPB at the end of the operation, the pO(2) returned to pre-anaesthetic values. During the first hours after admission of the patients to the intensive care unit, the pO(2) progressively decreased, reached a minimum value after four hours, and increased slowly thereafter. There was a significant correlation of pO(2) with mean arterial blood pressure and blood flow during that time. The result of this first measurement seems to demonstrate that the standard technique of conducting cardiopulmonary bypass produces low muscle oxygen tension and, thus, little perfusion of skeletal muscle. The data also indicate that both high mean arterial blood pressure and high flow are necessary during CPB to ensure skeletal muscle perfusion. The investigation is continuing.

  3. Case definition, aetiology and risk assessment of early childhood caries (ECC): a revisited review.

    PubMed

    Vadiakas, G

    2008-09-01

    To provide a review of the existing literature on early childhood caries (ECC) with particular reference on the nomenclature, case definition, epidemiology, etiology and risk assessment. An electronic search was used to identify and critically review papers that have been published and are pertinent to the above issues, evaluate and compile the reported evidence. The term ECC has been adopted to more accurately describe dental caries that affects primary dentitions, replacing previously used terminology that associated the disease with the nursing habit. Suggested ECC case definition uses caries patterns as defining criteria, however, further refinement to include different clinical expressions of a varying severity is necessary. Significant percentages of preschool child populations are affected by ECC today, with the disease concentrating disproportionately in deprived families. Early colonization by mutans streptococci (MS) is associated with increased ECC development, with bacteria being transmitted in both vertical and horizontal ways. Dietary factors related to sugar consumption predispose to early MS colonization and establishment and increase the risk for ECC development, being part of the causal chain. Inappropriate bottle and breast-feeding behaviors also increase the risk, without showing a direct causal relationship. High risk children belong to ethnic minority groups and to low income families with poor parental behaviors and attitudes. Further high-quality studies are needed to explore the role bacteria other than MS may play in caries initiation and progression, elucidate the interaction of the saliva immune defence system with a potentially defective tooth, and investigate the effect distant behavioral factors have on the causal chain that leads to ECC development.

  4. Fatigue enhancement of concrete beam with ECC layer

    SciTech Connect

    Leung, Christopher K.Y. . E-mail: ckleung@ust.hk; Cheung, Y.N.; Zhang Jun

    2007-05-15

    The pseudo strain-hardening behavior of Engineered Cementitious Composites (ECC) is a desirable characteristic for it to replace concrete to suppress brittle failure. This widespread use of ECC in the industry is, however, limited by its high cost. To achieve higher performance/cost, ECC can be strategically applied in parts of a structure that is under relatively high stress and strain. In this paper, layered ECC-concrete beams subjected to static and fatigue flexural loads were investigated by experiments. The static test results showed that the application of a layer of ECC on the tensile side of a flexural beam increased its flexural strength and the degree of improvement increased with the thickness of ECC applied. In addition, the layer of ECC enhanced the ductility of the beam and the failure mode changed from brittle to ductile. Under four-point cyclic loading, the ECC layer significantly improved the fatigue life of the beam. Moreover, in comparison to plain concrete beams, layered ECC beams could sustain fatigue loading at a larger deflection without failure. The great improvement in fatigue performance was attributed to the effectiveness of ECC in controlling the growth of small cracks. The experimental findings reflect the feasibility of using ECC strategically in critical locations for the control of fatigue crack growth.

  5. Economics of elective coronary revascularization. Comparison of costs and charges for conventional angioplasty, directional atherectomy, stenting and bypass surgery.

    PubMed

    Cohen, D J; Breall, J A; Ho, K K; Weintraub, R M; Kuntz, R E; Weinstein, M C; Baim, D S

    1993-10-01

    This study was designed to evaluate more closely the true in-hospital costs of elective revascularization by directional coronary atherectomy and intracoronary stenting and to compare these costs with those of the traditional revascularization alternatives (i.e., conventional balloon angioplasty and coronary artery bypass surgery). Previous studies have suggested that total hospital charges for directional coronary atherectomy or intracoronary stenting are significantly higher than those for conventional angioplasty. However, hospital charges do not necessarily reflect true economic costs, and their use may provide misleading data with regard to cost-effectiveness. We analyzed in-hospital charges from the itemized hospital accounts of 300 patients undergoing elective angioplasty, directional atherectomy, Palmaz-Schatz coronary stenting or bypass surgery between January 1, 1990 and December 31, 1991. Costs were then derived by adjusting itemized patient accounts for department-specific cost/charge ratios. Catheterization laboratory costs were based on actual resource consumption, and daily room costs were adjusted for the intensity of nursing services provided. Length of hospital stay was similar for atherectomy (2.3 +/- 1.5 days) and conventional angioplasty (2.6 +/- 1.7 days) but significantly longer for stenting (5.5 +/- 2.6 days, p < 0.05). Total costs were also significantly higher for coronary stenting ($7,878 +/- $3,270, median $6,699, p < 0.05) than for angioplasty ($5,396 +/- $2,829, median $4,753) or atherectomy ($5,726 +/- $2,716, median $4,986). However, length of stay, resource consumption (laboratory and radiologic testing, drugs, blood products, for example) and total costs for bypass surgery were still greater than for any of the percutaneous interventional procedures. In contrast to previous studies utilizing only hospital charges, the in-hospital costs of angioplasty and directional coronary atherectomy were similar. Although the cost of coronary

  6. EUS-directed transgastric ERCP for Roux-en-Y gastric bypass anatomy: a minimally invasive approach.

    PubMed

    Kedia, Prashant; Tyberg, Amy; Kumta, Nikhil A; Gaidhane, Monica; Karia, Kunal; Sharaiha, Reem Z; Kahaleh, Michel

    2015-09-01

    ERCP is challenging in patients with Roux-en-Y gastric bypass. Using EUS to gain access to the excluded stomach and subsequently performing transcutaneous ERCP was described recently. We describe our initial experience with an internal EUS-directed transgastric ERCP (EDGE) procedure by using a lumen-apposing metal stent (LAMS). Single-center case series. Tertiary center with expertise in EUS-guided procedures. Five patients with Roux-en-Y gastric bypass underwent EDGE via a LAMS. A linear echoendoscope was used to access the excluded stomach. A LAMS was deployed over a wire to create a gastrogastric or jejunogastric fistula. A duodenoscope was then passed through the LAMS and conventional ERCP was performed. Technical and clinical success rates as well as adverse events. EUS-guided creation of a gastrogastric or jejunogastric fistula via placement of a LAMS was successful in all cases (100%). The ability to perform ERCP through the fashioned fistula during the index procedure was successful in 3 of 5 cases (60%). Two LAMS dislodgments requiring restenting were observed. No major adverse events were observed. No weight regain occurred. The median procedure time was 68.0 minutes. Small sample, single-institution experience. The internal EDGE procedure may offer a cost-effective, minimally invasive option for a common problem in a growing patient demographic. Further refinement of the technique is required to minimize adverse events. ( NCT01522573.). Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  7. Effects of solution mass transport on the ECC ozonesonde background current. [Electrochemical Concentration Cell

    NASA Technical Reports Server (NTRS)

    Thornton, D. C.; Niazy, N.

    1983-01-01

    A technique is developed to measure the effective mass transport parameter for the electrochemical concentration cell (ECC) ozonesonde in order to determine the mass transport rate constant for the ECC as a function of pressure. It is shown that a pressure dependent factor in the background current originates in a convective mass transport parameter. It is determined that for atmospheric pressures greater than 100 mb the mass transport parameter is a constant, while at pressures less than 100 mb it decreases logarithmically with pressure. It is suggested that the background current correction is directly correlated to the mass transport parameter pressure dependence. The presently used background current correction, which is based on the partial pressure of oxygen, is found to lead to an overestimation of the integrated ozone value in the troposphere for the ECC ozonesonde data.

  8. Mortality risk prediction models for coronary artery bypass graft surgery: current scenario and future direction.

    PubMed

    Karim, Mohammed N; Reid, Christopher M; Cochrane, Andrew; Tran, Lavinia; Alramadan, Mohammed; Hossain, Mohammed N; Billah, Baki

    2017-12-01

    Many risk prediction models are currently in use for predicting short-term mortality following coronary artery bypass graft (CABG) surgery. This review critically appraised the methods that were used for developing these models to assess their applicability in current practice setting as well as for the necessity of up-gradation. Medline via Ovid was searched for articles published between 1946 and 2016 and EMBASE via Ovid between 1974 and 2016 to identify risk prediction models for CABG. Article selection and data extraction was conducted using the CHARMS checklist for review of prediction model studies. Association between model development methods and model's discrimination was assessed using Kruskal-Wallis one-way analysis of variance and Mann-Whitney U-test. A total of 53 risk prediction models for short-term mortality following CABG were identified. The review found a wide variation in development methodology of risk prediction models in the field. Ambiguous predictor and outcome definition, sub-optimum sample size, inappropriate handling of missing data and inefficient predictor selection technique are major issues identified in the review. Quantitative synthesis in the review showed "missing value imputation" and "adopting machine learning algorithms" may result in better discrimination power of the models. There are aspects in current risk modeling, where there is room for improvement to reflect current clinical practice. Future risk modelling needs to adopt a standardized approach to defining both outcome and predictor variables, rational treatment of missing data and robust statistical techniques to enhance performance of the mortality risk prediction.

  9. [IVUS-controlled aorto-ostial directional coronary atherectomy in higher grade stenosis of the central anastomosis of a sequential triple venous bypass].

    PubMed

    Schiele, T M; Beauport, J; Niehues, R; Jacksch, R

    1998-12-01

    Following coronary artery bypass grafting repeat ischemia mandatory for reintervention occurs in 2 to 30% of cases, depending mainly on graft age. Selection of a suitable strategy for revascularisation--transcatheter angioplasty or reoperation--depends on various parameters including coronary morphology, left ventricular performance, comorbidity and availability of graft material. Catheter-based interventions on saphenous vein bypass grafts are feasible, but lower primary success rates and a higher incidence of restenosis--compared with native coronary arteries--have to be expected. Repeat coronary artery bypass graft operations are associated with a significantly higher perioperative morbidity and mortality, patency rates are lower and late clinical outcome is worse than in primary surgery. We report on a patient who underwent coronary artery bypass grafting 4 years ago revealing a high grade ostial stenosis in a jump-graft supplying RCA, LAD and Cx sequentially, making reintervention necessary. As a prerequisite serial balloon angioplasty of two native vessels was performed prior to ostial intervention. Intravascular-ultrasound guided directional coronary atherectomy was performed with good primary and long-term result. Our case demonstrates that, if all relevant clinical parameters and different therapeutic options are taken into account, complex transcatheter angioplasty procedures are feasible and associated with a reasonable amount of risk, thus avoiding repeat coronary artery bypass graft operations.

  10. Mini ECC vs. conventional ECC: an examination of venous oxygen saturation, haemoglobin, haematocrit, flow, cardiac index and oxygen delivery.

    PubMed

    Döbele, T; Schwirtz, G; Gahl, B; Eckstein, F

    2010-05-01

    In our clinical daily routine, it is noticeable that lower cardiac indices are reached more often without negative consequences when using mini extracorporeal circulation (ECC) systems than when using open ECC systems. We evaluated haemoglobin concentration, haematocrit, blood flow, cardiac index (CI) and mixed-venous oxygen saturation (vSO2) in patients undergoing surgery using mini ECC (n=10 cases) and ECC (n=10 cases). This analysis shows that, with a mini ECC system, the range of oxygen delivery is equal to that achieved when using an open standard ECC system, despite a lower cardiac index. This phenomenon can be explained through a significant lower haemodilution and, therefore, a higher concentration of haemoglobin.

  11. Determinants of ECC in Sardinian preschool children.

    PubMed

    Campus, G; Solinas, G; Sanna, A; Maida, C; Castiglia, P

    2007-12-01

    The aim of the study was to assess the influence of determinants on the presence of caries in pre-school children. A matched case-control study (1:2) was designed: 55 children (32 males, 23 females) with at least one buccal or lingual caries lesion on one primary maxillary incisor were selected (caries affected=1) and compared to randomly selected controls (no caries=0) paired for age and gender. Several variables concerning oral hygiene habits, use of fluoride supplementation, dietary habits, socio-economic status of the family and lifestyle factors were considered as risk predictors for early childhood caries (ECC). A conditional logistic regression model was used to perform matched case-control analysis. Bottle feeding at night (OR=1.90; 95%CI=1.03-3.50) and socio-economic level (OR=1.69; 95%CI=1.01-2.81) were positively associated with case status. We conclude that ECC seemed to be associated with bottle feeding at night and a low socio-economic level.

  12. Goal-directed Therapy Improves the Outcome of High-risk Cardiac Patients Undergoing Off-pump Coronary Artery Bypass

    PubMed Central

    Kapoor, Poonam Malhotra; Magoon, Rohan; Rawat, Rajinder Singh; Mehta, Yatin; Taneja, Sameer; Ravi, R; Hote, Milind P

    2017-01-01

    Background: There has been a constant emphasis on developing management strategies to improve the outcome of high-risk cardiac patients undergoing surgical revascularization. The performance of coronary artery bypass surgery on an off-pump coronary artery bypass (OPCAB) avoids the risks associated with extra-corporeal circulation. The preliminary results of goal-directed therapy (GDT) for hemodynamic management of high-risk cardiac surgical patients are encouraging. The present study was conducted to study the outcome benefits with the combined use of GDT with OPCAB as compared to the conventional hemodynamic management. Material and Method: Patients with the European System for Cardiac Operative Risk Evaluation ≥3 scheduled for OPCAB were randomly divided into two groups; the control and GDT groups. The GDT group included the monitoring and optimization of advanced parameters, including cardiac index (CI), systemic vascular resistance index, oxygen delivery index, stroke volume variation; continuous central venous oxygen saturation (ScVO2), global end-diastolic volume, and extravascular lung water (EVLW), using FloTrac™, PreSep™, and EV-1000® monitoring panels, in addition to the conventional hemodynamic management in the control group. The hemodynamic parameters were continuously monitored for 48 h in Intensive Care Unit (ICU) and corrected according to GDT protocol. A total of 163 patients consented for the study. Result: Seventy-five patients were assigned to the GDT group and 88 patients were in the control group. In view of 9 exclusions from the GDT group and 12 exclusions from control group, 66 patients in the GDT group and 76 patients in control group completed the study. Conclusion: The length of stay in hospital (LOS-H) (7.42 ± 1.48 vs. 5.61 ± 1.11 days, P < 0.001) and ICU stay (4.2 ± 0.82 vs. 2.53 ± 0.56 days, P < 0.001) were significantly lower in the GDT group as compared to control group. The duration of inotropes (3.24 ± 0.73 vs. 2.89

  13. Goal-directed therapy improves the outcome of high-risk cardiac patients undergoing off-pump coronary artery bypass.

    PubMed

    Kapoor, Poonam Malhotra; Magoon, Rohan; Rawat, Rajinder Singh; Mehta, Yatin; Taneja, Sameer; Ravi, R; Hote, Milind P

    2017-01-01

    There has been a constant emphasis on developing management strategies to improve the outcome of high-risk cardiac patients undergoing surgical revascularization. The performance of coronary artery bypass surgery on an off-pump coronary artery bypass (OPCAB) avoids the risks associated with extra-corporeal circulation. The preliminary results of goal-directed therapy (GDT) for hemodynamic management of high-risk cardiac surgical patients are encouraging. The present study was conducted to study the outcome benefits with the combined use of GDT with OPCAB as compared to the conventional hemodynamic management. Patients with the European System for Cardiac Operative Risk Evaluation ≥3 scheduled for OPCAB were randomly divided into two groups; the control and GDT groups. The GDT group included the monitoring and optimization of advanced parameters, including cardiac index (CI), systemic vascular resistance index, oxygen delivery index, stroke volume variation; continuous central venous oxygen saturation (ScVO 2 ), global end-diastolic volume, and extravascular lung water (EVLW), using FloTrac™ , PreSep™ , and EV-1000 ® monitoring panels, in addition to the conventional hemodynamic management in the control group. The hemodynamic parameters were continuously monitored for 48 h in Intensive Care Unit (ICU) and corrected according to GDT protocol. A total of 163 patients consented for the study. Seventy-five patients were assigned to the GDT group and 88 patients were in the control group. In view of 9 exclusions from the GDT group and 12 exclusions from control group, 66 patients in the GDT group and 76 patients in control group completed the study. The length of stay in hospital (LOS-H) (7.42 ± 1.48 vs. 5.61 ± 1.11 days, P < 0.001) and ICU stay (4.2 ± 0.82 vs. 2.53 ± 0.56 days, P < 0.001) were significantly lower in the GDT group as compared to control group. The duration of inotropes (3.24 ± 0.73 vs. 2.89 ± 0.68 h, P = 0.005) was also significantly lower

  14. Estimated human absorbed dose for (68)Ga-ECC based on mice data: comparison with (67)Ga-ECC.

    PubMed

    Shanehsazzadeh, Saeed; Yousefnia, Hassan; Jalilian, Amir Reza; Zolghadri, Samaneh; Lahooti, Afsaneh

    2015-07-01

    Nowadays, the efficacies of (68)Ga-based tracers are comparable to that of (18)F-based agents and have stimulated researchers to investigate the potential of (68)Ga-based positron emission tomography (PET) imaging agents. In this study, the human absorbed dose of (68)Ga labeled with ethylenecysteamine cysteine (68)Ga-ECC and (67)Ga-ECC was estimated based on biodistribution data in mice by the medical internal radiation dose (MIRD) method. For biodistribution of (67)Ga/(68)Ga-ECC, three mice were killed by CO2 asphyxiation at each selected times after injection (15, 30, 45, 60, 120 min for (68)Ga-ECC and 0.5, 2 and 48 h for (67)Ga-ECC), and then the tissue (heart, lung, brain, intestine, skin, stomach, kidneys, liver, muscle and bone) was removed. (68)Ga-ECC as a new PET renal imaging agent was prepared with radiochemical purity of >97 % in less than 30 min. The biodistribution data for (68)Ga-ECC showed that the most of the activity extracted from the urinary tract very fast. Comparison between human absorbed dose estimation for these two agents indicated that the absorbed dose of the most organs after injection of (67)Ga-ECC is approximately tenfold higher than the amount after (68)Ga-ECC injection. The results showed that (68)Ga-ECC is a more appropriate agent rather than (67)Ga-ECC and generally can be a good candidate for PET renal imaging applications.

  15. ECCE Toolkit: Prototyping Sensor-Based Interaction

    PubMed Central

    Bellucci, Andrea; Aedo, Ignacio; Díaz, Paloma

    2017-01-01

    Building and exploring physical user interfaces requires high technical skills and hours of specialized work. The behavior of multiple devices with heterogeneous input/output channels and connectivity has to be programmed in a context where not only the software interface matters, but also the hardware components are critical (e.g., sensors and actuators). Prototyping physical interaction is hindered by the challenges of: (1) programming interactions among physical sensors/actuators and digital interfaces; (2) implementing functionality for different platforms in different programming languages; and (3) building custom electronic-incorporated objects. We present ECCE (Entities, Components, Couplings and Ecosystems), a toolkit for non-programmers that copes with these issues by abstracting from low-level implementations, thus lowering the complexity of prototyping small-scale, sensor-based physical interfaces to support the design process. A user evaluation provides insights and use cases of the kind of applications that can be developed with the toolkit. PMID:28241502

  16. Views from the 1995 ECC conference

    SciTech Connect

    Lowry, J.C.; Haegelin, J.K.; Underwood, J.K.

    1995-12-01

    The Engineering and Construction Contracting Division (ECC) of the AIChE held its 27th Annual Conference in Scottsdale, Arizona, Sept. 7--8, 1995. Each year the conference is attended by management representatives from manufacturers, producers, engineering and construction contractors, consultants and major equipment suppliers. The 1995 conference theme was, Applying Advanced Methodology to Improve Project Execution. What were the issues and recommendations resulting from the conference? Here are the composite results from the annual workshops, as well as some perspectives from three selected participants. The paper discusses modularization in the process industry, innovative construction practices, creation and use of 3-D models for the plant`s life cycle, alliances and pay-for-performance contracting, and new workshop formats, and ends with general views from selected participants.

  17. ECCE Toolkit: Prototyping Sensor-Based Interaction.

    PubMed

    Bellucci, Andrea; Aedo, Ignacio; Díaz, Paloma

    2017-02-23

    Building and exploring physical user interfaces requires high technical skills and hours of specialized work. The behavior of multiple devices with heterogeneous input/output channels and connectivity has to be programmed in a context where not only the software interface matters, but also the hardware components are critical (e.g., sensors and actuators). Prototyping physical interaction is hindered by the challenges of: (1) programming interactions among physical sensors/actuators and digital interfaces; (2) implementing functionality for different platforms in different programming languages; and (3) building custom electronic-incorporated objects. We present ECCE (Entities, Components, Couplings and Ecosystems), a toolkit for non-programmers that copes with these issues by abstracting from low-level implementations, thus lowering the complexity of prototyping small-scale, sensor-based physical interfaces to support the design process. A user evaluation provides insights and use cases of the kind of applications that can be developed with the toolkit.

  18. Electronic bypass of spinal lesions: activation of lower motor neurons directly driven by cortical neural signals

    PubMed Central

    2014-01-01

    Background Lower motor neurons in the spinal cord lose supraspinal inputs after complete spinal cord injury, leading to a loss of volitional control below the injury site. Extensive locomotor training with spinal cord stimulation can restore locomotion function after spinal cord injury in humans and animals. However, this locomotion is non-voluntary, meaning that subjects cannot control stimulation via their natural “intent”. A recent study demonstrated an advanced system that triggers a stimulator using forelimb stepping electromyographic patterns to restore quadrupedal walking in rats with spinal cord transection. However, this indirect source of “intent” may mean that other non-stepping forelimb activities may false-trigger the spinal stimulator and thus produce unwanted hindlimb movements. Methods We hypothesized that there are distinguishable neural activities in the primary motor cortex during treadmill walking, even after low-thoracic spinal transection in adult guinea pigs. We developed an electronic spinal bridge, called “Motolink”, which detects these neural patterns and triggers a “spinal” stimulator for hindlimb movement. This hardware can be head-mounted or carried in a backpack. Neural data were processed in real-time and transmitted to a computer for analysis by an embedded processor. Off-line neural spike analysis was conducted to calculate and preset the spike threshold for “Motolink” hardware. Results We identified correlated activities of primary motor cortex neurons during treadmill walking of guinea pigs with spinal cord transection. These neural activities were used to predict the kinematic states of the animals. The appropriate selection of spike threshold value enabled the “Motolink” system to detect the neural “intent” of walking, which triggered electrical stimulation of the spinal cord and induced stepping-like hindlimb movements. Conclusion We present a direct cortical “intent”-driven electronic spinal

  19. Optimal preparation of the ECC ozonesonde. [electrochemical cells

    NASA Technical Reports Server (NTRS)

    Thornton, D. C.

    1982-01-01

    The ECC background current was identified as the removal of residual tri-iodide (iodine) as the cell approaches equilibrium. The altitude dependence of this source of the background current is expected to be only slowly changed in the troposphere with a more rapid decrease in the stratosphere. Oxygen does not play a role in the background current except in the unlikely situation where the electrodes have had all forms of iodine removed from them and the electrodes have not re-equilibrated with the sonde solutions before use. A solution mass transport parameter in the ECC was identified and its altitude dependence determined. The mass transport of tri-iodide dominates in the chemical transduction of ozone to electrical signal. The effect of the mass transport on the ECC background current is predicted. An electrochemical model of the ECC has been developed to predict the response of the ECC to various ozone vertical profiles. The model corresponds very closely to the performance of the ECC in the laboratory. Based on this model, an ECC with no background current is predicted to give total ozone values within 1% of the correct value, although the vertical profile may be in error by as much as + or - 15%.

  20. Condensation during gravity driven ECC: Experiments with PACTEL

    SciTech Connect

    Munther, R.; Kalli, H.; Kouhia, J.

    1995-09-01

    This paper provides the results of the second series of gravity driven emergency core cooling (ECC) experiments with PACTEL (Parallel Channel Test Loop). The simulated accident was a small break loss-of-coolant accident (SBLOCA) with a break in a cold leg. The ECC flow was provided from a core makeup tank (CMT) located at a higher elevation than the main part of the primary system. The CMT was pressurized with pipings from the pressurizer and a cold leg. The tests indicated that steam condensation in the CMT can prevent ECC and lead to core uncovery.

  1. Heart bypass surgery

    MedlinePlus

    Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...

  2. [Patient's pain feeling and surgeon's comfort--ECCE versus phacoemulsification].

    PubMed

    Kałuzny, Jakub J; Eliks, Iwona; Mierzejewski, Andrzej; Kałuzny, Bartłomiej

    2004-01-01

    To compare patient's pain and surgeon's comfort during ECCE performed under retrobulbar anesthesia and phacoemulsification under topical anesthesia. 120 patients scheduled for planned routine cataract extraction were divided in 2 groups: group 1-60 eyes, ECCE under retrobulbar anesthesia and group II-60 eyes, phacoemulsification under topical anesthesia. Immediately after operation patients were asked, to answer questions about their feeling during surgery. Simultaneously, the surgeon filled up the questionnaire, concerning patients behavior during the entire procedure. Statistically significant higher level of pain was reported in group I (ECCE). The most painful moment of the procedure was retrobulbar injection. During surgery pain feeling in both groups was similar. Both types of anesthesia provided very good level of surgeon's comfort. The longer operation, the higher level of pain and lower surgeon's comfort were reported in both groups. Patients having ECCE performed under retrobulbar anesthesia reported more pain comparing to phacoemulsification under topical anesthesia. Both anesthesia methods provided high level of surgeon's comfort.

  3. Early Childhood Caries (ECC): what's in a name?

    PubMed

    De Grauwe, A; Aps, J K; Martens, L C

    2004-06-01

    It is evident from the number of published scientific papers on Early Childhood Caries (ECC) that interest in this problem has grown in recent years. Many authors have been trying to devise a clear definition or classification for ECC. The aim of this review was to inventory the prevalence of ECC and to seek a consensus regarding definition and diagnosis. Further attention was paid to the aetiological factors including the role of microrganisms. Finally, education, parenting and treatment procedures were discussed. For this review, epidemiological studies on caries prevalence in children aged between 0 and 36 months were compiled through a systematic approach using Medline. This clearly showed that ECC continues to be a serious public health problem and that there is a great variety of definitions and diagnoses used worldwide, reflected in the prevalence data. This review confirms the multicausal aetiology and the need for further research. The authors strongly support the recommendations formulated at the workshop in Bethesda 1999, and the policy statements by the AAPD. More efforts should be made to reach the high risk groups within populations, in order to reduce the prevalence of ECC and S-ECC (Severe Early Childhood Caries) and consequently to ameliorate the quality of life of these children. Long-term intervention studies are required for the evaluation of these efforts.

  4. ECC Ozonesonde Reliability, Observations, and Comparisons with Satellite Ozone Instruments

    NASA Technical Reports Server (NTRS)

    Schmidlin, F. J.; Northam, E. T.; Ross, E. D.; Schauer, A. G.; Gerlach, John C. (Technical Monitor)

    2001-01-01

    Electrochemical Concentration Cell (ECC) ozone instruments depend on the quality of care exercised in their pre-flight preparation. The ozone-measuring project conducted at Goddard Space Flight Center's Wallops Flight Facility uses a number of mechanisms designed to inspect the ECC for anomalies that may interfere with the reception of valid ozone profiles. Complete electronic testing of the instrument, individually and when coupled to its radiosonde has led to exceptional monitoring of ozone for detecting long-term atmospheric changes. A number of factors are considered when preparing an ECC instrument for flight. These basically are specific calibrations of pump efficiency, volumetric flow rate, temperature of the air entering the pump, and background current. The concentration of the potassium iodide solution is also important. Wallops is the only site using a UV photometer (Dasibi) to compare ECC ozone output at various concentrations of ozone that allows adjustment to be made to offsets that may appear in the balloon-borne instrument prior to release. All of the above procedures allow identification of potential problems before release of the ECC instrument. Procedures followed at Wallops also are employed in Brazil, and Ascension Island where NASA has cooperative agreements in place to obtain ozonesondes data. All ECC instruments are prepared 3-4 weeks prior to the day of observation. We will briefly describe the instrumental tests employed. These tests have included simultaneous dual observations to compare the effect of different solution concentrations, comparison of sensors of different manufacturers, and comparisons with surface- and space-based instrumentation such as the Dobson Spectrophotometer and satellites. Vertical profiles of ozone from Arctic, mid-latitudes, and Antarctica will be discussed. Although not unusual, the data reveals ozone structure that correlate well with typical atmospheric temperatures and possibly relative humidity. Finally

  5. ECC Ozonesonde Reliability, Observations, and Comparisons with Satellite Ozone Instruments

    NASA Technical Reports Server (NTRS)

    Schmidlin, F. J.; Northam, E. T.; Ross, E. D.; Schauer, A. G.; Gerlach, John C. (Technical Monitor)

    2001-01-01

    Electrochemical Concentration Cell (ECC) ozone instruments depend on the quality of care exercised in their pre-flight preparation. The ozone-measuring project conducted at Goddard Space Flight Center's Wallops Flight Facility uses a number of mechanisms designed to inspect the ECC for anomalies that may interfere with the reception of valid ozone profiles. Complete electronic testing of the instrument, individually and when coupled to its radiosonde has led to exceptional monitoring of ozone for detecting long-term atmospheric changes. A number of factors are considered when preparing an ECC instrument for flight. These basically are specific calibrations of pump efficiency, volumetric flow rate, temperature of the air entering the pump, and background current. The concentration of the potassium iodide solution is also important. Wallops is the only site using a UV photometer (Dasibi) to compare ECC ozone output at various concentrations of ozone that allows adjustment to be made to offsets that may appear in the balloon-borne instrument prior to release. All of the above procedures allow identification of potential problems before release of the ECC instrument. Procedures followed at Wallops also are employed in Brazil, and Ascension Island where NASA has cooperative agreements in place to obtain ozonesondes data. All ECC instruments are prepared 3-4 weeks prior to the day of observation. We will briefly describe the instrumental tests employed. These tests have included simultaneous dual observations to compare the effect of different solution concentrations, comparison of sensors of different manufacturers, and comparisons with surface- and space-based instrumentation such as the Dobson Spectrophotometer and satellites. Vertical profiles of ozone from Arctic, mid-latitudes, and Antarctica will be discussed. Although not unusual, the data reveals ozone structure that correlate well with typical atmospheric temperatures and possibly relative humidity. Finally

  6. Urgent treatment of severe symptomatic direct carotid cavernous fistula caused by ruptured cavernous internal carotid artery aneurysm using high-flow bypass, proximal ligation, and direct distal clipping: Technical case report

    PubMed Central

    Hasegawa, Hirotaka; Inoue, Tomohiro; Tamura, Akira; Saito, Isamu

    2014-01-01

    Background: Direct carotid cavernous fistula (CCF) secondary to ruptured carotid cavernous aneurysms (CCAs) is rare, but patients with this condition who develop acutely worsening and severe neuro-ophthalmic symptoms require urgent treatment. Endovascular methods are the first-line option, but this modality may not be available on an urgent basis. Case Description: In this article, we report a 45-year-old female with severe direct CCF due to rupture of the CCA. She presented with intractable headache and acute worsening of double vision and visual acuity. Emergent radiographic study revealed high-flow fistula tracked from the CCA toward the contralateral cavernous sinus and drained into the engorged left superior orbital vein. To prevent permanent devastating neuro-ophthalmic damages, urgent high-flow bypass with placement of a radial artery graft was performed followed by right cervical internal carotid artery (ICA) ligation and the clipping of the ICA at the C3 portion, proximal to the ophthalmic artery. In the immediate postoperative period, her symptoms resolved and angiography confirmed patency of the high-flow bypass and complete occlusion of the CCF. Conclusion: With due consideration of strategy and techniques to secure safety, open surgical intervention with trapping and bypass is a good treatment option for direct severe CCF when the endovascular method is not available, not possible, or is unsuccessful. PMID:24818056

  7. Acute Pre-operative Infarcts and Poor Cerebrovascular Reserve are Independent Risk Factors for Severe Ischemic Complications Following Direct Extracranial-Intracranial Bypass for Moyamoya Disease

    PubMed Central

    Pulling, T. Michael; Rosenberg, Jarrett; Marks, Michael P.; Steinberg, Gary K.; Zaharchuk, Greg

    2015-01-01

    Background and Purpose Severe ischemic changes are a rare but devastating complication following direct superficial temporal artery to middle cerebral artery (STA MCA) bypass in Moyamoya patients. This study was undertaken to determine whether pre-operative MR imaging and/or cerebrovascular reserve (CVR) assessment using reference standard stable xenon enhanced computed tomography (xeCT) could predict such complications. Materials and Methods Among all adult patients receiving direct bypass at our institution between 2005 and 2010 who received a clinically interpretable xeCT examination, we identified index cases (patients with >15 ml post-operative infarcts) and control cases (patients without post-operative infarcts and without transient or permanent ischemic symptoms). Differences between groups were evaluated using the Mann Whitney test. Univariate and multivariate generalized linear model regression were employed to test predictors of post-operative infarct. Results Six index cases were identified and compared with 25 controls. Infarct size in the index cases was 95±55 ml. Four of six index cases (67%), but no control patients, had pre-operative acute infarcts. Baseline CBF was similar, but CVR was significantly lower in the index cases compared with control cases. For example, in the anterior circulation, median CVR was 0.4% (range: −38.0% to 16.6%) in index vs. 26.3% (range: −8.2% to 60.5%) in control patients (p=0.003). Multivariate analysis demonstrated that the presence of a small pre-operative infarct (regardless of location) and impaired CVR were independent, significant predictors of severe post-operative ischemic injury. Conclusion Acute infarcts and impaired CVR on pre operative imaging are independent risk factors for severe ischemic complications following STA MCA bypass in Moyamoya disease. PMID:26564435

  8. Coronary Artery Bypass Grafting

    MedlinePlus

    ... from the NHLBI on Twitter. What Is Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is ... bypass multiple coronary arteries during one surgery. Coronary Artery Bypass Grafting Figure A shows the location of ...

  9. ECC ozonesonde performance at high altitudes: Pump efficiency

    NASA Technical Reports Server (NTRS)

    Torres, A. L.

    1981-01-01

    The ECC ozonesonde sampling behavior was examined at pressures ranging from 60 to 6 hPa with the objective of evaluating uncertainties in high altitude ozone data caused by variations in pumping efficiency. The averaged pump efficiency correction curve for a 43 sample set of 3A type ECC pumps showed a 2-3% bias from the curve provided by the manufacturer. In addition, random pump to pump variations (2 sigma) + or - were 5% at 6 hPa. These values probably represent minimum errors since the pumps were from the same production batch. A seven sample set of the newer 4A type ECC pumps was examined, with similar findings as for the 3A types.

  10. Intraocular pressure following ECCE, phacoemulsification, and PC-IOL implantation.

    PubMed

    Kooner, K S; Cooksey, J C; Perry, P; Zimmerman, T J

    1988-09-01

    Abnormal intraocular pressure (IOP), either transient or permanent, may follow extracapsular cataract extraction (ECCE) with phacoemulsification (PE) and posterior chamber intraocular lens (PC-IOL) implantation. We retrospectively studied IOP measurements at different intervals post ECCE and PE in 242 eyes of 211 patients: 105 males, 106 females, 198 Caucasians and 13 blacks. Elevated IOP (greater than 23 mm Hg) was observed in 20 eyes (8.2%). Only two patients (0.8%) had persistent (greater than 3 months) IOP elevation and needed antiglaucoma therapy. Six more eyes (2.5%), however, developed glaucoma after 1 year. Hence, the incidence of secondary pseudophakic glaucoma at the conclusion of this study was 3.3%. No patient required laser or other mechanical surgery for IOP control. ECCE and PE with PC-IOL does not appear to adversely affect IOP. Patients, however, must be followed closely, as some may develop glaucoma months after surgery.

  11. Visual outcomes after anterior vitrectomy: comparison of ECCE and phacoemulsification.

    PubMed Central

    Bobrow, J C

    1999-01-01

    PURPOSE: To determine whether vitrectomy instrumentation improved outcomes when vitreous loss occurred during either extracapsular cataract extraction (ECCE) or phacoemulsification (PE) with posterior chamber lens implantation (PCIOL). METHODS: A consecutive series of ECCE + PCIOL (group 1: 1985-1989) and PE + PCIOL (group 2: 1993-1997) surgeries by a single surgeon was reviewed retrospectively. RESULTS: In group 1, 14 of 647 patients (2.2%) and in group 2, 9 of 665 patients (1.4%) experienced vitreous loss. In group 1, final visual acuity averaged 20/83; in group 2, 20/25 (P = .005). Average follow-up was 5.7 years (group 1) and 3.2 years (group 2). Uveitis, glaucoma, corneal problems, and retinal problems were assessed. CONCLUSIONS: Anterior vitrectomy reduced complications from vitreous loss. Fewer vitreous losses occurred with PE than ECCE. Patients with vitreous loss after PE attained better vision. PMID:10703129

  12. Visual outcomes after anterior vitrectomy: comparison of ECCE and phacoemulsification.

    PubMed

    Bobrow, J C

    1999-01-01

    To determine whether vitrectomy instrumentation improved outcomes when vitreous loss occurred during either extracapsular cataract extraction (ECCE) or phacoemulsification (PE) with posterior chamber lens implantation (PCIOL). A consecutive series of ECCE + PCIOL (group 1: 1985-1989) and PE + PCIOL (group 2: 1993-1997) surgeries by a single surgeon was reviewed retrospectively. In group 1, 14 of 647 patients (2.2%) and in group 2, 9 of 665 patients (1.4%) experienced vitreous loss. In group 1, final visual acuity averaged 20/83; in group 2, 20/25 (P = .005). Average follow-up was 5.7 years (group 1) and 3.2 years (group 2). Uveitis, glaucoma, corneal problems, and retinal problems were assessed. Anterior vitrectomy reduced complications from vitreous loss. Fewer vitreous losses occurred with PE than ECCE. Patients with vitreous loss after PE attained better vision.

  13. 16-Kbit SPI phase change memory chip with ECC scheme

    NASA Astrophysics Data System (ADS)

    Zhang, Yiyun; Chen, Houpeng; Song, Zhitang; Li, Xi; Hong, Xiao; Wang, Qian; Jin, Rong; Wang, Zhaomin; Cai, Daoling

    A serial peripheral interface (SPI) 16-Kbit phase change memory chip based on 0.13μm CMOS process is designed. It contains a parallel error correcting code (ECC) circuit, which can correct 2 bits in every 8 bits without clock delay, enabling the write and read operations performed at bus speed. All the data transfers in 8-bit groups and can be read or written with write protection scheme by unlimited cycle, in which address can automatically increase one by one. Simulation results show that the chip can work correctly in SPI mode and with ECC scheme. It is now under testing.

  14. Performance tests on the Kohmyr ECC ozone sonde

    NASA Technical Reports Server (NTRS)

    Bandy, A. R.; Torres, A. L.

    1975-01-01

    The reliability and accuracy of the Kohmyr ECC ozone sonde are determined. Emphasis is placed on establishing and testing for leak-free connections and stable pump flow rates as well as properly adjusting the pumping pressure. Calibration of the Kohmyr ECC ozone sondes and Dasibi monitors is described. Raw ordinate data and ozone connection data are presented in tabular form. The results of a linear regression treatment of the sonde-indicated ozone concentration vs. Dasibi readings for each switch position are included along with averages of the regression parameters over the six sequencing switch positions. It is suggested that sondes and Dasibi monitors be individually calibrated before flight.

  15. Early Childhood Caries (ECC): an infectious transmissible oral disease.

    PubMed

    Poureslami, Hamid Reza; Van Amerongen, Willem Evert

    2009-02-01

    Dental caries in babies and toddlers is called Early Childhood Caries (ECC). It is an infectious and transmissible die-to-bacterial disease. Detailed knowledge regarding the acquisition and transmission of infectious agents facilitates a more comprehensive approach toward prevention. Mutans streptococci are important organisms in the initiation and progression of dental caries. Recent evidence demonstrates that these bacteria are found in the mouths of pre-dentate infants and are acquired via vertical and/or horizontal transmission from human reservoirs. This information should facilitate the focusing of clinical interventions that prevent or delay infant infection, thereby reducing the prevalence of dental caries (ECC) in babies and toddlers.

  16. Gastric bypass surgery - discharge

    MedlinePlus

    Bariatric surgery - gastric bypass - discharge; Roux-en-Y gastric bypass - discharge; Gastric bypass - Roux-en-Y - discharge; Obesity ... Gloy VL, Briel M, Bhatt DL, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic ...

  17. Considerations for realistic ECCS evaluation methodology for LWRs

    SciTech Connect

    Rohatgi, U.S.; Saha, P.; Chexal, V.K.

    1985-01-01

    This paper identifies the various phenomena which govern the course of large and small break LOCAs in LWRs, and affect the key parameters such as Peak Clad Temperature (PCT) and timing of the end of blowdown, beginning of reflood, PCT, and complete quench. A review of the best-estimate models and correlations for these phenomena in the current literature has been presented. Finally, a set of models have been recommended which may be incorporated in a present best-estimate code such as TRAC or RELAP5 in order to develop a realistic ECCS evaluation methodology for future LWRs and have also been compared with the requirements of current ECCS evaluation methodology as outlined in Appendix K of 10CFR50. 58 refs.

  18. An overview of the BWR ECCS strainer blockage issues

    SciTech Connect

    Serkiz, A.W.; Marshall, M.L. Jr.; Elliott, R.

    1996-03-01

    This Paper provides a brief overview of actions taken in the mid 1980s to resolve Unresolved Safety Issue (USI) A-43, {open_quotes}Containment Emergency Sump Performance,{close_quotes} and their relationship to the BWR strainer blockage issue; the importance of insights gained from the Barseback-2 (a Swedish BWR) incident in 1992 and from ECCS strainer testing and inspections at the Perry nuclear power plant in 1992 and 1993; an analysis of an US BWR/4 with a Mark I containment; an international community sharing of knowledge relevant to ECCS strainer blockage, additional experimental programs; and identification of actions needed to resolve the strainer blockage issue and the status of such efforts.

  19. Abdominal Pain following Gastric Bypass: Suspects & Solutions

    PubMed Central

    Greenstein, Alexander J.; O’Rourke, Robert W.

    2010-01-01

    Introduction Gastric bypass remains the mainstay of surgical therapy for obesity. Abdominal pain after gastric bypass is common, and accounts for up to half of all postoperative complaints and emergency room visits. This manuscript reviews the most important causes of abdominal pain specific to gastric bypass and discusses management considerations. Data Sources The current surgical literature was reviewed using PubMed, with a focus on abdominal pain after gastric bypass and the known pathologies that underlie its pathogenesis. Conclusions The differential diagnosis for abdominal pain after gastric bypass is large and includes benign and life-threatening entities. Its diverse causes require a broad evaluation that should be directed by history and clinical presentation. In the absence of a clear diagnosis, the threshold for surgical exploration in patients with abdominal pain after gastric bypass should be low. PMID:21333269

  20. Kelch-repeat proteins interacting with the Gα protein Gpa2 bypass adenylate cyclase for direct regulation of protein kinase A in yeast

    PubMed Central

    Peeters, Tom; Louwet, Wendy; Geladé, Ruud; Nauwelaers, David; Thevelein, Johan M.; Versele, Matthias

    2006-01-01

    The cAMP–PKA pathway consists of an extracellular ligand-sensitive G protein-coupled receptor, a G protein signal transmitter, and the effector, adenylate cyclase, of which the product, cAMP, acts as an intracellular second messenger. cAMP activates PKA by dissociating the regulatory subunit from the catalytic subunit. Yeast cells (Saccharomyces cerevisiae) contain a glucose/sucrose-sensitive seven-transmembrane domain receptor, Gpr1, that was proposed to activate adenylate cyclase through the Gα protein Gpa2. Consistently, we show here that adenylate cyclase binds only to active, GTP-bound Gpa2. Two related kelch-repeat proteins, Krh1/Gpb2 and Krh2/Gpb1, are associated with Gpa2 and were suggested to act as Gβ mimics for Gpa2, based on their predicted seven-bladed β-propeller structure. However, we find that although Krh1 associates with both GDP and GTP-bound Gpa2, it displays a preference for GTP-Gpa2. The strong down-regulation of PKA targets by Krh1 and Krh2 does not require Gpa2 but is strictly dependent on both the catalytic and the regulatory subunits of PKA. Krh1 directly interacts with PKA by means of the catalytic subunits, and Krh1/2 stimulate the association between the catalytic and regulatory subunits in vivo. Indeed, both a constitutively active GPA2 allele and deletion of KRH1/2 lower the cAMP requirement of PKA for growth. We propose that active Gpa2 relieves the inhibition imposed by the kelch-repeat proteins on PKA, thereby bypassing adenylate cyclase for direct regulation of PKA. Importantly, we show that Krh1/2 also enhance the association between mouse R and C subunits, suggesting that Krh control of PKA has been evolutionarily conserved. PMID:16924114

  1. Seal Bypass Systems (Invited)

    NASA Astrophysics Data System (ADS)

    Cartwright, J. A.

    2009-12-01

    Joe Cartwright 3DLab, School of Earth, Ocean and Planetary Sciences, Cardiff University, Main Building, Park Place, Cardiff CF10 3YE, Wales, UK (cartwrightja@cf.ac.uk) A conceptual model for the analysis of the sealing potential of caprock sequences is summarised here based on the recognition that many high quality seals are breached episodically or semi-permanently by a range of geological structures that act as seal by-pass systems (SBS). We formally define SBS as seismically resolvable geological features embedded within sealing sequences that promote cross-stratal fluid migration and allow fluids to bypass the pore network. We advance the concept that if such bypass systems exist within a given sealing sequence sequence, then predictions of sealing capacity based exclusively on rock physical properties such as capillary entry pressure/hydraulic conductivity will be largely negated by the capacity of the bypass system to breach the grain and pore network. This model is based largely on observations of sealing sequences using 3D seismic data, in which there is direct evidence of highly focused vertical or sub-vertical fluid flow from subsurface reservoirs up through the sealing sequence with leakage internally at higher levels or to the surface as seeps or pockmarks. We classify SBS into three main classes based on seismic interpretational criteria: (1) fault related, (2) intrusion-related, and (3) pipe-related. Examples are presented of each class of SBS in a relevant context of a particular sealing sequence, and where seismic evidence of hydrocarbon leakage allows the role of the bypass features to be evaluated. These include mud volcano conduits, sandstone intrusions, normal and thrust faults, blowout pipes and igneous intrusions. We show how each class exhibits different modes of behaviour with potential for different scaling relationships between flux and dimensions, and different short and long-term impacts on seal behaviour. We conclude with an analysis of

  2. eccCL: parallelized GPU implementation of Ensemble Classifier Chains.

    PubMed

    Riemenschneider, Mona; Herbst, Alexander; Rasch, Ari; Gorlatch, Sergei; Heider, Dominik

    2017-08-17

    Multi-label classification has recently gained great attention in diverse fields of research, e.g., in biomedical application such as protein function prediction or drug resistance testing in HIV. In this context, the concept of Classifier Chains has been shown to improve prediction accuracy, especially when applied as Ensemble Classifier Chains. However, these techniques lack computational efficiency when applied on large amounts of data, e.g., derived from next-generation sequencing experiments. By adapting algorithms for the use of graphics processing units, computational efficiency can be greatly improved due to parallelization of computations. Here, we provide a parallelized and optimized graphics processing unit implementation (eccCL) of Classifier Chains and Ensemble Classifier Chains. Additionally to the OpenCL implementation, we provide an R-Package with an easy to use R-interface for parallelized graphics processing unit usage. eccCL is a handy implementation of Classifier Chains on GPUs, which is able to process up to over 25,000 instances per second, and thus can be used efficiently in high-throughput experiments. The software is available at http://www.heiderlab.de .

  3. Disease Management of Early Childhood Caries: ECC Collaborative Project.

    PubMed

    Ng, Man Wai; Ramos-Gomez, Francisco; Lieberman, Martin; Lee, Jessica Y; Scoville, Richard; Hannon, Cindy; Maramaldi, Peter

    2014-01-01

    Until recently, the standard of care for early childhood caries (ECC) has been primarily surgical and restorative treatment with little emphasis on preventing and managing the disease itself. It is now recognized that surgical treatment alone does not address the underlying etiology of the disease. Despite costly surgeries and reparative treatment, the onset and progression of caries are likely to continue. A successful rebalance of risk and protective factors may prevent, slow down, or even arrest dental caries and its progression. An 18-month risk-based chronic disease management (DM) approach to address ECC in preschool children was implemented as a quality improvement (QI) collaborative by seven teams of oral health care providers across the United States. In the aggregate, fewer DM children experienced new cavitation, pain, and referrals to the operating room (OR) for restorative treatment compared to baseline historical controls. The teams found that QI methods facilitated adoption of the DM approach and resulted in improved care to patients and better outcomes overall. Despite these successes, the wide scale adoption and spread of the DM approach may be limited unless health policy and payment reforms are enacted to compensate providers for implementing DM protocols in their practice.

  4. Disease Management of Early Childhood Caries: ECC Collaborative Project

    PubMed Central

    Lee, Jessica Y.

    2014-01-01

    Until recently, the standard of care for early childhood caries (ECC) has been primarily surgical and restorative treatment with little emphasis on preventing and managing the disease itself. It is now recognized that surgical treatment alone does not address the underlying etiology of the disease. Despite costly surgeries and reparative treatment, the onset and progression of caries are likely to continue. A successful rebalance of risk and protective factors may prevent, slow down, or even arrest dental caries and its progression. An 18-month risk-based chronic disease management (DM) approach to address ECC in preschool children was implemented as a quality improvement (QI) collaborative by seven teams of oral health care providers across the United States. In the aggregate, fewer DM children experienced new cavitation, pain, and referrals to the operating room (OR) for restorative treatment compared to baseline historical controls. The teams found that QI methods facilitated adoption of the DM approach and resulted in improved care to patients and better outcomes overall. Despite these successes, the wide scale adoption and spread of the DM approach may be limited unless health policy and payment reforms are enacted to compensate providers for implementing DM protocols in their practice. PMID:24723953

  5. Endothelial Dysfunction of Bypass Graft: Direct Comparison of In Vitro and In Vivo Models of Ischemia-Reperfusion Injury

    PubMed Central

    Veres, Gábor; Hegedűs, Péter; Barnucz, Enikő; Zöller, Raphael; Klein, Stephanie; Schmidt, Harald; Radovits, Tamás; Korkmaz, Sevil; Karck, Matthias; Szabó, Gábor

    2015-01-01

    Background Although, ischemia/reperfusion induced vascular dysfunction has been widely described, no comparative study of in vivo- and in vitro-models exist. In this study, we provide a direct comparison between models (A) ischemic storage and in-vitro reoxygenation (B) ischemic storage and in vitro reperfusion (C) ischemic storage and in-vivo reperfusion. Methods and Results Aortic arches from rats were stored for 2 hours in saline. Arches were then (A) in vitro reoxygenated (B) in vitro incubated in hypochlorite for 30 minutes (C) in vivo reperfused after heterotransplantation (2, 24 hours and 7 days reperfusion). Endothelium-dependent and independent vasorelaxations were assessed in organ bath. DNA strand breaks were assessed by TUNEL-method, mRNA expressions (caspase-3, bax, bcl-2, eNOS) by quantitative real-time PCR, proteins by Western blot analysis and the expression of CD-31 by immunochemistry. Endothelium-dependent maximal relaxation was drastically reduced in the in-vivo models compared to ischemic storage and in-vitro reperfusion group, and no difference showed between ischemic storage and control group. CD31-staining showed significantly lower endothelium surface ratio in-vivo, which correlated with TUNEL-positive ratio. Increased mRNA and protein levels of pro- and anti-apoptotic gens indicated a significantly higher damage in the in-vivo models. Conclusion Even short-period of ischemia induces severe endothelial damage (in-vivo reperfusion model). In-vitro models of ischemia-reperfusion injury can be limitedly suited for reliable investigations. Time course of endothelial stunning is also described. PMID:25875813

  6. ECC-RT-PCR: a new method to determine the viability and infectivity of Giardia cysts.

    PubMed

    Alum, Absar; Sbai, Basel; Asaad, Hamas; Rubino, Joseph R; Khalid Ijaz, M

    2012-05-01

    Giardia sp is a major cause of diarrheal illness worldwide, and millions of people are infected each year. Rapid methods to determine the infectivity and virulence of isolates are critical for the development of intervention strategies to control the transmission of Giardia sp cysts, which occurs through contaminated surfaces, food, and water. However, determining the viability, infectivity, and virulence of Giardia sp cysts using molecular methods is a technical challenge because of the lack of a cell culture model. This study was designed to evaluate mRNA expression in trophozoites and to assess trophozoite attachment to cell monolayer and changes in transcellular resistance as an indicator of Giardia sp viability and infectivity. Heat shock mRNA in Giardia cysts and variant-specific protein (VSP) mRNA in trophozoites were quantified by reverse transcription polymerase chain reaction (RT-PCR). C2bb (Caco-2) cells were grown on transwell chambers to study the attachment of trophozoites, changes in transcellular resistance, and expression of VSP in trophozoites. The results of these molecular and cell culture studies indicate a direct linear correlation between the viability and infectivity of fresh stocks of Giardia sp cysts. The attachment of trophozoites to cell monolayer, expression of VSP, and change in the transcellular resistance was directly correlated with their infectivity in neonatal mice. PCR was successfully combined with the electrophysiological analysis of cell culture (ECC-RT-PCR) post-trophozoite attachment. This study shows that the ECC-RT-PCR, a new integrated cell culture assay, can be used as a rapid and cost-effective tool for assessing the viability and infectivity of environmental isolates of Giardia sp cysts. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  7. Peripheral artery bypass - leg

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/007394.htm Peripheral artery bypass - leg To use the sharing features on this page, please enable JavaScript. Peripheral artery bypass is surgery to reroute the blood supply ...

  8. Combined group ECC protection and subgroup parity protection

    DOEpatents

    Gara, Alan G.; Chen, Dong; Heidelberger, Philip; Ohmacht, Martin

    2013-06-18

    A method and system are disclosed for providing combined error code protection and subgroup parity protection for a given group of n bits. The method comprises the steps of identifying a number, m, of redundant bits for said error protection; and constructing a matrix P, wherein multiplying said given group of n bits with P produces m redundant error correction code (ECC) protection bits, and two columns of P provide parity protection for subgroups of said given group of n bits. In the preferred embodiment of the invention, the matrix P is constructed by generating permutations of m bit wide vectors with three or more, but an odd number of, elements with value one and the other elements with value zero; and assigning said vectors to rows of the matrix P.

  9. [Combination surgery (ECCE+IOL+TE) and intraocular pressure levels].

    PubMed

    Hornová, J

    1997-08-01

    The authors investigated the effect of a combined operation, ECCE + TE + IOL, on reduction of intraocular pressure (IOP), changes in antiglaucomatous treatment and on vision six months after operation. In 1994 36 eyes were operated, 16 eyes with primary open angle glaucoma (POAG), 8 eyes with angular glaucoma (PACG) and 12 eyes with marked exfoliative syndrome (CG). Six months after operation the IOP declined from 26.4 mm Hg to 13.3 mm Hg (P 0.05), antiglaucomatous treatment was reduced from 2.55 to 1.11 (P 0.05), vision improved by 0.39, i.e. by 2-3 lines of optotypes (P 0.05). 89% of the operated patients have a vision better than 0.5. Comparison of values before and after operation revealed a more marked drop of IOP in CG (P 0.05) than in POAG.

  10. Combined group ECC protection and subgroup parity protection

    DOEpatents

    Gara, Alan; Cheng, Dong; Heidelberger, Philip; Ohmacht, Martin

    2016-02-02

    A method and system are disclosed for providing combined error code protection and subgroup parity protection for a given group of n bits. The method comprises the steps of identifying a number, m, of redundant bits for said error protection; and constructing a matrix P, wherein multiplying said given group of n bits with P produces m redundant error correction code (ECC) protection bits, and two columns of P provide parity protection for subgroups of said given group of n bits. In the preferred embodiment of the invention, the matrix P is constructed by generating permutations of m bit wide vectors with three or more, but an odd number of, elements with value one and the other elements with value zero; and assigning said vectors to rows of the matrix P.

  11. [Macular threshold after ECCE and posterior chamber IOL implantation].

    PubMed

    Baltatzis, S; Georgopoulos, G; Andreanos, D

    1989-01-01

    In the present paper, the macular threshold after ECCE and posterior chamber intraocular lens implantation, was studied in an effort to determine the time period needed for full postoperative recovery of macular function. We evaluated 22 eyes in 20 patients who underwent extracapsular cataract extraction and posterior chamber IOL implantation. There were 12 men and 8 women between the ages of 40 and 62 years with mean age of 53 years. Postoperative visual field testing was performed within the central 4 degrees with an automated static perimeter (Humphrey Visual Field Analyser), using a macular threshold test pattern. It has been established that central retinal sensitivity in pseudophakia shows a postoperative decrease and consequently recovers to almost normal levels within one month. The exact cause of this reduction remains under discussion and further control mainly with fluorescein angiography is necessary.

  12. Perioperative utility of goal-directed therapy in high-risk cardiac patients undergoing coronary artery bypass grafting: “A clinical outcome and biomarker-based study”

    PubMed Central

    Kapoor, Poonam Malhotra; Magoon, Rohan; Rawat, Rajinder; Mehta, Yatin

    2016-01-01

    Goal-directed therapy (GDT) encompasses guidance of intravenous (IV) fluid and vasopressor/inotropic therapy by cardiac output or similar parameters to help in early recognition and management of high-risk cardiac surgical patients. With the aim of establishing the utility of perioperative GDT using robust clinical and biochemical outcomes, we conducted the present study. This multicenter randomized controlled study included 130 patients of either sex, with European system for cardiac operative risk evaluation ≥3 undergoing coronary artery bypass grafting on cardiopulmonary bypass. The patients were randomly divided into the control and GDT group. All the participants received standardized care; arterial pressure monitored through radial artery, central venous pressure (CVP) through a triple lumen in the right internal jugular vein, electrocardiogram, oxygen saturation, temperature, urine output per hour, and frequent arterial blood gas (ABG) analysis. In addition, cardiac index (CI) monitoring using FloTrac™ and continuous central venous oxygen saturation (ScVO2) using PreSep™ were used in patients in the GDT group. Our aim was to maintain the CI at 2.5–4.2 L/min/m2, stroke volume index 30–65 ml/beat/m2, systemic vascular resistance index 1500–2500 dynes/s/cm5/m2, oxygen delivery index 450–600 ml/min/m2, continuous ScVO2 >70%, and stroke volume variation <10%; in addition to the control group parameters such as CVP 6–8 mmHg, mean arterial pressure 90–105 mmHg, normal ABG values, oxygen saturation, hematocrit value >30%, and urine output >1 ml/kg/h. The aims were achieved by altering the administration of IV fluids and doses of inotropes or vasodilators. The data of sixty patients in each group were analyzed in view of ten exclusions. The average duration of ventilation (19.89 ± 3.96 vs. 18.05 ± 4.53 h, P = 0.025), hospital stay (7.94 ± 1.64 vs. 7.17 ± 1.93 days, P = 0.025), and Intensive Care Unit (ICU) stay (3.74 ± 0.59 vs. 3.41 ± 0

  13. Cardiopulmonary Bypass Without Heparin.

    PubMed

    Rehfeldt, Kent H; Barbara, David W

    2016-03-01

    Due to familiarity, short half-life, ease of monitoring, and the availability of a reversal agent, heparin remains the anticoagulant of choice for cardiac operations requiring cardiopulmonary bypass (CPB). However, occasionally patients require CPB but should not receive heparin, most often because of acute or subacute heparin-induced thrombocytopenia (HIT). In these cases, if it is not feasible to wait for the disappearance of HIT antibodies, an alternative anticoagulant must be selected. A number of non-heparin anticoagulant options have been explored. However, current recommendations suggest the use of a direct thrombin inhibitor such as bivalirudin. This review describes the use of heparin alternatives for the conduct of CPB with a focus on the direct thrombin inhibitors.

  14. Prevention of early childhood caries (ECC)--review of literature published 1998-2007.

    PubMed

    Twetman, S

    2008-03-01

    This was to examine the literature published during the last decade and review the effectiveness of methods used for the prevention of early childhood caries (ECC). A critical review of papers. A broad search of the PubMed database was conducted from 1998 through September 2007, using "early childhood caries", "baby bottle tooth decay", "nursing caries", "infant caries", "caries prevention" and "oral health education" as index terms. Relevant papers published in English between 1998 and 2007 were identified after a review of their abstracts. Papers were selected if they reported a prospective controlled design with preventive or non-invasive intervention directed to children under the age of 3 years. A defined endpoint measure of cavitated or non-cavitated clinical caries, expressed as incidence or prevalence, was required. The targeted publications were critically assessed by the author concerning design, methodology and performance. The initial search revealed 66 papers of which 22 met the inclusion criteria. The results reinforced the role of fluoride toothpaste as the most cost-effective home-care measure and semi-annual fluoride varnish applications as the best professional method for infants at risk. The evidence concerning the preventive effect of antibacterial agents, primary-primary prevention and dental health education were inconclusive but the included studies supported the importance of early start, outreach activities and motivational interviewing as key factors to overcome cultural and socioeconomic barriers. Although there is a body of evidence for the use of fluoride in preventing ECC, further high-quality studies are needed to further establish the best way to maintain oral health in infants.

  15. Pharmacodynamic and Efficacy Profile of TGN 255, a Novel Direct Thrombin Inhibitor, in Canine Cardiopulmonary Bypass and Simulated Mitral Valve Repair

    PubMed Central

    Nelson, David A.; Nelson, Katherine T.; Miller, Matthew W.; Dupe, Robert; Chahwala, Suresh B.; Kennedy, Anthony; Chander, Chaman; Fossum, Theresa W.

    2008-01-01

    Abstract: Heparin-induced thrombocytopenia can be a life-threatening sequel to conventional use of unfractionated heparin in cardiopulmonary bypass (CPB). This study evaluated the pharmacokinetic/pharmacodynamic (PK/PD) and efficacy profile of a novel direct thrombin inhibitor, TGN 255, during cardiac surgery in dogs. Point-of-care coagulation monitoring was also compared against the plasma concentrations of TRI 50c, the active metabolite of TGN 255. The study was conducted in three phases using 10 animals: phase 1 was a dose-ranging study in conscious animals (n = 6), phase 2 was a similar but terminal dose-ranging study in dogs undergoing CPB (n = 6), and phase 3 was with animals undergoing simulated mitral valve repair (terminal) using optimal TGN 255 dose regimens derived from phases I and II (n = 4). During the study, PD markers and drug plasma levels were determined. In addition, determinations of hematologic markers and blood loss were undertaken. Phase 1 studies showed that a high-dose regimen of a 5-mg/kg bolus and infusion of 20 mg/kg/h elevated PD markers in conscious animals, at which time there were no measured effects on platelet or red blood cell counts, and the mean plasma concentration of TRI 50C was 20.6 fg/mL. In the phase 2 CPB dose-ranging study, this dosing regimen significantly elevated all the PD markers and produced hemorrhagic and paradoxical thrombogenic effects. In the phase 3 surgical study, a lower TGN 255 dose regimen of a 2.5-mg/kg bolus plus 10 mg/kg/h produced anticoagulation, elevated PD markers, and produced minimal post-operative blood loss in the animals. Plasma levels of TRI 50C trended well with the conventional point-of-care coagulation monitoring. TGN 255 provided effective anticoagulation in a canine CPB procedure, enabling successful completion with minimal blood loss. These findings support further evaluation of TGN 255 as an anticoagulant for CPB. PMID:18705547

  16. Comparison of Spectralis-OCT, GDxVCC and GDxECC in assessing retinal nerve fiber layer (RNFL) in glaucomatous patients.

    PubMed

    Schallenberg, Maurice; Dekowski, Dirk; Kremmer, Stephan; Selbach, J Michael; Steuhl, Klaus-Peter

    2013-05-01

    significant correlation between Spectralis-OCT and GDxECC, as well as Spectralis-OCT and GDxVCC, in assessing the RNFL thickness. The best instrument agreement was found between GDxECC and Spectralis-OCT. The RNFL thickness assessed with Spectralis-OCT and GDxECC showed a better correlation to visual field defects than GDxVCC. Evaluating GDx assessments with typical retardation pattern GDxVCC and GDxECC showed very similar RNFL thickness results. RNFL thickness assessments between GDxVCC, GDxECC, and Spectralis-OCT cannot be directly compared. The assessments are generally higher with Spectralis-OCT than with GDxVCC and GDxECC, because of differences in method of the devices. The atypical retardation pattern has a major impact on the RNFL thickness results of GDx devices. This must be taken into account when evaluating the assessed RNFL thickness results.

  17. Structures of EccB1 and EccD1 from the core complex of the mycobacterial ESX-1 type VII secretion system

    SciTech Connect

    Wagner, Jonathan M.; Chan, Sum; Evans, Timothy J.; Kahng, Sara; Kim, Jennifer; Arbing, Mark A.; Eisenberg, David; Korotkov, Konstantin V.

    2016-02-27

    The ESX-1 type VII secretion system is an important determinant of virulence in pathogenic mycobacteria, including Mycobacterium tuberculosis. This complicated molecular machine secretes folded proteins through the mycobacterial cell envelope to subvert the host immune response. Despite its important role in disease very little is known about the molecular architecture of the ESX-1 secretion system. This study characterizes the structures of the soluble domains of two conserved core ESX-1 components – EccB1 and EccD1. The periplasmic domain of EccB1 consists of 4 repeat domains and a central domain, which together form a quasi 2-fold symmetrical structure. The repeat domains of EccB1 are structurally similar to a known peptidoglycan binding protein suggesting a role in anchoring the ESX-1 system within the periplasmic space. The cytoplasmic domain of EccD1 has a ubiquitin-like fold and forms a dimer with a negatively charged groove. In conclusion, these structures represent a major step towards resolving the molecular architecture of the entire ESX-1 assembly and may contribute to ESX-1 targeted tuberculosis intervention strategies.

  18. Structures of EccB1 and EccD1 from the core complex of the mycobacterial ESX-1 type VII secretion system

    DOE PAGES

    Wagner, Jonathan M.; Chan, Sum; Evans, Timothy J.; ...

    2016-02-27

    The ESX-1 type VII secretion system is an important determinant of virulence in pathogenic mycobacteria, including Mycobacterium tuberculosis. This complicated molecular machine secretes folded proteins through the mycobacterial cell envelope to subvert the host immune response. Despite its important role in disease very little is known about the molecular architecture of the ESX-1 secretion system. This study characterizes the structures of the soluble domains of two conserved core ESX-1 components – EccB1 and EccD1. The periplasmic domain of EccB1 consists of 4 repeat domains and a central domain, which together form a quasi 2-fold symmetrical structure. The repeat domains ofmore » EccB1 are structurally similar to a known peptidoglycan binding protein suggesting a role in anchoring the ESX-1 system within the periplasmic space. The cytoplasmic domain of EccD1 has a ubiquitin-like fold and forms a dimer with a negatively charged groove. In conclusion, these structures represent a major step towards resolving the molecular architecture of the entire ESX-1 assembly and may contribute to ESX-1 targeted tuberculosis intervention strategies.« less

  19. Coronary–Coronary Bypass

    PubMed Central

    Erdil, Nevzat; Ates, Sanser; Demirkilic, Ufuk; Tatar, Harun; Sag, Cemal

    2002-01-01

    There is increased risk of systemic embolism during cardiopulmonary bypass in patients with a severely atherosclerotic ascending aorta. We report a coronary–coronary bypass in a 74-year-old man with a porcelain aorta. He underwent a proximal right coronary–distal right coronary artery bypass with a saphenous vein graft, combined with a pedicled arterial graft (left internal mammary artery) to the left anterior descending artery, in the presence of a beating heart without cardiopulmonary bypass. The patient survived without evidence of perioperative myocardial infarction or cerebrovascular accident. One year later, follow-up angiography showed graft patency with good distal runoff. Coronary–coronary bypass on a beating heart without cardiopulmonary bypass can be performed safely in a patient with porcelain aorta. (Tex Heart Inst J 2002;29:54–5) PMID:11995853

  20. Manual ECCE, the present state of the art.

    PubMed

    Blumenthal, M

    1994-11-01

    Manual ECCE has proved to be safe surgery compatible with small incision, no stitches, possible topical anesthesia, very cost effective and quick rehabilitation. The technique has a learning curve and needs experience. "Mini-nuc" stands for mini nucleus. This surgery can be achieved only if performed under positive intraocular pressure (IOP). A BSS bottle is connected to the eye by an anterior chamber maintainer (ACM). The height of the BSS bottle controls the IOP during the surgery. Controlled IOP is a principle suggested for all kinds of cataract surgery. It creates continuous flow which washes out of the eye cortex debris, blood, pigment, etc. The BSS contains antibiotics and adrenalin, it creates low turbulence due to the small amount of BSS used per case, 30-50 cc. A round capsulorhexis is essential. A special way of hydrodissection creates a very small hard core nucleus delivered to the anterior chamber and is extracted out through a sclero-corneal tunnel using a glide introduced under the nucleus to guide the nucleus out. Positive IOP during all stages of surgery creates the best operative conditions for controlled surgery throughout all manipulations. This technique is a very cost effective system and at the same time provides a high quality procedure.

  1. Refractive results after phacoemulsification and ECCE. A comparative study.

    PubMed

    Dam-Johansen, M; Olsen, T

    1993-06-01

    The refractive results were evaluated in 79 patients undergoing cataract extraction by phacoemulsification using a 6-7 mm tunnel incision, and compared with a group of 77 patients undergoing planned extracapsular cataract extraction (ECCE) by the same surgeon. A mean increase in the keratometric cylinder of 0.05D and 0.52D was found in the phacoemulsification and the extracapsular cataract extraction group, respectively. This was significantly different from zero for the extracapsular cataract extraction group (p < 0.05) but not for the phacoemulsification group (p > 0.05). By vector analysis, the mean surgically induced astigmatism was 0.91D and 1.36D in the phacoemulsification and the extracapsular cataract extraction group, respectively (p < 0.01). The IOL power prediction error (spectacle plane) was found to be 0.17D (+/- 0.69 SD) in the phacoemulsification group and 0.02 D (+/- 0.79 SD) in the extracapsular cataract extraction group, respectively. We conclude that phacoemulsification improves the surgical control of the refractive outcome of cataract surgery.

  2. Early childhood caries (ECC): a preventive-conservative treatment mode during a 12-month period.

    PubMed

    Peretz, Benjamin; Gluck, George

    2006-01-01

    To evaluate a preventive treatment mode for early childhood caries (ECC). The population to be studied included 30 children who, over a 12-month period, presented with ECC to a private dental clinic. Parents preferred non-invasive, preventive treatment over restorations. Parents were given hygiene and proper feeding instructions. Mesial slicing was performed where proximal caries was observed. Children were examined once every two months. They received supervised professional topical fluoride treatment. Plaque level, brushing, stopping the bottle, eating sweets, appearance of new lesions or exacerbation of existing condition were observed and recorded. In the vast majority of patients, the progression of ECC was arrested after the preventive regimen. Three children required restorations. They had failed to limit sugar consumption and to comply with brushing instruction. General improvement was observed in plaque control, brushing habits and sweets consumption. Preventive measures may successfully arrest ECC and thereby avoid invasive procedures as well as the need of anesthesia.

  3. Allogeneic Blood Product Usage in Coronary Artery Bypass Grafting (CABG) with minimalized Extracorporeal Circulation System (MECC) Versus Standard On-Pump Coronary Artery Bypass Grafting

    PubMed Central

    Lisy, M.; Schmid, E.; Kozok, J.; Rosenberger, P.; Stock, U.A.; Kalender, G.

    2016-01-01

    Aim: Intraoperative allogeneic blood product transfusion (ABPT) in cardiac surgery is associated with worse overall outcome, including mortality. The objective of this study was to evaluate the ABPTs in minimalized extracorporeal cardiopulmonary (MECCTM) compared with standard open system on-pump coronary revascularization. Methods: Data of 156 patients undergoing myocardial revascularization between September 2008 and September 2010 were reviewed. 83 patients were operated by the MECC technique and 73 were treated by standard extracorporeal circulation (sECC). ABPT and overall early postoperative complications were analyzed. Results: Operative mortality and morbidity were similar in both groups. ABPT in the MECC group was significantly lower than in the sECC group both intraoperatively (7.2 vs. 60.3% of patients p<0.001) and during the first five postoperative days (19.3 vs. 57.5%; p<0.001). “Skin to skin”- (214 ± 45 vs. 232 ± 45 min; p=0.012), cardiopulmonary bypass (CPB) - (82 ± 25 vs. 95 ± 26 min; p=0.014), and X-clamp- times (50 ± 16 vs. 56 ± 17 min; p=0.024) were significantly lower in the MECC group than in the sECC group. Length of ICU (intensive care unit) - and hospital stay were also significantly lower in the MECC group vs. the sECC group (26.7 ± 20.2 vs. 54.5 ± 68.9 h; p<0.001, and 12.0 ± 4.1 vs. 14.5 ± 4.6 days; p<0.001). Conclusion: Application of MECC as on-pump coronary artery bypass graft (CABG) results in significantly lower ABPT as well as shorter ICU and in-hospital stay. In order to achieve these benefits of MECC autologous retrograde priming, Bispectral index (BIS) monitoring, intraoperative cell salvage, meticulous hemostasis and strict peri- and postoperative volume management are crucial. PMID:27499818

  4. Allogeneic Blood Product Usage in Coronary Artery Bypass Grafting (CABG) with minimalized Extracorporeal Circulation System (MECC) Versus Standard On-Pump Coronary Artery Bypass Grafting.

    PubMed

    Lisy, M; Schmid, E; Kozok, J; Rosenberger, P; Stock, U A; Kalender, G

    2016-01-01

    Intraoperative allogeneic blood product transfusion (ABPT) in cardiac surgery is associated with worse overall outcome, including mortality. The objective of this study was to evaluate the ABPTs in minimalized extracorporeal cardiopulmonary (MECC(TM)) compared with standard open system on-pump coronary revascularization. Data of 156 patients undergoing myocardial revascularization between September 2008 and September 2010 were reviewed. 83 patients were operated by the MECC technique and 73 were treated by standard extracorporeal circulation (sECC). ABPT and overall early postoperative complications were analyzed. Operative mortality and morbidity were similar in both groups. ABPT in the MECC group was significantly lower than in the sECC group both intraoperatively (7.2 vs. 60.3% of patients p<0.001) and during the first five postoperative days (19.3 vs. 57.5%; p<0.001). "Skin to skin"- (214 ± 45 vs. 232 ± 45 min; p=0.012), cardiopulmonary bypass (CPB) - (82 ± 25 vs. 95 ± 26 min; p=0.014), and X-clamp- times (50 ± 16 vs. 56 ± 17 min; p=0.024) were significantly lower in the MECC group than in the sECC group. Length of ICU (intensive care unit) - and hospital stay were also significantly lower in the MECC group vs. the sECC group (26.7 ± 20.2 vs. 54.5 ± 68.9 h; p<0.001, and 12.0 ± 4.1 vs. 14.5 ± 4.6 days; p<0.001). Application of MECC as on-pump coronary artery bypass graft (CABG) results in significantly lower ABPT as well as shorter ICU and in-hospital stay. In order to achieve these benefits of MECC autologous retrograde priming, Bispectral index (BIS) monitoring, intraoperative cell salvage, meticulous hemostasis and strict peri- and postoperative volume management are crucial.

  5. Determinants of early childhood caries (ECC) in a rural Manitoba community: a pilot study.

    PubMed

    Schroth, Robert J; Moffatt, Michael E K

    2005-01-01

    Preschool oral health is often overlooked as an important aspect of childhood health and well-being. The purposes of this study were to: (1) determine the dental status of 3-year-old children in the community of Carman, Manitoba, Canada; and (2) identify the principal determinants of Early Childhood Caries (ECC) in 2 consecutive years. All children and mothers attending a preschool health screening fair were invited to participate. Study procedures included a retrospective interview with parents and dental examination of the child. Statistical analyses included ANOVA, chi-square, and multiple regression. A P value of <.05 denoted significance. A total of 61 children participated (mean age=45.7+/-3.4 months). The prevalence of ECC was 44%, while the mean deft was 2+/-3.3. Increased caries activity and ECC were associated with lower maternal level of education (P<.01). Family size was associated with deft scores (P=.03) while the presence of debris was also associated with ECC (P<.05). ECC prevalence among these 3-year-olds is less than exhibited among other Canadian preschool children. Factors associated with ECC included debris on the primary teeth and low maternal education. Factors most associated with increased caries activity included low maternal education and increased family size. In addition, parents were able to reliably assess their child's dental health status. Larger epidemiological studies of ECC are needed to better assess prevalence and risk factors. Such data may, therefore, assist in identifying those children at greatest risk for ECC. It may also help in the redirection of scarce resources to effective preventive oral health interventions, as these children have an increased caries burden along the continuum of childhood.

  6. A retrospective comparative study of minimally invasive extracorporeal circulation versus conventional extracorporeal circulation in emergency coronary artery bypass surgery patients: a single surgeon analysis.

    PubMed

    Rufa, Magdalena; Schubel, Jens; Ulrich, Christian; Schaarschmidt, Jan; Tiliscan, Catalin; Bauer, Adrian; Hausmann, Harald

    2015-07-01

    At the moment, the main application of minimally invasive extracorporeal circulation (MiECC) is reserved for elective cardiac operations such as coronary artery bypass grafting (CABG) and/or aortic valve replacement. The purpose of this study was to compare the outcome of emergency CABG operations using either MiECC or conventional extracorporeal circulation (CECC) in patients requiring emergency CABG with regard to the perioperative course and the occurrence of major adverse cardiac and cerebral events (MACCE). We analysed the emergency CABG operations performed by a single surgeon, between January 2007 and July 2013, in order to exclude the differences in surgical technique. During this period, 187 emergency CABG patients (113 MiECC vs 74 CECC) were investigated retrospectively with respect to the following parameters: in-hospital mortality, MACCE, postoperative hospital stay and perioperative transfusion rate. The mean logistic European System for Cardiac Operative Risk Evaluation was higher in the CECC group (MiECC 12.1 ± 16 vs CECC 15.0 ± 20.8, P = 0.15) and the number of bypass grafts per patient was similar in both groups (MiECC 2.94 vs CECC 2.93). There was no significant difference in the postoperative hospital stay or in major postoperative complications. The in-hospital mortality was higher in the CECC group 6.8% versus MiECC 4.4% (P = 0.48). The perioperative transfusion rate was lower with MiECC compared with CECC (MiECC 2.6 ± 3.2 vs CECC 3.8 ± 4.2, P = 0.025 units of blood per patient). In our opinion, the use of MiECC in urgent CABG procedures is safe, feasible and shows no disadvantages compared with the use of CECC. Emergency operations using the MiECC system showed a significantly lower blood transfusion rate and better results concerning the unadjusted in-hospital mortality. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  7. Self-Healing of Microcracks in Engineered Cementitious Composites (ECC) Under a Natural Environment.

    PubMed

    Herbert, Emily N; Li, Victor C

    2013-07-15

    This paper builds on previous self-healing engineered cementitious composites (ECC) research by allowing ECC to heal outdoors, in the natural environment, under random and sometimes extreme environmental conditions. Development of an ECC material that can heal itself in the natural environment could lower infrastructure maintenance costs and allow for more sustainable development in the future by increasing service life and decreasing the amount of resources and energy needed for repairs. Determining to what extent current ECC materials self-heal in the natural environment is the first step in the development of an ECC that can completely heal itself when exposed to everyday environmental conditions. This study monitored outdoor ECC specimens for one year using resonant frequency (RF) and mechanical reloading to determine the rate and extent of self-healing in the natural environment. It was found that the level of RF, stiffness, and first cracking strength recovery increased as the duration of natural environment exposure increased. For specimens that underwent multiple damage cycles, it was found that the level of recovery was highly dependent on the average temperature and amount of precipitation between each damage event. However, RF, stiffness, and first cracking strength recovery data for specimens that underwent multiple loading cycles suggest that self-healing functionality can be maintained under multiple damage events.

  8. Reduction in blood product usage associated with routine use of mini bypass systems in extracorporeal circulation.

    PubMed

    Perthel, M; Klingbeil, A; El-Ayoubi, L; Gerick, M; Laas, J

    2007-01-01

    The objective of this study is to investigate the hypothesis that a reduced prime extracorporeal circulation (ECC) system and ensuing reduction in patient hemodilution can affect blood product use. We performed a prospective, randomized study from a group of 60 consecutive coronary artery bypass graft (CABG) patients, comparing blood product usage and postoperative bleeding in 30 mini bypass systems (n = 30) to 30 conventional systems (n = 30). The patient demographics in terms of patient weight, height, age, preoperative hemoglobin, preoperative hematocrit, BSA, ejection fraction, and NYHA were not statistically significant. Blood product use, including fresh frozen plasma (FFP) and homolgous blood transfusions was tracked through the operating theater and into the intensive care unit. In the mini bypass group, while no homologous blood transfusions were given in the OR, 27% of the patients received at least one unit of homologous blood. In the control group, 43% of the patients received at least one unit of blood in the OR or in the ICU and there was a stastistically-significant 38% reduction in homologous blood product use (p = 0.05). For the patients who received homologous blood, there was also a significant reduction in transfused volume (0.53 +/- 0.90 units blood mini bypass vs 1.3 +/- 1.93 units conventional, p < 0.05). In terms of FFP, there was also a stastistically significant difference between the two groups (0 units transfused in mini bypass group vs 3 patients receiving one unit FFP in the control group, p < 0.001). Cumulative postoperative bleeding during the ICU stay was also evaluated, yielding a significant reduction (365 +/- 495 ml mini bypass vs 825 +/- 975 ml conventional, p < 0.05). Mini bypass reduces on-pump hemodilution and, therefore, donor blood usage in routine CABG patients as compared to conventional ECC circuits and can reduce postoperative bleeding as compared to a traditional system. The mini bypass system is safe in routine

  9. Heart bypass surgery

    MedlinePlus Videos and Cool Tools

    Heart bypass surgery begins with an incision made in the chest, with the breastbone cut exposing the heart. Next, a portion of the saphenous vein is ... used to bypass the blocked arteries in the heart. The venous graft is sewn to the aorta ...

  10. Incorporation of a lauric acid-conjugated GRGDS peptide directly into the matrix of a poly(carbonate-urea)urethane polymer for use in cardiovascular bypass graft applications.

    PubMed

    Kidane, Asmeret G; Punshon, Geoffrey; Salacinski, Henryk J; Ramesh, Bala; Dooley, Audrey; Olbrich, Michael; Heitz, Johannes; Hamilton, George; Seifalian, Alexander M

    2006-12-01

    Gly-Arg-Gly-Asp-Ser (GRGDS) was modified by conjugation to lauric acid (LA) to facilitate incorporation into the matrix of a poly(carbonate-urea)urethane (PCU) used in vascular bypass grafts. GRGDS and LA-GRGDS were synthesized using solid phase Fmoc chemistry and characterized by high performance liquid chromatography and Fourier transform infrared spectroscopy. LA-GRGDS was passively coated and incorporated as nanoparticle dispersion on the PCU films. Biocompatibility of the modified surfaces was investigated. Endothelial cells seeded on LA-GRGDS coated and incorporated PCU showed after 48 h and 72 h a significant (p < 0.05) increase in metabolism compared with unmodified PCU. The platelet adhesion and hemolysis studies showed that the modification of PCU had no adverse effect. In conclusion, LA-conjugated RGD derivatives, such as LA-GRGDS, that permit solubility into solvents used in solvent casting methodologies should have wide applicability in polymer development for use in coronary, vascular, and dialysis bypass grafts, and furthermore scaffolds utilized for tissue regeneration and tissue engineering.

  11. Thrust reverser for high bypass turbofan engine

    SciTech Connect

    Matta, R.K.; Bhutiani, P.K.

    1990-05-08

    This patent describes a thrust reverser for a gas turbine engine of the type which includes an outer wall spaced from the center body of a core engine to define a bypass duct therebetween. The thrust reverser comprising: circumferentially displaced blocker doors, each of the doors being movable between a normal position generally aligned with the outer wall and a thrust reversing position extending transversely of the bypass duct for blocking the exhaust of air through the bypass duct and directing the air through an opening in the outer wall for thrust reversal; each of the blocker doors being of lightweight construction and including a pit in the inner surface thereof in the normal position; means for covering the pit during normal flow of air through the bypass duct to reduce the pressure drop in the bypass duct and to reduce noise. The covering means including a pit cover hingedly mounted at one end thereof on the blocker door and means of biasing the pit cover away from the blocker door to a position providing smooth flow of air through the bypass duct during normal operation.

  12. The prevalence and risks of early childhood caries (ECC) in Toronto, Canada.

    PubMed

    Al-Jewair, Thikriat S; Leake, James L

    2010-10-14

    To determine the prevalence and risks of early childhood caries (ECC) among children less than 71 months of age in Toronto, Canada, and to evaluate the association between parental/caregiver depression and ECC. A secondary analysis of data previously collected by the Toronto Public Health as part of the 2003 Toronto Perinatal and Child Health Survey was performed. The 90-item survey was conducted over the telephone to 1,000 families with children from zero years (birth) to six years of age. Parents/caregivers were asked about factors related to the development and health of their children. For this study, only children younger than six years of age (less than 71 months) were included (n=833). The primary outcome of interest was self-reported and measured by the response to the question of whether a physician/dentist had ever told the parent/caregiver his/her child had ECC. The prevalence of ECC was 4.7 percent (37 of 791 children). The child's age, his/her history of dental visits, teeth brushing, the use of fluoridated toothpaste, the parent's/caregiver's depressive tendencies, the language spoken at home, and the household annual income were all significant in the bivariate analysis. Multiple logistic regression identified four factors associated with ECC: the child's age (being three years of age or older), having at least one parent/caregiver with depression, not speaking English at home, and having an annual household income less than $40,000 in Canadian dollars (CAD). While a child's age, home language, and household income are known risks for ECC, the finding that parental/caregiver depression may be related to ECC is new. Multiple risk factors are involved in the development of early childhood caries. Of particular importance are demographic (e.g., child's age), social (e.g., annual household income), and psychosocial factors (e.g., parental/caregiver depression) that are indirectly linked to ECC. More attention needs to be placed on understanding the role

  13. Energy-dissipating and self-repairing SMA-ECC composite material system

    NASA Astrophysics Data System (ADS)

    Li, Xiaopeng; Li, Mo; Song, Gangbing

    2015-02-01

    Structural component ductility and energy dissipation capacity are crucial factors for achieving reinforced concrete structures more resistant to dynamic loading such as earthquakes. Furthermore, limiting post-event residual damage and deformation allows for immediate re-operation or minimal repairs. These desirable characteristics for structural ‘resilience’, however, present significant challenges due to the brittle nature of concrete, its deformation incompatibility with ductile steel, and the plastic yielding of steel reinforcement. Here, we developed a new composite material system that integrates the unique ductile feature of engineered cementitious composites (ECC) with superelastic shape memory alloy (SMA). In contrast to steel reinforced concrete (RC) and SMA reinforced concrete (SMA-RC), the SMA-ECC beams studied in this research exhibited extraordinary energy dissipation capacity, minimal residual deformation, and full self-recovery of damage under cyclic flexural loading. We found that the tensile strain capacity of ECC, tailored up to 5.5% in this study, allows it to work compatibly with superelastic SMA. Furthermore, the distributed microcracking damage mechanism in ECC is critical for sufficient and reliable recovery of damage upon unloading. This research demonstrates the potential of SMA-ECC for improving resilience of concrete structures under extreme hazard events.

  14. Gastric Bypass Surgery

    MedlinePlus

    ... much you can eat or by reducing the absorption of nutrients, or both. Gastric bypass and other ... you can eat at one sitting and reducing absorption of nutrients. The surgeon cuts across the top ...

  15. Gastric bypass surgery

    MedlinePlus

    ... your legs to help prevent blood clots from forming. You will receive shots of medicine to prevent ... diversion with duodenal switch Dumping syndrome References Buchwald H. Laparoscopic Roux-en-Y gastric bypass. In: Buchwald ...

  16. Seizures Following Cardiopulmonary Bypass

    PubMed Central

    Brouwer, Monique E.; McMeniman, William J.

    2016-01-01

    Abstract: Seizures following cardiopulmonary bypass are an immediate and alarming indication that a neurologic event has occurred. A case report of a 67-year-old man undergoing aortic valve surgery who unexpectedly experiences seizures following cardiopulmonary bypass is outlined. Possible contributing factors including atheromatous disease in the aorta, low cerebral perfusion pressures, an open-chamber procedure, and the use of tranexamic acid are identified. PMID:27729707

  17. An evaluation of electrochemical concentration Cell (ECC) sonde measurements of atmospheric ozone

    NASA Technical Reports Server (NTRS)

    Geraci, M. J.; Luers, J. K.

    1978-01-01

    Using Dobson spectrophotometer measurements of total ozone as a comparison, an analysis of the electrochemical concentration cell (ECC) ozonesonde's measurement accuracy is presented. Days of conjunctive ECC-Dobson observations (from 1970 to 1976 at Wallops Flight Center) provide a set of 123 pairs of total ozone values. Sample set statistics are generated with means and standard deviations of total ozone values and differences being noted. An in-depth study of factors such as time assumptions used in calculating residual ozone, and other possible sources of errors are examined. A study of ECC ozone profiles is also presented with an evaluation of sonde measurement of seasonal trends, altitude or peak ozone concentration, and other important ozone parameters. Short-period changes in total ozone using Dobson data during the observational period are also described.

  18. Intraocular pressure following ECCE and IOL implantation in patients with glaucoma.

    PubMed

    Kooner, K S; Dulaney, D D; Zimmerman, T J

    1988-08-01

    Patients with glaucoma may suffer optic nerve head damage due to elevated intraocular pressure (IOP) after any intraocular procedure. We retrospectively reviewed the IOP data in 82 consecutive patients (103 eyes) with glaucoma after extracapsular cataract extraction (ECCE) and posterior chamber intraocular lens (PC-IOL) implantation. Nine eyes had previous trabeculectomy and three eyes required combined trabeculectomy with ECCE and PC-IOL. The average follow-up period is 1.5 years (range 0.5 to 6 years). The postoperative IOP rise of 8 mm Hg over baseline or above 23 mm Hg was observed in 45 eyes (49.5%). Two eyes needed argon laser trabeculoplasty and one required trabeculectomy to control postoperative IOP elevation. Most of the patients required the same or lesser number of medications for IOP control after surgery. Results suggest that ECCE with PC-IOL may be a relatively safe procedure in cataract patients with preexisting glaucoma.

  19. Lightweight ECC based RFID authentication integrated with an ID verifier transfer protocol.

    PubMed

    He, Debiao; Kumar, Neeraj; Chilamkurti, Naveen; Lee, Jong-Hyouk

    2014-10-01

    The radio frequency identification (RFID) technology has been widely adopted and being deployed as a dominant identification technology in a health care domain such as medical information authentication, patient tracking, blood transfusion medicine, etc. With more and more stringent security and privacy requirements to RFID based authentication schemes, elliptic curve cryptography (ECC) based RFID authentication schemes have been proposed to meet the requirements. However, many recently published ECC based RFID authentication schemes have serious security weaknesses. In this paper, we propose a new ECC based RFID authentication integrated with an ID verifier transfer protocol that overcomes the weaknesses of the existing schemes. A comprehensive security analysis has been conducted to show strong security properties that are provided from the proposed authentication scheme. Moreover, the performance of the proposed authentication scheme is analyzed in terms of computational cost, communicational cost, and storage requirement.

  20. Clinical outcomes and costs of cataract surgery performed by planned ECCE and phacoemulsification.

    PubMed

    Castells, X; Comas, M; Castilla, M; Cots, F; Alarcón, S

    1998-01-01

    To compare clinical outcomes and costs of cataract surgery between patients operated with standard extracapsular extraction (ECCE) and those undergoing phacoemulsification. Patients from the Ophthalmology Department of a teaching hospital in Barcelona (Spain) scheduled for cataract surgery, not combined with any other ophthalmic procedure. A retrospective analysis has been performed on a database of 1046 patients undergoing ECCE and phacoemulsification. The outcome measures used were: surgical complications, visual acuity and costs of surgery and of follow-up. Overall rate of all complications and postoperative visual acuity were compared between the two groups, adjusting for age, preoperative visual acuity, medical and ocular comorbidity. 31.9% of the patients (334) underwent phacoemulsification, and 68.1% (712) underwent ECCE. Patients undergoing phacoemulsification presented a frequency of intra- and postoperative complications lower than those undergoing ECCE (odds ratio 0.57, 95%CI 0.37-0.87 and 0.66, 95%CI 0.46-0.96, respectively), specifically for intraoperative iris trauma (3.1% vs 0.3%, p = 0.004), residual posterior capsular opacity (2% vs 0.3%, p = 0.035) and postoperative corneal edema (7.4% vs 3.6%, p = 0.016). Costs of intervention and follow-up were lower for phacoemulsification compared with ECCE (23.9% and 14%, respectively). But global costs were slightly higher for phacoemulsification (4.87%), due to supply costs, which were more than twice those of ECCE. Phacoemulsification, when performed by an experienced surgeon, has better clinical outcomes than planned extracapsular extraction, and costs may be lower since supply costs are expected to decrease as the phacoemulsification technique becomes more widespread.

  1. A pedoprosthetic rehabilitation in patients with severe early childhood caries (S-ECC).

    PubMed

    Mishra, Apurva; Pandey, Ramesh; Pandey, Neelisha; Jain, Eesha

    2013-07-09

    Early childhood caries (ECC) is a rapid form of dental caries. ECC is the most common chronic childhood disease that can compromise a child's self-esteem, nutritional intake, oral development and quality of life, subsequently leading to malocclusion and psychological problems. The restoration of severely decayed primary teeth is often a difficult procedure that offers a great challenge to paediatric dentists. The present case series document the clinical management of patients suffering from severe early childhood caries using removable partial prosthesis restoring their masticatory function and aesthestics. The ultimate aim of the treatment was to improve psychological and physiological development leading to better functioning of the stomatognathic system.

  2. ECC-based grouping-proof RFID for inpatient medication safety.

    PubMed

    Lin, Qiping; Zhang, Fangguo

    2012-12-01

    Several papers were proposed in which symmetric cryptography was used to design RFID grouping-proof for medication safety in the Journal of Medical Systems. However, if we want to ensure privacy, authentication and protection against the tracking of RFID-tags without losing system scalability, we must design an asymmetric cryptography-based RFID. This paper will propose a new ECC-based grouping-proof for RFID. Our ECC-based grouping-proof reduces the computation of tags and prevents timeout problems from occurring in n-party grouping-proof protocol. Based on asymmetric cryptography, the proposed scheme is practical, secure and efficient for medication applications.

  3. Equally increased hypercoagulability irrespective of using minimized or conventional ECC systems.

    PubMed

    Steinbrüchel, Ann S; Johansson, Pär I; Rafiq, Sulman; Stensgaard, Jens; Steinbrüchel, Daniel A

    2012-08-01

    Minimized extracorporeal circulation systems in coronary artery bypass may have less impairing effect on hematological parameters and bleeding compared to conventional systems. The aim of this study was to investigate whether the use of mini systems does result in an increased postoperative hypercoagulative status. Patients with increased risk of postoperative blood transfusion were randomly allocated to coronary bypass surgery using conventional or minimized extracorporeal circulation. Serial thrombelastographic analysis was performed preoperatively, at day 1 and 5. Forty-six patients were included. In 56% of the patients in the experimental and in 62% in the control group an activated coagulation system, measured as maximal amplitude above normal reference was found preoperatively. This was normalized the day after operation. At day 5 a significant number of patients in the experimental group (p = 0.03) overshooted the preoperative maximal clot strength compared to the control group (p = 0.15); however, a direct intergroup analysis showed no difference. In both groups, hemoglobin levels and platelet counts decreased at day one after surgery. At day 5, hemoglobin was partly and platelets completely normalized. No differences were found with respect to transfusion needs. Mini systems seem to induce at least an equal increased state of hypercoagulability after coronary surgery. No clinical relevant differences could be demonstrated. This could indicate that patients after using mini systems are not protected against a postoperative state of increased hypercoagulability.

  4. Bridging education and training in ageing and disability: the European Care Certificate (ECC)

    PubMed Central

    Churchill, James; Gyorki, Eva

    2009-01-01

    Introduction There has been significant movement of workers between EU countries seeking work in the social care sector, causing problems for workers and employers who cannot easily evaluate the worth of qualifications gained abroad. The European Care Certificate (ECC) helps workers start work in the social care sector by defining basic knowledge and offering recognition for their learning. Development of product A LEONARDO project involving six countries (BE, UK, AT, DE, RO, PO) established a set of learning outcomes—the BESCLO (Basic European Social Care Learning Outcomes) covering eight key areas of knowledge (not competence). Existing awards and courses become ‘ECC compliant’ by demonstrating coverage of all the BESCLO. Students pass a multi-choice exam to gain the Certificate. There is a developing system of Lead and Delivery Partners spreading the ECC across Europe. Conclusion The BESCLO covers essential knowledge with a common set of values in social care. The ECC fits within existing training courses, is cheap and easy to operate, is at entry level, covers all client groups, can be made available in any language and is equally useful in recruitment, workplace induction training, or more formal college/university courses as an early achievement marker. Website: http://www.eclicence.eu

  5. Zirconia crowns--an esthetic and resistant restorative alternative for ECC affected primary teeth.

    PubMed

    Planells del Pozo, P; Fuks, A B

    2014-01-01

    The present report discusses briefly the problem of ECC in very young children and the recommended approaches for prevention and treatment. The esthetic restoration of the maxillary incisors with Zirconia Nu Smile crowns is described. It is also stressed that the luxation injury two months after placement did not damage the appearance nor the stability of the crowns.

  6. Caregiver knowledge and attitudes of preschool oral health and early childhood caries (ECC).

    PubMed

    Schroth, Robert J; Brothwell, Douglas J; Moffatt, Michael E K

    2007-04-01

    Prevention strategies are integral to improving the oral health for young Aboriginal children. For such to be effective, it is important to understand the social value that parents and caregivers ascribe to primary teeth. The purpose of this paper is to report caregiver knowledge and attitudes toward preschool oral health and early childhood caries (ECC) from 4 communities in Manitoba. Cross-sectional study, including a retrospective interview with caregivers. Children and their main caregivers served as the sample. Preschoolers underwent a comprehensive dental screening while caregivers completed a questionnaire that explored knowledge and attitudes toward preschool dental health. Caregiver responses were matched with findings from each child's examination. A majority agreed that primary teeth were important, that dental disease could lead to health problems and that a first dental visit should be made by age 1. Caregivers of children with ECC were more likely to believe that caries could not affect a child's health while those who believed primary teeth are important had children with significantly less decay. Most caregivers believed that primary teeth are important and correctly responded to inquiries about knowledge and attitudes toward oral health. Attitudes on the importance of baby teeth and bottle feeding after one year of age, the effect of rotten teeth on childhood health and night-time nursing emerged as variables most associated with the absence/presence of ECC and deft rates. Incorporating such questioning into caries risk assessments may be a useful means to determine a child's risk for ECC.

  7. Early childhood caries (ECC) and neglect in child care: analysis of an Italian sample.

    PubMed

    Scorca, A; Santoro, V; De Donno, A; Grattagliano, I; Tafuri, S; Introna, F

    2013-01-01

    Dental caries was identified as the single most common chronic childhood disease; its prevention should be a priority for dentists. With the aim of describing the correlation between early childhood caries (ECC) and the phenomenon of child neglect, a questionnaire which recorded socio-economic and dental service use data was provided to a randomly chosen sample of parents at three pediatric health service centers in Bari (Italy). In order to evaluate the association among risk factors and ECC, contingency tables were created and the value of the Odds Ratio (OR) was calculated, indicating the confidence intervals and chi square values. A student's t-test for independent samples was performed to evaluate the differences between the averages. A value of p≤0.5 was considered to be significant for all tests used. Of the 63 children examined, 61.9% (n=39; 95%CL=49.9- 73.9) presented with ECC, of which 47.6% (n=30; 95%CL=34.9-60.6) were classified as Wyne's Type I; 12.7% (n=8; 95%CL=5.6-23.5) were classified as Type II; and 1.6% (n=1; 95%CL=0-8.5) as Type III. Interestingly, the frequency of Types II and III were shown to be higher in low-income families (chi-square=8.50; p=0.03). Dentists should recognize children's susceptibility to ECC and their exposure to risk factors for neglect, thus facilitating a primary prevention visit.

  8. Bypass Flow Study

    SciTech Connect

    Richard Schultz

    2011-09-01

    The purpose of the fluid dynamics experiments in the MIR (Matched Index of-Refraction) flow system at Idaho National Laboratory (INL) is to develop benchmark databases for the assessment of Computational Fluid Dynamics (CFD) solutions of the momentum equations, scalar mixing, and turbulence models for the flow ratios between coolant channels and bypass gaps in the interstitial regions of typical prismatic standard fuel element (SFE) or upper reflector block geometries of typical Modular High-temperature Gas-cooled Reactors (MHTGR) in the limiting case of negligible buoyancy and constant fluid properties. The experiments use Particle Image Velocimetry (PIV) to measure the velocity fields that will populate the bypass flow study database.

  9. Comparison of outcomes following combined ECCE-trabeculectomy versus phacoemulsification-trabeculectomy.

    PubMed

    Tous, Horacio M; Nevárez, Juan

    2006-12-01

    To analyze and compare the main outcomes between trabeculectomies combined with extracapsular cataract extraction (ECCE) versus those with phacoemulsification (Phaco). The authors retrospectively reviewed one surgeon's 357 consecutive cases (475 eyes) of combined cataract extraction, intraocular lens implantation and Mitomycin enhanced trabeculectomy. Patients were divided into two groups, those who underwent extracapsular cataract extraction (80 eyes) and those having phacoemulsification (395 eyes). Analysis of postoperative visual acuity, intraocular pressure (IOP), number of glaucoma medications, postoperative adverse events and additional procedures required, was done. Minimum follow-up was 12 months with an average of 53 months. There was no significant difference (p = 1.000) between the groups in terms of visual acuity improvement rate, 66% (ECCE) versus 59% (Phaco). Postoperatively IOP with both techniques fell significantly (p < 0.0001). Earlier IOP reduction was obtained with Phacoemulsification, but there was no difference by the end of the follow up period (14.4 mmHg ECCE vs. 14.1 mmHg Phaco, p = 1.0000). Postoperative pressure spikes occurred in 6% versus 10% (p = 0.3995) of the eyes. No significant difference (55% ECCE versus 63% Phaco, p = 0.1674) between the two groups in terms of glaucoma medication reduction was found. The total number of postoperative complications (89% versus 68.5%) were significantly higher (p = 0.0001) in the ECCE-group, as well as the total number of eyes which required further interventions (86% versus 64%, p = 0.0001). Both combined surgery techniques are effective and yielded similar long-term results. However phacoemulsification can decrease the post operative complications associated with this surgery.

  10. Preparation and Evaluation of (68)Ga-ECC as a PET Renal Imaging Agent.

    PubMed

    Mirzaei, Alireza; Jalilian, Amir Reza; Aghanejad, Ayuob; Mazidi, Mohammad; Yousefnia, Hassan; Shabani, Gholamali; Ardaneh, Khosro; Geramifar, Parham; Beiki, Davood

    2015-09-01

    Development of a gallium-68-labeled renal tracer can be a good substitute for Tc-99m, a known SPECT tracer. In this study, effort was made to develop (68)Ga-ethylenecysteamine cysteine ((68)Ga-ECC). Ga-ECC was prepared using generator-based (68)GaCl3 and ethylenecysteamine cysteine (ECC) at optimized conditions. Stability of the complex was checked in human serum followed by partition coefficient determination of the tracer. The biodistribution of the tracer in rats was studied using tissue counting and PET/CT imaging up to 120 min. Ga-ECC was prepared at optimized conditions in 15 min at 90 °C (radiochemical purity ≈97 ± 0.88 % ITLC, >99 % HPLC, specific activity: 210 ± 5 GBq/mM). (68)Ga-ECC was a water-soluble complex based on partition coefficient data (log P; -1.378) and was stable in the presence of human serum for 2 h at 37 °C. The biodistribution of the tracer demonstrated high kidney excretion of the tracer in 10-20 min. The SUVmax ratios of the liver to left kidney were 0.38 and 0.39 for 30 and 90 min, respectively, indicating high kidney uptake. Initial biodistribution results showed significant kidney and urinary excretion of the tracer comparable to that of the homologous (99m)Tc compound. The complex could be a possible PET kidney imaging agent with a fast imaging time.

  11. Analyses of 1/15 scale Creare bypass transient experiments. [PWR

    SciTech Connect

    Kmetyk, L.N.; Buxton, L.D.; Cole, R.K. Jr.

    1982-09-01

    RELAP4 analyses of several 1/15 scale Creare H-series bypass transient experiments have been done to investigate the effect of using different downcomer nodalizations, physical scales, slip models, and vapor fraction donoring methods. Most of the analyses were thermal equilibrium calculations performed with RELAP4/MOD5, but a few such calculations were done with RELAP4/MOD6 and RELAP4/MOD7, which contain improved slip models. In order to estimate the importance of nonequilibrium effects, additional analyses were performed with TRAC-PD2, RELAP5 and the nonequilibrium option of RELAP4/MOD7. The purpose of these studies was to determine whether results from Westinghouse's calculation of the Creare experiments, which were done with a UHI-modified version of SATAN, were sufficient to guarantee SATAN would be conservative with respect to ECC bypass in full-scale plant analyses.

  12. Superior Vena Cava Bypass

    PubMed Central

    Trainini, Jorge Carlos; Auricchio, Renato; Del Bagno, Horacio Augusto; Federico, Vicente; Acrich, Mario Willie; Osorio, Julio Nestor

    1983-01-01

    A case of superior vena cava obstruction due to carcinoma of unknown origin is reported. A superior vena cava bypass with polytetrafluoroethylene was performed by suturing the prosthesis to the left innominate vein and the right atrium, respectively. Long-term satisfactory results were achieved. Images PMID:15227139

  13. Modeling Sediment Bypassing around Rocky Headlands

    NASA Astrophysics Data System (ADS)

    George, D. A.; Largier, J. L.; Pasternack, G. B.; Erikson, L. H.; Storlazzi, C. D.; Barnard, P.

    2016-12-01

    Sediment bypassing rocky headlands remains understudied despite the importance of characterizing littoral processes and sediment budgets for erosion abatement, climate change adaptation, and beach management. This study was developed to identify controlling factors on and the mechanisms supporting sediment bypassing. Sediment flux around four idealized rocky headlands was investigated using the hydrodynamic model Delft3D and spectral wave model SWAN. The experimental design involved 120 simulations to explore the influence of headland morphology, substrate composition, sediment grain size, and oceanographic forcing. Headlands represented sizes and shapes found in natural settings, grain sizes ranged from fine to medium sand, and substrates from sandy beds to offshore bedrock reefs. The oceanography included a constructed representative tide, an alongshore background current, and four wave conditions derived from observational records in the eastern Pacific Ocean. A bypassing ratio was developed for alongshore flux between upstream and downstream cross-shore transects to determine the degree of blockage by a headland. Results showed that northwesterly oblique large waves (Hs = 7 m, Tp = 16 s) generated the most flux around headlands, whereas directly incident waves blocked flux across a headland apex. The headland shape heavily influenced the sediment fate by changing the relative angle between the shoreline and the incident waves. The bypassing ratio characterized each headland's capacity to allow alongshore flux under different wave conditions. All headlands may allow flux, although larger ones block sediment more effectively, promoting their ability to be littoral cell boundaries compared to smaller headlands. The controlling factors on sediment bypassing were determined to be wave angle, shape and size of the headland, and sediment grain size. This novel numerical modeling study advances headland modeling from the generic realm to broadly applicable classes of

  14. Human cytokine responses to coronary artery bypass grafting with and without cardiopulmonary bypass.

    PubMed

    Strüber, M; Cremer, J T; Gohrbandt, B; Hagl, C; Jankowski, M; Völker, B; Rückoldt, H; Martin, M; Haverich, A

    1999-10-01

    Coronary artery bypass grafting (CABG) is associated with a systemic inflammatory response. This has been attributed to cytokine release caused by extracorporeal circulation and myocardial ischemia. This study compares the inflammatory response after CABG with cardiopulmonary bypass and after minimally invasive direct coronary artery bypass grafting (MIDCABG) without cardiopulmonary bypass. Cytokine release and complement activation (interleukin-6 and interleukin-8, soluble tumor necrosis factor receptors 1 and 2, complement factor C3a, and C1 esterase inhibitor) were determined in 24 patients before and after CABG or MIDCABG. The maximum body temperature, chest drainage, and fluid balance were recorded for 24 hours after operation. Release of interleukin-6, interleukin-8, and tumor necrosis factor receptors 1 and 2 was significantly higher (p < or = 0.005) in the CABG group than the MIDCABG group just after operation. After 24 hours, a significant increase in interleukin-6 was also found in the MIDCABG group (p = 0.001) compared with preoperative value. Body temperature and fluid balance were significantly higher after CABG (p < or = 0.001). Minimally invasive direct coronary artery bypass grafting represents a less traumatizing technique of surgical revascularization. The reduction in the inflammatory response may be advantageous for patients with a high degree of comorbidity.

  15. Prosthetic Oral Rehabilitation of a Child With S-ECC: A Case Report with Histopathologic Analysis.

    PubMed

    Tannure, P N; Moraes, G G; Borba, McU; Abrahão, A; Andrade, Mtrc; Fidalgo, Tks

    2015-01-01

    The aim of this case report is to describe the treatment planning of a young child with severe early childhood caries (S-ECC) as well as the prosthetic rehabilitation technique. A 3-year-old female child was referred to the pediatric dentistry clinic with the chief complaint of tooth pain, difficulty in eating and recurrent hospitalizations caused by dental infections. The mother reported intermittent episodes of fever and recurrent swelling of child's face. The girl presented angular cheilitis and was referred to a dietitian. The treatment plain consisted on a behavior changes in oral hygiene habits, exodontias of all primary teeth and oral rehabilitation with a prosthesis. The extracted teeth with periapical lesions were submitted to histopathologic analysis (hematoxilin and eosin staining) and revealed an inflammatory infiltrate. The aesthetic requirement of children with S-ECC has been a challenge to pediatric dentists. In the present case, the oral rehabilitation provided for the children better aesthetic, nutrition, phonation, and functional conditions.

  16. [ECCE with self-sealing cataract incision. Technique and clinical results].

    PubMed

    Pham, D T; Wollensak, J; Drosch, S

    1995-06-01

    We present of modified technique for sutureless ECCE with a trapezoidal tunnel incision of 11 mm. The operation can be performed in a closed system because of the self-sealing wound construction. Compared to the sutured corneoscleral ECCE the new procedure has important advantages: the procedure is safe even during the critical phase following nucleus extraction. The procedure is therefore safer, faster, more economical and suture-induced astigmatism is avoided. Clinical experience after 2 years showed that postoperative complications were reduced significantly. Iris prolapse, wound dehiscens and hyphema occurred at a rate of 2%. The astigmatism (Jaffe analysis) was at a rate of 2 D, stable within 4 weeks after surgery, and did not change up to 2 years postoperatively. The astigmatism induced was then reduced about 0.5 D by a radical suture.

  17. Nd:YAG laser removal of pupillary membranes developed after ECCE with PC-IOL implantation.

    PubMed

    Kozobolis, V P; Pallikaris, I G; Tsambarlakis, I G; Vlachonikolis, I G

    1997-12-01

    To define the frequency of development of pupillary membranes after ECCE with PC-IOL implantation, and to remove the pupillary membranes using the Nd:YAG laser. From 400 patients who had undergone ECCE and were free from local or systemic illness affecting the blood-ocular barrier, 20 eyes developed pupillary membranes Nd:YAG laser was used to remove these pupillary membranes. The frequency of pupillary membranes was found to be 5% (9.8% in pex eyes and 3.3% to the non-pex eyes). Visual acuity improved in 17 eyes by 2 to 5 Snellen lines. No serious complications were observed, endothelium inclusive. Pseudoexfoliation might play a significant role in the development of postoperative pupillary membranes which could be successfully treated with the use of Nd:YAG laser. The safety of the procedure has to be evaluated in relation to the corneal endothelium damage in long-term.

  18. Modifying the ECC-based grouping-proof RFID system to increase inpatient medication safety.

    PubMed

    Ko, Wen-Tsai; Chiou, Shin-Yan; Lu, Erl-Huei; Chang, Henry Ker-Chang

    2014-09-01

    RFID technology is increasingly used in applications that require tracking, identification, and authentication. It attaches RFID-readable tags to objects for identification and execution of specific RFID-enabled applications. Recently, research has focused on the use of grouping-proofs for preserving privacy in RFID applications, wherein a proof of two or more tags must be simultaneously scanned. In 2010, a privacy-preserving grouping proof protocol for RFID based on ECC in public-key cryptosystem was proposed but was shown to be vulnerable to tracking attacks. A proposed enhancement protocol was also shown to have defects which prevented proper execution. In 2012, Lin et al. proposed a more efficient RFID ECC-based grouping proof protocol to promote inpatient medication safety. However, we found this protocol is also vulnerable to tracking and impersonation attacks. We then propose a secure privacy-preserving RFID grouping proof protocol for inpatient medication safety and demonstrate its resistance to such attacks.

  19. Candida albicans Carriage in Children with Severe Early Childhood Caries (S-ECC) and Maternal Relatedness

    PubMed Central

    Xiao, Jin; Moon, Yonghwi; Li, Lihua; Rustchenko, Elena; Wakabayashi, Hironao; Zhao, Xiaoyi; Feng, Changyong; Gill, Steven R.; McLaren, Sean; Malmstrom, Hans; Ren, Yanfang; Quivey, Robert

    2016-01-01

    Introduction Candida albicans has been detected together with Streptococcus mutans in high numbers in plaque-biofilm from children with early childhood caries (ECC). The goal of this study was to examine the C. albicans carriage in children with severe early childhood caries (S-ECC) and the maternal relatedness. Methods Subjects in this pilot cross-sectional study were recruited based on a convenient sample. DMFT(S)/dmft(s) caries and plaque scores were assessed during a comprehensive oral exam. Social-demographic and related background information was collected through a questionnaire. Saliva and plaque sample from all children and mother subjects were collected. C. albicans were isolated by BBL™ CHROMagar™ and also identified using germ tube test. S. mutans was isolated using Mitis Salivarius with Bacitracin selective medium and identified by colony morphology. Genetic relatedness was examined using restriction endonuclease analysis of the C. albicans genome using BssHII (REAG-B). Multilocus sequence typing was used to examine the clustering information of isolated C. albicans. Spot assay was performed to examine the C. albicans Caspofungin susceptibility between S-ECC children and their mothers. All statistical analyses (power analysis for sample size, Spearman’s correlation coefficient and multiple regression analyses) were implemented with SAS 9.4 Results A total of 18 S-ECC child-mother pairs and 17 caries free child-mother pairs were enrolled in the study. Results indicated high C. albicans carriage rate in the oral cavity (saliva and plaque) of both S-ECC children and their mothers (>80%). Spearman’s correlation coefficient also indicated a significant correlation between salivary and plaque C. albicans and S. mutans carriage (p<0.01) and caries severity (p<0.05). The levels of C. albicans in the prepared saliva and plaque sample (1ml resuspension) of S-ECC children were 1.3 ± 4.5 x104 cfu/ml and 1.2 ± 3.5 x104 cfu/ml (~3-log higher vs. caries

  20. Candida albicans Carriage in Children with Severe Early Childhood Caries (S-ECC) and Maternal Relatedness.

    PubMed

    Xiao, Jin; Moon, Yonghwi; Li, Lihua; Rustchenko, Elena; Wakabayashi, Hironao; Zhao, Xiaoyi; Feng, Changyong; Gill, Steven R; McLaren, Sean; Malmstrom, Hans; Ren, Yanfang; Quivey, Robert; Koo, Hyun; Kopycka-Kedzierawski, Dorota T

    2016-01-01

    Candida albicans has been detected together with Streptococcus mutans in high numbers in plaque-biofilm from children with early childhood caries (ECC). The goal of this study was to examine the C. albicans carriage in children with severe early childhood caries (S-ECC) and the maternal relatedness. Subjects in this pilot cross-sectional study were recruited based on a convenient sample. DMFT(S)/dmft(s) caries and plaque scores were assessed during a comprehensive oral exam. Social-demographic and related background information was collected through a questionnaire. Saliva and plaque sample from all children and mother subjects were collected. C. albicans were isolated by BBL™ CHROMagar™ and also identified using germ tube test. S. mutans was isolated using Mitis Salivarius with Bacitracin selective medium and identified by colony morphology. Genetic relatedness was examined using restriction endonuclease analysis of the C. albicans genome using BssHII (REAG-B). Multilocus sequence typing was used to examine the clustering information of isolated C. albicans. Spot assay was performed to examine the C. albicans Caspofungin susceptibility between S-ECC children and their mothers. All statistical analyses (power analysis for sample size, Spearman's correlation coefficient and multiple regression analyses) were implemented with SAS 9.4. A total of 18 S-ECC child-mother pairs and 17 caries free child-mother pairs were enrolled in the study. Results indicated high C. albicans carriage rate in the oral cavity (saliva and plaque) of both S-ECC children and their mothers (>80%). Spearman's correlation coefficient also indicated a significant correlation between salivary and plaque C. albicans and S. mutans carriage (p<0.01) and caries severity (p<0.05). The levels of C. albicans in the prepared saliva and plaque sample (1ml resuspension) of S-ECC children were 1.3 ± 4.5 x104 cfu/ml and 1.2 ± 3.5 x104 cfu/ml (~3-log higher vs. caries-free children). Among 18 child

  1. [The impact of 2010 international consensus on CPR and ECC science with treatment recommendations on Japan].

    PubMed

    Miyake, Yasufumi

    2011-04-01

    New guidelines on cardiopulmonary resuscitation(CPR) and emergency cardiovascular care (ECC) were published in October 2010 from International Liaison Committee on Resuscitation (ILCOR). Changes of these guidelines will have dramatic effects on Japan. Starting with chest compressions first will increase by-stander CPR. Cases of recovery of spontaneous heartbeat could increase as a result. Intensive care and radical treatments for cardiovascular emergency and brain damage after cardiopulmonary arrest would be essential. Education, implementation and teams (EIT) will be the third subject.

  2. Comparison of data on Early Childhood Caries (ECC) with previous data for Baby Bottle Tooth Decay (BBTD) in an Italian kindergarten population.

    PubMed

    Ferro, R; Besostri, A; Meneghetti, B; Beghetto, M

    2004-06-01

    This was to assess the prevalence of Early Childhood Caries (ECC) among preschool children attending nursery schools and to compare the results with those of a previous survey where the investigators used the term and diagnosis for Baby Bottle Tooth Decay (BBTD) syndrome. A cross-sectional survey of 1006 children aged 1-6 years was carried out. WHO recommendations for oral health surveys were used for caries diagnosis (non cavitated lesions were excluded). In addition, a comparison was made for prevalence of ECC between immigrant and native born children. Data were compared for ECC in the present survey with BBTD data in a previous study (1994) in the same area with a sample of 401 children aged 4 years. All examinations were by one examiner (Cohen's Kappa=0.96). Of the 1006 children originally selected 52 children aged more than 71 months were excluded according to published ECC definition and diagnostic criteria. The overall sample was 29 children aged <36 months; 271 aged 3 years; 364 aged 4 years and 290 aged 5 years. ECC was diagnosed in 19.7% of the overall sample. The prevalence of ECC (and S-ECC) were respectively by age: <36 months S-ECC=17.2%; at 3 years: 13.28% (6.64%); at 4 years: 18.95% (9.34%); at 5 years: 26.9% (12.75%). In the native born children (916) the ECC was 18.34%, while in immigrants (38) it was 52.63% (p<0.001). In 1994 the prevalence of BBTD syndrome was 11.9% and in the present study 6.5%. The ECC prevalence, as, ECC and severe (S-ECC),increased with age. In immigrant children ECC was 3 times (S-ECC 6 times) more frequent than in native born. Using the BBTD diagnosis the prevalence had dropped from 11.9% in 1994 to 6.5% in the present survey.

  3. A Secure-Enhanced Data Aggregation Based on ECC in Wireless Sensor Networks

    PubMed Central

    Zhou, Qiang; Yang, Geng; He, Liwen

    2014-01-01

    Data aggregation is an important technique for reducing the energy consumption of sensor nodes in wireless sensor networks (WSNs). However, compromised aggregators may forge false values as the aggregated results of their child nodes in order to conduct stealthy attacks or steal other nodes' privacy. This paper proposes a Secure-Enhanced Data Aggregation based on Elliptic Curve Cryptography (SEDA-ECC). The design of SEDA-ECC is based on the principles of privacy homomorphic encryption (PH) and divide-and-conquer. An aggregation tree disjoint method is first adopted to divide the tree into three subtrees of similar sizes, and a PH-based aggregation is performed in each subtree to generate an aggregated subtree result. Then the forged result can be identified by the base station (BS) by comparing the aggregated count value. Finally, the aggregated result can be calculated by the BS according to the remaining results that have not been forged. Extensive analysis and simulations show that SEDA-ECC can achieve the highest security level on the aggregated result with appropriate energy consumption compared with other asymmetric schemes. PMID:24732099

  4. A secure-enhanced data aggregation based on ECC in wireless sensor networks.

    PubMed

    Zhou, Qiang; Yang, Geng; He, Liwen

    2014-04-11

    Data aggregation is an important technique for reducing the energy consumption of sensor nodes in wireless sensor networks (WSNs). However, compromised aggregators may forge false values as the aggregated results of their child nodes in order to conduct stealthy attacks or steal other nodes' privacy. This paper proposes a Secure-Enhanced Data Aggregation based on Elliptic Curve Cryptography (SEDA-ECC). The design of SEDA-ECC is based on the principles of privacy homomorphic encryption (PH) and divide-and-conquer. An aggregation tree disjoint method is first adopted to divide the tree into three subtrees of similar sizes, and a PH-based aggregation is performed in each subtree to generate an aggregated subtree result. Then the forged result can be identified by the base station (BS) by comparing the aggregated count value. Finally, the aggregated result can be calculated by the BS according to the remaining results that have not been forged. Extensive analysis and simulations show that SEDA-ECC can achieve the highest security level on the aggregated result with appropriate energy consumption compared with other asymmetric schemes.

  5. Access to the bypassed stomach after gastric bypass.

    PubMed

    Fobi, M A; Chicola, K; Lee, H

    1998-06-01

    The gastric bypass (GBP) Operation is progressively being widely used to treat severe obesity. One problem with this operation is that it leaves the bypassed segment of the gastrointestinal tract not readily available for either mechanical, radiological or endoscopic evaluation. We have addressed this problem by putting a gastrostomy tube in the bypassed stomach at the time of the GBP. A radio-opaque marker placed around the gastrostomy site enables easy radiological localization of and thus easy percutaneous access to the bypassed stomach. The surgical technique is presented.

  6. Direct reperfusion of the right common carotid artery prior to cardiopulmonary bypass in patients with brain malperfusion complicated with acute aortic dissection.

    PubMed

    Okita, Yutaka; Matsumori, Masamichi; Kano, Hiroya

    2016-04-01

    The cases of 3 patients with brain malperfusion secondary to acute aortic dissection who underwent preoperative perfusion of the right common carotid artery are presented. The patients were 64, 65 and 72 years old and 2 were female. All were in a comatose or semi-comatose state with left hemiplegia. The right common carotid artery was exposed and directly cannulated, using a 12-Fr paediatric arterial cannula. The right common femoral artery was chosen for arterial drainage, using a 14-Fr double-lumen cannula. The circuit contained a small roller pump and heat exchanger coil. Target flow was set at 90 ml/min and blood temperature at 30 °C. Durations of right carotid perfusion were 120, 100 and 45 min, respectively. All underwent partial arch replacement and survived. Postoperative neurological sequelae were minimal in all cases.

  7. Are the American College of Cardiology/Emergency Cardiac Care (ACC/ECC) guidelines useful in triaging patients to telemetry units?

    PubMed

    Tiongson, Jay; Robin, Jason; Chana, Amar; Shin, David D; Gheorghiade, Mihai

    2006-01-01

    To determine if the ACC/ECC guidelines (1991) properly stratify patients according to risk of arrhythmia, defined as a single event on cardiac monitoring, and benefit, defined as a subsequent management change from a recorded telemetry event. In 2003, a prospective study of 217 consecutive patients admitted to a 24-bed telemetry unit was conducted for 25 days at a major academic hospital. Patients were categorized per ACC/ECC guidelines as appropriate (class I & II) or inappropriate (class III) based on a non-cardiologist admission diagnosis. A cardiologist-led group then reclassified patients at the time of admission using a brief interview. Continuous telemetry-recorded arrhythmias and resultant management changes were reviewed and recorded daily. Subgroup analysis of patients admitted with a chief complaint of chest pain was also performed. In 2004, after this trial was performed, the American Heart Association released a scientific statement updating practice standards for ECG monitor; however, this paper is based upon the original 1991 ACC/ECC guidelines. Reclassification significantly decreased the percentage of all class I & II patients from 91% to 71% (P<0.001) and the percentage of class I & II patients with chest pain from 100% to 58% (P<0.001) without increasing the percentage of arrhythmias occurring in class III patients. Class II patients had a statistically significant higher percentage of arrhythmias than class I and III patients before and after reclassification (P<0.001 and P<0.001, respectively). Management changes occurring as a direct result of telemetry events were higher in class II than class I or III patients before and after reclassification (P = 0.01 and P = 0.03). Life-threatening arrhythmias (sustained ventricular tachycardia or ventricular fibrillation) occurred in 1% of the 216 patients enrolled in this study. (1) Cardiology input using ACC/ECC guidelines and a brief interview at admission safely reduced total admissions primarily by

  8. Bypass surgery for lower extremity limb salvage: vein bypass.

    PubMed

    El-Sayed, Hosam F

    2012-01-01

    Bypass surgery for limb salvage in cases of chronic limb ischemia is a well-established treatment modality. Use of an autogenous vein provides the best conduit for infrainguinal arterial bypass procedures, particularly for bypass to the infrapopliteal arteries. In this article, we discuss infrainguinal vein bypass surgery including indications, perioperative care, and long-term follow up. We also discuss the outcomes of the procedure with regard to patient survival and limb salvage. The autogenous vein continues to be the best available conduit with the highest patency rate and the best treatment option. Compared to all other revascularization options for infrainguinal disease, the vein bypass has the best limb salvage and long-term survival in patients appropriately selected for the procedure.

  9. Heart bypass surgery incision (image)

    MedlinePlus

    ... the left part of the chest between the ribs. This incision is much less traumatic than the traditional heart bypass surgery incision which separates the breast bone. Minimally invasive heart bypass surgery allows the patient less pain and a faster recovery.

  10. Spiritual Bypass: A Preliminary Investigation

    ERIC Educational Resources Information Center

    Cashwell, Craig S.; Glosoff, Harriet L.; Hammond, Cheree

    2010-01-01

    The phenomenon of spiritual bypass has received limited attention in the transpersonal psychology and counseling literature and has not been subjected to empirical inquiry. This study examines the phenomenon of spiritual bypass by considering how spirituality, mindfulness, alexithymia (emotional restrictiveness), and narcissism work together to…

  11. Spiritual Bypass: A Preliminary Investigation

    ERIC Educational Resources Information Center

    Cashwell, Craig S.; Glosoff, Harriet L.; Hammond, Cheree

    2010-01-01

    The phenomenon of spiritual bypass has received limited attention in the transpersonal psychology and counseling literature and has not been subjected to empirical inquiry. This study examines the phenomenon of spiritual bypass by considering how spirituality, mindfulness, alexithymia (emotional restrictiveness), and narcissism work together to…

  12. Medium bypass turbofan engine

    SciTech Connect

    Williams, S.B.; Jones, J.F.; Dorer, D.K.

    1986-07-08

    A gas turbine engine of the turbofan type is described which consists of: A. a generally tubular axially extending housing assembly defining a radially outer annular bypass duct extending from the inlet end of the housing assembly to the exhaust end thereof; B. an annular burner positioned within the housing assembly radially inwardly of the bypass duct and concentric to the central axis of the housing assembly; C. a low pressure spool assembly including a first shaft journaled on the central axis of the housing assembly, a fan on the first shaft disposed proximate the inlet end of the housing assembly, and a low pressure turbine on the first shaft disposed proximate the exhaust end of the housing assembly; and D. a high pressure spool assembly including a hollow second shaft telescopically received over the first shaft, a high pressure compressor on the second shaft positioned between the fan and the burner, a high pressure turbine on the second shaft positioned between the burner and the low pressure turbine, and an annular rotary slinger on the second shaft positioned between the high pressure compressor and the high pressure turbine and arranged to sling fuel radially outwardly into the burner.

  13. Passive bypass valve assembly

    SciTech Connect

    Siedlecki, W.F. Jr.

    1992-05-19

    This patent describes a bypass valve assembly for controlling fluid flow in a gas turbine engine. It comprises an annular frame including an outer casing, an inner casing spaced from the outer casing to define a channel for channeling fluid flow and the outer casing including an annular opening therein; a plurality of circumferentially juxtaposed bypass valve doors disposed in the annular opening, each of the valve doors having an inner surface for facing the fluid flowable in the channel, an outer surface, a first end pivotally connected to the frame, and a second end, the doors being positionable in a first position generally parallel to the outer casing, and in a second position inclined relative to the outer casing, the fluid flow flowable against the door inner surface being effective for generating a fluid force on the door; and means for automatically positioning the doors in first and second positions in response to differential pressure across the door, the positioning means providing a torque on the doors for moving the door from the first to the second positions and including torque adjustment means for reducing the torque for at least a portion of travel of the doors from the second to the first positions.

  14. The CSNI/PWG-1 international task group on ECCS reliability

    SciTech Connect

    Sandervag, O.; Riekert, T.; Serkiz, A.; Hyvarinen, J.

    1996-03-01

    A steam line loss-of-coolant accident (LOCA) occurred when a safety relief valve inadvertently opened in the Barseback-2 nuclear power plant. The steam jet stripped fibrous insulation from adjacent pipework. Part of that insulation debris was transported to the wetwell pool and clogged the intake strainers for the drywell spray system after about one hour. Although the incident in itself was not very serious, it revealed a weakness in the defense-in-depth concept which under other circumstances could have led to failure of the emergency core cooling system (ECCS) to provide water to the core. Before the Barseback-2 LOCA, international regulators of nuclear power plants and the nuclear power plant industry had considered safety questions related to strainer clogging as resolved. Many European countries had followed the guidance for strainers in pressurized water reactors (PWRs) contained in United States Nuclear Regulatory Commission`s (USNRC) Regulatory Guide 1.82, Water Sources for Long Term Recirculation Cooling Following a Loss-of-Coolant Accident, 1974. However, data obtained from European experimental programs carried out in the late seventies to determine the performance of strainers indicated that this guide was not adequate. In addition, Swedish plant owners had used this guidance to judge performance of emergency core cooling systems (ECCS) in their plants. Analyses at that time had indicated that strainer clogging, if occurring at all, would at least not occur during the first ten hours after a LOCA. Since operation of the ECCS would be needed for a long time, backflushing capabilities and monitors of pressure drop across the strainers were installed in older Swedish BWR plants with small strainer areas. These actions were judged to be adequate compliance with the revised USNRC Regulatory Guide 1.82, Rev. 1, issued in 1985. Safety questions related to strainer clogging were considered to have been resolved until the incident happened in Barseback-2.

  15. Clinical outcomes for Early Childhood Caries (ECC): the influence of health locus of control.

    PubMed

    Chase, I; Berkowitz, R J; Proskin, H M; Weinstein, P; Billings, R

    2004-06-01

    To assess the relationship between clinical outcomes for children treated for ECC and health locus of control. The study cohort consisted of 79 children (42 males, 37 females) treated for ECC; age range was 2.3-7.3 years (mean 4.2 years) at the time of entry into the study. A questionnaire [developed by DeVellis et al., 1993] was administered to each child's parent(s) on the day of dental surgery. This questionnaire examined the expectation that healthcare outcomes in children are influenced by one of the following loci of control: Professional, Parent, Child, Media, Fate and Divine. The cohort was evaluated for new caries lesions at 6 months post dental surgery. Relapse was defined as the presence of new smooth surface caries lesions. For each locus, the scores for the Relapse versus Non-relapse groups (returning patients) and the scores for the returning versus non-returning patients were compared using t-tests. 57 children (72%) returned for follow-up and 21 of these 57 (37%) relapsed. No statistically significant difference for Relapse versus Non-relapse groups was indicated with respect to the scores for any locus parameter (p values ranged from 0.35 to 0.95). Returning parents (N=57) versus non- returning parents (N=22) exhibited statistically significant differences with respect to the Parent, Divine and Fate loci. Returning parents exhibited higher scores on the Parent locus (p=0.0392) and lower scores on the Fate (p=0.0024) and Divine (p=0.0031) loci. 1). The relapse rate (37%) was high and rapid for children treated for ECC; 2). no meaningful difference existed between the Relapse versus Non-relapse groups with respect to each health locus of control parameter; 3). parents who returned for follow-up care appeared to have an internal health locus of control while those who did not return had an external locus.

  16. Impact of di-ethylhexylphthalate exposure on metabolic programming in P19 ECC-derived cardiomyocytes.

    PubMed

    Schaedlich, Kristina; Schmidt, Juliane-Susanne; Kwong, Wing Yee; Sinclair, Kevin D; Kurz, Randy; Jahnke, Heinz-Georg; Fischer, Bernd

    2015-07-01

    Di(2-ethylhexyl)phthalate (DEHP) is the most common plasticizer in plastic devices of everyday use. It is a ubiquitous environmental contaminant and primarily known to impair male gonadal development and fertility. Studies concerning the long-term effects of prenatal DEHP exposure on certain diseases [The Developmental Origins of Health and Disease paradigm (DOHaD) hypothesis] are scarce although it is proven that DEHP crosses the placenta. Rising environmental pollution during the last centuries coincides with an increasing prevalence of cardiovascular and metabolic diseases. We have investigated the effects of an early embryonic DEHP exposure at different developmental stages on cardiomyogenesis. We used an in-vitro model, the murine P19 embryonic carcinoma cell line (P19 ECC), mimicking early embryonic stages up to differentiated beating cardiomyocytes. P19 ECC were exposed to DEHP (5, 50, 100 µg ml(-1)) at the undifferentiated stage for 5 days and subsequently differentiated to beating cardiomyocytes. We analyzed the expression of metabolic (Pparg1, Fabp4 and Glut4), cardiac (Myh6, Gja1) and methylation (Dnmt1, Dnmt3a) marker genes by quantitative real-time PCR (qRT-PCR), beating rate and the differentiation velocity of the cells. The methylation status of Pparg1, Ppara and Glut4 was investigated by pyrosequencing. DEHP significantly altered the expression of all investigated genes. The beating rate and differentiation velocity were accelerated. Exposure to DEHP led to small but statistically significant increases in methylation of specific CpGs within Ppara and Pparg1, which otherwise were generally hypomethylated, but methylation of Glut4 was unaltered. Early DEHP exposure of P19 ECC alters the expression of genes associated with cellular metabolism and the functional features of cardiomyocytes.

  17. Monitoring the conjunctiva for carbon dioxide and oxygen tensions and pH during cardiopulmonary bypass.

    PubMed

    Weiss, Irwin K; Isenberg, Sherwin J; McArthur, David L; Del Signore, Madeline; McDonald, John S

    2011-03-01

    The purpose of this study was to measure, for the first time, multiple physiologic parameters of perfusion (pH, PCO2, PO2, and temperature) from the conjunctiva of adult patients during cardiopulmonary bypass while undergoing cardiothoracic surgery. Ten patients who underwent either intracardiac valve repair, atrial septal defect repair, or coronary artery bypass graft surgery had placement of a sensor which directly measured pH, PCO2, PO2, and temperature from the conjunctiva. Data were stratified into seven phases (0-5 minutes prior to bypass; 0-5, 6-10, and 11-15 minutes after initiation of bypass; 0-5 minutes prior to conclusion of bypass; and 0-5 and 6-10 minutes after bypass) and analyzed using a mixed model analysis.The change in conjunctival pH over the course of measurement was not statistically significant (p = .56). The PCO2 level followed a quadratic pattern, decreasing from a mean pre-bypass level of 37.7 mmHg at baseline prior to the initiation of cardiopulmonary bypass to a nadir of 33.2 mmHg, then increasing to a high of 39.4 mmHg at 6-10 minutes post bypass (p < .01). The PO2 declined from a mean pre-bypass level of 79.5 mmHg to 31.3 mmHg by 6-10 minutes post bypass and even post-bypass, it never returned to baseline values (p < .01). Temperature followed a pattern similar to PCO2 by returning to baseline levels as the patient was re-warmed following bypass (p < .01). There was no evidence of any eye injury or inflammation following the removal of the sensor. In the subjects studied, the conjunctival sensor yielded reproducible measurements during the various phases of cardiopulmonary bypass without ocular injury. Further study is necessary to determine the role of conjunctival measurements in critical settings.

  18. The course of nonproliferative diabetic retinopathy following ECCE with posterior chamber IOL implantation.

    PubMed

    Raniel, Y; Teichner, Y; Friedman, Z

    1994-01-01

    A prospective study on the effect of ECCE + IOL implantation on the course of diabetic retinopathy (DR) in 59 eyes showed that in one to three years following surgery, progression of DR, including the development of newly formed one, occurred in 28.8% of the eyes. This was more marked in patient with IDDM (IDDM-46%, NIDDM-24%) as well as in eyes with pre-operative BDR (pre-operative BDR-62.5%, no pre-operative BDR-16.3%). Final visual acuity was better in eyes without pre-operative DR as well as in eyes that did not show progression of the retinopathy.

  19. Microorganisms found in secondary cataract material of ECCE patients, a study with SEM and TEM.

    PubMed

    Kalicharan, D; Jongebloed, W L; Los, L I; Worst, J G

    1993-01-01

    Globular secondary cataract material, removed from 24 patients with ECCE after ophthalmic cleaning of the anterior capsule, were investigated with SEM and TEM. Besides spherical, somewhat oval shaped bodies of various shape and size comparable with those found in cataractous lenses, (an)aerobic bacteria and yeast cells were found in approximately 70% of the cases, all of them in eyes without intra-ocular inflammation. Probably these bacteria have been transferred from the conjunctiva during IOL.-implantation and were encapsulated without starting an inflammation.

  20. Predicting Clearance Mechanism in Drug Discovery: Extended Clearance Classification System (ECCS).

    PubMed

    Varma, Manthena V; Steyn, Stefanus J; Allerton, Charlotte; El-Kattan, Ayman F

    2015-12-01

    Early prediction of clearance mechanisms allows for the rapid progression of drug discovery and development programs, and facilitates risk assessment of the pharmacokinetic variability associated with drug interactions and pharmacogenomics. Here we propose a scientific framework--Extended Clearance Classification System (ECCS)--which can be used to predict the predominant clearance mechanism (rate-determining process) based on physicochemical properties and passive membrane permeability. Compounds are classified as: Class 1A--metabolism as primary systemic clearance mechanism (high permeability acids/zwitterions with molecular weight (MW) ≤400 Da), Class 1B--transporter-mediated hepatic uptake as primary systemic clearance mechanism (high permeability acids/zwitterions with MW >400 Da), Class 2--metabolism as primary clearance mechanism (high permeability bases/neutrals), Class 3A--renal clearance (low permeability acids/zwitterions with MW ≤400 Da), Class 3B--transporter mediated hepatic uptake or renal clearance (low permeability acids/zwitterions with MW >400 Da), and Class 4--renal clearance (low permeability bases/neutrals). The performance of the ECCS framework was validated using 307 compounds with single clearance mechanism contributing to ≥70% of systemic clearance. The apparent permeability across clonal cell line of Madin - Darby canine kidney cells, selected for low endogenous efflux transporter expression, with a cut-off of 5 × 10(-6) cm/s was used for permeability classification, and the ionization (at pH7) was assigned based on calculated pKa. The proposed scheme correctly predicted the rate-determining clearance mechanism to be either metabolism, hepatic uptake or renal for ~92% of total compounds. We discuss the general characteristics of each ECCS class, as well as compare and contrast the framework with the biopharmaceutics classification system (BCS) and the biopharmaceutics drug disposition classification system (BDDCS

  1. [Extracapsular cataract extraction (ECCE) with posterior chamber IOL implantation in the very elderly].

    PubMed

    Gao, Y; Zhang, Y Z

    1992-07-01

    A study of the operations of ECCE with posterior chamber IOL implantation in 30 eyes of 25 patients aged 75-86 years showed that the average postoperative corrected visual acuity was 18/20, the average corrective spherical lens power was -0.70D and those of cylindrical power 1.18D(AR) and 1.33D(WR). There was no difference in operative complications between these very old and general elderly patients. However, since the health state was often compromised in the very old, to ensure uneventful operations, the ophthalmic surgeon should solicit advice from geriatricians, in addition to his own meticulous perioperative and postoperative care.

  2. Clinical outcomes for Early Childhood Caries (ECC): the influence of salivary mutans streptococci levels.

    PubMed

    Chase, I; Berkowitz, R J; Mundorff-Shrestha, S A; Proskin, H M; Weinstein, P; Billings, R

    2004-09-01

    To assess the relationship between clinical outcomes for children treated for Early Childhood Caries (ECC) and salivary mutans streptococci (MS) levels. The study cohort consisted of 79 children (42 males, 37 females) treated for ECC, aged from 2.3 to 7.3 years at time of entry. Whole non-stimulated saliva samples were obtained from each subject prior to dental surgery and at 6 mths post dental surgery, by saturating a cotton swab in the saliva pooled in the floor of the mouth. Samples were placed into PBS on ice and processed within 2 hours. Samples were sonicated, serially diluted and plated onto MSB and SBA agar plates, then incubated 48 hours anaerobically; SBA plates were incubated an additional 24 hours aerobically. The MS level in each sample was expressed as a percentage of the total cultivable flora. The cohort was evaluated for new caries lesions at 6 months post dental surgery. Relapse was defined as the presence of new smooth surface caries lesions. Comparisons between Relapse (R) and Non-Relapse (NR) groups with respect to mutans streptococci levels were performed using Wilcoxon tests. Within group comparisons were performed using Wilcoxon signed-rank tests. 57 children (72%) returned for the 6 months examination and 21 of these subjects (37%) relapsed. No statistically significant difference in median salivary MS levels existed between the R (0.20%) and NR (0.033%) groups at baseline (p=0.647) or at 6 months post dental surgery (R=0.03%; NR=0.01%; p=0.273). A statistically significant difference between baseline and 6 months post dental surgery was noted in the median salivary MS level within the R group (p=0.0007) and within the NR group (P<0.0001). The relapse rate (37%) was high and rapid for children treated for ECC. Dental surgery resulted in a statistically significant reduction in salivary MS reservoirs for children treated for ECC. However, this did not translate into acceptable clinical outcomes.

  3. Electrochemical-coupling layer-by-layer (ECC-LbL) assembly.

    PubMed

    Li, Mao; Ishihara, Shinsuke; Akada, Misaho; Liao, Meiyong; Sang, Liwen; Hill, Jonathan P; Krishnan, Venkata; Ma, Yuguang; Ariga, Katsuhiko

    2011-05-18

    Electrochemical-coupling layer-by-layer (ECC-LbL) assembly is introduced as a novel fabrication methodology for preparing layered thin films. This method allows us to covalently immobilize functional units (e.g., porphyrin, fullerene, and fluorene) into thin films having desired thicknesses and designable sequences for both homo- and heteroassemblies while ensuring efficient layer-to-layer electronic interactions. Films were prepared using a conventional electrochemical setup by a simple and inexpensive process from which various layering sequences can be obtained, and the photovoltaic functions of a prototype p/n heterojunction device were demonstrated. © 2011 American Chemical Society

  4. Post-manufacturing, 17-times acceptable raw bit error rate enhancement, dynamic codeword transition ECC scheme for highly reliable solid-state drives, SSDs

    NASA Astrophysics Data System (ADS)

    Tanakamaru, Shuhei; Fukuda, Mayumi; Higuchi, Kazuhide; Esumi, Atsushi; Ito, Mitsuyoshi; Li, Kai; Takeuchi, Ken

    2011-04-01

    A dynamic codeword transition ECC scheme is proposed for highly reliable solid-state drives, SSDs. By monitoring the error number or the write/erase cycles, the ECC codeword dynamically increases from 512 Byte (+parity) to 1 KByte, 2 KByte, 4 KByte…32 KByte. The proposed ECC with a larger codeword decreases the failure rate after ECC. As a result, the acceptable raw bit error rate, BER, before ECC is enhanced. Assuming a NAND Flash memory which requires 8-bit correction in 512 Byte codeword ECC, a 17-times higher acceptable raw BER than the conventional fixed 512 Byte codeword ECC is realized for the mobile phone application without an interleaving. For the MP3 player, digital-still camera and high-speed memory card applications with a dual channel interleaving, 15-times higher acceptable raw BER is achieved. Finally, for the SSD application with 8 channel interleaving, 13-times higher acceptable raw BER is realized. Because the ratio of the user data to the parity bits is the same in each ECC codeword, no additional memory area is required. Note that the reliability of SSD is improved after the manufacturing without cost penalty. Compared with the conventional ECC with the fixed large 32 KByte codeword, the proposed scheme achieves a lower power consumption by introducing the "best-effort" type operation. In the proposed scheme, during the most of the lifetime of SSD, a weak ECC with a shorter codeword such as 512 Byte (+parity), 1 KByte and 2 KByte is used and 98% lower power consumption is realized. At the life-end of SSD, a strong ECC with a 32 KByte codeword is used and the highly reliable operation is achieved. The random read performance is also discussed. The random read performance is estimated by the latency. The latency is below 1.5 ms for ECC codeword up to 32 KByte. This latency is below the average latency of 15,000 rpm HDD, 2 ms.

  5. Ryanodine receptor type 1 (RyR1) mutations C4958S and C4961S reveal excitation-coupled calcium entry (ECCE) is independent of sarcoplasmic reticulum store depletion.

    PubMed

    Hurne, Alanna M; O'Brien, Jennifer J; Wingrove, Douglas; Cherednichenko, Gennady; Allen, Paul D; Beam, Kurt G; Pessah, Isaac N

    2005-11-04

    Bi-directional signaling between ryanodine receptor type 1 (RyR1) and dihydropyridine receptor (DHPR) in skeletal muscle serves as a prominent example of conformational coupling. Evidence for a physiological mechanism that upon depolarization of myotubes tightly couples three calcium channels, DHPR, RyR1, and a Ca(2+) entry channel with SOCC-like properties, has recently been presented. This form of conformational coupling, termed excitation-coupled calcium entry (ECCE) is triggered by the alpha(1s)-DHPR voltage sensor and is highly dependent on RyR1 conformation. In this report, we substitute RyR1 cysteines 4958 or 4961 within the TXCFICG motif, common to all ER/SR Ca(2+) channels, with serine. When expressed in skeletal myotubes, C4958S- and C4961S-RyR1 properly target and restore L-type current via the DHPR. However, these mutants do not respond to RyR activators and do not support skeletal type EC coupling. Nonetheless, depolarization of cells expressing C4958S- or C4961S-RyR1 triggers calcium entry via ECCE that resembles that for wild-type RyR1, except for substantially slowed inactivation and deactivation kinetics. ECCE in these cells is completely independent of store depletion, displays a cation selectivity of Ca(2+)>Sr(2+) approximately Ba(2+), and is fully inhibited by SKF-96365 or 2-APB. Mutation of other non-CXXC motif cysteines within the RyR1 transmembrane assembly (C3635S, C4876S, and C4882S) did not replicate the phenotype observed with C4958S- and C4961S-RyR1. This study demonstrates the essential role of Cys(4958) and Cys(4961) within an invariant CXXC motif for stabilizing conformations of RyR1 that influence both its function as a release channel and its interaction with ECCE channels.

  6. Bypass diode integration

    NASA Technical Reports Server (NTRS)

    Shepard, N. F., Jr.

    1981-01-01

    Protective bypass diodes and mounting configurations which are applicable for use with photovoltaic modules having power dissipation requirements in the 5 to 50 watt range were investigated. Using PN silicon and Schottky diode characterization data on packaged diodes and diode chips, typical diodes were selected as representative for each range of current carrying capacity, an appropriate heat dissipating mounting concept along with its environmental enclosure was defined, and a thermal analysis relating junction temperature as a function of power dissipation was performed. In addition, the heat dissipating mounting device dimensions were varied to determine the effect on junction temperature. The results of the analysis are presented as a set of curves indicating junction temperature as a function of power dissipation for each diode package.

  7. A provably-secure ECC-based authentication scheme for wireless sensor networks.

    PubMed

    Nam, Junghyun; Kim, Moonseong; Paik, Juryon; Lee, Youngsook; Won, Dongho

    2014-11-06

    A smart-card-based user authentication scheme for wireless sensor networks (in short, a SUA-WSN scheme) is designed to restrict access to the sensor data only to users who are in possession of both a smart card and the corresponding password. While a significant number of SUA-WSN schemes have been suggested in recent years, their intended security properties lack formal definitions and proofs in a widely-accepted model. One consequence is that SUA-WSN schemes insecure against various attacks have proliferated. In this paper, we devise a security model for the analysis of SUA-WSN schemes by extending the widely-accepted model of Bellare, Pointcheval and Rogaway (2000). Our model provides formal definitions of authenticated key exchange and user anonymity while capturing side-channel attacks, as well as other common attacks. We also propose a new SUA-WSN scheme based on elliptic curve cryptography (ECC), and prove its security properties in our extended model. To the best of our knowledge, our proposed scheme is the first SUA-WSN scheme that provably achieves both authenticated key exchange and user anonymity. Our scheme is also computationally competitive with other ECC-based (non-provably secure) schemes.

  8. A Provably-Secure ECC-Based Authentication Scheme for Wireless Sensor Networks

    PubMed Central

    Nam, Junghyun; Kim, Moonseong; Paik, Juryon; Lee, Youngsook; Won, Dongho

    2014-01-01

    A smart-card-based user authentication scheme for wireless sensor networks (in short, a SUA-WSN scheme) is designed to restrict access to the sensor data only to users who are in possession of both a smart card and the corresponding password. While a significant number of SUA-WSN schemes have been suggested in recent years, their intended security properties lack formal definitions and proofs in a widely-accepted model. One consequence is that SUA-WSN schemes insecure against various attacks have proliferated. In this paper, we devise a security model for the analysis of SUA-WSN schemes by extending the widely-accepted model of Bellare, Pointcheval and Rogaway (2000). Our model provides formal definitions of authenticated key exchange and user anonymity while capturing side-channel attacks, as well as other common attacks. We also propose a new SUA-WSN scheme based on elliptic curve cryptography (ECC), and prove its security properties in our extended model. To the best of our knowledge, our proposed scheme is the first SUA-WSN scheme that provably achieves both authenticated key exchange and user anonymity. Our scheme is also computationally competitive with other ECC-based (non-provably secure) schemes. PMID:25384009

  9. [Comparison of corneal endothelial cells after ECCE and phacoemulsification of the lens].

    PubMed

    Trnavec, B; Cuvala, J; Cernák, A; Vodrázková, E

    1997-08-01

    The authors evaluate the finding on the corneal endothelium before and after operation of cataract. For examination of the endothelium they used a specular microscope SP 1.000 of Topcon Co. The group comprised 64 eyes of 64 patients. The patients were divided at random into two groups. The first group comprised 26 patients, where ECCE was performed. The second group comprised 38 patients and the opaque lens was removed by phacoemulsification. The mean age in the first group was 69.3 years and in the second group 70.7 years. The same viscoelastic material (methylcellulose) was used and the same synthetic lens from PMMA material was implanted into the capsule. The endothelium was examined one day after operation and on the 7th to 10th day after operation. The following parameters were evaluated: density of the endothelial cells in the centre, mean cell size, polymegethism, coefficient of variation, pleomorphism. In the group of patients who had ECCE the loss of endothelial cells was 18.53%, in the group with phacoemulsification of the nucleus the loss was 16.43%. This difference is not statistically significant. After operation in both groups enlargement of the minimal, maximal as well as mean cell size was observed, the coefficient of variation increased while the grade of cell hexagonality decreased. However these differences in endothelial cells were not statistically significant. After operation of cataract not only endothelial cells are lost but also significant changes in cell morphology occur.

  10. [3 1/2 years experiences with ECCE with tunnel incision].

    PubMed

    Häberle, H; Anders, N; Antoni, H J; Pham, D T; Wollensak, J

    1997-01-01

    Since January 1992 planned extracapsular cataract extraction (ECCE) is performed routinely with the no-stitch technique at our clinic. To minimize surgically induced astigmatism further, modified wound constructions for planned ECCE with on 1.1-mm tunnel width were evaluated. The follow-up time was up to 3 years postoperatively. For 250 eyes wound closure was performed prospectively either sutureless (n = 70), with a single perpendicular suture (n = 100) or cross sutures (n = 40) at the 12 o'clock position or sutureless in the temporal position (n = 40). The complication rate was 4% (filtering bleb, iris prolapse or transient hypotonia). There were no wound ruptures, but once endophthalmitis was observed. Late mean astigmatism after up to 3 years follow-up for vertical incision was 2.05 +/- 1.16 D (1.01 +/- 0.96 D preoperatively) for sutureless wound closure, 1.63 +/- 1.08 D (0.86 +/- 0.95 D) for perpendicular and 1.76 +/- 0.88 D (0.73 +/- 0.55 D) for cross-sutures. A temporal incision resulted in 0.78 +/- 0.52 D (1.0 +/- 0.69 D) of astigmatism and was only performed on eyes with against the rule astigmatism preoperatively. Surgically induced astigmatism was stabilized early. For with the rule astigmatism preoperatively, a 12 o'clock incision with a perpendicular single suture is recommended and for against the rule astigmatism, a temporal incision.

  11. Japan Arteriosclerosis Longitudinal Study-Existing Cohorts Combine (JALS-ECC): rationale, design, and population characteristics.

    PubMed

    2008-10-01

    The Japan Arteriosclerosis Longitudinal Study-Existing Cohorts Combine (JALS-ECC) is a pooled study based on individual participant data from existing prospective cohort studies in Japan. Its purpose was to consider associations between risk factors and cardiovascular disease (CVD) outcomes, as well as differences between subgroups, defined by age, gender or geographical region, which could not be detected in the smaller samples. Individual records for 66,691 participants in 21 cohort studies were pooled, accounting for a total of 575,628 person-years. From this data, there were 409 deaths attributed to stroke and 169 deaths attributed to coronary heart disease (CHD). Total stroke and CHD events were 1,478 and 178, respectively. Of the 1,424 total stroke events with a reported stroke subtype, 975 were classified as ischemic, 267 as hemorrhagic, and 178 as subarachnoid hemorrhage. The JALS-ECC collected data from existing cohort studies covering a diverse Japanese population, which has provided information about the effects of modifiable factors on the risks of the CVD. Such information should provide a reliable basis for establishing prevention strategies.

  12. Assessment of human effective absorbed dose of 67 Ga-ECC based on biodistribution rat data.

    PubMed

    Shanehsazzadeh, Saeed; Yousefnia, Hassan; Lahooti, Afsaneh; Zolghadri, Samaneh; Jalilian, Amir Reza; Afarideh, Hossien

    2015-02-01

    In a diagnostic context, determination of absorbed dose is required before the introduction of a new radiopharmaceutical to the market to obtain marketing authorization from the relevant agencies. In this work, the absorbed dose of [67 Ga]-ethylenecysteamine cysteine [(67 Ga)ECC] to human organs was determined by using distribution data for rats. For biodistribution data, the animals were sacrificed by CO2 asphyxiation at selected times after injection (0.5, 2 and 48 h, n = 3 for each time interval), then the tissue (blood, heart, lung, brain, intestine, feces, skin, stomach, kidneys, liver, muscle and bone) were removed. The absorbed dose was determined by Medical Internal Radiation Dose (MIRD) method after calculating cumulated activities in each organ. Our prediction shows that a 185-MBq injection of (67)Ga-ECC into the humans might result in an estimated absorbed dose of 0.029 mGy in the whole body. The highest absorbed doses are observed in the spleen and liver with 33.766 and 16.847 mGy, respectively. The results show that this radiopharmaceutical can be a good SPECT tracer since it can be produced easily and also the absorbed dose in each organ is less than permitted absorbed dose.

  13. [Correction of the complicated pectus excavatum with extracorporeal circulation (ECC) support].

    PubMed

    Hernández, S; Fernández, A; Ramírez, M; López, S; De la Torre, C A; Miguel, M; Bret, M; Aroca, A; Olivares, P; Tovar, J A

    2011-01-01

    The most serious complication in surgery of the pectus excavatum is the possible cardiac perforation. After its resolution, it is very likely that the relapse of the excavatum will be more severe due to the intense retrosternal fibrosis generated, involving cardiac structures and fixing them to the sternum. Reintervention requires modifications of the usual techniques and special monitoring due to the increased risk of cardiac and large vessel lesions. We present the case of 2 patients with severe pectus excavatum with a previous attempt for correction with cardiac perforation. Case 1. A 16 year old male with Haller index 9.9, diagnosed of Ehlers-Danlos syndrome and operated on in neonatal period of cardiac disease, with previous attempt for correction using the Ravitch technique that relapsed and cardiac perforation during it. Case 2. An 11 year old girl, with background of diaphragmatic hernia and cardiac perforation on introducing the Nuss bar at 5 years of age, with Haller index 5.5. Both were operated on under ECC with the collaboration of the Cardiac Surgery Service and cardiac adherences were released after median sternotomy. After it, the Nuss bar was introduced and then sternal closure was performed with reinforced steel wires with titanium plates in the anterior and posterior part. The backgrounds of the cardiac approach complicate the intervention for the correction of the pectus excavatum, with a high risk of cardiac trauma. Counting on the support of the cardiac surgery and the ECC, we achieve an adequate control and prediction of the complications

  14. Diffusion-weighted magnetic resonance imaging for the detection of ischemic brain lesions in coronary artery bypass graft surgery: relation to extracorporeal circulation and heparinization.

    PubMed

    Mirow, N; Zittermann, A; Körperich, H; Börgermann, J; Koertke, H; Knobl, H; Gieseke, J; Ostertun, B; Coskun, T; Kleesiek, K; Burchert, W; Gummert, J F

    2011-02-01

    Cognitive decline is a well recognized complication after on-pump coronary artery bypass graft (CABG) surgery. We investigated whether the design of extracorporeal circulation (ECC) and the extent of perioperative heparinization have an impact on neurological dysfunction. Sixty-three CABG surgery patients were randomly perfused with an uncoated ECC-set (group A) or with two different heparin-coated ECC-sets (groups B and C). In groups A and B, systemic heparin was given in doses of 400 IU/kg body weight, whereas group C received 150 IU/kg body weight. ECC sets in group C included a diagonal pump and low priming as opposed to roller pumps in groups A and B. Furthermore, in group C blood contact to surfaces other than endothelium and heparin coated material was eliminated. Brain lesions were detected by diffusion-weighted magnetic resonance imaging (DWI). Neurological complications were assessed clinically until discharge (manifest motoric, sensitive or cognitive disturbance). Biochemical coagulation and inflammation parameters were measured pre-, peri-, and postoperatively. No major neurological events were observed in either group until discharge. DWIs showed 61 new lesions in 19 of 45 patients who terminated all MRI study procedures. Number and volume of the lesions did not differ between groups (P>0.05). Biochemical and inflammatory parameters showed the expected time courses and variations between groups. Ischemic brain lesions are frequently observed in CABG surgery patients but are neither associated with clinically relevant neurological complications nor with ECC set-up and intraoperative heparin dosage. DWI may help in the development of new surgical strategies to reduce postoperative brain damage.

  15. Photovoltaic module bypass diode encapsulation

    NASA Technical Reports Server (NTRS)

    Shepard, N. J., Jr.

    1983-01-01

    The design and processing techniques necessary to incorporate bypass diodes within the module encapsulant are presented. The Semicon PN junction diode cells were selected. Diode junction to heat spreader thermal resistance measurements, performed on a variety of mounted diode chip types and sizes, have yielded values which are consistently below 1 deg C per watt, but show some instability when thermally cycled over the temperature range from -40 to 150 deg C. Three representative experimental modules, each incorporating integral bypass diode/heat spreader assemblies of various sizes, were designed. Thermal testing of these modules enabled the formulation of a recommended heat spreader plate sizing relationship. The production cost of three encapsulated bypass diode/heat spreader assemblies were compared with similarly rated externally mounted packaged diodes. It is concluded that, when proper designed and installed, these bypass diode devices will improve the overall reliability of a terrestrial array over a 20 year design lifetime.

  16. Cerebral oxygenation during cardiopulmonary bypass

    PubMed Central

    Wardle, S; Yoxall, C; Weindling, A

    1998-01-01

    Cerebral fractional oxygen extraction (FOE) was monitored in 30 children, using near infrared spectroscopy during cardiopulmonary bypass, to investigate the effect of hypothermia and circulatory arrest. One group of children (n = 15) underwent profound hypothermia with total circulatory arrest (n = 8) or continuous flow (n =7). Another group (n = 15), of whom only one had circulatory arrest, underwent mild (n = 6) or moderate (n = 9) hypothermia.
 The mean FOE (SD) before bypass was 0.35 (0.12) and this correlated negatively with the preoperative arterial oxygen content (r=−0.58). Between the stage of cooling on bypass and cold bypass there was a reduction in FOE in all groups. Between cold bypass and rewarming there was an increase in FOE only in the groups with continuous flow. In the circulatory arrest group, the FOE remained low during rewarming and was significantly lower than that of the continuous flow group. No patients died and none had neurological abnormalities postoperatively.
 Apparent changes in oxidised cytochrome oxidase concentration were also monitored using near infrared spectroscopy. There was a fall in cytochrome aa3 on starting cardiopulmonary bypass, but there were no significant differences in the changes in cytochrome aa3 between any stage in any of the patient groups.
 Using this non-invasive technique, cooling was shown to reduce cerebral FOE. During rewarming on bypass there was an increase in cerebral FOE only in patients who had had continuous flow bypass. In contrast, the cerebral FOE in those with circulatory arrest remained constant after arrest and during the duration of the study. This may have implications for the timing of hypoxic brain injury.

 PMID:9534672

  17. Adapted ECC ozonesonde for long-duration flights aboard boundary-layer pressurised balloons

    NASA Astrophysics Data System (ADS)

    Gheusi, François; Durand, Pierre; Verdier, Nicolas; Dulac, François; Attié, Jean-Luc; Commun, Philippe; Barret, Brice; Basdevant, Claude; Clenet, Antoine; Derrien, Solène; Doerenbecher, Alexis; El Amraoui, Laaziz; Fontaine, Alain; Hache, Emeric; Jambert, Corinne; Jaumouillé, Elodie; Meyerfeld, Yves; Roblou, Laurent; Tocquer, Flore

    2016-12-01

    Since the 1970s, the French space agency CNES has developed boundary-layer pressurised balloons (BLPBs) with the capability to transport lightweight scientific payloads at isopycnic level and offer a quasi-Lagrangian sampling of the lower atmosphere over very long distances and durations (up to several weeks).

    Electrochemical concentration cell (ECC) ozonesondes are widely used under small sounding balloons. However, their autonomy is limited to a few hours owing to power consumption and electrolyte evaporation. An adaptation of the ECC sonde has been developed specifically for long-duration BLPB flights. Compared to conventional ECC sondes, the main feature is the possibility of programming periodic measurement sequences (with possible remote control during the flight). To increase the ozonesonde autonomy, the strategy has been adopted of short measurement sequences (2-3 min) regularly spaced in time (e.g. every 15 min). The rest of the time, the sonde pump is turned off. Results of preliminary ground-based tests are first presented. In particular, the sonde was able to provide correct ozone concentrations against a reference UV-absorption ozone analyser every 15 min for 4 days. Then we illustrate results from 16 BLBP flights launched over the western Mediterranean during three summer field campaigns of the ChArMEx project (http://charmex.lsce.ipsl.fr): TRAQA in 2012, and ADRIMED and SAFMED in 2013. BLPB drifting altitudes were in the range 0.25-3.2 km. The longest flight lasted more than 32 h and covered more than 1000 km. Satisfactory data were obtained when compared to independent ozone measurements close in space and time. The quasi-Lagrangian measurements allowed a first look at ozone diurnal evolution in the marine boundary layer as well as in the lower free troposphere. During some flight segments, there was indication of photochemical ozone production in the marine boundary layer or even

  18. Escharotic Treatment for ECC-positive CIN3 in Childbearing Years: A Case Report

    PubMed Central

    Windstar, Kimberly; Dunlap, Corina; Zwickey, Heather

    2014-01-01

    A persistent human papillomavirus (HPV) infection of a high-risk type is necessary for cervical cancer to develop. The severity of the diagnosis, together with colposcopy findings, determines the standard for treatment, and ablative or excisional options may be recommended. Escharotic treatment, together with an oral, anticarcinogenic HPV protocol and a vaginal-suppository protocol, is an alternative treatment, especially for those women of childbearing age who are concerned about the possibility of obstetrical complications associated with the use of loop electrosurgical excision (LEEP). The aim of the current case study was to observe the effect of an ablative escharotic treatment for a woman with severe dysplasia, cervical intraepithelial neoplasia grade 3 (CIN3). A 28-y-old female visited the National College of Natural Medicine clinic to obtain suggestions for alternative treatments following a satisfactory colposcopy and a biopsy revealing a high-risk HPV effect, severe dysplasia CIN3, and a positive endocervical curettage (ECC). She refused the recommended standard of care, a LEEP, because of concerns about the potential for future obstetrical complications. As an alternative, she elected to receive an escharotic treatment at a frequency of 2 treatments/wk for 5 wk. In addition to the escharotic treatment, she followed an oral protocol consisting of vitamins and botanical medicine for 1 y and she completed a 12-wk regime of vaginal suppositories following the escharotic. The authors followed her for 2 y. The woman’s Papanicolaou (Pap) test at the 6-mo follow-up revealed negative cervical cytology for intraepithelial lesion or malignancy, and her follow-up ECC was negative. Liquid-based Pap results were normal, and HPV testing was negative at her 1-y follow-up. Her Pap continued to remain normal at her 2-y follow-up. For women with high-grade cervical neoplasias and positive ECCs, with satisfactory colposcopies, escharotic treatment, accompanied by oral

  19. Modified ECC ozone sonde for long-duration flights aboard isopicnic drifting balloons

    NASA Astrophysics Data System (ADS)

    Gheusi, Francois; Durand, Pierre; Verdier, Nicolas; Dulac, François; Attié, Jean-Luc; Commun, Philippe; Barret, Brice; Basdevant, Claude; Clénet, Antoine; Fontaine, Alain; Jambert, Corinne; Meyerfeld, Yves; Roblou, Laurent; Tocquer, Flore

    2015-04-01

    Since few years, the French space agency CNES has developed boundary-layer pressurized balloons (BLPB) with the capability to transport scientific payloads at isopicnic level over very long distances and durations (up to several weeks in absence of navigation limits). However, the autonomy of conventional electrochemical concentration cell (ECC) ozone sondes, that are widely used for tropospheric and stratospheric soundings, is limited to few hours due to power consumption and electrolyte evaporation (owing to air bubbling in the cathode solution). In collaboration with the French research community, CNES has developed a new ozone payload suited for long duration flights aboard BLPB. The mechanical elements (Teflon pump and motor) and the electrochemical cell of conventional ECC sondes have been kept but the electronic implementation is entirely new. The main feature is the possibility of programming periodic measurement sequences -- with possible remote control during the flight. To increase the ozone sonde autonomy, a strategy has been adopted of short measurement sequences (typically 2-3 min) regularly spaced in time (e.g. every 15 min, which is usually sufficient for air quality studies). The rest of the time, the sonde is at rest (pump motor off). The response time of an ECC sonde to an ozone concentration step is below one minute. Consequently, the measurement sequence is typically composed of a one-minute spin-up period after the pump has been turned on, followed by a one- to two-minute acquisition period. All time intervals can be adjusted before and during the flight. Results of a preliminary ground-based test in spring 2012 are first presented. The sonde provided correct ozone concentrations against a reference UV analyzer every 15 minutes during 4 days. Then we illustrate results from 16 BLBP flights launched in the low troposphere over the Mediterranean during summer field campaings in 2012 and 2013 (TRAQA and ChArMEx programmes). BLPB drifting

  20. Bypass rewiring and robustness of complex networks

    NASA Astrophysics Data System (ADS)

    Park, Junsang; Hahn, Sang Geun

    2016-08-01

    A concept of bypass rewiring is introduced, and random bypass rewiring is analytically and numerically investigated with simulations. Our results show that bypass rewiring makes networks robust against removal of nodes including random failures and attacks. In particular, random bypass rewiring connects all nodes except the removed nodes on an even degree infinite network and makes the percolation threshold 0 for arbitrary occupation probabilities. In our example, the even degree network is more robust than the original network with random bypass rewiring, while the original network is more robust than the even degree networks without random bypass. We propose a greedy bypass rewiring algorithm which guarantees the maximum size of the largest component at each step, assuming which node will be removed next is unknown. The simulation result shows that the greedy bypass rewiring algorithm improves the robustness of the autonomous system of the Internet under attacks more than random bypass rewiring.

  1. Cost-minimization analysis of capsulotomy after ECCE and IOL implantation.

    PubMed

    Lertsumitkul, S; La Nauze, J

    1996-06-01

    An economic evaluation of capsulotomy for posterior capsular opacification after extracapsular cataract extraction (ECCE) and intraocular lens (IOL) implantation was carried out using a cost minimization model. This model demonstrates the use of cost comparison to aid the decision making process. A flow-chart of capsulotomy mode, with associated complications, is illustrated. Costs of complications are calculated using assigned probability for each tree. Overall comparative costs are displayed graphically Further, the model is presented using a computer-assisted spreadsheet with an added calculation program. Variables can therefore be adjusted with instantaneous outcomes visually displayed. We present several examples with different sets of variables and find that, in most instances, YAG capsulotomy is a more economical option than surgical capsulotomy. This finding is a relevant finding in planning for eye health programs, particularly in developing countries. We suggest that the model be modified using local parameters in order to provide optimal benefits in similar health programs.

  2. A Secure ECC-based RFID Mutual Authentication Protocol to Enhance Patient Medication Safety.

    PubMed

    Jin, Chunhua; Xu, Chunxiang; Zhang, Xiaojun; Li, Fagen

    2016-01-01

    Patient medication safety is an important issue in patient medication systems. In order to prevent medication errors, integrating Radio Frequency Identification (RFID) technology into automated patient medication systems is required in hospitals. Based on RFID technology, such systems can provide medical evidence for patients' prescriptions and medicine doses, etc. Due to the mutual authentication between the medication server and the tag, RFID authentication scheme is the best choice for automated patient medication systems. In this paper, we present a RFID mutual authentication scheme based on elliptic curve cryptography (ECC) to enhance patient medication safety. Our scheme can achieve security requirements and overcome various attacks existing in other schemes. In addition, our scheme has better performance in terms of computational cost and communication overhead. Therefore, the proposed scheme is well suitable for patient medication systems.

  3. On the Quality of ECC Ozonesondes Data: Improvements of the Ground Based Data for Satellites Validation

    NASA Astrophysics Data System (ADS)

    Stubi, R.; Levrat, G.; Romanens, G.; Deshler, T.; Kivi, R.; Davis, J.; Schmidlin, F.; Johnson, B.

    2010-12-01

    The ozonesondes networks play an important role in the validation of the satellites instruments because of their high altitude resolution from the ground up to the mid-stratosphere and the very long term record starting in the late 70-ies. However, there is a lack of homogeneity of the ECC ozonesondes data from the various stations around the world. Progresses have been made over the last 10 years to identify the major source of biases affecting the ozonesondes profiles (see [1] and [2]), in particular regarding the sensing solution composition, the back-ground current and the sonde provider. To illustrate these effects on real data comparison and to test first order correction procedures, SCIAMACHY ozone columns are compared to three different processings of the Nairobi and Payerne aerological stations data.

  4. Intracranial-to-intracranial bypass for posterior inferior cerebellar artery aneurysms: options, technical challenges, and results in 35 patients.

    PubMed

    Abla, Adib A; McDougall, Cameron M; Breshears, Jonathan D; Lawton, Michael T

    2016-05-01

    -quarter of all PICA aneurysms treated microsurgically at our center requiring bypass without a single EC-IC bypass. The selection of PICA bypass is almost algorithmic: trapped aneurysms at the PICA origin or p1 segment are revascularized with a PICA-PICA bypass, with PICA reimplantation as an alternative; trapped p2 segment aneurysms are reanastomosed, bypassed in situ, or reimplanted; distal p3 segment aneurysms are reanastomosed or revascularized with a PICA-PICA bypass; and aneurysms of the p4 segment that are too distal for PICA-PICA bypass are reanastomosed. Interposition grafts are reserved for when these 3 primary options are unsuitable. A constructive approach that preserves the PICA with direct clipping or replaces flow with a bypass when sacrificed should remain an alternative to deconstructive PICA occlusion and endovascular coiling when complete aneurysm occlusion is unlikely.

  5. Experiments of ECCS strainer blockage and debris settling in suppression pools

    SciTech Connect

    Hecker, G.E.; Johnson, A.B.; Murthy, P.; Padmanabhan

    1996-03-01

    If a rupture occurs in a nuclear power station pipe that leads to or from the reactor pressure vessel, the resultant Loss of Coolant Accident (LOCA) would initiate a chain of events involving complex flow phenomena. In a Boiling Water Reactor (BWR), the steam or liquid pipe break pressurizes the dry well, forcing the inert containment gases and steam through downcomers into the suppression pool, thoroughly mixing any particulates and pipe insulation debris carried with the gas flow to the pool. As the steam flow decreases, its unsteady condensation at the end of the downcomers (Condensation Oscillation and Chugging) produces continued water motion in the suppression pool and downcomers. During the blowdown event, high pressure and then low pressure pumps automatically start injecting water from the suppression pool into the reactor to keep its temperature under control. Proper functioning of this Emergency Core Cooling System (ECCS) is critical for the first 30 minutes or so, before operators have time to consider and align alternative sources of cooling water. A major concern for proper operation of the ECCS is the effect of fragmented insulation and plant particulates on the head loss at pump suction strainers. Sufficient loss could exceed the NPSH margin, causing cavitation with a resultant loss of pump capacity and longevity. The bead loss increases with the mass of debris accumulated on the pump strainers, which in turn is dependent on the debris concentration versus time in the suppression pool. This paper describes two sets of experiments that quantified the strainer head loss. One set of experiments considered the mixing and settling of fibrous insulation debris and fine iron oxide particles in the suppression pool during and after chugging. These tests used a reduced scale facility which duplicated the kinetic energy per unit water volume to define the concentration of the actual materials in the pool versus time.

  6. Interference of sulphur dioxide to balloon-borne ECC ozone sensors over the Valley of Mexico

    NASA Astrophysics Data System (ADS)

    Kanda, I.; Basaldud, R.; Horikoshi, N.; Okazaki, Y.; Benítez Garcia, S. E.; Ortínez, A.; Ramos Benítez, V. R.; Cárdenas, B.; Wakamatsu, S.

    2014-01-01

    Abnormal decrease in the ozonesonde sensor signal occurred during air-pollution study campaigns in November 2011 and March 2012 in Mexico City. Sharp drops around 5 km a.s.l. and above were observed in November 2011, and a broad deficit in the convective boundary layer in March 2012. Various circumstantial evidence indicates that the decrease was due to interference of SO2 gas to Electrochemical Concentration Cell (ECC) ozone sensors. The sharp drops in November 2011 are considered to be caused by the SO2 plume from the Popocatépetl volcano to the south-east of Mexico City. Response experiments of the ECC sensor to representative atmospheric trace gases showed that only SO2 could generate the observed abrupt drops. The vertical structure of the plume reproduced by a Lagrangian particle diffusion simulation also supported this assumption. The near-ground deficit in March 2012 is considered to be generated by the SO2 plume from the Tula industrial complex to the north-west of Mexico City. Sporadic large SO2 emission is known to occur from this region, and before and at the ozonesonde launching time, large intermittent peaks of SO2 concentration were recorded at the ground-level monitoring stations. The difference between the O3 concentration obtained by ozonesonde and that by UV-based O3 monitor was consistent with the SO2 concentration measured by a UV-based monitor on the ground. The plume vertical profiles estimated by the Lagrangian particle diffusion simulation agreed fairly well with the observed profile. Statistical analysis of the wind field in Mexico City revealed that the Popocatépetl effect is most likely to occur from June to October, and the Tula effect all the year.

  7. Simultaneous algae-polluted water treatment and electricity generation using a biocathode-coupled electrocoagulation cell (bio-ECC).

    PubMed

    Dong, Yue; Qu, Youpeng; Li, Chao; Han, Xiaoyu; Ambuchi, John J; Liu, Junfeng; Yu, Yanling; Feng, Yujie

    2017-10-15

    How to utilize electrocoagulation (EC) technology for algae-polluted water treatment in an energy-efficient manner remains a critical challenge for its widespread application. Herein, a novel biocathode-coupled electrocoagulation cell (bio-ECC) with sacrificial iron anode and nitrifying biocathode was developed. Under different solution conductivities (2.33±0.25mScm(-1) and 4.94±0.55mScm(-1)), the bio-ECC achieved almost complete removal of algae cells. The maximum power densities of 8.41 and 11.33Wm(-3) at corresponding current densities of 48.03Am(-3) and 66.26Am(-3) were obtained, with the positive energy balance of 4.52 and 7.44Wm(-3). In addition, the bio-ECC exhibited excellent NH4(+)-N removal performance with the nitrogen removal rates of 7.28mgL(-1)h(-1) and 6.77mgL(-1)h(-1) in cathode chamber, indicating the superiority of bio-ECC in NH4(+)-N removal. Pyrosequencing revealed that nitrifiers including Nitrospira, Nitrobacter, Nitrosococcus, and Nitrosomonas were enriched in biocathode. The removal mechanisms of algae in anode chamber were also explored by AFM and SEM-EDX tests. These results provide a proof-of-concept study of transferring energy-intensive EC process into an energy-neutral process with high-efficiency algae removal and electricity recovery. Copyright © 2017. Published by Elsevier B.V.

  8. Incorporating Indigenous Knowledge and Practice into ECCE: A Comparison of Programs in The Gambia, Senegal and Mali

    ERIC Educational Resources Information Center

    Soudee, Alicia Ranck

    2009-01-01

    Early Childhood Development (ECD) has emerged as a theme in international and African dialogue on education in recent years. UNESCO's Division of Basic Education Early Childhood promotes an integrated approach to Early Childhood Care and Education (ECCE) policy development and review. The study examines how this is implemented in three West…

  9. Bypass surgery versus medical treatment for symptomatic moyamoya disease in adults.

    PubMed

    Jang, Dong-Kyu; Lee, Kwan-Sung; Rha, Hyoung Kyun; Huh, Pil-Woo; Yang, Ji-Ho; Park, Ik Seong; Ahn, Jae-Geun; Sung, Jae Hoon; Han, Young-Min

    2016-11-11

    OBJECTIVE In this study the authors evaluated whether extracranial-intracranial bypass surgery can prevent stroke occurrence and decrease mortality in adult patients with symptomatic moyamoya disease (MMD). METHODS The medical records of 249 consecutive adult patients with symptomatic MMD that was confirmed by digital subtraction angiography between 2002 and 2011 at 8 institutions were retrospectively reviewed. The study outcomes of stroke recurrence as a primary event and death during the 6-year follow-up and perioperative complications within 30 days as secondary events were compared between the bypass and medical treatment groups. RESULTS The bypass group comprised 158 (63.5%) patients, and the medical treatment group comprised 91 (36.5%) patients. For 249 adult patients with MMD, bypass surgery showed an HR of 0.48 (95% CI 0.27-0.86, p = 0.014) for stroke recurrence calculated by Cox regression analysis. However, for the 153 patients with ischemic MMD, the HR of bypass surgery for stroke recurrence was 1.07 (95% CI 0.43-2.66, p = 0.887). For the 96 patients with hemorrhagic MMD, the multivariable adjusted HR of bypass surgery for stroke recurrence was 0.18 (95% CI 0.06-0.49, p = 0.001). For the treatment modality, indirect bypass and direct bypass (or combined bypass) did not show any significant difference for stroke recurrence, perioperative stroke, or mortality (log rank; p = 0.524, p = 0.828, and p = 0.616, respectively). CONCLUSIONS During the treatment of symptomatic MMD in adults, bypass surgery reduces stroke recurrence for the hemorrhagic type, but it does not do so for the ischemic type. The best choice of bypass methods in adult patients with MMD is uncertain. In adult ischemic MMD, a prospective randomized study to evaluate the effectiveness and safety of bypass surgery to prevent recurrent stroke is necessary.

  10. Two types of squalor: findings from a factor analysis of the Environmental Cleanliness and Clutter Scale (ECCS).

    PubMed

    Snowdon, John; Halliday, Graeme; Hunt, Glenn E

    2013-07-01

    Most people who collect and hoard, and then have difficulty discarding items, do not live in squalor, even though accumulation of hoarded items can make cleaning very difficult. Commonly, people living in squalor accumulate garbage, but relatively few fulfill proposed criteria for "hoarding disorder." We examined the overlap between hoarding and squalor among people referred because of unacceptable living conditions. Ongoing collection of data by a Squalor Project team, including ratings on the Environmental Cleanliness and Clutter Scale (ECCS), allowed (1) description of characteristics of cases and (2) examination of ratings of uncleanliness, and of the effect of accumulation of items or material on access within dwellings. Principal component analysis was used to examine latent variables underlying the ECCS. The mean age of the referred occupants (108 male, 95 female) was 61.9 years. The mean ECCS score in 186 rated cases was 18.5. Factor analysis of ECCS data showed a two-factor solution as the most plausible. Factor 1, comprising seven squalor items, accounted for 33.7% of the variance. Factor 2 comprised reduced accessibility and accumulation of items of little value (variance 17.6%). Accumulation of garbage loaded equally on the two factors. High levels of squalor and/or accumulation were recorded in 105 (56%) of the 186 dwellings. One-third scored high on accumulation/hoarding, while 38% scored high on squalor; 15% scored high on both squalor and accumulation. A quarter of those scoring high on squalor scored low on hoarding/accumulation. The ECCS is useful when describing whether referred cases show high levels of squalor, hoarding, or both.

  11. Parametric study of the potential for BWR ECCS strainer blockage due to LOCA generated debris. Final report

    SciTech Connect

    Zigler, G.; Brideau, J.; Rao, D.V.; Shaffer, C.; Souto, F.; Thomas, W.

    1995-10-01

    This report documents a plant-specific study for a BWR/4 with a Mark I containment that evaluated the potential for LOCA generated debris and the probability of losing long term recirculation capability due ECCS pump suction strainer blockage. The major elements of this study were: (1) acquisition of detailed piping layouts and installed insulation details for a reference BWR; (2) analysis of plant specific piping weld failure probabilities to estimate the LOCA frequency; (3) development of an insulation and other debris generation and drywell transport models for the reference BWR; (4) modeling of debris transport in the suppression pool; (5) development of strainer blockage head loss models for estimating loss of NPSH margin; (6) estimation of core damage frequency attributable to loss of ECCS recirculation capability following a LOCA. Elements 2 through 5 were combined into a computer code, BLOCKAGE 2.3. A point estimate of overall DEGB pipe break frequency (per Rx-year) of 1.59E-04 was calculated for the reference plant, with a corresponding overall ECCS loss of NPSH frequency (per Rx-year) of 1.58E-04. The calculated point estimate of core damage frequency (per Rx-year) due to blockage related accident sequences for the reference BWR ranged from 4.2E-06 to 2.5E-05. The results of this study show that unacceptable strainer blockage and loss of NPSH margin can occur within the first few minutes after ECCS pumps achieve maximum flows when the ECCS strainers are exposed to LOCA generated fibrous debris in the presence of particulates (sludge, paint chips, concrete dust). Generic or unconditional extrapolation of these reference plant calculated results should not be undertaken.

  12. ECC-1 cells: a well-differentiated steroid-responsive endometrial cell line with characteristics of luminal epithelium.

    PubMed

    Mo, Bilan; Vendrov, Aleksandr E; Palomino, Wilder A; DuPont, Barbara R; Apparao, K B C; Lessey, Bruce A

    2006-09-01

    Endometrial cancer cell lines have provided a valuable model to study endometrial epithelial cells in vitro. Since the first development of HEC1B over 35 yr ago, many different cell lines have been isolated and described. One valuable cell line that maintains hormone responsiveness and unique stability over time is the ECC-1 cell line, developed originally by the late P.G. Satyaswaroop. In this study, we investigated some of the properties of these cells and present their salient characteristics. Like Ishikawa cells, ECC-1 cells maintain both estrogen receptors (ESR1 [ER alpha] and ESR2 [ER beta]), progesterone receptors (PR A and B; PGRs), and androgen receptors (ARs), along with the p160 steroid receptor coactivators NCOA1 (formerly SRC1), NCOA2 (formerly TIF2), and NCOA3 (formerly AIB1). The karyotype of these cells is abnormal, with multiple structural rearrangements in all cells analyzed. Unlike Ishikawa cells that express glandular epithelial antigens, ECC-1 cells maintain a luminal phenotype, with expression of KRT13 (cytokeratin 13) and KRT18 (cytokeratin 18). Apparent differences in the regulation of ESR2 also were evident in ECC-1 cells compared to Ishikawa cells. Like other endometrial cell lines, ECC-1 cells express the steroid receptor coactivators and exhibit epidermal growth factor-stimulated expression of known luminal proteins thought to be involved in implantation, including the hyaluronate receptor CD44 and SPP1 (formerly osteopontin) and CD55 (decay-accelerating factor). These characteristics appear to be stable and persistent over multiple cell passages, making this well-differentiated cell line an excellent choice to study endocrine and paracrine regulation of endometrial epithelium in vitro.

  13. Cycling firing method for bypass operation of bridge converters

    DOEpatents

    Zabar, Zivan

    1982-01-01

    The bridge converter comprises a number of switching elements and an electronic logic system which regulated the electric power levels by controlling the firing, i.e., the initiation of the conduction period of the switching elements. Cyclic firing of said elements allows the direct current to bypass the alternating current system with high power factor and negligible losses.

  14. Carotid bypass for carotid occlusion.

    PubMed

    Hage, Ziad A; Behbahani, Mandana; Amin-Hanjani, Sepideh; Charbel, Fady T

    2015-07-01

    The 2-year risk of ipsilateral ischemic stroke following internal carotid artery occlusion (ICAO) in a patient undergoing maximal medical therapy is 5-8% per year. While medical therapy may reduce the risk of stroke, it does not completely eliminate it. Since the 1985 extracranial-intracranial (EC-IC) bypass study, additional trials have been conducted to further investigate the usefulness of EC-IC bypass surgery in more selected patients with cerebral ischemia and impaired hemodynamic reserve. These important studies will be briefly reviewed in this article, as well as a discussion regarding the utility of bypass surgery for ICAO in current clinical practice. In addition, a short discussion regarding the pathophysiology of carotid occlusion will be presented. We will also highlight our own institutional patient selection criteria based on the latest methods for hemodynamic assessment, as well as our intraoperative flow assisted surgical techniques (FAST), and post-operative patient follow-up.

  15. Glaukos iStent® Trabecular Micro-Bypass

    PubMed Central

    Nichamin, Louis D.

    2009-01-01

    The iStent trabecular micro-bypass system (Glaukos Corp. Laguna Hills, CA) was developed to address the limitations of current medical and surgical therapies for glaucoma treatment. The iStent® is inserted ab interno through a small temporal clear corneal incision, bypassing the trabecular meshwork and placed in Schlemm's canal at the lower nasal quadrant. Implantation of this stent into Schlemm's canal allows aqueous humor to drain directly from the anterior chamber into Schlemm's canal bypassing the obstructed trabecular meshwork. For this review, a Medline search was performed using the terms “trabecular micro-bypass stent” and “trabecular bypass stent.” The online abstract database for the American Academy of Ophthalmology was also reviewed. Abstracts which duplicated published articles were excluded. All relevant papers (n is equal to three) and abstracts (n is equal to one) were included in this review. Multiple, prospective multi-country, clinical trials have demonstrated the safety and efficacy of iStent in reducing IOP, when compared to traditional treatment modalities, while reducing/ eliminating the need for ocular antihypertensive drugs when implanted in OAG patients during combined cataract surgery or in patients with glaucoma refractory to traditional treatment modalities. PMID:20142980

  16. Thermal activation of dislocations in large scale obstacle bypass

    NASA Astrophysics Data System (ADS)

    Sobie, Cameron; Capolungo, Laurent; McDowell, David L.; Martinez, Enrique

    2017-08-01

    Dislocation dynamics simulations have been used extensively to predict hardening caused by dislocation-obstacle interactions, including irradiation defect hardening in the athermal case. Incorporating the role of thermal energy on these interactions is possible with a framework provided by harmonic transition state theory (HTST) enabling direct access to thermally activated reaction rates using the Arrhenius equation, including rates of dislocation-obstacle bypass processes. Moving beyond unit dislocation-defect reactions to a representative environment containing a large number of defects requires coarse-graining the activation energy barriers of a population of obstacles into an effective energy barrier that accurately represents the large scale collective process. The work presented here investigates the relationship between unit dislocation-defect bypass processes and the distribution of activation energy barriers calculated for ensemble bypass processes. A significant difference between these cases is observed, which is attributed to the inherent cooperative nature of dislocation bypass processes. In addition to the dislocation-defect interaction, the morphology of the dislocation segments pinned to the defects play an important role on the activation energies for bypass. A phenomenological model for activation energy stress dependence is shown to describe well the effect of a distribution of activation energies, and a probabilistic activation energy model incorporating the stress distribution in a material is presented.

  17. Coronary Artery Disease: Angioplasty or Bypass Surgery?

    MedlinePlus

    Coronary artery disease: Angioplasty or bypass surgery? I'm getting a cardiac catheterization. If blockages are found, ... angioplasty or bypass surgery? Answers from Rekha Mankad, M.D. During cardiac catheterization, your doctor will examine ...

  18. Secondary and College LD Bypass Strategies.

    ERIC Educational Resources Information Center

    Mosby, Robert J.

    1981-01-01

    The author describes the Developmental By-Pass (DBP) Instructional technology for teaching secondary and college learning disabled (LD) students by allowing students to bypass ordering and organizational deficits. (SB)

  19. Types of Coronary Artery Bypass Grafting

    MedlinePlus

    ... from the NHLBI on Twitter. Types of Coronary Artery Bypass Grafting There are several types of coronary ... for you based on your needs. Traditional Coronary Artery Bypass Grafting Traditional CABG is used when at ...

  20. Psychological Effects of Intestinal Bypass Surgery.

    ERIC Educational Resources Information Center

    Wampler, Richard S.; And Others

    1980-01-01

    Preoperative and postoperative intestinal bypass patients were evaluated. Results suggest that postoperative bypass patients have improved psychological health and an increased sense of freedom and well-being but may need assistance in improving self-concepts. (Author)

  1. Technology Solutions Case Study: Preventing Thermal Bypass

    SciTech Connect

    none,

    2012-10-01

    This project highlights the importance of continuous air barriers in full alignment with insulation to prevent thermal bypasses and achieve high energy performance, and recommends use of ENERGY STAR's Thermal Bypass Inspection Checklist.

  2. 30 CFR 77.302 - Bypass stacks.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ....302 Bypass stacks. Thermal dryer systems shall include a bypass stack, relief stack or individual discharge stack provided with automatic venting which will permit gases from the dryer heating unit to bypass the heating chamber and vent to the outside atmosphere during any shutdown operation. ...

  3. 30 CFR 77.302 - Bypass stacks.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ....302 Bypass stacks. Thermal dryer systems shall include a bypass stack, relief stack or individual discharge stack provided with automatic venting which will permit gases from the dryer heating unit to bypass the heating chamber and vent to the outside atmosphere during any shutdown operation. ...

  4. Interventions in Infrainguinal Bypass Grafts

    SciTech Connect

    Mueller-Huelsbeck, S. Order, B.-M.; Jahnke, T.

    2006-02-15

    The interventional radiologist plays an important role in the detection and prevention of infrainguinal bypass failure. Early detection and evaluation of flow-limiting lesions effectively preserve graft (venous bypass and polyester or expanded polytetrafluoroethylene bypass) patency by identifying stenoses before occlusion occurs. Delay in treatment of the at-risk graft may result in graft failure and a reduced chance of successful revascularization. For this reason, surveillance protocols form an important part of follow-up after infrainguinal bypass surgery. As well as having an understanding of the application of imaging techniques including ultrasound, MR angiography, CT angiography and digital subtraction angiography, the interventional radiologist should have detailed knowledge of the minimally invasive therapeutic options. Percutaneous transluminal angioplasty (PTA), or alternatively cutting balloon angioplasty, is the interventional treatment of choice in prevention of graft failure and occlusion. Further alternatives include metallic stent placement, fibrinolysis, and mechanical thrombectomy. Primary assisted patency rates following PTA can be up to 65% at 5 years. When the endovascular approach is unsuccessful, these therapeutic options are complemented by surgical procedures including vein patch revision, jump grafting, or placement of a new graft.

  5. Heart bypass surgery - minimally invasive

    MedlinePlus

    ... MIDCAB; Robot-assisted coronary artery bypass; RACAB; Keyhole heart surgery; CAD - MIDCAB; Coronary artery disease - MIDCAB ... To perform this surgery: The heart surgeon will make a 3- to 5-inch (8 to 13 centimeters) surgical cut in the left part of your chest ...

  6. Turbine bypass turbofan with mid-turbine reingestion and method of operating the same

    SciTech Connect

    Klees, G.W.

    1984-03-13

    A supersonic two spool turbofan engine is disclosed capable not only of developing sufficient power to accelerate up to supersonic cruise and maintain efficient operation at supersonic cruise, but also arranged to cruise at subsonic velocities with a relatively low specific fuel consumption. The engine is provided with a variable bypass passageway downstream of the compressor. Flow into the bypass passageway is controlled so that during low power setting the bypass passageway is closed so that all the gaseous flow is directed through the turbine. During higher power settings, the bypass passageway is opened to the extent that a selected portion of the gaseous flow is directed through the bypass passageway to bypass the first stage of the turbine section so that the corrected flow to the first turbine stage remains substantially constant for high and low power setting of the engine. The bypass flow is then directed into the area between the first and second turbine to combine with the gaseous flow passing through the first turbine and pass through the second turbine.

  7. Pre-test CFD Calculations for a Bypass Flow Standard Problem

    SciTech Connect

    Rich Johnson

    2011-11-01

    The bypass flow in a prismatic high temperature gas-cooled reactor (HTGR) is the flow that occurs between adjacent graphite blocks. Gaps exist between blocks due to variances in their manufacture and installation and because of the expansion and shrinkage of the blocks from heating and irradiation. Although the temperature of fuel compacts and graphite is sensitive to the presence of bypass flow, there is great uncertainty in the level and effects of the bypass flow. The Next Generation Nuclear Plant (NGNP) program at the Idaho National Laboratory has undertaken to produce experimental data of isothermal bypass flow between three adjacent graphite blocks. These data are intended to provide validation for computational fluid dynamic (CFD) analyses of the bypass flow. Such validation data sets are called Standard Problems in the nuclear safety analysis field. Details of the experimental apparatus as well as several pre-test calculations of the bypass flow are provided. Pre-test calculations are useful in examining the nature of the flow and to see if there are any problems associated with the flow and its measurement. The apparatus is designed to be able to provide three different gap widths in the vertical direction (the direction of the normal coolant flow) and two gap widths in the horizontal direction. It is expected that the vertical bypass flow will range from laminar to transitional to turbulent flow for the different gap widths that will be available.

  8. Comparison of Long Term Tropospheric Ozone Trends Measured by Lidar and ECC Ozonesondes from 1991 to 2010 in Southern France

    NASA Astrophysics Data System (ADS)

    Ancellet, G.; Gaudel, A.; Godin-Beekmann, S.

    2016-06-01

    ECC (Electrochemical Concentration Cell) ozonesondes and UV DIAL (Differential Absorption Lidar) measurements have been carried out simultaneously at OHP (Observatoire de Haute Provence, 44°N, 6.7°E, 690 m) since 1991. A unique long-term trend assessment by two different instruments operated routinely at the same location is possible. Air mass trajectories have been calculated for all the ozone observations available at OHP. The bias between the seasonal mean calculated with lidar and ECC ozone vertical profiles for 4 timeperiods of 5 years is 0.6 ppbv in the free troposphere (4-8 km). Larger differences (> 10 ppbv) are explained by the need for clear sky conditions during lidar observations. The measurements of both instruments have been combined to decrease the impact of short-term atmospheric variability on the trend estimate.

  9. Estimated net value and uncertainty for automating ECCS switchover at PWRs

    SciTech Connect

    Walsh, B.; Brideau, J.; Comes, L.; Darby, J.; Guttmann, H.; Sciacca, F.; Souto, F.; Thomas, W.; Zigler, G.

    1996-02-01

    Question for resolution of Generic Safety Issue No. 24 is whether or not PWRs that currently rely on a manual system for ECCS switchover to recirculation should be required to install an automatic system. Risk estimates are obtained by reevaluating the contributions to core damage frequencies (CDFs) associated with failures of manual and semiautomatic switchover at a representative PWR. This study considers each separate instruction of the corresponding emergency operating procedures (EOPs), the mechanism for each control, and the relation of each control to its neighbors. Important contributions to CDF include human errors that result in completely coupled failure of both trains and failure to enter the required EOP. It is found that changeover to a semiautomatic system is not justified on the basis of cost-benefit analysis: going from a manual to a semiautomatic system reduces the CDF by 1.7 {times} 10{sup {minus}5} per reactor-year, but the probability that the net cost of the modification being less than $1, 000 per person-rem is about 20% without license renewal. Scoping analyses, using optimist assumptions, were performed for a changeover to a semiautomatic system with automatic actuation and to a fully automatic system; in these cases the probability of a net cost being less than $1,000/person-rem is about 50% without license renewal and over 95% with license renewal.

  10. Ageing and COPD affect different domains of nutritional status: the ECCE study.

    PubMed

    Battaglia, S; Spatafora, M; Paglino, G; Pedone, C; Corsonello, A; Scichilone, N; Antonelli-Incalzi, R; Bellia, V

    2011-06-01

    Chronic obstructive pulmonary disease (COPD) and ageing may contribute to malnutrition. We aimed to explore whether COPD and ageing determine malnutrition in different manners. 460 stable COPD outpatients (376 males and 84 females) from the Extrapulmonary Consequences of COPD in the Elderly (ECCE) study database were investigated (age 75.0±5.9 yrs; forced expiratory volume in 1 s 54.7±18.3% predicted). Nutritional status was evaluated using the Mini Nutritional Assessment® (MNA) questionnaire. From the MNA, three scores exploring the domains of the nutritional status were calculated: body composition, energy intake and body functionality scores. Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages were negatively correlated with five MNA items exploring mobility, patient's perception of own nutrition and health status, and arm and calf circumferences (lowest Spearman's rho (rs)=-0.011; highest p=0.039). GOLD stages were independently correlated with body composition and body functionality scores (model r2=0.073). Age was negatively correlated with four MNA items exploring loss of appetite, fluid intake, mobility and autonomy in daily life (lowest rs=-0.013; highest p=0.030). Age was independently correlated with body functionality score (model r2=0.037). Severe COPD and ageing are independent and probably concurrent conditions leading to malnutrition. The MNA questionnaire allows a valuable insight into the complexity of components of nutritional status and may provide useful clues for treatment strategies.

  11. [Visco-hydraulic irrigation of the lens cortex. A safe ECCE method].

    PubMed

    Friedburg, D

    1994-12-01

    The safe and effective Hydrojet nucleus expression (Klin Monatsbl Augenheilkd 1993; 202:288-291) should be completed by a safe non traumatic and easy to perform method of cortex removal. OPERATION TECHNIQUE: 8-mm tunnel incision, spiral capsulorhexis, hydrodissection and viscodissection of the nucleus, hydrojet nucleus expression. The lens cortex can be separated from the lens capsule by injection of hydroxypropylmethylcellulose (Metho), the viscoelastic substance acts as a wedge to separate the cortex from the capsule step by step. Finally the cortex is expressed by the injection of Metho. The capsule remains so clean, that often polishing is not necessary. PMMA lenses with an over all diameter of 10 or 11-mm and 7-mm optics were implanted. In 100 consecutive cases complications which occurred intraoperatively or within the following 2 days were listed. The following complications occurred: Hyphaema (2x, the blood disappeared spontaneously within 4-5 days), small cortex flake in the anterior chamber (2x), rhexis rim not intact (1x, nevertheless exact lens centration in the bag). No lesion of the capsule/zonule diaphragm, no fibrin reaction, no corneal edema. The method described is a safe method for ECCE. Capsulorhexis and tunnel incision are required. The method does not need any high technology equipment.

  12. Robust ECC-based authenticated key agreement scheme with privacy protection for Telecare medicine information systems.

    PubMed

    Zhang, Liping; Zhu, Shaohui

    2015-05-01

    To protect the transmission of the sensitive medical data, a secure and efficient authenticated key agreement scheme should be deployed when the healthcare delivery session is established via Telecare Medicine Information Systems (TMIS) over the unsecure public network. Recently, Islam and Khan proposed an authenticated key agreement scheme using elliptic curve cryptography for TMIS. They claimed that their proposed scheme is provably secure against various attacks in random oracle model and enjoys some good properties such as user anonymity. In this paper, however, we point out that any legal but malicious patient can reveal other user's identity. Consequently, their scheme suffers from server spoofing attack and off-line password guessing attack. Moreover, if the malicious patient performs the same time of the registration as other users, she can further launch the impersonation attack, man-in-the-middle attack, modification attack, replay attack, and strong replay attack successfully. To eliminate these weaknesses, we propose an improved ECC-based authenticated key agreement scheme. Security analysis demonstrates that the proposed scheme can resist various attacks and enables the patient to enjoy the remote healthcare services with privacy protection. Through the performance evaluation, we show that the proposed scheme achieves a desired balance between security and performance in comparisons with other related schemes.

  13. Water-hammer in the cold leg during an SBLOCA due to cold ECCS injection

    SciTech Connect

    Ortiz, M.G.; Ghan, L.S.

    1991-12-01

    Water-hammer might occur in the cold leg of pressurized water reactors (PWR) during small break loss-of-coolant accidents (SBLOCA`s), when cold emergency core cooling system (ECCS) water is injected into a pipe that may be partially filled with saturated steam. The water may mix with the steam and cause it to condense abruptly. Depending on the flow regime present, slugs of liquid may then be accelerated towards each other or against the piping structure. The possibility of this phenomenon is of concern to us because it may become a dominant phenomenon and change the character of the transient. In performing the code scaling, applicability, and uncertainty study (CSAU) on a SBLOCA scenario, we had to examine the possibility that the transient being analyzed could experience water-hammer and thus depart from the scope of the study. Two criteria for water-hammer initiation were investigated and tested using a RELAP5/MOD3 simulation of the transient. Our results indicated a very low likelihood of occurrence of the phenomenon. 8 refs., 6 figs.

  14. Water-hammer in the cold leg during an SBLOCA due to cold ECCS injection

    SciTech Connect

    Ortiz, M.G.; Ghan, L.S.

    1991-01-01

    Water-hammer might occur in the cold leg of pressurized water reactors (PWR) during small break loss-of-coolant accidents (SBLOCA's), when cold emergency core cooling system (ECCS) water is injected into a pipe that may be partially filled with saturated steam. The water may mix with the steam and cause it to condense abruptly. Depending on the flow regime present, slugs of liquid may then be accelerated towards each other or against the piping structure. The possibility of this phenomenon is of concern to us because it may become a dominant phenomenon and change the character of the transient. In performing the code scaling, applicability, and uncertainty study (CSAU) on a SBLOCA scenario, we had to examine the possibility that the transient being analyzed could experience water-hammer and thus depart from the scope of the study. Two criteria for water-hammer initiation were investigated and tested using a RELAP5/MOD3 simulation of the transient. Our results indicated a very low likelihood of occurrence of the phenomenon. 8 refs., 6 figs.

  15. Implementation and verification of different ECC mitigation designs for BRAMs in flash-based FPGAs

    NASA Astrophysics Data System (ADS)

    Yang, Zhen-Lei; Wang, Xiao-Hui; Zhang, Zhan-Gang; Liu, Jie; Su, Hong

    2016-04-01

    Embedded RAM blocks (BRAMs) in field programmable gate arrays (FPGAs) are susceptible to single event effects (SEEs) induced by environmental factors such as cosmic rays, heavy ions, alpha particles and so on. As technology scales, the issue will be more serious. In order to tackle this issue, two different error correcting codes (ECCs), the shortened Hamming codes and shortened BCH codes, are investigated in this paper. The concrete design methods of the codes are presented. Also, the codes are both implemented in flash-based FPGAs. Finally, the synthesis report and simulation results are presented in the paper. Moreover, heavy-ion experiments are performed, and the experimental results indicate that the error cross-section of the device using the shortened Hamming codes can be reduced by two orders of magnitude compared with the device without mitigation, and no errors are discovered in the experiments for the device using the shortened BCH codes. Supported by National Natural Science Foundation of China (11079045, 11179003 and 11305233)

  16. The latitudinal distribution of ozone to 35 km altitude from ECC ozonesonde observations, 1982-1990

    NASA Technical Reports Server (NTRS)

    Komhyr, W. D.; Oltmans, S. J.; Lathrop, J. A.; Kerr, J. B.; Matthews, W. A.

    1994-01-01

    Electrochemical concentration cell (ECC) ozone-sonde observations, made in recent years at ten stations whose locations range from the Arctic to Antarctica, have yielded a self-consistent ozone data base from which mean seasonal and annual latitudinal ozone vertical distributions to 35 km have been derived. Ozone measurement uncertainties are estimated, and results are presented in the Bass-Paur (1985) ozone absorption coefficient scale adopted for use with Dobson ozone spectrophotometers January 1, 1992. The data should be useful for comparison with model calculations of the global distribution of atmospheric ozone, for serving as apriori statistical information in deriving ozone vertical distributions from satellite and Umkehr observations, and for improving the satellite and Umkehr ozone inversion algorithms. Attention is drawn to similar results based on a less comprehensive data set published in Ozone in the Atmosphere, Proceedings of the 1988 Quadrennial Ozone Symposium where errors in data tabulations occurred for three of the stations due to inadvertent transposition of ozone partial pressure and air temperature values.

  17. Modified Ultrafiltration During Cardiopulmonary Bypass and Postoperative Course of Pediatric Cardiac Surgery

    PubMed Central

    Ziyaeifard, Mohsen; Alizadehasl, Azin; Massoumi, Gholamreza

    2014-01-01

    Context: The use of cardiopulmonary bypass (CPB) provokes the inflammatory responses associated with ischemic/reperfusion injury, hemodilution and other agents. Exposure of blood cells to the bypass circuit surface starts a systemic inflammatory reaction that may causes post-CPB organ dysfunction, particularly in lungs, heart and brain. Evidence Acquisition: We investigated in the MEDLINE, PUBMED, and EMBASE databases and Google scholar for every available article in peer reviewed journals between 1987 and 2013, for related subjects to CPB with conventional or modified ultrafiltration (MUF) in pediatrics cardiac surgery patients. Results: MUF following separation from extracorporeal circulation (ECC) provides well known advantages in children with improvements in the hemodynamic, pulmonary, coagulation and other organs functions. Decrease in blood transfusion, reduction of total body water, and blood loss after surgery, are additional benefits of MUF. Conclusions: Consequently, MUF has been associated with attenuation of morbidity after pediatric cardiac surgery. In this review, we tried to evaluate the current evidence about MUF on the organ performance and its effect on post-CPB morbidity in pediatric patients. PMID:25478538

  18. Comparison of results and complications following combined ECCE-trabeculectomy versus small-incision-trabeculectomy and posterior chamber lens implantation.

    PubMed

    Wedrich, A; Menapace, R; Hirsch, U; Papapanos, P; Derbolav, A; Ries, E

    To compare the efficacy and complication rate of two standard cataract extraction techniques with different incision lengths when combined with trabeculectomy. 54 eyes after combined ECCE, posterior chamber lens implantation and trabeculectomy (ECCE-group) are compared with 49 eyes following phacoemulsification, trabeculectomy and implantation of a folded flexible posterior chamber lens (small-incision group). Minimum follow-up was 24 months. Glaucoma control was achieved in all eyes of both groups. There was a tendency towards a higher number of patients without therapy in the small-incision group (82% versus 65%, p = 0.07). Final mean IOP (14.2 +/- 3.0 mmHg versus 15.5 +/- 2.7 mmHg, p = 0.02) and mean therapy index (0.2 +/- 0.5 versus 0.4 +/- 0.6, p = 0.03) were significantly lower in the small-incision group. Postoperative complications such as severe fibrin effusion (41% versus 18%, p = 0.018), early postoperative IOP rises > 25 mmHg (18% versus 2%, p = 0.009), filtering bleb scarring (63% versus 8%, p < 0.0001) and the total number of complications (87% versus 63%, p = 0.006) were significantly higher in the ECCE-group. With the decrease of the incision size necessary for the cataract extraction a reduction of postoperative complications and better functional results are achieved in combined cataract/glaucoma surgery.

  19. Minimized extracorporeal circulation system in coronary artery bypass surgery: a 10-year single-center experience with 2243 patients.

    PubMed

    Puehler, Thomas; Haneya, Assad; Philipp, Alois; Zausig, York A; Kobuch, Reinhard; Diez, Claudius; Birnbaum, Dietrich E; Schmid, Christof

    2011-04-01

    Coronary artery bypass grafting (CABG) is the gold standard for the surgical therapy of multivessel coronary artery disease. To reduce the side effects, associated with standard extracorporeal circulation (ECC), a concept of minimal extracorporeal circulation (MECC) was devised in our center. We report on our 10-year experience with the MECC for coronary revascularization. From January 1998 to August 2009, 2243 patients underwent CABG with MECC in our center. In a retrospective observational study, we analyzed indication, preoperative patient co-morbidity, postoperative clinical course, and perioperative outcome of all patients operated on with MECC. Furthermore, the risk factors for mortality in the MECC group were assessed. Patients showed a mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) of 4.5±0.1%. The mean age of the patients was 66.8±9.1 years. The overall 30-day mortality after CABG with MECC was 2.3%, ranging from 1.1% for elective to 13.0% for emergent patients and was significantly better than standard ECC. Only 15.3% (n=344) of patients with MECC required intra-operative blood transfusion. Postoperative catecholamine support, red blood cell transfusion, need for hemodialysis, release of creatinine kinase, incidence of stroke, and postoperative delirium were low after MECC revascularization. Ejection fraction below 30% (odds ratio (OR): 5.1), emergent operation (OR: 9.4), and high-dose catecholamine therapy (OR: 2.6) were associated predictors for mortality. MECC until now is an established concept and has become an alternative for ECC in routine CABG in our center. The use of the MECC system is associated with low mortality and conversion rate. Excellent survival rates and low transfusion requirements in the perioperative course were achieved. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  20. Comparison of allele frequency for HLA-DR and HLA-DQ between patients with ECC and caries-free children.

    PubMed

    Bagherian, A; Nematollahi, H; Afshari, J T; Moheghi, N

    2008-03-01

    Early childhood caries (ECC) is one of the most common diseases of childhood. The etiology of ECC is multifactorial and both genetic and environmental factors play important roles in the pathogenesis of the disease. Genetic variations in the hosts may contribute to changes in the risk for dental caries. Genetic factors such as human leukocyte antigen (HLA) have recently been suggested as a predisposing factor. The aim of this study was to look for an association between HLA-DRB1 and HLA-DQB1 with ECC for developing new strategies for the diagnosis as well as the prevention of the disease. In this study, we extracted the genomic DNAs from whole blood samples of 44 patients with ECC and 35 caries-free children by the salting-out method. We amplified the genomic DNA by PCR-SSP and then HLA-typing was performed for all alleles. The results revealed a significant increase in the frequency of HLA-DRB1*04 in the patient group (P=0.019). The odds ratio for this allele was detected to be 10. The frequency of HLA-DQB1 alleles was not significantly different between the two groups. The above results suggest that HLA-DRB1*04 is associated with the susceptibility to ECC. Thus HLA-DRB1*04 detection as a molecular marker for early diagnosis of ECC may be recommended.

  1. Characterization of EccA3, a CbbX family ATPase from the ESX-3 secretion pathway of M. tuberculosis.

    PubMed

    Gaur, Amit; Sharma, Vijay Kumar; Shree, Sonal; Rai, Niyati; Ramachandran, Ravishankar

    2017-04-08

    EccA family proteins are conserved components of ESX secretion pathways in M. tuberculosis H37Rv. Here, we report the characterization of EccA3 (Rv0282), a CbbX family AAA (ATPases Associated with diverse cellular Activities) protein from the ESX-3 pathway that is required for in vitro growth of mycobacteria, secretion of virulence factors, and acquisition of iron and zinc. EccA3 is a thermostable ATPase with a molecular weight of ~68kDa. It exists as a dodecamer in the apo form and associates as a hexamer in the presence of ATP. Its C-terminal region consists of a CbbX-like AAA-domain while the N-terminal region contains a tetratricopeptide repeat (TPR) domain with lower homology to other EccA-type proteins. Further, the C-terminal domain functions as the oligomerization domain and also exhibits ATPase activity. Mutational analysis, steady state kinetics and molecular docking studies identify R573 as the important 'sensor arginine' and R505 as an 'arginine finger' in EccA3. Dynamic fluorescence quenching experiments suggest that the N-terminal domain moves closer to the C-terminal domain upon ATP-binding. The ATP-dependent 'open-close' relative movements of the two domains might help EccA3 interaction and secretion of essential virulence factors.

  2. Mini cardiopulmonary bypass: Anesthetic considerations

    PubMed Central

    Alsatli, Raed A.

    2012-01-01

    This review article is going to elaborate on the description, components, and advantages of mini-cardiopulmonary bypass (mini-CPB), with special reference to the anesthetic management and fast track anesthesia with mini-CPB. There are several clinical advantages of mini-CPB like, reduced inflammatory reaction to the pump, reduced need for allogenic blood transfusion and lower incidence of postoperative neurological complications. There are certainly important points that have to be considered by anesthesiologists to avoid sever perturbation in the cardiac output and blood pressure during mini-CPB. Fast-track anesthesia provides advantages regarding fast postoperative recovery from anesthesia, and reduction of postoperative ventilation time. Mini bypass offers a sound alternative to conventional CPB, and has definite advantages. It has its limitations, but even with that it has a definite place in the current practice of cardiac surgery. PMID:25885494

  3. Bypass system modification at Bonneville Dam on the Columbia River improved the survival of juvenile salmon

    USGS Publications Warehouse

    Ferguson, J.W.; Sandford, B.P.; Reagan, R.E.; Gilbreath, L.G.; Meyer, E.B.; Ledgerwood, R.D.; Adams, N.S.

    2007-01-01

    From 1987 to 1992, we evaluated a fish bypass system at Bonneville Dam Powerhouse 2 on the Columbia River. The survival of subyearling Chinook salmon Oncorhynchus tshawytscha released into the system ranged from 0.774 to 0.911 and was significantly lower than the survival of test fish released into turbines and the area immediately below the powerhouse where bypass system flow reentered the river. Yearling and subyearling Chinook salmon and yearling coho salmon O. kisutch released into the bypass system were injured or descaled. Also, levels of blood plasma cortisol and lactate were significantly higher in yearling and subyearling Chinook salmon that passed through the bypass system than in fish released directly into a net located over the bypass exit. This original system was then extensively modified using updated design criteria, and the site where juvenile fish reentered the river was relocated 2.8 km further downstream to reduce predation on bypassed fish by northern pikeminnow Ptychocheilus oregonensis. Based on studies conducted from 1999 to 2001, the new bypass system resulted in high fish survival, virtually no injuries to fish, fish passage times that were generally similar to water travel times, and mild stress responses from which fish recovered quickly. The mean estimated survival of subyearling Chinook salmon passing through the new bypass system was 0.946 in 2001, which was an usually low-flow year. Survival, physical condition, passage timing, and blood physiological indicators of stress were all useful metrics for assessing the performance of both bypass systems and are discussed. The engineering and hydraulic criteria used to design the new bypass system that resulted in improved fish passage conditions are described.

  4. Testing neonate-infant membrane oxygenators with the University of Texas neonatal pulsatile cardiopulmonary bypass system in vitro.

    PubMed

    Undar, A; Holland, M C; Howelton, R V; Benson, C K; Ybarra, J R; Miller, O L; Rossbach, M M; Runge, T M; Johnson, S B; Sako, E Y; Calhoon, J H

    1998-09-01

    Neurologic complications are already well documented after cardiopulmonary bypass (CPB) procedures in neonates and infants. Physiologic pulsatile flow CPB systems may be the alternative to the currently used steady-flow CPB circuits. In addition to the pulsatile pump, a membrane oxygenator should be chosen carefully, because only a few membrane oxygenators are suitable for physiologic pulsatile flow. We have tested four different types of neonate-infant membrane oxygenators for physiologic pulsatility with The University of Texas neonate-infant pulsatile CPB system in vitro. Evaluation criteria were based on mean ejection time, extracorporeal circuit (ECC) pressure, and upstroke of dp/dt. The results suggested that the Capiox 308 hollow-fibre membrane oxygenator produced the best physiologic pulsatile waveform according to the ejection time, ECC pressure, and the upstroke of dp/dt. The Minimax Plus and Masterflo Infant hollow-fibre membrane oxygenators also produced adequate pulsatile flow. Only the Variable Prime Cobe Membrane Lung (VPCML) Plus flat-sheet membrane oxygenator failed to reach the criteria for physiologic pulsatility. Depending on the oxygenator used, the lowest priming volume of the infant CPB circuit was 415 ml and the highest 520 ml.

  5. Cardiopulmonary bypass with bivalirudin in type II heparin-induced thrombocytopenia.

    PubMed

    Clayton, Stephanie B; Acsell, Jeffrey R; Crumbley, Arthur J; Uber, Walter E

    2004-12-01

    Cardiopulmonary bypass in patients with type II heparin induced-thrombocytopenia poses significant challenges. Inadequate pharmacokinetic profiles, monitoring, reversibility, and availability often limit alternative anticoagulation strategies. Bivalirudin, a semisynthetic direct thrombin inhibitor, was recently approved for use in patients undergoing percutaneous coronary interventions. Its unique properties, including a relatively short half-life, an anticoagulation effect that closely correlates with activated clotting time, and an alternate metabolic pathway for elimination, make bivalirudin an attractive agent for cardiopulmonary bypass in patients with type II heparin induced-thrombocytopenia. We report our experience using bivalirudin in 2 patients undergoing coronary artery bypass grafting.

  6. Performance Analyses of ECCS and Containment Systems for the 4500 MW ESBWR

    SciTech Connect

    Cheung, Y.K.; Shiralkar, B.S.; Marquino, W.

    2006-07-01

    GE latest evolution of the Boiling Water Reactor, the ESBWR, is an advanced, 4500 MWth nuclear power plant design, submitted to the NRC for design certification in 2005. This paper presents the key results of performance analyses of ESBWR ECCS and containment systems. The ESBWR is designed to take full advantage of passive features to improve the plant performance and economics. The key features are the use of natural circulation during normal operation and passive safety systems for decay heat removal and inventory control. The use of natural circulation results in relatively taller reactor vessel and more in-vessel coolant inventory. Consequently, the water level always covers the core following an accident, assuring no fuel heatup. The use of passive systems results in simpler safety systems. The peak containment pressure and margin to the design value basically depend on the containment volumes and the water inventories. Additionally, these passive systems impose no significant challenge to the operator. Performance analyses for the 4500 MWth ESBWR were made for a spectrum of LOCA events. These calculations accounted for uncertainties and biases in the computer models and used conservative initial conditions and plant parameters. Results of these performance analyses show that: (1) core remains covered with large margin and there is no core heatup in the ESBWR for any break size, (2) the long-term containment pressure increases gradually with time, in the order of hours, and the peak pressure is below the design value with large margin, and (3) the margins depend on the containment volumes and water inventories. (authors)

  7. Ramjet bypass duct and preburner configuration

    NASA Technical Reports Server (NTRS)

    Orlando, Robert J. (Inventor)

    1994-01-01

    A combined turbofan and ramjet aircraft engine includes a forward bypass duct which allows the engine to operate more efficiently during the turbofan mode of operation. By mounting a ramjet preburner in the forward duct and isolating this duct from the turbofan bypass air, a transition from turbofan operation to ramjet operation can take place at lower flight Mach numbers without incurring pressure losses or blockage in the turbofan bypass air.

  8. Ultra High Bypass Ratio Low Noise Engine Study

    NASA Technical Reports Server (NTRS)

    Dalton, W. N., III

    2003-01-01

    A study was conducted to identify engine cycle and technologies needed for a regional aircraft which could be capable of achieving a 10 EPNdB reduction in community noise level relative to current FAR36 Stage 3 limits. The study was directed toward 100-passenger regional aircraft with engine configurations in the 15,000 pound thrust class. The study focused on Ultra High Bypass Ratio (UHBR) cycles due to low exhaust jet velocities and reduced fan tip speeds. The baseline engine for this study employed a gear-driven, 1000 ft/sec tip speed fan and had a cruise bypass ratio of 14:1. A revised engine configuration employing fan and turbine design improvements are predicted to be 9.2 dB below current takeoff limits and 12.8 dB below current approach limits. An economic analysis was also done by estimating Direct Operating Cost (DOC).

  9. Prevalence and socio-behavioral influence of early childhood caries, ECC, and feeding habits among 6 – 36 months old children in Uganda and Tanzania

    PubMed Central

    2012-01-01

    Background Early childhood caries (ECC) is a serious problem that has remained unexplored in sub-Saharan Africa. This study aimed to identify possible socio-behavioral correlates of ECC focusing 6–36 months old children and their caretakers. Methods Cross sectional studies were conducted in a high fluoride rural area, Manyara, Tanzania and a low fluoride urban area, Kampala, Uganda. Totals of 1221 and 816 child - caretaker pairs attending health care facilities for growth monitoring were recruited in Manyara and Kampala, respectively. All caretakers completed face to face interviews at the health care facility. Children underwent oral clinical examination whereby ECC and Enamel hypoplasia were recorded using the dmft (WHO 1997) and the DDE index (FDI 1992). Results The prevalence of ECC was 3.7% in Manyara and 17.6% in Kampala. According to multiple logistic regression analyses, received oral health information from health worker was the strongest determinant of ECC in Manyara, adjusted OR 0.3, 95% CI 0.09 – 0.93. In Kampala, visible plaque, high sugar intake and presence of enamel hypoplasia associated with ECC, adjusted ORs 2.8 (95% CI 1.61- 4.95), 3.0 (95% CI 1.39 – 6.34) and 2.3 (95% CI 1.36 - 3.95). Conclusion Oral health education aimed at caretakers of 6–36 months, including health care workers’ information regarding the detrimental consequences for oral health of frequent sugar consumption and poor oral hygiene is important for prevention of ECC in Tanzania and Uganda. PMID:22834770

  10. Prevalence and socio-behavioral influence of early childhood caries, ECC, and feeding habits among 6-36 months old children in Uganda and Tanzania.

    PubMed

    Masumo, Ray; Bardsen, Asgeir; Mashoto, Kijakazi; Åstrøm, Anne Nordrehaug

    2012-07-26

    Early childhood caries (ECC) is a serious problem that has remained unexplored in sub-Saharan Africa. This study aimed to identify possible socio-behavioral correlates of ECC focusing 6-36 months old children and their caretakers. Cross sectional studies were conducted in a high fluoride rural area, Manyara, Tanzania and a low fluoride urban area, Kampala, Uganda. Totals of 1221 and 816 child - caretaker pairs attending health care facilities for growth monitoring were recruited in Manyara and Kampala, respectively. All caretakers completed face to face interviews at the health care facility. Children underwent oral clinical examination whereby ECC and Enamel hypoplasia were recorded using the dmft (WHO 1997) and the DDE index (FDI 1992). The prevalence of ECC was 3.7% in Manyara and 17.6% in Kampala. According to multiple logistic regression analyses, received oral health information from health worker was the strongest determinant of ECC in Manyara, adjusted OR 0.3, 95% CI 0.09 - 0.93. In Kampala, visible plaque, high sugar intake and presence of enamel hypoplasia associated with ECC, adjusted ORs 2.8 (95% CI 1.61- 4.95), 3.0 (95% CI 1.39 - 6.34) and 2.3 (95% CI 1.36 - 3.95). Oral health education aimed at caretakers of 6-36 months, including health care workers' information regarding the detrimental consequences for oral health of frequent sugar consumption and poor oral hygiene is important for prevention of ECC in Tanzania and Uganda.

  11. A novel small animal extracorporeal circulation model for studying pathophysiology of cardiopulmonary bypass.

    PubMed

    Fujii, Yutaka; Shirai, Mikiyasu; Inamori, Shuji; Takewa, Yoshiaki; Tatsumi, Eisuke

    2015-03-01

    Extracorporeal circulation (ECC) is indispensable for cardiac surgery. Despite the fact that ECCcauses damage to blood components and is non-physiologic, its pathophysiology has not been fully elucidated. This is because difficulty in clinical research and animal experiments keeps the knowledge insufficient. Therefore, it is desirable to have a miniature ECC model for small animals, which enables repetitive experiments, to study the mechanism of pathophysiological changes during ECC. We developed a miniature ECC system and applied it to the rat. We measured changes in hemodynamics, blood gases and hemoglobin (Hb) concentration, serum cytokines (TNF-α, IL-6, IL-10), biochemical markers (LDH, AST, ALT), and the wet-to-dry weight (W/D) ratio of the lung for assessing whether the rat ECC model is comparable to the human ECC. The ECC system consisted of a membranous oxygenator (polypropylene, 0.03 m(2)), tubing line (polyvinyl chloride), and roller pump. Priming volume of this system is only 8 ml. Rats (400-450 g) were divided into the SHAM group (n = 7) and the ECC group (n = 7). Blood samples were collected before, 60 and 120 min after initiation of ECC. During ECC, blood pressure and Hb were maintained around 80 mmHg and 10 g/dL, respectively. The levels of the inflammatory and biochemical markers and the W/D ratio were significantly elevated in the ECC group, indicating some organ damages and systemic inflammatory responses during ECC. We successfully established the ECC for the rat. This miniature ECC model could be a useful approach for studying the mechanism of pathophysiology during ECC and basic assessment of the ECC devices.

  12. Roux-en-Y gastric bypass versus calorie restriction: support for surgery per se as the direct contributor to altered responses of insulin and incretins to a mixed meal.

    PubMed

    Berggren, Johan; Lindqvist, Andreas; Hedenbro, Jan; Groop, Leif; Wierup, Nils

    2017-02-01

    To study the immediate effects of Roux-en-Y gastric bypass (RYGB) on glucose homeostasis, insulin, and incretin responses to mixed-meal tests compared with the effects of calorie restriction (CR). University-affiliated bariatric surgery clinic. RYGB induces remission of type 2 diabetes (T2D) long before significant weight loss occurs. The time course and underlying mechanisms of this remission remain enigmatic. A prevailing theory is that secretory patterns of incretin hormones are altered due to rearrangement of the gastrointestinal tract. To what extent reduced calorie intake contributes to the remission of T2D is unknown. Nine normoglycemic patients and 10 T2D patients were subjected to mixed-meal tests (MMT) 4 weeks before surgery before initiation of a very low calorie diet regimen (MMT-4 w), 1 day before surgery on a very low calorie diet regimen (MMT-1 d), on the morning of the first day after surgery (MMT+1 d; first postsurgical meal), and 6 weeks after surgery (MMT+6 w). Insulin, glucose, active glucagon-like peptide 1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) were measured. CR lowered insulin in T2D patients, whereas glucose, GIP, and GLP-1 were unaffected. RYGB immediately increased plasma insulin and GIP. The GLP-1 response was delayed compared with the GIP response. T2D patients exhibited lower insulin responses after RYGB compared with normoglycemic patients. GIP responses were similar in both groups at all occasions, whereas T2D patients displayed markedly elevated GLP-1 responses 6 weeks after RYGB. Glucose was unaffected by CR and RYGB in both groups. Insulin sensitivity was unaffected by CR but improved with RYGB. RYGB exerts powerful and immediate effects on insulin and incretin responses to food, independently of changes caused by CR. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  13. Laparoscopic Band-Separated One Anastomosis Gastric Bypass.

    PubMed

    Ospanov, Oral B

    2016-09-01

    This video demonstrates laparoscopic band-separated one anastomosis gastric bypass-combining the advantages of banding and gastric bypass without stapler and cutter use. This is basically a gastrojejunal loop bypass above an obstructive band in the upper stomach. An adjustable low pressure "Medsil" gastric band was introduced in the abdomen and retracted through the retrogastric tunnel. The front wall of the stomach below the band was displaced in the upward direction through the ring band, increasing the size of the anterior portion of the stomach pouch so that a gastroenteroanastomosis could be created at this point. Gastro-gastric sutures were placed to create a gastro-gastric plication around the band and hold it in position. The band tubing was exteriorized and connected to a special port, which was secured to the abdominal wall fascia. A jejunal loop was created about 200 cm from the ligament of Treitz and anastomosed to the gastric pouch by hand using Vicryl 2/0 sutures. Between November 2015 and February 2016, the study was performed on 10 patients. The average operating time for all cases was 75 min (range 63-87). There was no morbidity or mortality. No complications were observed, including band erosion and band infection. Operation costs were about $2000 lower with this method than with standard gastric bypass surgery. Postop the patients lost weight by 3-4 kg per month. Preliminary results show that laparoscopic band-separated one anastomosis gastric bypass have feasibility, safety, efficacy, and reduced operating costs.

  14. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass coronary pressure gauge... Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure... the coronary arteries. (b) Classification. Class II (performance standards). ...

  15. R&D Plan for RISMC Industry Application #1: ECCS/LOCA Cladding Acceptance Criteria

    SciTech Connect

    Szilard, Ronaldo Henriques; Zhang, Hongbin; Epiney, Aaron Simon; Tu, Lei

    2016-04-01

    The Nuclear Regulatory Commission (NRC) is finalizing a rulemaking change that would revise the requirements in 10 CFR 50.46. In the proposed new rulemaking, designated as 10 CFR 50.46c, the NRC proposes a fuel performance-based equivalent cladding reacted (ECR) criterion as a function of cladding hydrogen content before the accident (pre-transient) in order to include the effects of higher burnup on cladding performance as well as to address other technical issues. A loss of operational margin may result due to the more restrictive cladding embrittlement criteria. Initial and future compliance with the rule may significantly increase vendor workload and licensee costs as a spectrum of fuel rod initial burnup states may need to be analyzed to demonstrate compliance. The Idaho National Laboratory (INL) has initiated a project, as part of the DOE Light Water Reactor Sustainability Program (LWRS), to develop analytical capabilities to support the industry in the transition to the new rule. This project is called the Industry Application 1 (IA1) within the Risk-Informed Safety Margin Characterization (RISMC) Pathway of LWRS. The general idea behind the initiative is the development of an Integrated Evaluation Model (IEM). The motivation is to develop a multiphysics framework to analyze how uncertainties are propagated across the stream of physical disciplines and data involved, as well as how risks are evaluated in a LOCA safety analysis as regulated under 10 CFR 50.46c. This IEM is called LOTUS which stands for LOCA Toolkit for US, and it represents the LWRS Program’s response to the proposed new rule making. The focus of this report is to complete an R&D plan to describe the demonstration of the LOCA/ECCS RISMC Industry Application # 1 using the advanced RISMC Toolkit and methodologies. This report includes the description and development plan for a RISMC LOCA tool that fully couples advanced MOOSE tools already in development in order to characterize and optimize

  16. Comprehensive Oral Health Care to Reduce the Incidence of Severe Early Childhood Caries (s-ECC) in Urban China.

    PubMed

    Si, Yan; Guo, Yan; Yuan, Chao; Xu, Tao; Zheng, Shu Guo

    2016-03-01

    To explore the effectiveness of comprehensive oral health care to reduce the caries incidence for children with severe early childhood caries (s-ECC) in an urban area in China. A total of 357 children aged 3 to 4 years old and diagnosed with s-ECC were recruited in this randomised controlled, single-blinded clinical trial for 1 year. Children of two different kindergarten classes were enrolled in this study and randomly divided into a test group (205 children) and a control group (152 children). The test group received comprehensive oral health care, which included: oral health examination, oral health education, topical fluoride application and dental treatment, and the children in the control group only received the oral health examination. The evaluation of the oral health questionnaire for parents was also performed. An evaluation was carried out at the time of recruitment and 1 year later to explore the effectiveness of the comprehensive oral health care model. The differences in decayed teeth (dt), decayed tooth surfaces (ds), filled teeth (ft), filled tooth surfaces (fs) and the ratio of ft /(dt + ft) between the two groups were statistically significant (P < 0.001) at 1 year. The incidence of caries in the control group was higher than that of the test group (P = 0.02). The rate of awareness of oral health knowledge (P = 0.01) and the practice of good diet habits (P = 0.02) by parents in the test group were significantly higher than those in the control group. The present study demonstrated that the comprehensive oral health care program reduces and prevents caries amongst children with s-ECC.

  17. Evaluation of retinal nerve fiber layer thickness measurements for glaucoma detection: GDx ECC versus spectral-domain OCT.

    PubMed

    Bertuzzi, Francesca; Benatti, Eleonora; Esempio, Giulia; Rulli, Eliana; Miglior, Stefano

    2014-01-01

    To assess the ability of retinal nerve fiber layer (RNFL) thickness measurements obtained using GDx-enhanced corneal compensation (ECC) or spectral-domain optical coherence tomography (RTVue), and that of ganglion cell complex (GCC) scan available on RTVue, to detect glaucoma. One randomly selected eye of 205 subjects (70 normal, 65 ocular hypertension, and 70 glaucoma) underwent a complete clinical and instrumental examination. RTVue spectral-domain optical coherence tomography was used to assess RNFL thickness and GCC parameters, GDx ECC to assess RNFL thickness. Areas under the receiver operating characteristic curves (AUCs) and sensitivity of the RNFL and GCC parameters were calculated at a fixed specificity of 95%, and the diagnostic abilities of the RNFL values obtained using the 2 instruments were compared. We also compared the results obtained in the normal, ocular hypertensive, and glaucomatous subjects. Best GDx RNFL parameter was nerve fiber indicator (NFI) (AUC 0.99, sensitivity 96%); the best RTVue parameters were average (AUC 0.98, sensitivity 90%), inferior-temporal (AUC 0.97, sensitivity 89%), and superior-temporal RNFL thickness (AUC 0.96, sensitivity 87%). There were no significant differences between the 2 devices (P>0.05). Best GCC parameters were focal loss volume (AUC 0.98, sensitivity 91%) and global loss volume (AUC 0.96, sensitivity 87%). GDx ECC and RTVue show a very good diagnostic ability to detect glaucoma. Most of the RNFL parameters had high AUCs and sensitivities. The diagnostic validity of GCC was comparable with that of the RNFL parameters, and they may be very useful in detecting RNFL damage.

  18. Feeding practice among 6-36 months old in Tanzania and Uganda: reliability and relationship with early childhood caries, ECC.

    PubMed

    Masumo, Ray; Bardsen, Asgeir; Mashoto, Kijakazi; Åstrøm, Anne Nordrehaug

    2013-09-01

    To assess the reproducibility of caregivers' responses to dietary recall from birth and 24-h dietary recall with respect to infants' intake of sugared snacks and to assess whether those assessment methods provide comparable results for groups of infants. Re-test reliability and clinical covariates of time to first exposure of sugared snacks and time to termination of breastfeeding were also examined. It was hypothesized that time to first exposure/termination would vary according to socio-demographic profile and ECC. Interviews and clinical oral examinations were carried out in Kampala and Manyara, including 1221 and 816 child-caregiver pairs. Reproducibility was assessed using Cohen's kappa and Intra Class Correlation Coefficient, ICC. Adjusted Cox regression was used to model time to first exposure of sugared snacks and time to termination of breastfeeding. Cohen's kappa for intake of sugar items ranged from 0.40-1.0, with no differences observed between average intakes at test-re-test. Mean sugar score based on 24-h recall increased significantly by increasing quartiles of the sugar score based on recall from birth. Cox regression revealed that the odds ratio, OR, for early exposure to various sugared snacks and the ORs for early termination of breastfeeding were significantly smaller in infants with than without ECC. Fair-to-good reproducibility was established. Infant's sugar consumption emerge as early as 6 months of age. Survival of any breastfeeding and non-exposure to sugared snacks was most prolonged among infants with ECC. This has implications for interventions needed to improve feeding habits of infants and toddlers.

  19. History of cardiopulmonary bypass (CPB).

    PubMed

    Hessel, Eugene A

    2015-06-01

    The development of cardiopulmonary bypass (CPB), thereby permitting open-heart surgery, is one of the most important advances in medicine in the 20th century. Many currently practicing cardiac anesthesiologists, cardiac surgeons, and perfusionists are unaware of how recently it came into use (60 years) and how much the practice of CPB has changed during its short existence. In this paper, the development of CPB and the many changes and progress that has taken place over this brief period of time, making it a remarkably safe endeavor, are reviewed. The many as yet unresolved questions are also identified, which sets the stage for the other papers in this issue of this journal.

  20. Prevention of early childhood caries (ECC) through parental toothbrushing training and fluoride varnish application: a 24-month randomized controlled trial.

    PubMed

    Jiang, Emily Ming; Lo, Edward Chin Man; Chu, Chun Hung; Wong, May Chun Mei

    2014-12-01

    To investigate the effectiveness of hands-on training in parental toothbrushing, with or without semi-annual applications of 5% sodium fluoride varnish in preventing ECC. Study was conducted in Hong Kong where water is optimally fluoridated. Children aged 8-23 months were recruited and randomly allocated to one of three groups: Gp 1 - control, one-off oral health education talk to parents; Gp 2 - oral health education talk and parental toothbrushing training, reinforced every 6 months; Gp 3 - semi-annual application of fluoride varnish onto child's teeth in addition to the intervention provided to Gp 2. Clinical examinations of the children and interviews were conducted at baseline and after 24 months to assess the children's dental caries status and toothbrushing behaviour. Out of the 450 child-parent dyads recruited at baseline, 415 (92%) remained after 24 months. At baseline, 2% of the children had non-cavitated enamel caries lesions and the mean dmft score was 0.03 ± 0.24. Most of the children did not have daily parental toothbrushing (65-73%) and self toothbrushing (86-90%). At 24-month follow-up, including both non-cavitated and cavitated carious lesions, the incidences of ECC in Gp 1 to Gp 3 were 11.9%, 11.8%, and 17.5%, respectively (p>0.05); and the mean new dmft scores in Gp 1 to Gp 3 were 0.3, 0.2, and 0.3, respectively (p>0.05). Proportions of parents who practiced parental toothbrushing twice daily were 62.7%, 60.4%, and 65.7% in Gp 1 to Gp 3, respectively (p>0.05). In a water fluoridated area, hands-on training in parental toothbrushing, with or without semi-annual application of 5% sodium fluoride varnish may not have additional effect on preventing ECC in young children with low risk of dental caries compared to provision of oral health education to parents. In a water fluoridated area, provision of individual oral health education to parents may be sufficient for preventing ECC in young children below age 3. Supplemental training in parental

  1. Ultra High Bypass Integrated System Test

    NASA Image and Video Library

    2015-09-14

    NASA’s Environmentally Responsible Aviation Project, in collaboration with the Federal Aviation Administration (FAA) and Pratt & Whitney, completed testing of an Ultra High Bypass Ratio Turbofan Model in the 9’ x 15’ Low Speed Wind Tunnel at NASA Glenn Research Center. The fan model is representative of the next generation of efficient and quiet Ultra High Bypass Ratio Turbofan Engine designs.

  2. 40 CFR 403.17 - Bypass.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Bypass. 403.17 Section 403.17 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PRE-TREAT-MENT REGULATIONS FOR EXIST-ING AND NEW SOURCES OF POLLUTION § 403.17 Bypass....

  3. 40 CFR 403.17 - Bypass.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) Definitions. (1) Bypass means the intentional diversion of wastestreams from any portion of an Industrial User... applicable Pretreatment Standards or Requirements. An Industrial User may allow any bypass to occur which... paragraphs (c) and (d) of this section. (c) Notice. (1) If an Industrial User knows in advance of the...

  4. 40 CFR 403.17 - Bypass.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 29 2011-07-01 2009-07-01 true Bypass. 403.17 Section 403.17 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PRE-TREAT-MENT REGULATIONS FOR EXIST-ING AND NEW SOURCES OF POLLUTION § 403.17 Bypass....

  5. 40 CFR 403.17 - Bypass.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... bypass, such as the use of auxiliary treatment facilities, retention of untreated wastes, or maintenance... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PRETREATMENT REGULATIONS FOR EXISTING AND NEW SOURCES OF POLLUTION § 403.17 Bypass. (a...

  6. 40 CFR 403.17 - Bypass.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... bypass, such as the use of auxiliary treatment facilities, retention of untreated wastes, or maintenance... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS GENERAL PRETREATMENT REGULATIONS FOR EXISTING AND NEW SOURCES OF POLLUTION § 403.17 Bypass. (a...

  7. Analysis of pesticides in surface water and sediment from Yolo Bypass, California, 2004-2005

    USGS Publications Warehouse

    Smalling, Kelly L.; Orlando, James L.; Kuivila, Kathryn

    2005-01-01

    Inputs to the Yolo Bypass are potential sources of pesticides that could impact critical life stages of native fish. To assess the direct inputs during inundation, pesticide concentrations were analyzed in water, in suspended and bed-sediment samples collected from six source watersheds to the Yolo Bypass, and from three sites within the Bypass in 2004 and 2005. Water samples were collected in February 2004 from the six input sites to the Bypass during the first flood event of the year representing pesticide inputs during high-flow events. Samples were also collected along a transect across the Bypass in early March 2004 and from three sites within the Bypass in the spring of 2004 under low-flow conditions. Low-flow data were used to understand potential pesticide contamination and its effects on native fish if water from these areas were used to flood the Bypass in dry years. To assess loads of pesticides to the Bypass associated with suspended sediments, large-volume water samples were collected during high flows in 2004 and 2005 from three sites, whereas bed sediments were collected from six sites in the fall of 2004 during the dry season. Thirteen current-use pesticides were detected in surface water samples collected during the study. The highest pesticide concentrations detected at the input sites to the Bypass corresponded to the first high-flow event of the year. The highest pesticide concentrations at the two sites sampled within the Bypass during the early spring were detected in mid-April following a major flood event as the water began to subside. The pesticides detected and their concentrations in the surface waters varied by site; however, hexazinone and simazine were detected at all sites and at some of the highest concentrations. Thirteen current-use pesticides and three organochlorine insecticides were detected in bed and suspended sediments collected in 2004 and 2005. The pesticides detected and their concentrations varied by site and sediment

  8. Bypass Surgery in Limb Salvage: Polytetrafluoroethylene Prosthetic Bypass

    PubMed Central

    Naoum, Joseph J.; Arbid, Elias J.

    2012-01-01

    Polytetrafluoroethylene (PTFE) grafts have proven to be an adequate alternative conduit for peripheral bypass operations. Whether or not one uses PTFE depends on several factors: surgeon preference, individual patient circumstances, or when autologous greater saphenous vein is not available or adequate. These conventional grafts have evolved and undergone modification. The intraluminal surface has been coated with carbon or bonded with heparin. The structure of grafts has been modified with the creation of a hood or cuff, with the incorporation of a stent-graft segment for a sutureless anastomosis, or the fusion of PTFE with an outer polyester layer to minimize suture hole bleeding. This evolution intends to limit graft thrombogenicity, ameliorate the formation of intimal hyperplasia, decrease complications, and improve overall graft patency. PMID:23342188

  9. Comparison of direct and enrichment methods for the selective isolation of vancomycin-resistant enterococci from feces of pigs and poultry.

    PubMed

    Butaye, P; Devriese, L A; Haesebrouck, F

    1999-01-01

    Isolation results of vancomycin-resistant enterococci (VRE) of fecal samples from pigs and broiler and layer chickens obtained with two vancomycin-supplemented enrichment media, kanamycin aesculin azide (KAA) broth and Enterococcosel (ECC) broth, and three isolation media, KAA agar, ECC agar, and Slanetz and Bartley (SL) agar, were compared. Direct isolation on vancomycin-containing agar plates was not efficient in swine and layer chickens, which had only low numbers of VRE. In broilers chickens, the VRE content of the samples was high, and SL as well as ECC were found to perform better than KAA agar. The same three agar media were used as selective plating media after 1 and 2 days incubation of the samples in KAA and ECC enrichment broths. Sensitivities of the 12 different enrichment-plate combinations tested ranged from 0 to 81% in layer chickens and from 5 to 44% in samples from pigs. In the high prevalence type of samples from broilers, sensitivities still varied substantially from 52 to 78%. Incubating vancomycin-containing enrichment broths for 2 days compared with 1 day was favorable for the isolation of vancomycin-resistant Enterococcus faecalis, E. gallinarum, and E. casseliflavus but not for E. faecium and E. hirae/E. durans. ECC broth and ECC plates yielded the highest number of E. gallinarum and E. casseliflavus. In layer as well as in broiler chickens, ECC broth incubated for 2 days and plated on ECC agar was the most sensitive method. In pigs, however, KAA broth incubated for 2 days and plated on ECC medium yielded the highest number of VRE.

  10. Satellite and correlative measurements of stratospheric ozone - Comparison of measurements made by SAGE, ECC balloons, chemiluminescent, and optical rocketsondes

    NASA Technical Reports Server (NTRS)

    Mccormick, M. P.; Swissler, T. J.; Osborn, M. T.; Hilsenrath, E.; Krueger, A. J.

    1984-01-01

    The validity of ozone-profile data from the satellite sensor SAGE was tested in a series of correlative experiments conducted at five fixed sites between 6 deg S and 65 deg N during 1979-1980. The intercomparisons included data taken with electrochemical ozone (ECC) balloonsondes and chemiluminescent and optical rocketsondes. The average mean difference for 17 separate comparisons between the SAGE and ECC balloonsonde observations over the altitudes 18-28 km was 9.3 percent with a standard deviation of 2.8 percent. Excluding comparisons separated by greater than 500 km reduces the average mean difference to 8.9 percent and the standard deviation to 2.1 percent. The average mean difference between SAGE and three optical rocketsonde observations over the altitudes 25-50 km was 11 percent, and between SAGE and two chemiluminescent rocketsondes over the altitudes 20-60 km it was 13.5 percent. Considering the differences in vertical resolution, experimental errors, and ozone time and space gradients, the agreement between SAGE-derived ozone profiles and these correlative measurements is considered very good. In addition, isopleths of ozone mixing ratio versus latitude and altitude are in good agreement with previously published results.

  11. Neuropsychological changes after cardiopulmonary bypass for coronary artery bypass grafting.

    PubMed

    Wimmer-Greinecker, G; Matheis, G; Brieden, M; Dietrich, M; Oremek, G; Westphal, K; Winkelmann, B R; Moritz, A

    1998-08-01

    An alarming incidence (1% to 83%) of neuropsychological dysfunction has been reported after operations using cardiopulmonary bypass (CPB). The present clinical study re-evaluates these complications with current CPB technology in a strictly selected low-risk group of coronary artery bypass (CABG) patients. 76 CABG patients, without history of stroke or internal carotid artery stenosis, were examined before, 5 days after, and 2 months after surgery. A neuropsychological test battery was employed according to the "Statement of Consensus on Assessment of Neurobehavioral Outcomes after Cardiac Surgery". Tests include the Block Design Test (problem-solving strategies, recognition and analysis of forms), the Trail Making Test (cognitive achievement at speed), and the Digit Span Test (short-term memory and memory of figures). Both postoperative test scores were not significantly decreased as compared to preoperative values. In contrast, neuron specific enolase (NSE) and S100 b protein, biochemical markers of cerebral injury, increased markedly during and immediately after surgery (NSE preop.: 7.07 +/- 2.40 ng/ml, 1 h postop.: 13.64 +/- 4.50 ng/ml, p < 0.001; S100 b preop.: 0.04 +/- 0.07 ng/ml, after crossclamp: 0.90 +/- 0.69 ng/ml, p < 0.001). One patient displayed postoperative transitional syndrome, another patient suffered from transitory paresis and hypesthesia of the left arm, which disappeared during hospital stay. Biochemical markers demonstrate significant postoperative cerebral injury during and immediately after CPB. However, CPB for CABG does not lead to marked impairment of neuropsychological scores, and clinically relevant neurological findings were observed in one patient only.

  12. Interpositional carotid artery bypass strategies in the surgical management of aneurysms and tumors of the skull base.

    PubMed

    Liu, James K; Couldwell, William T

    2003-03-15

    Cerebral revascularization is an important component in the surgical management of complex skull base tumors and aneurysms. Patients who harbor complex aneurysms that cannot be clipped directly and in whom parent vessel occlusion cannot be tolerated may require cerebrovascular bypass surgery. In cases in which skull base tumors encase the carotid artery (CA) and a resection is desired, a cerebrovascular bypass may be necessary in planned CA occlusion or sacrifice. In this review the authors discuss options for performing high-flow anterograde interposition CA bypass for lesions of the skull base. The authors review three important bypass techniques involving saphenous vein grafts: the cervical-to-petrous internal carotid artery (ICA), petrous-to-supraclinoid ICA, and cervical-to-supraclinoid ICA bypass. These revascularization techniques are important tools in the surgical treatment of complex aneurysms and tumors of the skull base and cavernous sinus.

  13. Effect of sucrose concentration on sucrose-dependent adhesion and glucosyltransferase expression of S. mutans in children with severe early-childhood caries (S-ECC).

    PubMed

    Zhao, Wei; Li, Wenqing; Lin, Jiacheng; Chen, Zhuoyu; Yu, Dongsheng

    2014-09-09

    Sucrose, extracellular polysaccharide, and glucosyltransferases (GTFs) are key factors in sucrose-dependent adhesion and play important roles in the process of severe early-childhood caries (S-ECC). However, whether sucrose concentration regulates gtf expression, extracellular polysaccharide synthesis, and sucrose-dependent adhesion is related to the different genotypes of S. mutans isolated from ECC in children and still needs to be investigated. In this study, 52 strains of S. mutans were isolated from children with S-ECC and caries-free (CF) children. Water-insoluble glucan (WIG) synthesis was detected by the anthrone method, adhesion capacity by the turbidimetric method, and expression of gtf by RT-PCR in an in vitro model containing 1%-20% sucrose. The genotypes of S. mutans were analyzed by AP-PCR. The results showed that WIG synthesis, adhesion capacity, and gtf expression increased significantly when the sucrose concentration was from 1% to 10%. WIG synthesis and gtfB as well as gtfC expression of the 1% and 5% groups were significantly lower than those of the 10% and 20% groups (p < 0.05). There were no significant differences between the 10% and 20% groups. The fingerprints of S. mutans detected from individuals in the S-ECC group exhibited a significant difference in diversity compared with those from CF individuals (p < 0.05). Further, the expression of gtfB and gtfC in the S-ECC group was significantly different among the 1- to 5-genotype groups (p < 0.05). It can be concluded that sucrose-dependent adhesion might be related to the diversity of genotypes of S. mutans, and the 10% sucrose level can be seen as a "turning point" and essential factor for the prevention of S-ECC.

  14. Effect of Sucrose Concentration on Sucrose-Dependent Adhesion and Glucosyltransferase Expression of S. mutans in Children with Severe Early-Childhood Caries (S-ECC)

    PubMed Central

    Zhao, Wei; Li, Wenqing; Lin, Jiacheng; Chen, Zhuoyu; Yu, Dongsheng

    2014-01-01

    Sucrose, extracellular polysaccharide, and glucosyltransferases (GTFs) are key factors in sucrose-dependent adhesion and play important roles in the process of severe early-childhood caries (S-ECC). However, whether sucrose concentration regulates gtf expression, extracellular polysaccharide synthesis, and sucrose-dependent adhesion is related to the different genotypes of S. mutans isolated from ECC in children and still needs to be investigated. In this study, 52 strains of S. mutans were isolated from children with S-ECC and caries-free (CF) children. Water-insoluble glucan (WIG) synthesis was detected by the anthrone method, adhesion capacity by the turbidimetric method, and expression of gtf by RT-PCR in an in vitro model containing 1%–20% sucrose. The genotypes of S. mutans were analyzed by AP-PCR. The results showed that WIG synthesis, adhesion capacity, and gtf expression increased significantly when the sucrose concentration was from 1% to 10%. WIG synthesis and gtfB as well as gtfC expression of the 1% and 5% groups were significantly lower than those of the 10% and 20% groups (p < 0.05). There were no significant differences between the 10% and 20% groups. The fingerprints of S. mutans detected from individuals in the S-ECC group exhibited a significant difference in diversity compared with those from CF individuals (p < 0.05). Further, the expression of gtfB and gtfC in the S-ECC group was significantly different among the 1- to 5-genotype groups (p < 0.05). It can be concluded that sucrose-dependent adhesion might be related to the diversity of genotypes of S. mutans, and the 10% sucrose level can be seen as a “turning point” and essential factor for the prevention of S-ECC. PMID:25207825

  15. Comparison of diagnostic accuracy of the RTVue Fourier-domain OCT and the GDx-VCC/ECC polarimeter to detect glaucoma.

    PubMed

    Garas, Anita; Vargha, Péter; Holló, Gábor

    2012-01-01

    To compare sensitivity and specificity of retinal nerve fiber layer thickness (RNFLT) measurements made using RTVue-100 Fourier-domain optical coherence tomography (RTVue-OCT) and scanning laser polarimetry with variable (GDx-VCC) or enhanced compensation (GDx-ECC). One eye of each of 177 consecutive patients was imaged. Healthy (n=50) and ocular hypertensive (n = 28) eyes were defined as structurally undamaged, preperimetric (n=33) and perimetric (n=66) glaucoma eyes as diseased. For average RNFLT, sensitivity was higher (χ(2) test, p=0.002) with RTVue-OCT (65.7%) than with GDx-VCC (49.5%). For superior and inferior RNFLT, sensitivity was similar with all methods. For the different nerve fiber bundle parameters, sensitivity of RTVue-OCT (64.6% to 84.8%) was consistently up to 35% higher (p<0.001) than that of GDx-VCC/ECC (28.3% to 72.7%). Specificity ranged from 84.6% to 98.7% with RTVue-OCT, 92.3% to 100% with GDx-VCC, and 94.9% to 100% with GDx-ECC, with no significant difference between the methods except for one nerve fiber bundle parameter, for which RTVue-OCT was less specific than either GDx method (p ≤ 0.004). Diagnostic accuracy of the GDx-VCC/ECC nerve fiber indicator (NFI) and RTVue-OCT average RNFLT were similar. Of the detected glaucoma cases, 87.7% were identified both by GDx-VCC/ECC NFI and average RNFLT of RTVue-OCT. In this clinical setting, all methods were similarly highly specific, but for localized RNFLT damage RTVue-OCT was statistically and clinically significantly more sensitive than GDx-VCC and GDx-ECC. Most detected glaucoma cases were identified with all 3 methods.

  16. Does the additional use of heparin-coated extracorporeal circuits (ECC) optimize the effect of modified ultrafiltration (MUF) in pediatric perfusion?

    PubMed

    Harig, F; Meier, C; Hakami, L; Strasser, R; Bretzger, J; Münch, F; Vestweber-Wilmes, E; Singer, H; Weyand, M; Cesnjevar, R

    2006-04-01

    Modified ultrafiltration (MUF) has been shown to exert beneficial effects on the coagulation system and the capillary leak after pediatric cardiac surgery using extracorporeal circulation (ECC). The aim of this study was to investigate whether the additional use of heparin-coated circuits is a useful option for improving biocompatibility. We randomized 28 children, using heparin-coated ECC circuits in group A (n = 14) and an uncoated equivalent set in group B (n = 14). After congenital heart surgery, MUF was performed post ECC in a standardized fashion. Blood samples were analyzed preoperatively, 10 min, 30 min, 1 h, and 48 h after ECC by flow cytometric analysis (FACSort) using surface antigens CD62/CD41b (platelets) and CD45/CD14 (monocytes). No significant difference was found with respect to mean age (20.6 months vs. 21.6 months), mean body weight (9.2 kg vs. 8.4 kg), mean ultrafiltration rate (9.1 ml/kg vs. 11.4 ml/kg), chest tube drainage, blood products, ICU stay, and 30-d survival. The percentage of CD62/CD41-positive platelets in group A (vs. B) increased up to 118 % at 60 min vs. 130 % ( P < 0.05) and declined to 98 % at 48 h postop. vs. 99 % (n. s.). The percentage of CD45/CD14-positive monocytes in group A (vs. B) increased up to 158 % at 60 min vs. 155 % (n. s.) and declined to 122 % (A) at 48 h postop. vs. 61 % (B) ( P > 0.05). Heparin coating of ECC in addition to MUF leads to a lower platelet activation. Monocyte surface markers CD45 and CD14 indicated a marked activation during ECC in both groups but additional heparin coating showed a better postoperative regeneration of monocyte markers in the late course indicating a beneficial additive effect.

  17. Capacity analysis of a bypass of roundabouts

    NASA Astrophysics Data System (ADS)

    Sedlačik, Ivan; Slabý, Petr

    2017-09-01

    The capacity of the roads network mainly depends on the capacity of its nodal points - intersections. A connecting branch or a bypass is a lane or lanes inserted between two adjacent branches of a roundabout, providing redirection of vehicles, that would otherwise burden a circular lane. A bypass effect to the capacity of roundabouts, but also other types of level intersections, is undeniable. A connecting branch increases the total capacity of an intersection that takes a part of vehicles performing a manoeuver of the first right turn completely out of an intersection area. Redirecting vehicles reduces delay times at intersections and reduces queues at the entrance to an intersection. Bypasses improve the quality of transport. Limiting for the capacity of bypasses is the point of disconnection from the entrance into the roundabout and the connection point into the exit from the roundabout. Central parts of the bypasses have minimal effects on the capacity. The length of a bypass has to match with the maximum length of a queue of waiting vehicles at a given intensity level. The article deals with analysis of the bypass capacity at the roundabouts.

  18. Gastric bypass reversal: a 7-year experience.

    PubMed

    Pernar, Luise I M; Kim, Julie J; Shikora, Scott A

    After gastric bypass, some patients develop conditions that ultimately require reversal of the bypass. There are currently few publications on the topic to guide clinicians. To describe the indications, techniques, and outcomes for gastric bypass reversal. Two academic medical centers. We conducted a retrospective chart review of all patients who underwent gastric bypass reversal at our institutions between 2008 and 2015. Information regarding the original operation, the indications for reversal, procedures performed, and the postoperative outcomes were collected and analyzed. Nineteen patients underwent gastric bypass reversal. All but 4 reversal operations were performed laparoscopically. The indications for reversal were malnutrition or excessive weight loss (6 patients); chronic nausea, vomiting, and abdominal pain (5); neuroglycopenia (4); massive small bowel loss due to internal hernia (3); and need for surveillance gastric endoscopy (1). In the perioperative period, 4 patients had a complication that required intervention. Five patients required additional delayed procedures. One patient was lost to follow-up. The remaining patients' mean follow-up was 22±18 months. Symptoms that prompted reversal of the gastric bypass resolved in the majority of patients. However, 1 patient's hypoglycemia did not resolve and 2 continued to have diarrhea. Six patients were weaned off of total parenteral nutrition. Laparoscopic gastric bypass reversal is feasible and well tolerated. The procedure can be employed to treat a variety of conditions that may occur after gastric bypass and the majority of patients benefit, with resolution of symptoms. In a carefully selected patient population, gastric bypass reversal should be considered if conservative approaches to adverse conditions fail. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  19. Gastric bypass reduces fat intake and preference.

    PubMed

    le Roux, Carel W; Bueter, Marco; Theis, Nadine; Werling, Malin; Ashrafian, Hutan; Löwenstein, Christian; Athanasiou, Thanos; Bloom, Stephen R; Spector, Alan C; Olbers, Torsten; Lutz, Thomas A

    2011-10-01

    Roux-en-Y gastric bypass is the most effective therapy for morbid obesity. This study investigated how gastric bypass affects intake of and preference for high-fat food in an experimental (rat) study and within a trial setting (human). Proportion of dietary fat in gastric bypass patients was significantly lower 6 yr after surgery compared with patients after vertical-banded gastroplasty (P = 0.046). Gastric bypass reduced total fat and caloric intake (P < 0.001) and increased standard low-fat chow consumption compared with sham controls (P < 0.001) in rats. Compared with sham-operated rats, gastric bypass rats displayed much lower preferences for Intralipid concentrations > 0.5% in an ascending concentration series (0.005%, 0.01%, 0.05%, 0.1%, 0.5%, 1%, 5%) of two-bottle preference tests (P = 0.005). This effect was demonstrated 10 and 200 days after surgery. However, there was no difference in appetitive or consummatory behavior in the brief access test between the two groups (P = 0.71) using similar Intralipid concentrations (0.005% through 5%). Levels of glucagon-like peptide-1 (GLP-1) were increased after gastric bypass as expected. An oral gavage of 1 ml corn oil after saccharin ingestion in gastric bypass rats induced a conditioned taste aversion. These findings suggest that changes in fat preference may contribute to long-term maintained weight loss after gastric bypass. Postingestive effects of high-fat nutrients resulting in conditioned taste aversion may partially explain this observation; the role of GLP-1 in mediating postprandial responses after gastric bypass requires further investigation.

  20. Gastric bypass reduces fat intake and preference

    PubMed Central

    Bueter, Marco; Theis, Nadine; Werling, Malin; Ashrafian, Hutan; Löwenstein, Christian; Athanasiou, Thanos; Bloom, Stephen R.; Spector, Alan C.; Olbers, Torsten; Lutz, Thomas A.

    2011-01-01

    Roux-en-Y gastric bypass is the most effective therapy for morbid obesity. This study investigated how gastric bypass affects intake of and preference for high-fat food in an experimental (rat) study and within a trial setting (human). Proportion of dietary fat in gastric bypass patients was significantly lower 6 yr after surgery compared with patients after vertical-banded gastroplasty (P = 0.046). Gastric bypass reduced total fat and caloric intake (P < 0.001) and increased standard low-fat chow consumption compared with sham controls (P < 0.001) in rats. Compared with sham-operated rats, gastric bypass rats displayed much lower preferences for Intralipid concentrations > 0.5% in an ascending concentration series (0.005%, 0.01%, 0.05%, 0.1%, 0.5%, 1%, 5%) of two-bottle preference tests (P = 0.005). This effect was demonstrated 10 and 200 days after surgery. However, there was no difference in appetitive or consummatory behavior in the brief access test between the two groups (P = 0.71) using similar Intralipid concentrations (0.005% through 5%). Levels of glucagon-like peptide-1 (GLP-1) were increased after gastric bypass as expected. An oral gavage of 1 ml corn oil after saccharin ingestion in gastric bypass rats induced a conditioned taste aversion. These findings suggest that changes in fat preference may contribute to long-term maintained weight loss after gastric bypass. Postingestive effects of high-fat nutrients resulting in conditioned taste aversion may partially explain this observation; the role of GLP-1 in mediating postprandial responses after gastric bypass requires further investigation. PMID:21734019

  1. Bearing-bypass material system test

    NASA Astrophysics Data System (ADS)

    Crew, John H., Jr.

    1988-01-01

    A material specimen containing a central hole is bolted between two bearing guide plates. An applied load control exerts an applied load, either tension or compression, to one end of the specimen and a bypass load control applies a bypass load to the other end of the specimen. Both load controls have their control inputs supplied by a single input signal generator. The difference between the applied load and the bypass load is transmitted through the bolt and plate to the bearing load cells.

  2. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass pump speed control. 870... Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a... control the speed of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class...

  3. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass pump speed control. 870... Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a... control the speed of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class...

  4. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass pump speed control. 870... Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a... control the speed of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class...

  5. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass pump speed control. 870... Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a... control the speed of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class...

  6. 30 CFR 56.19018 - Overtravel by-pass switches.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Overtravel by-pass switches. 56.19018 Section... Hoisting Hoists § 56.19018 Overtravel by-pass switches. When an overtravel by-pass switch is installed, the... switch is held in the closed position by the hoistman. The overtravel by-pass switch shall...

  7. 30 CFR 57.19018 - Overtravel by-pass switches.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Overtravel by-pass switches. 57.19018 Section... Hoisting Hoists § 57.19018 Overtravel by-pass switches. When an overtravel by-pass switch is installed, the... switch is held in the closed position by the hoistman. The overtravel by-pass switch shall...

  8. 21 CFR 870.4380 - Cardiopulmonary bypass pump speed control.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pump speed control. 870... Cardiopulmonary bypass pump speed control. (a) Identification. A cardiopulmonary bypass pump speed control is a... control the speed of blood pumps used in cardiopulmonary bypass surgery. (b) Classification. Class...

  9. 30 CFR 57.19018 - Overtravel by-pass switches.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Overtravel by-pass switches. 57.19018 Section... Hoisting Hoists § 57.19018 Overtravel by-pass switches. When an overtravel by-pass switch is installed, the... switch is held in the closed position by the hoistman. The overtravel by-pass switch shall return...

  10. 30 CFR 57.19018 - Overtravel by-pass switches.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Overtravel by-pass switches. 57.19018 Section... Hoisting Hoists § 57.19018 Overtravel by-pass switches. When an overtravel by-pass switch is installed, the... switch is held in the closed position by the hoistman. The overtravel by-pass switch shall return...

  11. 30 CFR 56.19018 - Overtravel by-pass switches.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Overtravel by-pass switches. 56.19018 Section... Hoisting Hoists § 56.19018 Overtravel by-pass switches. When an overtravel by-pass switch is installed, the... switch is held in the closed position by the hoistman. The overtravel by-pass switch shall return...

  12. 30 CFR 56.19018 - Overtravel by-pass switches.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Overtravel by-pass switches. 56.19018 Section... Hoisting Hoists § 56.19018 Overtravel by-pass switches. When an overtravel by-pass switch is installed, the... switch is held in the closed position by the hoistman. The overtravel by-pass switch shall return...

  13. 30 CFR 57.19018 - Overtravel by-pass switches.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Overtravel by-pass switches. 57.19018 Section... Hoisting Hoists § 57.19018 Overtravel by-pass switches. When an overtravel by-pass switch is installed, the... switch is held in the closed position by the hoistman. The overtravel by-pass switch shall return...

  14. 30 CFR 57.19018 - Overtravel by-pass switches.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Overtravel by-pass switches. 57.19018 Section... Hoisting Hoists § 57.19018 Overtravel by-pass switches. When an overtravel by-pass switch is installed, the... switch is held in the closed position by the hoistman. The overtravel by-pass switch shall return...

  15. 30 CFR 56.19018 - Overtravel by-pass switches.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Overtravel by-pass switches. 56.19018 Section... Hoisting Hoists § 56.19018 Overtravel by-pass switches. When an overtravel by-pass switch is installed, the... switch is held in the closed position by the hoistman. The overtravel by-pass switch shall return...

  16. 30 CFR 56.19018 - Overtravel by-pass switches.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Overtravel by-pass switches. 56.19018 Section... Hoisting Hoists § 56.19018 Overtravel by-pass switches. When an overtravel by-pass switch is installed, the... switch is held in the closed position by the hoistman. The overtravel by-pass switch shall return...

  17. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass coronary pressure gauge... Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood...

  18. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood perfusing... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass coronary pressure gauge...

  19. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood perfusing... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass coronary pressure gauge...

  20. 21 CFR 870.4310 - Cardiopulmonary bypass coronary pressure gauge.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Cardiopulmonary bypass coronary pressure gauge. (a) Identification. A cardiopulmonary bypass coronary pressure gauge is a device used in cardiopulmonary bypass surgery to measure the pressure of the blood perfusing... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass coronary pressure gauge...

  1. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in conjunction with short-term extracorporeal circulation devices to hold a reserve supply of blood in the bypass...

  2. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in conjunction with short-term extracorporeal circulation devices to hold a reserve supply of blood in the bypass...

  3. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in conjunction with short-term extracorporeal circulation devices to hold a reserve supply of blood in the bypass...

  4. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in conjunction with short-term extracorporeal circulation devices to hold a reserve supply of blood in the bypass...

  5. 21 CFR 870.4400 - Cardiopulmonary bypass blood reservoir.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass blood reservoir. 870.4400... bypass blood reservoir. (a) Identification. A cardiopulmonary bypass blood reservoir is a device used in conjunction with short-term extracorporeal circulation devices to hold a reserve supply of blood in the bypass...

  6. Superficial Temporal Artery-Middle Cerebral Artery Bypass Surgery for Refractory Symptomatic Intracranial Atherosclerotic Stenosis.

    PubMed

    Ma, Yan; Yang, Fan; Jiao, Liqun; Li, Meng; Wang, Yabing; Chen, Yanfei; Ling, Feng

    2017-08-01

    To evaluate blood flow changes after bypass surgery for refractory symptomatic intracranial atherosclerotic stenosis (ICAS). We examined a cohort of consecutive patients with symptomatic ICAS. Superficial temporal artery-middle cerebral artery (MCA) bypass was performed in refractory patients with poor perfusion. Angiograms were graded systematically for antegrade, collateral, and bypass flow, and clinical variables were collected preoperatively, at 7 days postoperatively, and 3, 6, and 12 months postoperatively. Among 185 consecutive cases with ICAS, 15 patients who were unsuitable for or did not respond to the best medical therapy or stenting underwent bypass surgery. No patients had new ischemic deficits within 7 days postoperatively. The mean follow-up period was 30.2 ± 12.3 months. Within this period, all anastomoses were patent by methods of ultrasound or computed tomography angiography. In 2 patients, stenotic lesions exhibited early postoperative occlusion conversion at 7 days on digital subtraction angiography. In 2 patients, stenotic lesions showed progression of occlusion at 6 and 8 months. The 2 lesions with early occlusion were both located in the MCA. The extent of retrograde blood flow via bypass anastomosis was correlated with early occlusion conversion. For refractory ICAS in patients with compromised hemodynamics, direct bypass might induce early occlusion of a stenotic area. MCA lesions may have a greater tendency toward early occlusion conversion. Copyright © 2017. Published by Elsevier Inc.

  7. Isopentenyl diphosphate (IPP)-bypass mevalonate pathways for isopentenol production

    SciTech Connect

    Kang, Aram; George, Kevin W.; Wang, George; Baidoo, Edward; Keasling, Jay D.; Lee, Taek Soon

    2015-12-17

    Branched C 5 alcohols are promising biofuels with excellent combustion properties. A mevalonate (MVA)-based isoprenoid biosynthetic pathway for C 5 alcohols was constructed in Escherichia coli using genes from several organisms, and the pathway was optimized to achieve over 50% theoretical yield. Although the MVA pathway is energetically less efficient than the native methylerythritol 4-phosphate (MEP) pathway, implementing the MVA pathway in bacterial hosts such as E. coli is advantageous due to its lack of endogenous regulation. The MVA and MEP pathways intersect at isopentenyl diphosphate (IPP), the direct precursor to isoprenoid-derived C 5 alcohols and initial precursor to longer chain terpenes, which makes independent regulation of the pathways difficult. In pursuit of the complete "decoupling" of the MVA pathway from native cellular regulation, we designed novel IPP-bypass MVA pathways for C 5 alcohol production by utilizing promiscuous activities of two enzymes, phosphomevalonate decarboxylase (PMD) and an E. coli-endogenous phosphatase (AphA). These bypass pathways have reduced energetic requirements, are further decoupled from intrinsic regulation, and are free from IPP-related toxicity. In addition to these benefits, we demonstrate that reduced aeration rate has less impact on the bypass pathway than the original MVA pathway. Finally, we showed that performance of the bypass pathway was primarily determined by the activity of PMD. We designed PMD mutants with improved activity and demonstrated titer increases in the mutant strains. These modified pathways would be a good platform for industrial production of isopentenol and related chemicals such as isoprene.

  8. A systematic review on robotic coronary artery bypass graft surgery.

    PubMed

    Cao, Christopher; Indraratna, Praveen; Doyle, Mathew; Tian, David H; Liou, Kevin; Munkholm-Larsen, Stine; Uys, Ciska; Virk, Sohaib

    2016-11-01

    Robotic-assisted coronary artery bypass graft surgery (CABG) has been performed over the past decade. Despite encouraging results from selected centres, there is a paucity of robust clinical data to establish its clinical safety and efficacy. The present systematic review aimed to identify all relevant clinical data on robotic CABG. The primary endpoint was perioperative mortality, and secondary endpoints included perioperative morbidities, anastomotic complications, and long-term survival. Electronic searches were performed using three online databases from their dates of inception to 2016. Relevant studies fulfilling the predefined search criteria were categorized according to surgical techniques as (I) totally endoscopic coronary artery bypass without cardiopulmonary bypass (TECAB off-pump); (II) TECAB on-pump; and robotic-assisted mammary artery harvesting followed by minimally invasive direct coronary artery bypass (robotic MIDCAB). The present systematic review identified 44 studies that fulfilled the study selection criteria, including nine studies in the TECAB off-pump group and 16 studies in the robotic MIDCAB group. Statistical analysis reported a pooled mortality of 1.7% for the TECAB off-pump group and 1.0% for the robotic MIDCAB group. Intraoperative details such as the number and location of grafts performed, operative times and conversion rates, as well as postoperative secondary endpoints such as morbidities, anastomotic complications and long-term outcomes were also summarized for both techniques. A number of technical, logistic and cost-related issues continue to hinder the popularization of the robotic CABG procedure. Current clinical evidence is limited by a lack of randomized controlled trials, heterogeneous definition of techniques and complications, as well as a lack of robust clinical follow-up with routine angiography. Nonetheless, the present systematic review reported acceptable perioperative mortality rates for selected patients at

  9. A systematic review on robotic coronary artery bypass graft surgery

    PubMed Central

    Indraratna, Praveen; Doyle, Mathew; Tian, David H.; Liou, Kevin; Munkholm-Larsen, Stine; Uys, Ciska; Virk, Sohaib

    2016-01-01

    Background Robotic-assisted coronary artery bypass graft surgery (CABG) has been performed over the past decade. Despite encouraging results from selected centres, there is a paucity of robust clinical data to establish its clinical safety and efficacy. The present systematic review aimed to identify all relevant clinical data on robotic CABG. The primary endpoint was perioperative mortality, and secondary endpoints included perioperative morbidities, anastomotic complications, and long-term survival. Methods Electronic searches were performed using three online databases from their dates of inception to 2016. Relevant studies fulfilling the predefined search criteria were categorized according to surgical techniques as (I) totally endoscopic coronary artery bypass without cardiopulmonary bypass (TECAB off-pump); (II) TECAB on-pump; and robotic-assisted mammary artery harvesting followed by minimally invasive direct coronary artery bypass (robotic MIDCAB). Results The present systematic review identified 44 studies that fulfilled the study selection criteria, including nine studies in the TECAB off-pump group and 16 studies in the robotic MIDCAB group. Statistical analysis reported a pooled mortality of 1.7% for the TECAB off-pump group and 1.0% for the robotic MIDCAB group. Intraoperative details such as the number and location of grafts performed, operative times and conversion rates, as well as postoperative secondary endpoints such as morbidities, anastomotic complications and long-term outcomes were also summarized for both techniques. Conclusions A number of technical, logistic and cost-related issues continue to hinder the popularization of the robotic CABG procedure. Current clinical evidence is limited by a lack of randomized controlled trials, heterogeneous definition of techniques and complications, as well as a lack of robust clinical follow-up with routine angiography. Nonetheless, the present systematic review reported acceptable perioperative

  10. Isopentenyl diphosphate (IPP)-bypass mevalonate pathways for isopentenol production

    DOE PAGES

    Kang, Aram; George, Kevin W.; Wang, George; ...

    2015-12-17

    Branched C 5 alcohols are promising biofuels with excellent combustion properties. A mevalonate (MVA)-based isoprenoid biosynthetic pathway for C 5 alcohols was constructed in Escherichia coli using genes from several organisms, and the pathway was optimized to achieve over 50% theoretical yield. Although the MVA pathway is energetically less efficient than the native methylerythritol 4-phosphate (MEP) pathway, implementing the MVA pathway in bacterial hosts such as E. coli is advantageous due to its lack of endogenous regulation. The MVA and MEP pathways intersect at isopentenyl diphosphate (IPP), the direct precursor to isoprenoid-derived C 5 alcohols and initial precursor to longermore » chain terpenes, which makes independent regulation of the pathways difficult. In pursuit of the complete "decoupling" of the MVA pathway from native cellular regulation, we designed novel IPP-bypass MVA pathways for C 5 alcohol production by utilizing promiscuous activities of two enzymes, phosphomevalonate decarboxylase (PMD) and an E. coli-endogenous phosphatase (AphA). These bypass pathways have reduced energetic requirements, are further decoupled from intrinsic regulation, and are free from IPP-related toxicity. In addition to these benefits, we demonstrate that reduced aeration rate has less impact on the bypass pathway than the original MVA pathway. Finally, we showed that performance of the bypass pathway was primarily determined by the activity of PMD. We designed PMD mutants with improved activity and demonstrated titer increases in the mutant strains. These modified pathways would be a good platform for industrial production of isopentenol and related chemicals such as isoprene.« less

  11. Frataxin-bypassing Isu1: characterization of the bypass activity in cells and mitochondria.

    PubMed

    Yoon, Heeyong; Knight, Simon A B; Pandey, Alok; Pain, Jayashree; Zhang, Yan; Pain, Debkumar; Dancis, Andrew

    2014-04-01

    Frataxin is a conserved mitochondrial protein, and deficiency underlies the neurodegenerative disease Friedreich's ataxia. Frataxin interacts with the core machinery for Fe-S cluster assembly in mitochondria. Recently we reported that in frataxin-deleted yeast strains, a spontaneously occurring mutation in one of two genes encoding redundant Isu scaffold proteins, bypassed the mutant phenotypes. In the present study we created strains expressing a single scaffold protein, either Isu1 or the bypass mutant M107I Isu1. Our results show that in the frataxin-deletion strain expressing the bypass mutant Isu1, cell growth, Fe-S cluster protein activities, haem proteins and iron homoeostasis were restored to normal or close to normal. The bypass effects were not mediated by changes in Isu1 expression level. The persulfide-forming activity of the cysteine desulfurase was diminished in the frataxin deletion (∆yfh1 ISU1) and was improved by expression of the bypass Isu1 (∆yfh1 M107I ISU1). The addition of purified bypass M107I Isu1 protein to a ∆yfh1 lysate conferred similar enhancement of cysteine desulfurase as did frataxin, suggesting that this effect contributed to the bypass mechanism. Fe-S cluster-forming activity in isolated mitochondria was stimulated by the bypass Isu1, albeit at a lower rate. The rescuing effects of the bypass Isu1 point to ways that the core defects in Friedreich's ataxia mitochondria can be restored.

  12. Exhaust gas bypass valve control for thermoelectric generator

    SciTech Connect

    Reynolds, Michael G; Yang, Jihui; Meisner, Greogry P.; Stabler, Francis R.; De Bock, Hendrik Pieter Jacobus; Anderson, Todd Alan

    2012-09-04

    A method of controlling engine exhaust flow through at least one of an exhaust bypass and a thermoelectric device via a bypass valve is provided. The method includes: determining a mass flow of exhaust exiting an engine; determining a desired exhaust pressure based on the mass flow of exhaust; comparing the desired exhaust pressure to a determined exhaust pressure; and determining a bypass valve control value based on the comparing, wherein the bypass valve control value is used to control the bypass valve.

  13. Leading-edge effects in bypass transition

    NASA Astrophysics Data System (ADS)

    Nagarajan, S.; Lele, S. K.; Ferziger, J. H.

    The effect of a blunt leading edge on bypass transition is studied by numerical simulation. A mixed direct and large-eddy simulation of a flat plate with a super-ellipse leading edge is carried out at various conditions. Onset and completion of transition is seen to move upstream with increasing bluntness. For sharper leading edges, at lower levels of turbulence, transition usually occurs through instabilities on low-speed streaks as observed by Jacobs & Durbin (2001) and Brandt et al. (2004) whereas increasing either the turbulence intensity or the leading-edge bluntness brings into play another mechanism. Free-stream vortices are amplified at the leading edge because of stretching. In the case of particularly strong vortices, this interaction induces a localized streamwise vortical disturbance in the boundary layer which then grows as it convects downstream and eventually breaks down to form a turbulent spot. These disturbances, which are localized and hence wavepacket-like, move at speeds in the range 0.55 U_{infty} 0.65 U_{infty} and occur in the lower portion of the boundary layer. Simulations conducted with isolated vortices confirm such a response of the boundary layer.

  14. Gastric infarction following gastric bypass surgery.

    PubMed

    Do, Patrick H; Kang, Young S; Cahill, Peter

    2016-04-01

    Gastric infarction is an extremely rare occurrence owing to the stomach's extensive vascular supply. We report an unusual case of gastric infarction following gastric bypass surgery. We describe the imaging findings and discuss possible causes of this condition.

  15. Heart bypass surgery - minimally invasive - discharge

    MedlinePlus

    ... thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest . 2012;141(2 ... bypass surgery - minimally invasive Heart failure - overview High blood cholesterol ...

  16. History of surgical treatment of ischemic heart disease--pre-'coronary bypass grafting' era.

    PubMed

    Kumar, Pawan; Moussa, Fuad; Nesher, Nachum; Goldman, Bernard

    2007-01-01

    To review the various concepts, surgical experiments, and actual procedures performed for the treatment of ischemic heart disease, which eventually led to the evolution of direct coronary artery bypass surgery. References were collected from original articles and through pubmed search. Various concepts and procedures were introduced, all with the aim of increasing myocardial blood flow and relief of angina. These included creation of vascular adhesions, denervation, thyroidectomies, using other organs for providing blood supply, and intramyocardial implantation of bleeding systemic arteries. Historically various innovative concepts existed and a variety of procedures were performed for treating ischemic myocardium, with variable results. These procedures continued till the evolution of direct coronary artery bypass grafting.

  17. Bypass diode for a solar cell

    DOEpatents

    Rim, Seung Bum [Palo Alto, CA; Kim, Taeseok [San Jose, CA; Smith, David D [Campbell, CA; Cousins, Peter J [Menlo Park, CA

    2012-03-13

    Bypass diodes for solar cells are described. In one embodiment, a bypass diode for a solar cell includes a substrate of the solar cell. A first conductive region is disposed above the substrate, the first conductive region of a first conductivity type. A second conductive region is disposed on the first conductive region, the second conductive region of a second conductivity type opposite the first conductivity type.

  18. Prophylactic digitalization for coronary artery bypass surgery.

    PubMed

    Johnson, L W; Dickstein, R A; Fruehan, C T; Kane, P; Potts, J L; Smulyan, H; Webb, W R; Eich, R H

    1976-05-01

    One hundred and twenty patients undergoing aortocoronary bypass procedures were randomly placed into control and digitalized groups. All were initially in normal sinus rhythm and without evidence of congestive heart failure. Supraventricular arrhythmias occurred in 17 of 66 controls and in only three of 54 digitalized patients (P less than 0.01). There was no evidence of digitals toxicity. Based on this evidence we recommend prophylactic digitalization for patients having aortocoronary bypass operations.

  19. The Dalles Dam juvenile bypass electrical systems

    SciTech Connect

    Bannister, B.D.; Luck, B.

    1995-12-31

    The Corps of Engineers is in the process of providing a juvenile fish bypass system at The Dalles Lock and Dam project on the lower Columbia River. This system is intended to preserve and enhance the dwindling stocks of wild anadromous fish. The impact of the proposed facilities on the electrical systems and on plant operations are developed along with descriptions of the special bypass features including the incorporation of provisions for a future small hydropower generator.

  20. Monsanto may bypass NIH in microbe test.

    PubMed

    Sun, Marjorie

    1985-01-11

    The Monsanto Company is planning to ask the Environmental Protection Agency for clearance to field test a genetically engineered microbial pesticide, bypassing the traditional approval process of the National Institutes of Health. Although only federally funded institutions are required to obtain NIH approval for genetic engineering tests, Monsanto is the first company to bypass the NIH regulatory process, which has become mired in a lawsuit brought by Jeremy Rifkin.

  1. MHD Energy Bypass Scramjet Engine

    NASA Technical Reports Server (NTRS)

    Mehta, Unmeel B.; Bogdanoff, David W.; Park, Chul; Arnold, Jim (Technical Monitor)

    2001-01-01

    Revolutionary rather than evolutionary changes in propulsion systems are most likely to decrease cost of space transportation and to provide a global range capability. Hypersonic air-breathing propulsion is a revolutionary propulsion system. The performance of scramjet engines can be improved by the AJAX energy management concept. A magneto-hydro-dynamics (MHD) generator controls the flow and extracts flow energy in the engine inlet and a MHD accelerator downstream of the combustor accelerates the nozzle flow. A progress report toward developing the MHD technology is presented herein. Recent theoretical efforts are reviewed and ongoing experimental efforts are discussed. The latter efforts also include an ongoing collaboration between NASA, the US Air Force Research Laboratory, US industry, and Russian scientific organizations. Two of the critical technologies, the ionization of the air and the MHD accelerator, are briefly discussed. Examples of limiting the combustor entrance Mach number to a low supersonic value with a MHD energy bypass scheme are presented, demonstrating an improvement in scramjet performance. The results for a simplified design of an aerospace plane show that the specific impulse of the MHD-bypass system is better than the non-MHD system and typical rocket over a narrow region of flight speeds and design parameters. Equilibrium ionization and non-equilibrium ionization are discussed. The thermodynamic condition of air at the entrance of the engine inlet determines the method of ionization. The required external power for non-equilibrium ionization is computed. There have been many experiments in which electrical power generation has successfully been achieved by magneto-hydrodynamic (MHD) means. However, relatively few experiments have been made to date for the reverse case of achieving gas acceleration by the MHD means. An experiment in a shock tunnel is described in which MHD acceleration is investigated experimentally. MHD has several

  2. Cardiopulmonary bypass: Evidence or experience based?

    PubMed

    Bartels, Claus; Gerdes, Anja; Babin-Ebell, Jörg; Beyersdorf, Friedhelm; Boeken, Udo; Doenst, Torsten; Feindt, Peter; Heiermann, Michael; Schlensak, Christian; Sievers, Hans-Hinrich

    2002-07-01

    Evidence-based medicine is emerging as a new paradigm for medical practice. The purpose of this study was to evaluate the amount and quality of scientific evidence supporting principles that are currently applied for cardiopulmonary bypass performance. A survey of all German departments of cardiac surgery regarding cardiopulmonary bypass performance disclosed major differences. Consequently, for 48 major principles of cardiopulmonary bypass performance, relevant Medical Subject Headings were identified, and a literature search of the Medline database was performed. Two sequentially applied sets of inclusion-exclusion criteria were selected to assess the best available evidence. Thirty-three thousand articles relating to the subject were identified. Among these, 1500 fulfilled the first set of inclusion criteria: meta-analysis of (randomized) controlled clinical trials and in vitro and animal studies. Rigorous methodological criteria were then applied to further select remaining publications. Ultimately, 225 articles referring to major cardiopulmonary bypass principles were identified as providing the best available evidence. These were graded according to their methodological rigor (susceptibility to bias). The scientific evidence on the investigated cardiopulmonary bypass principles did not prove to be of a high enough level to allow general recommendations to be made. The scientific data concerning the effectiveness and safety of key principles of cardiopulmonary bypass are insufficient in both amount and quality of scientific evidence to serve as a basis for practical, evidence-based guidelines.

  3. Influence of optic-disc size on parameters of retinal nerve fibre analysis as measured using GDx VCC and ECC in healthy subjects.

    PubMed

    Resch, Hemma; Deak, Gabor; Vass, Clemens

    2010-04-01

    To date, there is no knowledge on the impact of optic-disc size on the retinal nerve fibre layer (RNFL) as measured with GDx VCC or GDx ECC. Since the size of the optic disc is not taken into account for the analyses carried out by the GDx, it might affect sensitivity in large optic discs and specificity in small ones. Topographic optic-disc measurements and RNFL thickness values of 80 healthy subjects were measured using HRT3 and GDx VCC and ECC. Subjects were divided into three equally large groups depending on optic-disc area. The authors used ANOVA to test the differences between groups of the GDx VCC and ECC parameters TSNIT average, superior average, inferior average and NFI. The mean optic-disc sizes of the three groups were 1.61, 2.00 and 2.61 mm(2). The optic-disc area did not significantly affect any of the tested RNFL parameters of the GDx and HRT3. For all HRT3 parameters of optic-disc morphology, ANOVA showed statistical significance between the three groups of different optic-disc areas. The authors could not find any significant impact of optic-disc size on any RNFL parameter measured with GDx VCC or ECC and with HRT3.

  4. ECC (Electrochemical Concentration Cell) ozonesonde observations at Mirny, Antarctica, during 1988

    NASA Technical Reports Server (NTRS)

    Komhyr, W. D.; Lathrop, J. A.; Arbuzova, V. N.; Khattatov, V. U.; Nureyev, P. G.; Rudakov, V. V.; Zamyshlayev, I. V.

    1989-01-01

    Atmospheric ozone vertical distributions, air temperatures, and wind speed and direction data are presented for 40 balloon electrochemical concentration cell ozone soundings made at Mirny, Antarctica, in 1988.

  5. Brain microvascular function during cardiopulmonary bypass

    SciTech Connect

    Sorensen, H.R.; Husum, B.; Waaben, J.; Andersen, K.; Andersen, L.I.; Gefke, K.; Kaarsen, A.L.; Gjedde, A.

    1987-11-01

    Emboli in the brain microvasculature may inhibit brain activity during cardiopulmonary bypass. Such hypothetical blockade, if confirmed, may be responsible for the reduction of cerebral metabolic rate for glucose observed in animals subjected to cardiopulmonary bypass. In previous studies of cerebral blood flow during bypass, brain microcirculation was not evaluated. In the present study in animals (pigs), reduction of the number of perfused capillaries was estimated by measurements of the capillary diffusion capacity for hydrophilic tracers of low permeability. Capillary diffusion capacity, cerebral blood flow, and cerebral metabolic rate for glucose were measured simultaneously by the integral method, different tracers being used with different circulation times. In eight animals subjected to normothermic cardiopulmonary bypass, and seven subjected to hypothermic bypass, cerebral blood flow, cerebral metabolic rate for glucose, and capillary diffusion capacity decreased significantly: cerebral blood flow from 63 to 43 ml/100 gm/min in normothermia and to 34 ml/100 gm/min in hypothermia and cerebral metabolic rate for glucose from 43.0 to 23.0 mumol/100 gm/min in normothermia and to 14.1 mumol/100 gm/min in hypothermia. The capillary diffusion capacity declined markedly from 0.15 to 0.03 ml/100 gm/min in normothermia but only to 0.08 ml/100 gm/min in hypothermia. We conclude that the decrease of cerebral metabolic rate for glucose during normothermic cardiopulmonary bypass is caused by interruption of blood flow through a part of the capillary bed, possibly by microemboli, and that cerebral blood flow is an inadequate indicator of capillary blood flow. Further studies must clarify why normal microvascular function appears to be preserved during hypothermic cardiopulmonary bypass.

  6. Changing trends in emergency coronary bypass surgery.

    PubMed

    Maganti, Manjula; Brister, Stephanie J; Yau, Terrence M; Collins, Susan; Badiwala, Mitesh; Rao, Vivek

    2011-10-01

    Patients undergoing emergency coronary artery bypass grafting represent a unique and high-risk population that remains challenging for cardiac surgeons. We examined the changing trends in patients undergoing emergency bypass grafting over the past 20 years. We conducted a retrospective review of our database between 1990 and 2009 and patients were divided into 2 groups based on year of operation: 1990-1999, n = 393; 2000-2009, n = 184. The primary outcomes of interest for this study are operative mortality and incidence of low cardiac output syndrome. The percentage of patients undergoing emergency coronary bypass grafting has decreased from 2.7% to 1.7% over time. The percentage of patients with dyslipidemia, hypertension, triple vessel disease, peripheral vascular disease, and left main disease increased over time (P < .05). Operative mortality remained at 8.1% in both year groups. Preoperative hypertension, congestive heart failure, left ventricular ejection fraction less than 20%, and previous cardiac surgery independently predicted operative mortality by logistic regression analysis. Low cardiac output syndrome developed in 25% of the patient population undergoing emergency bypass grafting. The independent predictors of low cardiac output syndrome were small body surface area, congestive heart failure, shock, myocardial infarction, earlier decade (1990-1999) and increased age. Despite a changing preoperative risk profile, the operative mortality of emergency coronary artery bypass grafting has remained stable over the years. However, mortality remains significantly above the observed mortality in elective bypass grafting. Continued improvements in the management of heart failure and the care of the elderly will likely result in reduced risks of emergency coronary artery bypass grafting. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  7. Heparin-coated circuit during cardiopulmonary bypass. A clinical study using closed circuit, centrifugal pump and reduced heparinization.

    PubMed

    Sellevold, O F; Berg, T M; Rein, K A; Levang, O W; Iversen, O J; Bergh, K

    1994-05-01

    A prospective randomized study was performed to investigate the effect of surface coating with covalently endpoint-attached heparin (Carmeda Bio Active Surface) and reduced general heparinization on haematological indices and complement C5 activation. Care was taken to optimize the rheological design of the system using centrifugal pump and a closed system without venting or machine suction. Twenty patients scheduled for aortocoronary bypass grafting (EF > 0.5) participated in the study. Ten patients were randomized to be treated with heparin-coated equipment (CBAS) and reduced i.v. heparin (1.5 mg.kg-1) while 10 patients treated with identical but noncoated equipment and full heparinization (3 mg.kg-1) served in a Control group. A vacuum suction was used to collect the blood from the operating field and it was autotransfused at weaning from extracorporeal circulation (ECC). Blood samples were obtained from the venous (precircuit) and arterial (postcircuit) side. We used a new and very specific method for detection of C5a based on monoclonal antibodies. The concentration of C5a was low in both groups during the operation but a significant increase was seen on days 1 and 2. In the Control group there was an increase from 10.2 ng.ml-1 +/- 1.2 to 27.5 ng.ml-1 +/- 4.8 on day 2 and in the CBAS group from 10.7 ng.ml-1 +/- 1.2 to 35.6 ng.ml-1 +/- 11.6 on day 2 (NS between groups). The granulocytes and total leukocyte count increased at the end of ECC and was maintained at the elevated level throughout the study period. The amount of free haemoglobin was high in the autotransfused blood in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. "Orpheus" cardiopulmonary bypass simulation system.

    PubMed

    Morris, Richard W; Pybus, David A

    2007-12-01

    In this paper we describe a high-fidelity perfusion simulation system intended for use in the training and continuing education of perfusionists. The system comprises a hydraulic simulator, an electronic interface unit and a controlling computer with associated real-time computer models. It is designed for use within an actual operating theatre, or within a specialized simulation facility. The hydraulic simulator can be positioned on an operating table and physically connected to the circuit of the institutional heart-lung machine. The institutional monitoring system is used to display the arterial and central venous pressures, the ECG and the nasopharyngeal temperature using appropriate connections. The simulator is able to reproduce the full spectrum of normal and abnormal events that may present during the course of cardiopulmonary bypass. The system incorporates a sophisticated blood gas model that accurately predicts the behavior of a modern, hollow-fiber oxygenator. Output from this model is displayed in the manner of an in-line blood gas electrode and is updated every 500 msecs. The perfusionist is able to administer a wide variety of drugs during a simulation session including: vasoconstrictors (metaraminol, epinephrine and phenylephrine), a vasodilator (sodium nitroprusside), chronotropes (epinephrine and atropine), an inotrope (epinephrine) and modifiers of coagulation (heparin and protamine). Each drug has a pharmacokinetic profile based on a three-compartment model plus an effect compartment. The simulation system has potential roles in the skill training of perfusionists, the development of crisis management protocols, the certification and accreditation of perfusionists and the evaluation of new perfusion equipment and/or techniques.

  9. Massive sediment bypassing on the lower shoreface offshore of a wide tidal inlet - Cat Island Pass, Louisiana

    USGS Publications Warehouse

    Jaffe, B.E.; List, J.H.; Sallenger, A.H.

    1997-01-01

    Analysis of a series of historical bathymetric and shoreline surveys along the Louisiana coast west of the Mississippi River mouth detected a large area of deposition in water depths of 2.0-8.5 m offshore of a 9-km- wide tidal inlet, the Cat Island Pass/Wine Island Pass system. A 59.9 ?? 106 m3 sandy deposit formed from the 1930s-1980s, spanning 27 km in the alongshore direction, delineating the transport pathway for sediment bypassing offshore of the inlet on the shoreface. Bypassing connected the shorefaces of two barrier island systems, the Isles Dernieres and the Bayou Lafourche. The processes responsible for formation of this deposit are not well understood, but sediment-transport modeling suggests that sediment is transported primarily by wind-driven coastal currents during large storms and hurricanes. Deposition appears to be related to changes in shoreline orientation, closing of transport pathways into a large bay to the east and the presence of tidal inlets. This newly documented type of bypassing, an offshore bypassing of the inlet system, naturally nourished the immediate downdrift area, the eastern Isles Dernieres, where shoreface and shoreline erosion rates are about half of pre-bypassing rates. Erosion rates remained the same farther downdrift, where bypassing has not yet reached. As this offshore bypassing continues, the destruction of the Isles Dernieres will be slowed.

  10. Beating-heart coronary artery bypass surgery with the help of mini extracorporeal circulation for very high-risk patients.

    PubMed

    Munos, Emmanuel; Calderon, Joachim; Pillois, Xavier; Lafitte, Stéphane; Ouattara, Alexandre; Labrousse, Louis; Roques, Xavier; Barandon, Laurent

    2011-03-01

    Left ventricle dysfunction and co-morbidities are responsible for a large number of complications after coronary artery bypass graft (CABG) surgery. The best strategy for these patients, including the use or not and type of extracorporeal circulation (ECC), the use of minimized ECC (MECC), or conventional ECC (CECC), remains unclear. The aim of the present study was to investigate the potential effect of on-pump beating-heart (OPBH) surgery with the help of MECC for CABG in patients with a high-risk EuroSCORE and to compare this strategy to three other different procedures, including OPCAB and MECC or CECC with cardiac arrest. Patients were included if their EuroSCORE was strictly >" xbd="1427" xhg="1404" ybd="1477" yhg="1440"/>9. Four groups were retrospectively compared: an OPCAB, an OPBH, a MECC and a CECC group under cardiac arrest. 214 patients, mean age 74.26 ± 8.5 years, 68.7% male, were operated. Mean EuroSCORE was 12.1 ± 2.9, left ventricular (LV) function 37.4 ± 12.3%, recent myocardial infarction (MI) 49.5%, renal failure 48.1%, chronic obstructive pulmonary disease (COPD) 42.2%, and peripheral vascular disease (PVD) 55.6%. Mean number of grafts per patient was 2.4 ± 0.7. Our study showed that it was possible, in very high-risk patients, to carry out revascularisation with OPBH similar to that using MECC or CECC under cardiac arrest (p=NS). This technique reduces troponin release (3.23 vs 6.56, p<0.01), postoperative myocardial complications (2% vs 8%, p<0.01), cardiotonic drug prescription (15.7% vs 31.3%, p<0.01), ventilation time (4.57H vs 6.48H, p<0.01) and length of stay (LOS) in ICU (2.16 vs 2.53, p=0.02). The OPBH method seems to be safe, secure and effective in this population of very high-risk patients, reducing early complications and multi-organ failure. OPBH surgery, combining MECC without aortic cross-clamping, makes it possible to perform complete revascularization and is an interesting alternative for CABG in high-risk patients.

  11. Internal Maxillary Bypass for Complex Pediatric Aneurysms.

    PubMed

    Wang, Long; Lu, Shuaibin; Qian, Hai; Shi, Xiang'en

    2017-07-01

    Complex pediatric aneurysms (PAs) are an unusual clinicopathologic entity. Data regarding the use of a bypass procedure to treat complex PAs are limited. Internal maxillary artery-to-middle cerebral artery bypass with radial artery graft was used to isolate PAs. Bypass patency and aneurysm stability were evaluated using intraoperative Doppler ultrasound, indocyanine green videoangiography, and postoperative angiography. Modified Rankin Scale was used to assess neurologic function. Over a 5-year period, 7 pediatric patients (≤18 years old) were included in our analysis. Mean age of patients was 14.4 years (range, 12-18 years), and mean size of PAs was 23.6 mm (range, 9-37 mm). All cases manifested with complex characteristics. Proximal artery occlusion was performed in 3 cases, complete excision following aneurysmal distal internal maxillary artery bypass was performed in 2 cases, and combined proximal artery occlusion and aneurysm excision was performed in the 2 remaining cases. Mean intraoperative blood flow was 61.6 mL/minute (range, 40.0-90.8 mL/minute). Graft patency rate was 100% during postoperative recovery and at the last follow-up examination (mean, 20 months; range, 7-45 months). All patients had excellent outcomes except for 1 patient who died of multiple-organ failure. Internal maxillary artery bypass is an essential technique for treatment of selected cases of complex PAs. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Bypass transition in compressible boundary layers

    NASA Astrophysics Data System (ADS)

    Vandervegt, J. J.

    1992-09-01

    Transition to turbulence in aerospace applications usually occurs in a strongly disturbed environment. For instance, the effects of free-stream turbulence, roughness and obstacles in the boundary layer strongly influence transition. Proper understanding of the mechanisms leading to transition is crucial in the design of aircraft wings and gas turbine blades, because lift, drag and heat transfer strongly depend on the state of the boundary layer, laminar or turbulent. Unfortunately, most of the transition research, both theoretical and experimental, has focused on natural transition. Many practical flows, however, defy any theoretical analysis and are extremely difficult to measure. Morkovin introduced in his review paper the concept of bypass transition as those forms of transition which bypass the known mechanisms of linear and non-linear transition theories and are currently not understood by experiments. In an effort to better understand the mechanisms leading to transition in a disturbed environment, experiments are conducted studying simpler cases, viz. the effects of free stream turbulence on transition on a flat plate. It turns out that these experiments are very difficult to conduct, because generation of free stream turbulence with sufficiently high fluctuation levels and reasonable homogeneity is non trivial. For a discussion see Morkovin. Serious problems also appear due to the fact that at high Reynolds numbers the boundary layers are very thin, especially in the nose region of the plate where the transition occurs, which makes the use of very small probes necessary. The effects of free-stream turbulence on transition are the subject of this research and are especially important in a gas turbine environment, where turbulence intensities are measured between 5 and 20 percent, Wang et al. Due to the fact that the Reynolds number for turbine blades is considerably lower than for aircraft wings, generally a larger portion of the blade will be in a laminar

  13. Gas Turbine Engine Having Fan Rotor Driven by Turbine Exhaust and with a Bypass

    NASA Technical Reports Server (NTRS)

    Suciu, Gabriel L. (Inventor); Chandler, Jesse M. (Inventor)

    2016-01-01

    A gas turbine engine has a core engine incorporating a core engine turbine. A fan rotor is driven by a fan rotor turbine. The fan rotor turbine is in the path of gases downstream from the core engine turbine. A bypass door is moveable from a closed position at which the gases from the core engine turbine pass over the fan rotor turbine, and moveable to a bypass position at which the gases are directed away from the fan rotor turbine. An aircraft is also disclosed.

  14. Managing Heart Failure Patients with Multivessel Disease - Coronary Artery Bypass Graft versus Percutaneous Coronary Intervention.

    PubMed

    Pepper, John

    2015-10-01

    The foundation of treatment for heart failure with reduced ejection fraction is guideline-directed medical treatment. However, surgical revascularisation offers improved survival and quality of life for patients with more extensive coronary disease and the greatest degree of left ventricular systolic dysfunction and remodelling. The most commonly considered surgical interventions for patients with heart failure with reduced ejection fraction are coronary artery bypass surgery, sometimes combined with surgical ventricular reconstruction and surgery for mitral regurgitation. In this review, the author considers the risks and benefits of coronary artery bypass graft versus percutaneous coronary intervention in the management of heart failure patients with multivessel disease.

  15. Experimental Investigation of By-pass Transition

    NASA Astrophysics Data System (ADS)

    Sengupta, Tapan; Lim, T. T.; Chattopadhyay, Manojit

    2000-11-01

    By-pass transition, a phenomenon often encountered in nature and engineering devices, is a complex flow instability caused by moving disturbances over bodies. To date this phenomenon is not fully explained. In the present research a controlled experiment is performed to show that the violent breakdown during by-pass transition is dominated by a two-dimensional mechanism and the resultant broadband energy spectrum of the corresponding turbulent flow is excited at the receptivity stage itself by the primary instability. The experiment is conducted in a water tunnel using dye visualisation technique, and the by-pass transition is created by controlled motion of captive vortices. In the presentation, apart from showing video images of the phenomenon, the similarity of the observed events with secondary instability and fully developed turbulent flows will be discussed.

  16. (Updated) NCI Fiscal 2016 Bypass Budget Proposes $25 Million for Frederick National Lab | Poster

    Cancer.gov

    By Nancy Parrish, Staff Writer; image by Richard Frederickson, Staff Photographer The additional funding requested for Frederick National Laboratory for Cancer Research (FNLCR) in the Fiscal 2016 Bypass Budget was $25 million, or approximately 3.5 percent of the total additional funding request of $715 million. Officially called the Professional Judgment Budget, the Bypass Budget is a result of the National Cancer Act of 1971, which authorizes NCI to submit a budget directly to the president, to send to Congress. With a focus on NCI’s research priorities and areas of cancer research with potential for investment, the Bypass Budget specifies additional funding, over and above the current budget, that is needed to advance

  17. A review of the iStent® trabecular micro-bypass stent: safety and efficacy

    PubMed Central

    Wellik, Sarah R; Dale, Elizabeth A

    2015-01-01

    There is a significant demand for procedures that can effectively treat glaucoma with low risk and good visual outcomes. To fill this void, procedures termed “minimally invasive glaucoma surgery”, are gaining in popularity. This review will focus on the safety and efficacy of one such minimally invasive glaucoma surgery procedure, the trabecular micro-bypass stent. This stent is intended to lower intraocular pressure by directly cannulating Schlemm’s canal and thereby enhancing aqueous outflow. Recent randomized controlled trials and case series have demonstrated the micro-bypass stent to be a relatively safe procedure, with limited complications and no serious adverse sequelae. The most common complication across all studies was stent obstruction or malposition, which generally did not result in any adverse outcome in vision or pressure control. In addition, increased rates of hypotony, choroidal hemorrhage, or infection were not seen with the micro-bypass stent in comparison to cataract surgery alone. PMID:25931808

  18. Redox-mediated bypass of restriction point via skipping of G1pm

    PubMed Central

    Hoffman, Arnold; Greene, James J; Spetner, Lee M; Burke, Michael

    2006-01-01

    Background It is well known that cancer cells bypass the restriction point, R, and undergo uncontrolled cell proliferation. Hypothesis and evidence We suggest here that fibrosarcoma cells enter G1ps directly from M, skipping G1pm, hence bypassing R, in response to redox modulation. Evidence is presented from the published literature that demonstrate a shortening of the cycle period of transformed fibroblasts (SV-3T3) compared to the nontransformed 3T3 fibroblasts, corresponding to the duration of G1pm in the 3T3 fibroblasts. Evidence is also presented that demonstrate that redox modulation can induce the CUA-4 fibroblasts to bypass R, resulting in a cycle period closely corresponding to the cycle period of fibrosarcoma cells (HT1080). Conclusion The evidence supports our hypothesis that a low internal redox potential can cause fibrosarcoma cells to skip the G1pm phase of the cell cycle. PMID:16867189

  19. (Updated) NCI Fiscal 2016 Bypass Budget Proposes $25 Million for Frederick National Lab | Poster

    Cancer.gov

    By Nancy Parrish, Staff Writer; image by Richard Frederickson, Staff Photographer The additional funding requested for Frederick National Laboratory for Cancer Research (FNLCR) in the Fiscal 2016 Bypass Budget was $25 million, or approximately 3.5 percent of the total additional funding request of $715 million. Officially called the Professional Judgment Budget, the Bypass Budget is a result of the National Cancer Act of 1971, which authorizes NCI to submit a budget directly to the president, to send to Congress. With a focus on NCI’s research priorities and areas of cancer research with potential for investment, the Bypass Budget specifies additional funding, over and above the current budget, that is needed to advance

  20. Stress analysis method for clearance-fit joints with bearing-bypass loads

    NASA Technical Reports Server (NTRS)

    Naik, R. A.; Crews, J. H., Jr.

    1989-01-01

    A simple direct stress analysis method is proposed for a laminate with a clearance-fit fastener subjected to combined bearing and bypass loads in tension or compression, including bearing and bypass loads on bolt-hole contact and local stresses. The approach uses a linear-elastic finite element analysis with an inverse formulation; conditions along the bolt-hole interface are specified by constraint equations that limit nodal displacements to a circular arc corresponding to the bolt diameter. The application of the method to the analysis of the effects of bearing-bypass loading on bolt-hole contact angles and local stresses, with the plate material properties representing a quasi-isotropic T300/5208 graphite/epoxy laminate, is discussed.

  1. [Simplified laparoscopic gastric bypass. Initial experience].

    PubMed

    Hernández-Miguelena, Luis; Maldonado-Vázquez, Angélica; Cortes-Romano, Pablo; Ríos-Cruz, Daniel; Marín-Domínguez, Raúl; Castillo-González, Armando

    2014-01-01

    Antecedentes: la cirugía de la obesidad comprende diversos procedimientos gastrointestinales. El bypass gástrico en Y de Roux es el prototipo de los procedimientos mixtos y el más practicado en el mundo en sus diversas variedades. Una técnica similar y novedosa es la adoptada por Cardoso-Ramos y Galvao denominada "bypass simplificado" que rápidamente se aceptó por la mayor facilidad y resultados muy parecidos a la técnica convencional. Objetivo: describir los resultados a un año del bypass gástrico simplificado para el tratamiento de la obesidad mórbida. Material y métodos: estudio retrospectivo y descriptivo de todos los pacientes a quienes se realizó bypass gástrico de enero de 2008 a julio de 2012, en la clínica de obesidad de un hospital privado de la Ciudad de México. Resultados: se estudiaron 90 pacientes con diagnóstico de obesidad mórbida, con límites de edad de 18 y 65 años, operados para bypass gástrico simplificado. En 10% de los pacientes hubo complicaciones, las más frecuentes fueron: hemorragia y hernia interna. Durante el periodo de estudio la mortalidad fue de 0%. La pérdida de peso promedio a los 12 meses fue de 72.7%. Conclusión: el bypass gástrico simplificado laparoscópico es una cirugía segura, con buenos resultados a mediano plazo, y con una pérdida del exceso de peso adecuada en 71% de los casos.

  2. Battery Cell By-Pass Circuit

    NASA Technical Reports Server (NTRS)

    Evers, Jeffrey (Inventor); Gelger, Ronald V. (Inventor)

    2001-01-01

    The invention is a circuit and method of limiting the charging current voltage from a power supply net work applied to an individual cell of a plurality of cells making up a battery being charged in series. It is particularly designed for use with batteries that can be damaged by overcharging, such as Lithium-ion type batteries. In detail. the method includes the following steps: 1) sensing the actual voltage level of the individual cell; 2) comparing the actual voltage level of the individual cell with a reference value and providing an error signal representative thereof; and 3) by-passing the charging current around individual cell necessary to keep the individual cell voltage level generally equal a specific voltage level while continuing to charge the remaining cells. Preferably this is accomplished by by-passing the charging current around the individual cell if said actual voltage level is above the specific voltage level and allowing the charging current to the individual cell if the actual voltage level is equal or less than the specific voltage level. In the step of bypassing the charging current, the by-passed current is transferred at a proper voltage level to the power supply. The by-pass circuit a voltage comparison circuit is used to compare the actual voltage level of the individual cell with a reference value and to provide an error signal representative thereof. A third circuit, designed to be responsive to the error signal, is provided for maintaining the individual cell voltage level generally equal to the specific voltage level. Circuitry is provided in the third circuit for bypassing charging current around the individual cell if the actual voltage level is above the specific voltage level and transfers the excess charging current to the power supply net work. The circuitry also allows charging of the individual cell if the actual voltage level is equal or less than the specific voltage level.

  3. Coronary Artery Bypass Surgery: MedlinePlus Health Topic

    MedlinePlus

    ... and Blood Institute Start Here Coronary Artery Bypass (Texas Heart Institute) Also in Spanish Coronary Artery Bypass ... and Blood Institute) Specifics Limited-Access Heart Surgery (Texas Heart Institute) Also in Spanish Types of Coronary ...

  4. The effects of conventional extracorporeal circulation versus miniaturized extracorporeal circulation on microcirculation during cardiopulmonary bypass-assisted coronary artery bypass graft surgery.

    PubMed

    Yuruk, Koray; Bezemer, Rick; Euser, Mariska; Milstein, Dan M J; de Geus, Hilde H R; Scholten, Evert W; de Mol, Bas A J M; Ince, Can

    2012-09-01

    OBJECTIVES To reduce the complications associated with cardiopulmonary bypass (CPB) during cardiac surgery, many modifications have been made to conventional extracorporeal circulation systems. This trend has led to the development of miniaturized extracorporeal circulation systems. Cardiac surgery using conventional extracorporeal circulation systems has been associated with significantly reduced microcirculatory perfusion, but it remains unknown whether this could be prevented by an mECC system. Here, we aimed to test the hypothesis that microcirculatory perfusion decreases with the use of a conventional extracorporeal circulation system and would be preserved with the use of an miniaturized extracorporeal circulation system. METHODS Microcirculatory density and perfusion were assessed using sublingual side stream dark-field imaging in patients undergoing on-pump coronary artery bypass graft (CABG) surgery before, during and after the use of either a conventional extracorporeal circulation system (n = 10) or a miniaturized extracorporeal circulation system (n = 10). In addition, plasma neutrophil gelatinase-associated lipocalin and creatinine levels and creatinine clearance were assessed up to 5 days post-surgery to monitor renal function. RESULTS At the end of the CPB, one patient in the miniaturized extracorporeal circulation-treated group and five patients in the conventional extracorporeal circulation-treated group received one bag of packed red blood cells (300 ml). During the CPB, the haematocrit and haemoglobin levels were slightly higher in the miniaturized extracorporeal circulation-treated patients compared with the conventional extracorporeal circulation-treated patients (27.7 ± 3.3 vs 24.7 ± 2.0%; P = 0.03; and 6.42 ± 0.75 vs 5.41 ± 0.64 mmol/l; P < 0.01). The density of perfused vessels with a diameter <25 µm (i.e. perfused vessel density) decreased slightly in the conventional extracorporeal circulation-treated group from 16.4 ± 3.8 to 12.8

  5. Polymorphous ventricular tachycardia following cardiopulmonary bypass.

    PubMed Central

    Thompson, L. D.; Cohen, A. J.; Bellasis, R. M.

    1996-01-01

    A 62-year-old African-American man who underwent coronary artery bypass surgery was found to have repetitive ventricular tachycardia of the "Torsade des pointes" type. The arrhythmia was resistant to bretylium, lidocaine, and pacing, but was controlled by intravenous magnesium sulfate. The recurrent attacks were abolished by a bolus of 1 g magnesium sulfate and controlled using a 1 mg/minute drip for 12 hours. This case shows the effectiveness of intravenous magnesium in controlling Torsade des pointes in postoperative coronary bypass patients. PMID:8583493

  6. Variable volume combustor with an air bypass system

    DOEpatents

    Johnson, Thomas Edward; Ziminsky, Willy Steve; Ostebee, Heath Michael; Keener, Christopher Paul

    2017-02-07

    The present application provides a combustor for use with flow of fuel and a flow of air in a gas turbine engine. The combustor may include a number of micro-mixer fuel nozzles positioned within a liner and an air bypass system position about the liner. The air bypass system variably allows a bypass portion of the flow of air to bypass the micro-mixer fuel nozzles.

  7. [Pre- and postoperative corneal topography after combined single suture and running suture in ECCE. An analysis using the video keratoscope].

    PubMed

    Schickel, B; Holschbach, A; Strobel, J

    1993-12-01

    In a prospective study with 45 patients undergoing extracapsular cataract extraction (ECCE) with implantation of posterior chamber lens, curvature measurements of the cornea by means of computerized videokeratoscope were taken postoperatively. Analysis of the corneal shape on color-coded topographic maps of astigmatism showed an hourglass-shaped formation in all patients with a main axis in the sense of general astigmatism. Within a 3-mm zone (optical zone) the steepest meridian in all eyes was 96.1 +/- 13.3 degrees with an astigmatism of +4.4 +/- 2.1 D (1st postoperative day). Postoperatively we found that 35.6% of the patients examined had irregular astigmatism that could not be corroborated by the readings from the Javal ophthalmometer. An irregular astigmatism, corneal topographic analysis reveals regions peripheral to the center with a peak corneal refractive power of +43.8 +/- 1.4 D. In contrast to the conventional methods (for example, Javal ophthalmometer, autokeratometer), computerized videokeratoscope analysis provides additional and useful information on the corneal topography after intraocular operations.

  8. Risk-Informed Margin Management (RIMM) Industry Applications IA1 - Integrated Cladding ECCS/LOCA Performance Analysis - Problem Statement

    SciTech Connect

    Szilard, Ronaldo Henriques; Youngblood, Robert; Frepoli, Cesare; Yurko, Joseph P.; Swindlehurst, Gregg; Zhang, Hongbin; Zhao, Haihua; Bayless, Paul D.; Rabiti, Cristian; Alfonsi, Andrea; Smith, Curtis L.

    2015-04-01

    The U. S. NRC is currently proposing rulemaking designated as “10 CFR 50.46c” to revise the LOCA/ECCS acceptance criteria to include the effects of higher burnup on cladding performance as well as to address some other issues. The NRC is also currently resolving the public comments with the final rule expected to be issued in the summer of 2016. The impact of the final 50.46c rule on the industry will involve updating of fuel vendor LOCA evaluation models, NRC review and approval, and licensee submittal of new LOCA evaluations or reanalyses and associated technical specification revisions for NRC review and approval. The rule implementation process, both industry and NRC activities, is expected to take 5-10 years following the rule effective date. The need to use advanced cladding designs is expected. A loss of operational margin will result due to the more restrictive cladding embrittlement criteria. Initial and future compliance with the rule may significantly increase vendor workload and licensee cost as a spectrum of fuel rod initial burnup states may need to be analyzed to demonstrate compliance. Consequently there will be an increased focus on licensee decision making related to LOCA analysis to minimize cost and impact, and to manage margin.

  9. Investigation on the Core Bypass Flow in a Very High Temperature Reactor

    SciTech Connect

    Hassan, Yassin

    2013-10-22

    Uncertainties associated with the core bypass flow are some of the key issues that directly influence the coolant mass flow distribution and magnitude, and thus the operational core temperature profiles, in the very high-temperature reactor (VHTR). Designers will attempt to configure the core geometry so the core cooling flow rate magnitude and distribution conform to the design values. The objective of this project is to study the bypass flow both experimentally and computationally. Researchers will develop experimental data using state-of-the-art particle image velocimetry in a small test facility. The team will attempt to obtain full field temperature distribution using racks of thermocouples. The experimental data are intended to benchmark computational fluid dynamics (CFD) codes by providing detailed information. These experimental data are urgently needed for validation of the CFD codes. The following are the project tasks: • Construct a small-scale bench-top experiment to resemble the bypass flow between the graphite blocks, varying parameters to address their impact on bypass flow. Wall roughness of the graphite block walls, spacing between the blocks, and temperature of the blocks are some of the parameters to be tested. • Perform CFD to evaluate pre- and post-test calculations and turbulence models, including sensitivity studies to achieve high accuracy. • Develop the state-of-the art large eddy simulation (LES) using appropriate subgrid modeling. • Develop models to be used in systems thermal hydraulics codes to account and estimate the bypass flows. These computer programs include, among others, RELAP3D, MELCOR, GAMMA, and GAS-NET. Actual core bypass flow rate may vary considerably from the design value. Although the uncertainty of the bypass flow rate is not known, some sources have stated that the bypass flow rates in the Fort St. Vrain reactor were between 8 and 25 percent of the total reactor mass flow rate. If bypass flow rates are on the

  10. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is used in the blood pump head and which is cyclically compressed by the pump to cause the blood to...

  11. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is used in the blood pump head and which is cyclically compressed by the pump to cause the blood to...

  12. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is used in the blood pump head and which is cyclically compressed by the pump to cause the blood to...

  13. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is used in the blood pump head and which is cyclically compressed by the pump to cause the blood to...

  14. Bypass apparatus and method for series connected energy storage devices

    DOEpatents

    Rouillard, Jean; Comte, Christophe; Daigle, Dominik

    2000-01-01

    A bypass apparatus and method for series connected energy storage devices. Each of the energy storage devices coupled to a common series connection has an associated bypass unit connected thereto in parallel. A current bypass unit includes a sensor which is coupled in parallel with an associated energy storage device or cell and senses an energy parameter indicative of an energy state of the cell, such as cell voltage. A bypass switch is coupled in parallel with the energy storage cell and operable between a non-activated state and an activated state. The bypass switch, when in the non-activated state, is substantially non-conductive with respect to current passing through the energy storage cell and, when in the activated state, provides a bypass current path for passing current to the series connection so as to bypass the associated cell. A controller controls activation of the bypass switch in response to the voltage of the cell deviating from a pre-established voltage setpoint. The controller may be included within the bypass unit or be disposed on a control platform external to the bypass unit. The bypass switch may, when activated, establish a permanent or a temporary bypass current path.

  15. 21 CFR 870.4390 - Cardiopulmonary bypass pump tubing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pump tubing. 870.4390... bypass pump tubing. (a) Identification. A cardiopulmonary bypass pump tubing is polymeric tubing which is used in the blood pump head and which is cyclically compressed by the pump to cause the blood to...

  16. 20 CFR 631.18 - Federal by-pass authority.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Federal by-pass authority. 631.18 Section 631... Procedures § 631.18 Federal by-pass authority. (a) In the event that a State fails to submit a biennial State... Secretary's intent to exercise by-pass authority and an opportunity to request and to receive a hearing...

  17. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and pneumatically operated device used to create pulsatile blood flow. The...

  18. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and pneumatically operated device used to create pulsatile blood flow. The...

  19. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and pneumatically operated device used to create pulsatile blood flow. The...

  20. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and pneumatically operated device used to create pulsatile blood flow. The...

  1. 21 CFR 870.4320 - Cardiopulmonary bypass pulsatile flow generator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass pulsatile flow generator... Cardiopulmonary bypass pulsatile flow generator. (a) Identification. A cardiopulmonary bypass pulsatile flow generator is an electrically and pneumatically operated device used to create pulsatile blood flow. The...

  2. 46 CFR 56.20-20 - Valve bypasses.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Valve bypasses. 56.20-20 Section 56.20-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING PIPING SYSTEMS AND APPURTENANCES Valves § 56.20-20 Valve bypasses. (a) Sizes of bypasses shall be in accordance with MSS SP-45...

  3. 21 CFR 870.4430 - Cardiopulmonary bypass intracardiac suction control.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass intracardiac suction....4430 Cardiopulmonary bypass intracardiac suction control. (a) Identification. A cardiopulmonary bypass intracardiac suction control is a device which provides the vacuum and control for a cardiotomy return sucker...

  4. 46 CFR 56.20-20 - Valve bypasses.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Valve bypasses. 56.20-20 Section 56.20-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING PIPING SYSTEMS AND APPURTENANCES Valves § 56.20-20 Valve bypasses. (a) Sizes of bypasses shall be in accordance with MSS SP-45...

  5. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cardiopulmonary bypass temperature controller. 870... Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller is a device used to control the temperature of the fluid entering and leaving a heat exchanger. (b...

  6. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass temperature controller. 870... Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller is a device used to control the temperature of the fluid entering and leaving a heat exchanger. (b...

  7. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass temperature controller. 870... Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller is a device used to control the temperature of the fluid entering and leaving a heat exchanger. (b...

  8. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass temperature controller. 870... Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller is a device used to control the temperature of the fluid entering and leaving a heat exchanger. (b...

  9. 21 CFR 870.4250 - Cardiopulmonary bypass temperature controller.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass temperature controller. 870.4250 Section 870.4250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Cardiopulmonary bypass temperature controller. (a) Identification. A cardiopulmonary bypass temperature controller...

  10. Planetary science: Bypassing the habitable zone

    NASA Astrophysics Data System (ADS)

    Ingersoll, Andrew P.

    2017-08-01

    In our own solar system, Venus is too hot, Mars is too cold and Earth is just right. Simulations show that making an icy planet habitable is not as simple as melting its ice: many icy bodies swing from too cold to too hot, bypassing just right.

  11. Delirium in Children After Cardiac Bypass Surgery.

    PubMed

    Patel, Anita K; Biagas, Katherine V; Clarke, Eunice C; Gerber, Linda M; Mauer, Elizabeth; Silver, Gabrielle; Chai, Paul; Corda, Rozelle; Traube, Chani

    2017-02-01

    To describe the incidence of delirium in pediatric patients after cardiac bypass surgery and explore associated risk factors and effect of delirium on in-hospital outcomes. Prospective observational single-center study. Fourteen-bed pediatric cardiothoracic ICU. One hundred ninety-four consecutive admissions following cardiac bypass surgery, 1 day to 21 years old. Subjects were screened for delirium daily using the Cornell Assessment of Pediatric Delirium. Incidence of delirium in this sample was 49%. Delirium most often lasted 1-2 days and developed within the first 1-3 days after surgery. Age less than 2 years, developmental delay, higher Risk Adjustment for Congenital Heart Surgery 1 score, cyanotic disease, and albumin less than three were all independently associated with development of delirium in a multivariable model (all p < 0.03). Delirium was an independent predictor of prolonged ICU length of stay, with patients who were ever delirious having a 60% increase in ICU days compared with patients who were never delirious (p < 0.01). In our institution, delirium is a frequent problem in children after cardiac bypass surgery, with identifiable risk factors. Our study suggests that cardiac bypass surgery significantly increases children's susceptibility to delirium. This highlights the need for heightened, targeted delirium screening in all pediatric cardiothoracic ICUs to potentially improve outcomes in this vulnerable patient population.

  12. Educational Programs for By-Passed Populations.

    ERIC Educational Resources Information Center

    Morgan, Don A., Ed.

    The objective of the symposium from which this document resulted was to give visibility to some worthwhile programs for mobile and "by-passed" populations, in order to allow those in attendance at the symposium and those exposed to the published proceedings to capitalize on what has been learned through these programs. The conference report points…

  13. Sexual Adjustment following Coronary Bypass Surgery.

    ERIC Educational Resources Information Center

    Thurer, Shari

    1981-01-01

    Sexual adjustment of 19 individuals was measured before and four months after their coronary bypass surgery. Test variables were subject to an analysis of variance. Patients showed significant improvement in physical condition. Sexual adjustment, however, did not improve, as measured by the Structured and Scaled Interview to Measure Maladjustment.…

  14. Continuous mode interaction and the bypass route to transition

    NASA Astrophysics Data System (ADS)

    Zaki, Tamer A.

    Boundary layer transition to turbulence, without the intervention of Tollmien-Schlichting instability waves, is designated 'bypass transition'. That terminology is all-encompassing; many bypass mechanisms are possible, for example transition due to surface roughness, acoustic perturbations, or free-stream vortical disturbances. It is the last that has become synonymous with the term bypass, and is the focus of this work. The perspective that bypass is the complement to orderly transition suggests that it be studied by starting from the complement to Tollmien-Schlichting waves. The latter are the discrete modes of the Orr-Sommerfeld operator; their complement is the continuous spectrum. An examination of mode shapes sheds light on boundary layer receptivity to vortical disturbances: Low-frequency modes penetrate the boundary layer, while high frequencies are expelled---a result referred to as shear sheltering. Low frequency penetration can be characterized by a coupling coefficient. Large coupling, Orr-Sommerfeld modes resonantly force the Squire operator. The response is a superposition of Squire modes, and their incomplete cancellation gives rise to Klebanoff modes, which resemble jets in the perturbation field. While this is a route into the boundary layer, transition subsequently involves an inter-action between low and high frequency modes. The lifted, low-frequency perturbation jets are susceptible to a Kelvin-Helmholtz type instability that marks the onset of breakdown and turbulent spots. Continuous mode transition is illustrated by numerical simulations of pairwise mode interaction. Only two modes, one low-frequency penetrating and one high-frequency sheltered eigenfunction, can induce transition in a manner that emulates the influence of a spectrum of vortical disturbances. This new framework provides a link between the continuous eigenmodes from linear theory, and the non-linear interaction that causes transition to turbulence. The role of pressure

  15. Configurations and classifications of composite arterial grafts in coronary bypass surgery.

    PubMed

    Yuan, Shi-Min; Shinfeld, Amihay; Raanani, Ehud

    2008-01-01

    The aim of this review is to present the configurations and classifications of composite arterial grafts in coronary bypass surgery. Articles were collected by tracking references cited in the literature with regard to the configurations of composite arterial grafts in coronary bypass surgery. Figures of the configurations were drawn in accordance to the schematic drawings, angiograms, photographs, table contents or written captions of the literature. According to their structural nature, composite arterial grafts can be classified as: (i) alphabetical (Y, T, I, U, K, X and H) and (ii) complex grafts (TY, loop, pi and sling grafts). According to the conduits that form the composite graft, they can be classified as: (i) definite (all standard alphabetical grafts, classic pi and sling grafts); (ii) varying [internal mammary artery (IMA) loop, modified pi graft]; and (iii) indefinite conduit graft (TY graft). According to their application in coronary artery bypass grafting (CABG), they can be divided into complete arterial revascularization for: (i) triple vessel disease (T, Y, K, X, TY, pi and sling grafts); (ii) two vessel disease (U, right Y, and two-thirds right IMA T grafts); and (iii) single vessel disease, mainly the left anterior descending artery with or without the diagonal branch (H, I, IMA loop and left IMA T grafts). According to the CABG method, they can be classified as: (i) for conventional CABG (sling graft); (ii) for minimally invasive direct coronary artery bypass (H graft); and (iii) for both conventional CABG and off-pump coronary artery bypass (T, Y, U, K, I, TY, IMA loop, and pi grafts). Standard Y and T grafts have been accepted as the common figurations of composite arterial grafts to maximum graft length for the bypass of triple vessel disease. Composite arterial grafts overcome the limited availability of arterial conduits for performing total arterial myocardial revascularization, allow a gain in conduit length, and minimize the ascending

  16. Differential changes in dietary habits after gastric bypass versus gastric banding operations.

    PubMed

    Ernst, Barbara; Thurnheer, Martin; Wilms, Britta; Schultes, Bernd

    2009-03-01

    Reduction of food intake is an important mechanism by which bariatric procedures reduce body weight. However, only few studies have systematically assessed what patients actually eat after different types of bariatric operations. Dietary habits were assessed by a food frequency questionnaire in 121 bariatric patients (48 gastric bypass patients, 73 gastric banding patients) during follow-up visits in our interdisciplinary obesity center as well as in 45 severely obese (body mass index (BMI)>35 kg/m2) and 45 nonobese (BMI<27 kg/m2) control subjects. As compared with nonobese control subjects, obese control subjects consumed more meat, white bread, and diet soft drinks. Gastric bypass patients showed an enhanced consumption of foods rich in protein such as poultry, fish, and eggs as well as of cooked vegetables, while the consumption of fatty sweets like chocolate, cake, biscuits, and cookies was found to be distinctly reduced in this patient group. In contrast, gastric banding patients reported on a reduced intake of pasta, white bread, and fresh fruits and, just like gastric bypass patients, also on an enhanced intake of poultry and fish. Direct comparison of dietary habits between the two bariatric patient groups revealed that gastric bypass patients consumed more frequently fresh fruits, eggs, and diet soft drinks but strikingly less chocolate than gastric banding patients. Collectively, data clearly point to distinct changes in dietary habits after bariatric operations which markedly differ between gastric bypass and gastric banding patients. Overall, it is tempting to conclude that gastric bypass operations lead to a healthier and a more balanced diet than gastric band implantations.

  17. Differential Neuronal Vulnerability varies according to Specific Cardiopulmonary Bypass Insult in a Porcine Survival Model

    PubMed Central

    Ishibashi, Nobuyuki; Iwata, Yusuke; Okamura, Toru; Zurakowski, David; Lidov, Hart G.W.; Jonas, Richard A.

    2010-01-01

    Objective We investigated whether the degree of vulnerability of different areas in the developing brain varies according to the specific mechanism of the insults caused by cardiopulmonary bypass. Methods A meta-analysis of two experimental studies (n = 80) was conducted. The end points of the otherwise identical studies were tissue oxygen index in experiment one while cerebral micro-vessel vasoconstriction and inflammatory response of endothelial cells were directly visualized in the second study. We assigned ultra-low flow bypass at 25°C for 60 min as Control; circulatory arrest at 25°C for 60 min as ischemic stress under circulatory arrest (Ischemia-CA); and ultra-low flow bypass at 34°C for 60 min as the stress under ultra-low flow bypass (Ischemia-ULF). Histological neuronal damage was the primary outcome. Secondary measures included neurological recovery. Results Vasoconstriction following ischemia and inflammation after bypass were independent predictors of severe histological damage. The caudate nucleus was significantly vulnerable to Ischemia-CA and was significantly influenced by vasoconstriction. In contrast, the hippocampus was significantly vulnerable to Ischemia-ULF. The different forms of ischemic insults did not influence Purkinje cells, while Purkinje damage significantly correlated with inflammation. Tissue oxygen index had the ability to differentiate accurately regional damage. Neurological recovery under Ischemia-CA was significantly worse compared with Ischemia-ULF. Neurological recovery correlated with neuronal damage in the caudate nucleus, but did not correlate with damage in the hippocampus. Conclusion Neuronal vulnerability in different areas of the developing brain varies according to mechanisms of bypass-induced ischemic stress. Certain regional damage may not be apparent in assessing acute neurological recovery. PMID:20434176

  18. Bypass surgery for chronic lower limb ischaemia.

    PubMed

    Antoniou, George A; Georgiadis, George S; Antoniou, Stavros A; Makar, Ragai R; Smout, Jonathan D; Torella, Francesco

    2017-04-03

    Bypass surgery is one of the mainstay treatments for patients with critical lower limb ischaemia (CLI). This is the second update of the review first published in 2000. To assess the effects of bypass surgery in patients with chronic lower limb ischaemia. For this update, the Cochrane Vascular Group searched its trials register (last searched October 2016) and the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (last searched Issue 9, 2016). We selected randomised controlled trials of bypass surgery versus control or any other treatment. The primary outcome parameters were defined as early postoperative non-thrombotic complications, procedural mortality, clinical improvement, amputation, primary patency, and mortality within follow-up. For the update, two review authors extracted data and assessed trial quality. We analysed data using odds ratio (OR) and 95% confidence intervals (CIs). We applied fixed-effect or random-effects models. We selected 11 trials reporting a total of 1486 participants. Six trials compared bypass surgery with percutaneous transluminal angioplasty (PTA), and one each with remote endarterectomy, thromboendarterectomy, thrombolysis, exercise, and spinal cord stimulation. The quality of the evidence for the most important outcomes of bypass surgery versus PTA was high except for clinical improvement and primary patency. We judged the quality of evidence for clinical improvement to be low, due to heterogeneity between the studies and the fact that this was a subjective outcome assessment and, therefore, at risk of detection bias. We judged the quality of evidence for primary patency to be moderate due heterogeneity between the studies. For the remaining comparisons, the evidence was limited. For several outcomes, the CIs were wide.Comparing bypass surgery with PTA revealed a possible increase in early postinterventional non-thrombotic complications (OR 1.29, 95% CI 0.96 to 1.73; six studies; 1015 participants

  19. Cannulation of the axillary artery for cardiopulmonary bypass: safeguards and pitfalls.

    PubMed

    Sinclair, Michael C; Singer, Raymond L; Manley, Norman J; Montesano, Ralph M

    2003-03-01

    The ascending aorta is the customary site for arterial cannulation for cardiopulmonary bypass. Favorable experience at our institution and elsewhere using axillary artery cannulation in treating type A aortic dissections has caused us to broaden our indications for using this site for arterial cannulation for cardiopulmonary bypass. Medical records, operative notes, and perfusion records were reviewed in all patients in whom the axillary artery was cannulated directly or by a graft for cardiopulmonary bypass from January 1, 2000 through August 30, 2002. Seventy-five patients underwent axillary artery cannulation during the 32-month interval. Eleven patients had ascending aortic dissections, 20 had extensively diseased ascending aortas, and 44 were individuals undergoing repeat cardiac procedures. The right axillary artery was used in 72 patients and the left in 3. In 16 patients the artery was cannulated directly, and in 59 the arterial cannula was inserted into a prosthetic graft that had been anastomosed to the axillary artery. Axillary artery cannulation was satisfactory in 95% (71 of 75) of the cases in which it was used. Cannulation of the axillary artery for cardiopulmonary bypass is a dependable approach for procedures including reoperations, aortic dissections, and extensively diseased ascending aortas.

  20. Phacoemulsification with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.

    PubMed

    de Silva, Samantha R; Riaz, Yasmin; Evans, Jennifer R

    2014-01-29

    Age-related cataract is one of the leading causes of blindness worldwide. Therefore, it is important to establish the most effective surgical technique for cataract surgery. The aim of this review is to examine the effects of two types of cataract surgery for age-related cataract: phacoemulsification and extracapsular cataract extraction (ECCE). We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 4), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to May 2013), EMBASE (January 1980 to May 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to May 2013), Web of Science Conference Proceedings Citation Index - Science (CPCI-S) (January 1970 to May 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 13 May 2013. We included randomised controlled trials of phacoemulsification compared to ECCE for age-related cataract. Two authors independently selected and assessed all studies. We defined two primary outcomes: 'good functional vision' (presenting visual acuity of 6/12 or better) and 'poor visual outcome' (best corrected visual acuity of less than 6/60) at three and 12 months after surgery. We also collected data on intra and postoperative complications, and the cost of the procedures. We included 11 trials in this review with a total of 1228 participants, ranging from age 45 to 94. The studies were generally at unclear risk of bias due to poorly reported trial methods. No study reported presenting visual acuity, so we report both uncorrected (UCVA) and best corrected visual acuity (BCVA

  1. Functional Dissection of the Blocking and Bypass Activities of the Fab-8 Boundary in the Drosophila Bithorax Complex.

    PubMed

    Kyrchanova, Olga; Mogila, Vladic; Wolle, Daniel; Deshpande, Girish; Parshikov, Alexander; Cléard, Fabienne; Karch, Francois; Schedl, Paul; Georgiev, Pavel

    2016-07-01

    Functionally autonomous regulatory domains direct the parasegment-specific expression of the Drosophila Bithorax complex (BX-C) homeotic genes. Autonomy is conferred by boundary/insulator elements that separate each regulatory domain from its neighbors. For six of the nine parasegment (PS) regulatory domains in the complex, at least one boundary is located between the domain and its target homeotic gene. Consequently, BX-C boundaries must not only block adventitious interactions between neighboring regulatory domains, but also be permissive (bypass) for regulatory interactions between the domains and their gene targets. To elucidate how the BX-C boundaries combine these two contradictory activities, we have used a boundary replacement strategy. We show that a 337 bp fragment spanning the Fab-8 boundary nuclease hypersensitive site and lacking all but 83 bp of the 625 bp Fab-8 PTS (promoter targeting sequence) fully rescues a Fab-7 deletion. It blocks crosstalk between the iab-6 and iab-7 regulatory domains, and has bypass activity that enables the two downstream domains, iab-5 and iab-6, to regulate Abdominal-B (Abd-B) transcription in spite of two intervening boundary elements. Fab-8 has two dCTCF sites and we show that they are necessary both for blocking and bypass activity. However, CTCF sites on their own are not sufficient for bypass. While multimerized dCTCF (or Su(Hw)) sites have blocking activity, they fail to support bypass. Moreover, this bypass defect is not rescued by the full length PTS. Finally, we show that orientation is critical for the proper functioning the Fab-8 replacement. Though the inverted Fab-8 boundary still blocks crosstalk, it disrupts the topology of the Abd-B regulatory domains and does not support bypass. Importantly, altering the orientation of the Fab-8 dCTCF sites is not sufficient to disrupt bypass, indicating that orientation dependence is conferred by other factors.

  2. Prevalence of candida albicans in dental plaque and caries lesion of early childhood caries (ECC) according to sampling site

    PubMed Central

    Ghasempour, Maryam; Sefidgar, Seyed Ali Asghar; Eyzadian, Haniyeh; Gharakhani, Samaneh

    2011-01-01

    Background: Candida albicans may have cariogenic potential but its role in caries etiology has not been established. The aim of this study was to determine candida albicans in supragingival dental plaque and infected dentine of cervical and proximal in early childhood caries (ECC). Methods: This cross-sectional study was carried out on 6o children aged 2-5 years, which were divided into 3 groups: children with at least one cervical caries; children with at least one proximal caries and caries-free. The infected dentine was collected from cervical and proximal caries lesions and plaque samples were collected from the three groups in order to compare the frequency of candida albicans in the collected sites. All samples were cultured in Sabouraud and CHROMagar medium and the cases that were positive for candida albicans were cultured in germ tube. Data were collected and analyzed. Results: The mean age of the children was 3.9 years. From 100 samples, candida albicans samples were isolated in 55%, mold fungi were found in 29% cases and there was no fungal growth in 16% of the samples. In plaque samples, candida albicans were found in 15% of caries-free samples, 20% of the proximal and 80% of the cervical caries. In samples extracted from the caries, candida albicans were found in 60% of the proximal and 100% of the cervical caries. Mothers with university educational level had children with more cervical decays, caries free and proximal caries, respectively. Conclusion: The results showed that prevalence of Candida albicans in dental plaque and caries lesions of children with early childhood caries were relatively high and the prevalence was higher in cervical caries group. PMID:24551436

  3. Force and pressure-recovery characteristics at supersonic speeds of a conical nose inlet with bypasses discharging outward from the body axis

    NASA Technical Reports Server (NTRS)

    Beke, Andrew; Allen, J L

    1953-01-01

    Aerodynamic and performance characteristics of a conical spike nacelle-type inlet with two bypasses are presented at Mach numbers of 1.6, 1.8, and 2.0 for angles of attach up to 90 degrees. The bypasses were located 6 inlet diameters downstream of the inlet and were designed to discharge the bypass mass flow outward from the body axis. The inlet was designed to attain a mass-flow ratio of unity at a Mach number of 2.0. It is shown that discharging the bypass mass flow outward from the body nearly doubles the critical drag of a similar configuration but with bypass discharge in an axial direction. As a result of this greater drag, the net force on the model in the flight direction is reduced when comparison is made with the axial discharge case. The lift and pitching-moment coefficients are slightly higher than those for a configuration without bypasses. Approximately 25 % of the maximum inlet mass flow was discharged through the bypasses, and the pressure-recovery and mass-flow characteristics were in qualitative and quantitative agreement with the results of an investigation of a similar configuration with axial discharge.

  4. The Golden bypass landslide, Golden, Colorado

    USGS Publications Warehouse

    Highland, L.M.; Brown, W. M.

    1993-01-01

    Slope instability along a new highway bypass in Golden, Colorado, became a major concern in 1993. Rains and snowmelt accelerated movement of a landslide that had begun to develop before the bypass was opened to traffic in July of 1991. The downslope movement of earth materials increased significantly in 1993. During the first few months of the year, the landslide pushed onto the west shoulder of the road and crumpled the pavement beneath the south-bound lane. As we prepare this article (September, 1993), the slide continues to encroach onto the highway, posing a persistent problem despite repeated efforts to slow or stop its movement. As this article will show, permanent solutions to landslide problems of this kind are difficult to obtain. 

  5. Coronary artery bypass surgery in elderly people

    PubMed Central

    Natarajan, Arun; Samadian, Samad; Clark, Stephen

    2007-01-01

    An increasing number of elderly individuals are now undergoing coronary artery bypass surgery. Elderly patients, compared with patients of a younger age group, present for surgery with a greater burden of risk factors and reduced functional levels. Short‐term outcomes are hence poorer in them. But symptom relief occurs in most survivors and is accompanied by excellent rates of long‐term survival and a good quality of life. Therefore, an individualised risk–benefit profile must be carefully constructed by clinicians, taking into account several different factors and not just age alone. This review summarises the current concepts of coronary artery bypass surgery from the perspective of the very old. PMID:17344568

  6. Bypass surgery in limb salvage: inflow procedures.

    PubMed

    Bismuth, Jean; Duran, Cassidy

    2013-04-01

    Proper management of lower-extremity inflow vessel disease is critical to the success of distal interventions. Aortobifemoral bypass is the most effective means of treating aortoiliac disease, but this invasive procedure is not always ideal for a patient population that often has diffuse vascular disease and multiple comorbidities. Technologic advances and increasing experience have fundamentally altered the management algorithm for lower-extremity vascular lesions, and endovascular options have become the first-line therapy for Trans-Atlantic Inter-Society Guidelines (TASC) class A and B lesions. In fact, an endovascular first approach is being endorsed even for highly complex TASC C and even TASC D lesions. Other alternatives include minimally invasive (laparoscopic or robotic) options or extra-anatomic bypass procedures. Inadequate outflow can compromise any inflow procedure, but inflow treatment failures are the crux of all limb salvage in patients with lower-extremity vascular disease.

  7. Early rehabilitative treatment in aortocoronary bypass surgery.

    PubMed

    Petrucci, Lucia; Ramella, Francesca C; Ricotti, Susanna; Carlisi, Ettore; Di Natali, Giuseppe; Messina, Sara; Pavese, Chiara; Nicolardi, Salvatore; D'Armini, Andrea M; Dalla Toffola, Elena

    2013-01-01

    The objective of this retrospective study is to analyze functional recovery and response to rehabilitation treatment during the immediate postoperative phase of aortocoronary bypass (ACB) surgery. We studied 319 patients, who had undergone ACB surgery and who needed post-acute rehabilitation. All patients presented post-operative respiratory dysfunction, 300 cases presented inability in position changes and needed neuromotor exercises in addition to chest physiotherapy. Rehabilitation treatment began at a mean number of 1.79 +/-1.37 days after surgery and continued for 5.78 +/- 3.59 days. At the discharge, at mean 5.47 +/- 2.25 days after surgery, most of patients (65.61%) walked independently. Our study described a protocol of early rehabilitative treatment that appeared to be suitable in promoting patients'functional recovery after aortocoronary bypass surgery.

  8. Altered coronary microvascular serotonin receptor expression after coronary artery bypass grafting utilizing cardiopulmonary bypass

    PubMed Central

    Robich, Michael P.; Araujo, Eugenio G.; Feng, Jun; Osipov, Robert M.; Clements, Richard T.; Bianchi, Cesario; Sellke, Frank W.

    2009-01-01

    Objectives Evaluate the role of serotonin receptors 1B and 2A, thromboxane synthase and receptor and phospholipases A2 and C in response to cardiopulmonary bypass in patients. Methods Atrial tissue was harvested from patients before and after cardiopulmonary bypass with cardioplegia (n=13). Coronary microvessels were assessed for vasoactive response to serotonin with and without inhibitors of 5-HT1B and 5-HT2A receceptors, phospholipase A2 and C. Expression of 5-HT1B and 5-HT2A mRNA was determined by RT-PCR. Expression of 5-HT1B, 5-HT2A, Thromboxane A2 receptor and synthase protein was determined by immunoblotting and immunohistochemistry. Results Exposure of microvessels to serotonin elicited a 7.3 ± 2% relaxation response pre-bypass, changing to a strong contraction response of -19.2 ± 2% after bypass (p<0.001). Addition of either a specific 5-HT1B antagonist or inhibitor of PLA2 resulted in a significant decrease in the contractile response to -8.6 ±1% (p<0.001) and 2.8 ± 3% (p= 0.001), respectively. 5-HT1B receptor mRNA expression increased 1.82 ± 0.34 fold after bypass (p=0.044), while 5-HT2A mRNA expression did not change. 5-HT1B receptor, but not 5-HT2A, protein expression increased after bypass by 1.35 ± 0.7 fold (p=0.0413). Neither thromboxane synthase nor thromboxane receptor expression changed after bypass. Immunohistochemistry demonstrated 5-HT1B receptor increased mainly in the arterial smooth muscle. There was no appreciable difference in arterial expression of either thromboxane synthase or receptor. Conclusion These data indicate that 5-HT-induced vascular dysfunction after cardiopulmonary bypass with cardioplegia may be mediated by increased expression of 5-HT1B receptor and subsequent PLA2 activation in myocardial coronary smooth muscle. Mini Abstract The expression of 5-HT1B receptor protein and mRNA were increased in the atrial myocardium after cardioplegia and cardiopulmonary bypass (CP-CPB). Serotonin elicited a strong contraction

  9. Lessons learned from gastric bypass operations in rats.

    PubMed

    Seyfried, Florian; le Roux, Carel W; Bueter, Marco

    2011-01-01

    Numerous studies using gastric bypass rat models have been recently conducted to uncover underlying physiological mechanisms of Roux-en-Y gastric bypass. Reflecting on lessons learned from gastric bypass rat models may thus aid the development of gastric bypass models in mice and other species. This review aims to discuss technical and experimental details of published gastric bypass rat models to understand advantages and limitations of this experimental tool. The review is based on PubMed literature using the search terms 'animal model', 'rodent model', 'bariatric surgery', 'gastric bypass', and 'Roux-en-Y gastric bypass'. All studies published up until February 2011 were included. 32 studies describing 15 different rat gastric bypass models were included. Description of surgical technique differs in terms of pouch size, limb lengths, preservation of the vagal nerve, and mortality rate. Surgery was carried out exclusively in male rats of different strains and ages. Pre- and postoperative diets also varied significantly. Technical and experimental variations in published gastric bypass rat models complicate comparison and identification of potential physiological mechanisms involved in gastric bypass. In summary, there is no clear evidence that any of these models is superior, but there is an emerging need for standardization of the procedure to achieve consistent and comparable data. Copyright © 2011 S. Karger AG, Basel.

  10. Effects of Cardiopulmonary Bypass on Hemostasis

    DTIC Science & Technology

    2007-11-02

    agents as possible alternatives to heparin anticoagulation during CPB. Some of the agents mat have been found to be promising in these studies...67-76. 22Q. Terrell MR, Walenga JM, Koza MJ, et al. Efficacy of aprotinin with various anticoagulant agents in cardiopulmonary bypass. AnnThorac Surg...procedures, systemic anticoagulation with 3mg/kg of heparin prior to the institution of CPB elicits a modest but significant prolongation of the

  11. Aircraft High Bypass Fan Engine Performance

    DTIC Science & Technology

    1994-03-01

    in component efficiencies, combustor design, development of high temperature alloys , and the development of the high bypass fan. The biggest advance...Partially Modified 29.3:1 1.58:1 9.0:1 2900 7029 0.6213 P/M 107 Partially Modified 29.3:1 1.53:1 9.0:1 2700 6660 0.606 F/M 103 Fully Modified 29.3:1 1.53:1

  12. Control of Bypass Transition for Textile Surface

    NASA Astrophysics Data System (ADS)

    Kikuchi, Satoshi; Shimoji, Masayuki; Watanabe, Hideo; Kohama, Yasuaki

    The present research deals with turbulent friction reduction for bypass transition on a flat plate with a textile surface. Unique boundary layers such as those found in swimsuits, sail wings, or skiwear, where certain boundary layer trip structure-like folded edges or masts of a sailboat exist, contain limited turbulence level in the boundary layer even under laminar conditions. A turbulent transition delay in such boundary layers is observed for textile surfaces.

  13. Histoplasma infection of aortofemoral bypass graft.

    PubMed

    Patel, Nishit; Bronze, Michael S

    2014-05-01

    Histoplasma infection of vascular grafts is extremely rare. To our knowledge, there are only 4 cases reported with Histoplasma capsulatum infection of the aortic graft. All had previous disseminated histoplasmosis and atherosclerotic peripheral vascular disease. They were treated surgically with explantation of the infected graft and reimplantation of new graft in extra-anatomic uninfected site. The authors present a new case of H capsulatum infection of aortofemoral bypass graft, but unlike the other cases, this case was managed without surgical intervention.

  14. Percutaneous venovenous bypass in orthotopic liver transplantation.

    PubMed

    Washburn, W K; Lewis, W D; Jenkins, R L

    1995-11-01

    Since January 1994, we have used percutaneous placement of both the subclavian and femoral cannulae to establish access for venovenous bypass during orthotopic liver transplantation. Percutaneous subclavian and femoral cannulae were used in 36 patients of which 5 had portal decompression by placement of a cannula in inferior mesenteric vein percutaneously through the abdominal wall. Intraoperative placement of the subclavian cannula is facilitated by placing a subclavian central venous line before the abdominal incision. One patient underwent exploration for femoral vein bleeding early in our experience. Another patient sustained hypotension as a result of a kinked subclavian cannula. In 4 patients, early in this experience, we had difficulty placing the subclavian cannula and resorted to axillary vein cut-down. There were no episodes of deep venous thrombosis detected by routine postoperative duplex ultrasonography. Minimum and maximum flow rates were significantly better (P < .01), with percutaneously placed cannulae in comparison to a control group of patients who underwent transplantation in whom we used the standard venous cut-down approach with a #7 Gott shunt (2.14 and 3.17 L/min v 1.65 and 2.41 L/min, respectively). Percutaneous placement of cannulae for venovenous bypass during liver transplantation is quick, safe, and effective. We would advocate this technique as an alternative approach for patients in whom bypass is deemed necessary.

  15. Aortic surgery using total miniaturized cardiopulmonary bypass.

    PubMed

    Issitt, Richard W; Mulholland, John W; Oliver, Martin D; Yarham, Gemma J; Borra, Philippa J; Morrison, Paul; Dimarakis, Ioannis; Anderson, Jon R

    2008-08-01

    Few centers have attempted aortic surgery using miniaturized cardiopulmonary bypass (MCPB) systems due to concerns of air handling. The extra corporeal circuit optimized (ECCO) total MCPB system uses a venous air removal device and a parallel soft-shell reservoir that allows for venting of the heart. At our institution, total MCPB is used for all coronary artery bypass graft patients. Our objective was to assess the suitability of the ECCO total MCPB system during aortic surgery. Fifty consecutive and unselected aortic procedures using the ECCO system were undertaken. Surgical feasibility, air removal ability, and blood transfusion requirements were audited to determine the efficacy of this technique. The bypass time was 81.6 +/- 28.0 minutes and the ischemic time was 56.7 +/- 18.9 minutes. Total MCPB handled 1,910 +/- 404 mL of vented blood with 96 venous air removal device activations noted. The blood product transfusion rate was 12%, which was below the surgical transfusion rate for our unit. There were no complications. Aortic surgery can be undertaken safely and effectively using the ECCO total MCPB system.

  16. Vein harvesting and techniques for infrainguinal bypass.

    PubMed

    Albäck, Anders; Saarinen, Eva; Venermo, Maarit

    2016-04-01

    In order to achieve good long term results after bypass surgery, alongside with good inflow and outflow arteries, the bypass graft material also has an important role. The best patency and limb salvage rates are achieved with autologous vein. If great saphenous vein is not available, acceptable long-term results can be achieved with arm veins and lesser saphenous vein. The quality and size of the vein are important. A small-caliber vein, increased wall thickness, postphlebitic changes and varicosities are associated with a risk of early failure. Preoperative vein mapping with ultrasound reduces readmissions and postoperative surgical site infections. During the mapping, the vein to be used and its main tributaries are marked with a permanent marker pen. To reduce wound complication rates we recommend bridged incisions in vein harvesting. Endoscopic vein harvesting seems to have no benefit compared to open techniques in lower limb bypasses, and has been associated with higher risk of primary patency loss at one year. With deep tunneling of the graft the problems caused by wound infection can be avoided.

  17. Blood ionized magnesium concentrations during cardiopulmonary bypass and their correlation with other circulating cations.

    PubMed

    Aziz, S; Haigh, W G; Van Norman, G A; Kenny, R J; Kenny, M A

    1996-01-01

    The recent introduction of new measurement technology (using ion specific electrodes) makes intraoperative evaluation of blood ionized magnesium (Mg2+, or iMg)--the bioactive fraction of circulation magnesium--possible. The goals of this study were: (1) to examine the longitudinal pattern(s) of change in blood iMg during cardiopulmonary bypass (CPB); and (2) to determine the relationship of iMg to Ca2+ (iCa), K, pH, Na, and hematocrit (Hct) during CPB. Blood was collected serially before, during, and after CPB on 30 patients undergoing elective coronary artery bypass graft procedures and the iMg was measured with an AVL Scientific Corp., model 988-4 instrument. Overall, 73% of iMg results were abnormally low, 50% during CPB. Some cases had both hypo- and hyperionized magnesemic episodes. There were low iCa during CPB in 97% of cases. Using Spearman's rank order correlations and p < 0.05, iMg and K were directly correlated before, during, and after bypass, suggesting their parallel movement between tissue and blood. iMg and iCa were directly correlated before, and inversely correlated after, CPB, but unassociated during bypass. iMg and Na were inversely correlated after bypass in all cases. iMg was inversely correlated to pH and positively correlated to Hct during CPB only, and only in patients with concurrent association of iMg and iCa. Blood iMg depletion occurs frequently in CPB patients. iMg changes are not readily predictable. The association of intraoperative iMg depletion with postsurgical atrial fibrillation--reported to have a hypomagnesemic connection- should be investigated.

  18. Temperature inaccuracies during cardiopulmonary bypass.

    PubMed

    Salah, Mohammad; Sutton, Robin; Tsarovsky, Gary; Djuric, Michael

    2005-03-01

    Cerebral hyperthermia caused by perfusate temperature greater than 37 degrees C during the rewarming phase of CPB has been linked to postoperative neurologic deficits. The purpose of this study was to determine the accuracy of the coupled temperature measurement system and the CDI 500 arterial temperature sensor. Seventeen patients undergoing CPB were divided into four groups, each with a different temperature probe coupled to the oxygenator. The coupled temperature measurement system and CDI temperature sensors were compared with an indwelling probe placed in direct contact with the arterial perfusate. Blood, bladder, room and water temperatures, arterial line pressure, blood flow, and hemoglobin were recorded while the patients were supported with CPB. The actual blood temperature was significantly higher than the coupled temperature measurement system for two of the four groups (mean = 1.61 degrees C and 0.91 degrees C, p < 0.0001). A significant positive correlation between the actual temperature and the coupled temperature measurement system error was observed for the same two groups (r = 0.44, p < 0.0001). The actual temperature was significantly higher than the CDI temperature in all patients (mean = 1.2 degrees C, p < 0.0001). The coupling mechanism on the oxygenator generates inconsistent temperature readings. The perfusionist should consider these inconsistencies when using coupled temperature measurements and may consider the use of a direct temperature measurement system. The CDI temperature error is probably the result of inadequate flow through the sensor. On the test circuit, the flow of 170 mL/min was inadequate for circuit temperature accuracy. The accuracy of the CDI temperature drastically improved when the flow-through the sensor was increased to approximately 400 mL/min. Thus, the perfusionist must ensure adequate flow through the sensor in order for the temperature mechanism to function properly. Finally, the perfusionist can prevent cerebral

  19. A patent ductus arteriosus complicating cardiopulmonary bypass for combined coronary artery bypass grafting and aortic valve replacement only discovered by computed tomography 3D reconstruction.

    PubMed

    van Middendorp, Lars B; Maessen, Jos G; Sardari Nia, Peyman

    2014-12-01

    We describe the case of a 59-year old male patient undergoing combined coronary artery bypass grafting and aortic valve replacement. Manipulation of the heart during cardiopulmonary bypass significantly decreased venous return. Several measures were necessary to improve venous return to a level at which continuation of the procedure was safe. Based on the initial troubles with venous return, we decided to selectively cross-clamp the aorta. This resulted in a large amount of backflow of oxygenated blood from the left ventricle, necessitating additional vents in the pulmonary artery and directly in the left ventricle. The procedure was continued uneventfully, and postoperative recovery was without significant complications. Postoperative 2D computed tomography did not show any signs of a shunt, but 3D reconstruction showed a small patent ductus arteriosus.

  20. Ply-level failure analysis of a graphite/epoxy laminate under bearing-bypass loading

    NASA Technical Reports Server (NTRS)

    Naik, R. A.; Crews, J. H., Jr.

    1990-01-01

    A combined experimental and analytical study was conducted to investigate and predict the failure modes of a graphite/epoxy laminate subjected to combined bearing and bypass loading. Tests were conducted in a test machine that allowed the bearing-bypass load ratio to be controlled while a single-fastener coupon was loaded to failure in either tension or compression. Onset and ultimate failure modes and strengths were determined for each test case. The damage-onset modes were studied in detail by sectioning and micrographing the damaged specimens. A two-dimensional, finite-element analysis was conducted to determine lamina strains around the bolt hole. Damage onset consisted of matrix cracks, delamination, and fiber failures. Stiffness loss appeared to be caused by fiber failures rather than by matrix cracking and delamination. An unusual offset-compression mode was observed for compressive bearing-bypass loading in which the specimen failed across its width along a line offset from the hole. The computed lamina strains in the fiber direction were used in a combined analytical and experimental approach to predict bearing-bypass diagrams for damage onset from a few simple tests.

  1. Giant and complex aneurysms treatment with preservation of flow via bypass technique.

    PubMed

    Thines, L; Proust, F; Marinho, P; Durand, A; van der Zwan, A; Regli, L; Lejeune, J-P

    2016-02-01

    Due to their anatomical characteristics and the complexity of the procedures required to obtain their complete occlusion, the treatment of giant intracranial aneurysms is a real challenge. Direct reconstructive strategies, whether by interventional neuroradiology (coils, stents) or microsurgical (clipping) means, are not always applicable and, in patients that would not tolerate parent or collateral artery sacrifice, the adjunction of a revascularization procedure using a bypass technique might be necessary. Cerebral arterial bypasses can be classified according to their function (3 types: flow replacement, flow reversal or protective), the branching mode of the graft used (3 types: pedicled, interpositional or in situ), the sites of anastomosis (2 types: extracranial-intracranial or intracranial-intracranial) and the class of flow they are supposed to provide (3 types: low-, intermediate- or high-flow). In this article, the authors review the different aspects in the management of patients with a giant intracranial aneurysm using a bypass: preoperative work-up, types of bypass and indications, surgical techniques and results.

  2. Ply-level failure analysis of a graphite/epoxy laminate under bearing-bypass loading

    NASA Technical Reports Server (NTRS)

    Naik, R. A.; Crews, J. H., Jr.

    1988-01-01

    A combined experimental and analytical study was conducted to investigate and predict the failure modes of a graphite/epoxy laminate subjected to combined bearing and bypass loading. Tests were conducted in a test machine that allowed the bearing-bypass load ratio to be controlled while a single-fastener coupon was loaded to failure in either tension or compression. Onset and ultimate failure modes and strengths were determined for each test case. The damage-onset modes were studied in detail by sectioning and micrographing the damaged specimens. A two-dimensional, finite-element analysis was conducted to determine lamina strains around the bolt hole. Damage onset consisted of matrix cracks, delamination, and fiber failures. Stiffness loss appeared to be caused by fiber failures rather than by matrix cracking and delamination. An unusual offset-compression mode was observed for compressive bearing-bypass laoding in which the specimen failed across its width along a line offset from the hole. The computed lamina strains in the fiber direction were used in a combined analytical and experimental approach to predict bearing-bypass diagrams for damage onset from a few simple tests.

  3. Ply-level failure analysis of a graphite/epoxy laminate under bearing-bypass loading

    NASA Technical Reports Server (NTRS)

    Naik, R. A.; Crews, J. H., Jr.

    1990-01-01

    A combined experimental and analytical study was conducted to investigate and predict the failure modes of a graphite/epoxy laminate subjected to combined bearing and bypass loading. Tests were conducted in a test machine that allowed the bearing-bypass load ratio to be controlled while a single-fastener coupon was loaded to failure in either tension or compression. Onset and ultimate failure modes and strengths were determined for each test case. The damage-onset modes were studied in detail by sectioning and micrographing the damaged specimens. A two-dimensional, finite-element analysis was conducted to determine lamina strains around the bolt hole. Damage onset consisted of matrix cracks, delamination, and fiber failures. Stiffness loss appeared to be caused by fiber failures rather than by matrix cracking and delamination. An unusual offset-compression mode was observed for compressive bearing-bypass loading in which the specimen failed across its width along a line offset from the hole. The computed lamina strains in the fiber direction were used in a combined analytical and experimental approach to predict bearing-bypass diagrams for damage onset from a few simple tests.

  4. Jet-Pylon Interaction of High Bypass Ratio Separate Flow Nozzle Configurations

    NASA Technical Reports Server (NTRS)

    Thomas, Russell H.; Kinzie, Kevin W.

    2004-01-01

    NASA Langley Research Center, Hampton, Virginia, 23681-0001 USA An experimental investigation was performed of the acoustic effects of jet-pylon interaction for separate flow and chevron nozzles of both bypass ratio five and eight. The models corresponded to an approximate scale factor of nine. Cycle conditions from approach to takeoff were tested at wind tunnel free jet Mach numbers of 0.1, 0.2 and 0.28. An eight-chevron core nozzle, a sixteen chevron fan nozzle, and a pylon were primary configuration variables. In addition, two orientations of the chevrons relative to each other and to the pylon were tested. The effect of the pylon on the azimuthal directivity was investigated for the baseline nozzles and the chevron nozzles. For the bypass ratio five configuration, the addition of the pylon reduces the noise by approximately 1 EPNdB compared to the baseline case and there is little effect of azimuthal angle. The core chevron produced a 1.8 EPNdB reduction compared to the baseline nozzle. Adding a pylon to the chevron core nozzle produces an effect that depends on the orientation of the chevron relative to the pylon. The azimuthal directivity variation remains low at less than 0.5 EPNdB. For the bypass ratio eight configuration the effect of adding a pylon to the baseline nozzle is to slightly increase the noise at higher cycle points and for the case with a core chevron the pylon has little additional effect. The azimuthal angle effect continues to be very small for the bypass ratio eight configurations. A general impact of the pylon was observed for both fan and core chevrons at both bypass ratios. The pylon reduces the typical low frequency benefit of the chevrons, even eliminating it in some cases, while not impacting the high frequency. On an equal ideal thrust basis, the bypass ratio eight baseline nozzle was about 5 EPNdB lower than the bypass ratio five baseline nozzle at the highest cycle condition, however, with a pylon installed the difference

  5. Hypopotassemia following open heart surgery by cardio-pulmonary bypass.

    PubMed

    Abe, T; Nagata, Y; Yoshioka, K; Iyomasa, Y

    1977-01-01

    1. In this study where potassium concentration of perfusate of heart-lung machine was made high and no potassium was given until two hours after by-pass, the fall of plasma potassium level due to heart-lung bypass occurred in two stages, namely one hour of complete bypass and two hours after the end of bypass. 2. Regarding to the decrease of these plasma potassium level, increase of potassium excretion into urine and the movement of potassium from extracellular fluid into cells are presumed to be causes. Their genesis was discussed. 3. To prevent hypopotassemia following bypass, it is recommended to add KCl in the perfusate of heart-lung machine and to give intravenous drip of KCl immediately after bypass.

  6. Considerations for Probabilistic Analyses to Assess Potential Changes to Large-Break LOCA Definition for ECCS Requirements

    SciTech Connect

    Wilkowski, G.; Rudland, D.; Wolterman, R.; Krishnaswamy, P.; Scott, P.; Rahman, S.; Fairbanks, C.

    2002-07-01

    The U.S.NRC has undertaken a study to explore changes to the body of Part 50 of the U.S. Federal Code of Regulations, to incorporate risk-informed attributes. One of the regulations selected for this study is 10 CFR 50.46, {sup A}cceptance Criteria for Emergency Core Cooling Systems for Light-Water Nuclear Power Reactors{sup .} These changes will potentially enhance safety and reduce unnecessary burden on utilities. Specific attention is being paid to redefining the maximum pipe break size for LB-LOCA by determining the spectrum of pipe diameter (or equivalent opening area) versus failure probabilities. In this regard, it is necessary to ensure that all contributors to probabilistic failures are accounted for when redefining ECCS requirements. This paper describes initial efforts being conducted for the U.S.NRC on redefining the LB-LOCA requirements. Consideration of the major contributors to probabilistic failure, and deterministic aspects for modeling them, are being addressed. At this time three major contributors to probabilistic failures are being considered. These include: (1) Analyses of the failure probability from cracking mechanisms that could involve rupture or large opening areas from either through-wall or surface flaws, whether the pipe system was approved for leak-before-break (LBB) or not. (2) Future degradation mechanisms, such as recent occurrence of PWSCC in PWR piping need to be included. This degradation mechanism was not recognized as being an issue when LBB was approved for many plants or when the initial risk-informed inspection plans were developed. (3) Other indirect causes of loss of pressure-boundary integrity than from cracks in the pipe system also should be included. The failure probability from probabilistic fracture mechanics will not account for these other indirect causes that could result in a large opening in the pressure boundary: i.e., failure of bolts on a steam generator manway, flanges, and valves; outside force damage from

  7. The relative importance of graft surveillance and warfarin therapy in infrainguinal prosthetic bypass failure.

    PubMed

    Brumberg, Robert Scott; Back, Martin R; Armstrong, Paul A; Cuthbertson, David; Shames, Murray L; Johnson, Brad L; Bandyk, Dennis F

    2007-12-01

    We sought to describe modes of failure and associated limb loss after infrainguinal polytetrafluoroethylene bypass grafting in patients lacking a saphenous venous conduit and to define specific clinical or hemodynamic factors prognostic for bypass failure. We identified 121 patients (mean age, 67 years; 90 men and 31 women) with determinable outcomes (minimum follow-up, 2 months; mean, 17 months) after 130 prosthetic infrainguinal bypasses between 1997 and 2005. Ischemic presentation was rest pain in 52%, tissue loss in 34%, and disabling claudication and/or popliteal aneurysm in 14%, with 24% of patients requiring a redo bypass. Distal targets were the above-knee (n = 44), distal popliteal (n = 27), or tibial/pedal (n = 59) arteries. Sixty-six (77%) of the below-knee (BK) target (distal popliteal or tibial) bypasses had distal anastomotic adjuncts (vein cuff or patch). Duplex graft surveillance was performed at 1, 4, and 7 months after surgery and twice yearly thereafter, with recording of midgraft velocities and imaging encompassing inflow and outflow vessels. Arteriography and open/endovascular intervention was performed for stenoses identified by duplex scanning (peak systolic velocity >300 cm/s; velocity ratio >3.5). An attempt was made to salvage occluded grafts by using catheter-directed thrombolysis or open techniques. Eighty-six patients (74% of BK bypasses) were placed on chronic warfarin therapy with a target international normalized ratio range between 2 and 3. Prognostic factors were identified by using univariate statistics and multivariate logistic regression analysis. Three-year primary, assisted, and secondary patency rates were 39%, 43%, and 59%, respectively, for all bypasses, with no difference noted between above-knee and BK grafts (P = .5). At 3 years, freedom from limb loss was 75%, and patient survival was only 70%, with no adverse effect on survival imparted by amputation. Sixty-nine total adverse events occurred as a result of thrombotic

  8. Twenty-third water reactor safety information meeting. Volume 3, structural and seismic engineering, primary systems integrity, equipment operability and aging, ECCS strainer blockage research and regulatory issues

    SciTech Connect

    Monteleone, S.

    1996-03-01

    This three-volume report contains papers presented at the Twenty- Third Water Reactor Safety Information Meeting held at the Bethesda Marriott Hotel, Bethesda, Maryland, October 23-25, 1995. The papers are printed in the order of their presentation in each session and describe progress and results of programs in nuclear safety research conducted in this country and abroad. Foreign participation in the meeting included papers presented by researchers from France, Italy, Japan, Norway, Russia, Sweden, and Switzerland. This document, Volume 3, presents topics in Structural & Seismic Engineering, Primary Systems Integrity, Equipment Operability and Aging, and ECCS Strainer Blockage Research & Regulatory Issues. Individual papers have been cataloged separately.

  9. Heat exchanger bypass system for an absorption refrigeration system

    DOEpatents

    Reimann, Robert C.

    1984-01-01

    A heat exchanger bypass system for an absorption refrigeration system is disclosed. The bypass system operates to pass strong solution from the generator around the heat exchanger to the absorber of the absorption refrigeration system when strong solution builds up in the generator above a selected level indicative of solidification of strong solution in the heat exchanger or other such blockage. The bypass system includes a bypass line with a gooseneck located in the generator for controlling flow of strong solution into the bypass line and for preventing refrigerant vapor in the generator from entering the bypass line during normal operation of the refrigeration system. Also, the bypass line includes a trap section filled with liquid for providing a barrier to maintain the normal pressure difference between the generator and the absorber even when the gooseneck of the bypass line is exposed to refrigerant vapor in the generator. Strong solution, which may accumulate in the trap section of the bypass line, is diluted, to prevent solidification, by supplying weak solution to the trap section from a purge system for the absorption refrigeration system.

  10. Use of Robotics During Laparoscopic Gastric Bypass for Morbid Obesity

    PubMed Central

    Artuso, Dominick; Grossi, Robert

    2005-01-01

    To evaluate the theoretical increased precision offered by utilization of the robotic instrument, we attempted to determine whether incorporation of its use into traditional laparoscopic gastric bypass would duplicate or improve the success of the operation without increasing complications. The Roux-en-Y gastric bypass is the most commonly performed procedure for morbid obesity in the United States. We performed 120 gastric bypass procedures with traditional laparoscopy during a 30-month period. We began introducing the da Vinci Robotic Surgical System into our laparoscopic gastric bypass procedure and evaluated its effectiveness. PMID:16121869

  11. Jejunioleal Bypass Procedures in Morbid Obesity: Preoperative Psychological Findings

    ERIC Educational Resources Information Center

    Webb, Warren W.; And Others

    1976-01-01

    Seventy patients who averaged 155 percent overweight and requested jejunioleal bypass surgery as a treatment intervention for morbid obesity were studied preoperatively for prominent psychological characteristics. (Author)

  12. Clinical experience with minimally invasive reoperative coronary bypass surgery.

    PubMed

    Subramanian, V A

    1996-01-01

    To minimize the risk of standard and reoperative coronary artery bypass, we developed a minimally invasive approach. In this study we have evaluated the effectiveness of this technique. Between April 1994 and September 1995, 12 men and 6 women, aged 55-84 years (mean, 69 years) with chronic stable angina (4) and recent post-myocardial infarction unstable angina (14), with left ventricular ejection fractions ranging 17-60% (mean 37%), underwent reoperative coronary artery bypass grafting using 7-cm mini-left and right anterior thoracotomy and subxiphoid incisions. Coronary artery anastomoses were carried out on beating hearts with local coronary occlusion. Ischemic preconditioning, beta and calcium channel blockers and the maintenance of mean arterial pressure at 75-80 mm Hg, were used as adjuncts for myocardial protection. The internal mammary artery was isolated under direct vision up to the second rib with excision of the fourth costal cartilage. Coronary artery target sites were the left anterior descending in 12, right coronary artery in 4, obtuse marginal in 3, posterior descending in 1 and diagonal branch in 1 patient. Arterial grafts (mammary, right gastroepiploic, radial), either as single or composite grafts, were used liberally. Preoperative risk factors included congestive heart failure (7), chronic renal insufficiency (5), second reoperation (2), third reoperation (1), cerebrovascular disease (5), prior angioplasty (8) and preoperative intra-aortic balloon pumping in two patients. There was no perioperative mortality with minimal morbidity. Twelve patients underwent patency study of the grafts 48-72 h postoperatively. Ten of the twelve grafts were patent; one internal mammary artery graft to the left anterior descending coronary artery (<1.5 mm) early in our series was occluded and one additional left internal mammary graft had a kink several centimeters away from the anastomosis, which was successfully opened by angioplasty. At a mean follow

  13. Secondary structure of bacteriophage T4 gene 60 mRNA: implications for translational bypassing.

    PubMed

    Todd, Gabrielle C; Walter, Nils G

    2013-05-01

    Translational bypassing is a unique phenomenon of bacteriophage T4 gene 60 mRNA wherein the bacterial ribosome produces a single polypeptide chain from a discontinuous open reading frame (ORF). Upon reaching the 50-nucleotide untranslated region, or coding gap, the ribosome either dissociates or bypasses the interruption to continue translating the remainder of the ORF, generating a subunit of a type II DNA topoisomerase. Mutational and computational analyses have suggested that a compact structure, including a stable hairpin, forms in the coding gap to induce bypassing, yet direct evidence is lacking. Here we have probed the secondary structure of gene 60 mRNA with both Tb³⁺ ions and the selective 2'-hydroxyl acylation analyzed by primer extension (SHAPE) reagent 1M7 under conditions where bypassing is observed. The resulting experimentally informed secondary structure models strongly support the presence of the predicted coding gap hairpin and highlight the benefits of using Tb³⁺ as a second, complementary probing reagent. Contrary to several previously proposed models, however, the rest of the coding gap is highly reactive with both probing reagents, suggesting that it forms only a short stem-loop. Mutational analyses coupled with functional assays reveal that two possible base-pairings of the coding gap with other regions of the mRNA are not required for bypassing. Such structural autonomy of the coding gap is consistent with its recently discovered role as a mobile genetic element inserted into gene 60 mRNA to inhibit cleavage by homing endonuclease MobA.

  14. [Repeat bypass surgery for intracranial hemorrhage 30 years after indirect bypass for moyamoya disease].

    PubMed

    Hori, Satoshi; Kashiwazaki, Daina; Akioka, Naoki; Hamada, Hideo; Kuwayama, Naoya; Kuroda, Satoshi

    2014-04-01

    A 39-year-old man had been diagnosed with moyamoya disease and underwent a bilateral encephalo-duro-arterio-synangiosis(EDAS)intervention at the age of 9 years. During the 30 years after his bilateral EDAS, he experienced no cerebrovascular events. However, at age 39, he suddenly presented with mild consciousness disturbance and vomiting and was transferred to a local hospital. Brain CT showed an intracerebral hemorrhage associated with ventricular hematoma. He was referred to our hospital for further investigation and treatment. Cerebral angiography showed faint collaterals through the site of the bilateral EDAS and development of basal moyamoya vessels. SPECT showed decreased cerebral blood flow(CBF)and cerebrovascular reactivity(CVR)in the right frontal lobe. We diagnosed him with delayed cerebral hemorrhage due to delayed rupturing of fragile moyamoya vessels after indirect bypass. The patient underwent a repeat bypass surgery(STA-MCA anastomosis and encephalo-duro-myo-arterio-pericranial synangiosis;EDMAPS)on the right side. He showed improvement in cerebral hemodynamics after surgery, and has since remained free from cerebrovascular events. Hemorrhagic events occurring a very long time after indirect bypass surgery in pediatric-onset moyamoya disease are rare. In such cases, a lifelong follow-up strategy may be necessary. Repeat bypass surgery may be a powerful tool to prevent such hemorrhagic events.

  15. Preoperative graft assessment in aortocoronary bypass surgery

    PubMed Central

    Tinica, Grigore; Vartic, Cristina Luca; Mocanu, Veronica; Baran, Dana; Butcovan, Doina

    2016-01-01

    Coronary artery bypass graft (CABG) is a surgical procedure able to improve the blood supply to the myocardium. In the present study, the distal segments of grafts taken from the internal thoracic artery (ITA), radial artery (RA) and saphenous vein (SV) for use in aortocoronary bypass surgery were examined. The morphologies of the grafts were investigated in order to draw conclusions concerning their patency and viability. In addition, clinical and laboratory risk factors considered to be significant predictors of lesion severity in graft vessels used in CABGs were investigated. In total, 54 distal graft segments of ITAs, RAs and SVs from 20 men and 6 women aged between 42 and 78 years, were evaluated. Histological analyses were used to visualize graft lesions. Morphometrically, the intimal thickness index (ITI) and luminal narrowing were assessed as an indication of graft patency. The histological changes observed in the graft vessel walls included the presence of distinct atheromatous plaques (fatty streaks in 2 cases) or thickening of the intima (20 cases) and media (17 cases). Morphometric analysis showed that the mean ITI of the vessel conduits was 0.37 in the SVs, 0.95 in the RAs, and 1.66 in the ITAs. No patient had >50% conduit stenosis. By assessing the association between risk factors and graft lesions, it was found that all the patients showed risk factors for atherosclerosis, such as age (61.54%), arterial hypertension (65.38%), hyperlipidemia (65.38%), smoking (34.61%), diabetes mellitus (38.46%) and obesity (15.38%). The presence of pre-existing lesions in bypass grafts may contribute to a reduction in their viability, particularly in the case of venous grafts. Further long-term follow-ups are mandatory to evaluate the consequences of such lesions upon the patency of the grafts. PMID:27446279

  16. Embolic Activity During In Vivo Cardiopulmonary Bypass

    PubMed Central

    DeFoe, Gordon R.; Dame, Norman A.; Farrell, Mark S.; Ross, Cathy S.; Langner, Craig W.; Likosky, Donald S.

    2014-01-01

    Abstract: Neurologic injury after cardiac surgery is principally associated with emboli. Although much work has focused on surgical sources of emboli, less attention has been focused on emboli associated with the heart–lung machine. We tested whether emboli are associated with discrete processes during cardiopulmonary bypass (CPB). One hundred patients undergoing cardiothoracic surgery were enrolled between April 2008 and May 2011 at a single medical center. During each surgical procedure, emboli were counted in three CPB locations: the venous side (Channel 1), before the arterial line filter (Channel 2), and after the arterial line filter (Channel 3). We used prespecified event markers to identify perfusionist interventions. Identical circuits were used on all patients. Of the 100 patients enrolled, 62 underwent isolated coronary artery bypass grafting (CABG), 17 underwent isolated valve operations, and 21 underwent CABG plus valve. Median counts across Channels 1, 2, and 3 were 69,853, 3,017, and 1,251, respectively. The greatest contributor to emboli in Channels 1, 2, and 3, respectively, were achieving the calculated CPB flow, opening of the electronic arterial line clamp, and introducing a hemofilter. The circuit technology was efficient in reducing total emboli counts from Channels 1–2 irrespective of the size of the emboli. Nearly 71% of all emboli 30–100 mm in size were removed from the circuit between Channels 2 and 3. No significant association was found between emboli counts and S100B release. Emboli occur frequently during CPB and are predominantly associated with the initiation of bypass, operation of the electronic arterial line clamp, and the initiation of a hemofilter. Continued work to reduce the occurrence of emboli is warranted. PMID:25208432

  17. Femoropopliteal bypass for claudication: vein vs. PTFE.

    PubMed

    Allen, B T; Reilly, J M; Rubin, B G; Thompson, R W; Anderson, C B; Flye, M W; Sicard, G A

    1996-03-01

    The vascular graft of choice for femoropopliteal bypass in patients with intolerable claudication is controversial. We retrospectively reviewed our experience with 239 patients suffering from claudication secondary to superficial femoral artery obstruction. Femoropopliteal reconstruction was performed with saphenous vein to the below-knee popliteal artery in 66 patients (BK-vein). Polytetrafluoroethylene (PTFE) was used in 128 patients as a bypass graft to the above-knee popliteal artery (AK-PTFE) and 45 patients had a PTFE graft to the below-knee popliteal artery (BK-PTFE). All patients were enrolled in a postoperative graft surveillance program with graft revision when appropriate. There was one perioperative death (0.4%). Primary patency at 5 years for AK-PTFE, BK-PTFE, and BK-vein was 58.0%, and 60.3%, respectively, and was not significantly different among the graft groups. Graft revision for failed/failing grafts resulted in 5-year secondary patency rates of 79.2% (AK-PTFE), 73.3% (BK-PTFE), and 74.4% (BK-vein). These secondary patency rates were not statistically different. Eventual conversion to a vein graft in patients initially treated with PTFE maximized patency in the femoropopliteal segment with 5-year patency rates of 84.6% and 93.0% for the AK-PTFE and BK-PTFE graft groups, respectively. Major leg amputation was necessary during the entire course of the study in eight (3.3%) patients. We conclude that long-term patency rates for femoropopliteal bypass in patients with intolerable claudication are similar for PTFE and autologous saphenous vein grafts.

  18. Flow characteristics in narrowed coronary bypass graft

    NASA Astrophysics Data System (ADS)

    Bernad, S. I.; Bosioc, A.; Bernad, E. S.; Petre, I.; Totorean, A. F.

    2016-06-01

    Tortuous saphenous vein graft (SVG) hemodynamics was investigated using computational fluid dynamics (CFD) techniques. Computed tomography (CT) technology is used for non-invasive bypass graft assessment 7 days after surgery. CT investigation shown two regions with severe shape remodelling first is an elbow type contortion and second is a severe curvature with tortuous area reduction. In conclusion, the helical flow induced by vessel torsion may stabilize the blood flow in the distal part of the SVG, reducing the flow disturbance and suppressing the flow separation, but in the distal end of the graft, promote the inflammatory processes in the vessels.

  19. Bypass diode for a solar cell

    DOEpatents

    Rim, Seung Bum; Kim, Taeseok; Smith, David D; Cousins, Peter J

    2013-11-12

    Methods of fabricating bypass diodes for solar cells are described. In once embodiment, a method includes forming a first conductive region of a first conductivity type above a substrate of a solar cell. A second conductive region of a second conductivity type is formed on the first conductive region. In another embodiment, a method includes forming a first conductive region of a first conductivity type above a substrate of a solar cell. A second conductive region of a second conductivity type is formed within, and surrounded by, an uppermost portion of the first conductive region but is not formed in a lowermost portion of the first conductive region.

  20. Flow characteristics in narrowed coronary bypass graft

    SciTech Connect

    Bernad, S. I.; Bosioc, A.; Totorean, A. F.; Bernad, E. S.; Petre, I.

    2016-06-08

    Tortuous saphenous vein graft (SVG) hemodynamics was investigated using computational fluid dynamics (CFD) techniques. Computed tomography (CT) technology is used for non-invasive bypass graft assessment 7 days after surgery. CT investigation shown two regions with severe shape remodelling first is an elbow type contortion and second is a severe curvature with tortuous area reduction. In conclusion, the helical flow induced by vessel torsion may stabilize the blood flow in the distal part of the SVG, reducing the flow disturbance and suppressing the flow separation, but in the distal end of the graft, promote the inflammatory processes in the vessels.

  1. Conduits for Coronary Bypass: Vein Grafts

    PubMed Central

    Farkas, Emily A

    2012-01-01

    The saphenous vein has been the principal conduit for coronary bypass grafting from the beginning, circa 1970. This report briefly traces this history and concomitantly presents one surgeons experience and personal views on use of the vein graft. As such it is not exhaustive but meant to be practical with a modest number of references. The focus is that of providing guidance and perspective which may be at variance with that of others and recognizing that there may be many ways to accomplish the task at hand. Hopefully the surgeon in training/early career may find this instructive on the journey to surgical maturity. PMID:23130300

  2. Retinal Blood Vessel Distribution Correlates With the Peripapillary Retinal Nerve Fiber Layer Thickness Profile as Measured With GDx VCC and ECC.

    PubMed

    Resch, Hemma; Pereira, Ivania; Weber, Stephanie; Holzer, Stephan; Fischer, Georg; Vass, Clemens

    2015-01-01

    Aim of the present study was to evaluate whether there is a correlation between retinal blood vessel density (RVD) and the peripapillary retinal nerve fiber layer (RNFL) thickness profile. RNFL thickness of 106 healthy subjects was measured using scanning laser polarimetry, GDx variable corneal compensation (VCC), and GDx enhanced corneal compensation (ECC). A proprietary software was developed in MATLAB to measure the peripapillary retinal vessels using scanning laser ophthalmoscopy fundus images, centered on the optic disc measured by Cirrus spectral domain optical coherence tomography. The individual retinal vessel positions and thickness values were integrated in a 64-sector RVD profile and intrasubject and intersubject correlations were calculated. The mean R value±SD for intrasubject correlation between RVD and RNFL thickness measured with GDx VCC and GDx ECC was 0.714±0.157 and 0.629±0.140, with 105 of 106 subjects presenting significant correlations. In the intersubject linear regression analysis for GDx VCC, 33 of 64 (52%) sectors presented a significant Pearson correlation coefficient between RNFL thickness and RVD values, with a mean R value of 0.187±0.135 (P<0.05). Peripapillary RNFL thickness profiles correlate with the RVD over 50% of the sectors and might explain up to 26% of the interindividual variance of the peripapillary RNFL thickness values as measured with GDx VCC. To our opinion, taking into account RVD might reduce interindividual variation in peripapillary RNFL thickness profiles measured with scanning laser polarimetry.

  3. Manual small incision cataract surgery (MSICS) with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.

    PubMed

    Ang, Marcus; Evans, Jennifer R; Mehta, Jod S

    2014-11-18

    Age-related cataract is the opacification of the lens, which occurs as a result of denaturation of lens proteins. Age-related cataract remains the leading cause of blindness globally, except in the most developed countries. A key question is what is the best way of removing the lens, especially in lower income settings. To compare two different techniques of lens removal in cataract surgery: manual small incision surgery (MSICS) and extracapsular cataract extraction (ECCE). We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 8), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to September 2014), EMBASE (January 1980 to September 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to September 2014), Web of Science Conference Proceedings Citation Index- Science (CPCI-S), (January 1990 to September 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 23 September 2014. We included randomised controlled trials (RCTs) only. Participants in the trials were people with age-related cataract. We included trials where MSICS with a posterior chamber intraocular lens (IOL) implant was compared to ECCE with a posterior chamber IOL implant. Data were collected independently by two authors. We aimed to collect data on presenting visual acuity 6/12 or better and best-corrected visual acuity of less than 6/60 at three months and one year after surgery. Other outcomes included intraoperative complications, long-term complications (one year or more after surgery), quality of life, and cost

  4. Manual small incision cataract surgery (MSICS) with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.

    PubMed

    Ang, Marcus; Evans, Jennifer R; Mehta, Jod S

    2012-04-18

    Age-related cataract is the opacification of the lens, which occurs as a result of denaturation of lens proteins. Age-related cataract remains the leading cause of blindness globally, except in the most developed countries. A key question is what is the best way of removing the lens, especially in lower income settings. To compare two different techniques of lens removal in cataract surgery: manual small incision surgery (MSICS) and extracapsular cataract extraction (ECCE). We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 1), MEDLINE (January 1950 to February 2012), EMBASE (January 1980 to February 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to February 2012), Web of Science Conference Proceedings Citation Index- Science (CPCI-S), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 14 February 2012. We included randomised controlled trials (RCTs) only. Participants in the trials were people with age-related cataract. We included trials where MSICS with a posterior chamber intraocular lens (IOL) implant was compared to ECCE with a posterior chamber IOL implant. Data were collected independently by two authors. We aimed to collect data on presenting visual acuity 6/12 or better and best-corrected visual acuity of less than 6/60 at three months and one year after surgery. Other outcomes included intraoperative complications, long-term complications (one year or more after surgery), quality of life, and cost-effectiveness. There were not enough data available from the included trials to perform a meta-analysis. Three trials randomly allocating people with age

  5. Combined use of phenoxybenzamine and dopamine for low cardiac output syndrome in children at withdrawal from cardiopulmonary bypass.

    PubMed

    Kawamura, M; Minamikawa, O; Yokochi, H; Maki, S; Yasuda, T; Mizukawa, Y

    1980-04-01

    The combined use of phenoxybenzamine and dopamine was applied in infants and children when it was difficult to come off cardiopulmonary bypass for low cardiac output. The rationale of this method is to prevent the alpha-adrenergic action of dopamine by phenoxybenzamine and to encourage the beta-adrenergic and direct specific action of dopamine. Dopamine was used in dosage of 10 to 30 micrograms/kg per min after the additional administration of a half of the initial dosage of phenoxybenzamine; this was infused by drip always in a dosage of 0.5 to 1.0 mg/kg during the first half of cardiopulmonary bypass. It was possible to come off cardiopulmonary bypass with a stable haemodynamic state (mean arterial pressure more than 60 mmHg and total peripheral vascular resistance less than 2000 bynes s cm-5) and a good urinary output.

  6. Combined use of phenoxybenzamine and dopamine for low cardiac output syndrome in children at withdrawal from cardiopulmonary bypass.

    PubMed Central

    Kawamura, M; Minamikawa, O; Yokochi, H; Maki, S; Yasuda, T; Mizukawa, Y

    1980-01-01

    The combined use of phenoxybenzamine and dopamine was applied in infants and children when it was difficult to come off cardiopulmonary bypass for low cardiac output. The rationale of this method is to prevent the alpha-adrenergic action of dopamine by phenoxybenzamine and to encourage the beta-adrenergic and direct specific action of dopamine. Dopamine was used in dosage of 10 to 30 micrograms/kg per min after the additional administration of a half of the initial dosage of phenoxybenzamine; this was infused by drip always in a dosage of 0.5 to 1.0 mg/kg during the first half of cardiopulmonary bypass. It was possible to come off cardiopulmonary bypass with a stable haemodynamic state (mean arterial pressure more than 60 mmHg and total peripheral vascular resistance less than 2000 bynes s cm-5) and a good urinary output. PMID:7397040

  7. 20 CFR 631.38 - State by-pass authority.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false State by-pass authority. 631.38 Section 631.38 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS UNDER TITLE III OF THE JOB TRAINING PARTNERSHIP ACT State Administration § 631.38 State by-pass authority....

  8. 46 CFR 154.550 - Excess flow valve: Bypass.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Excess flow valve: Bypass. 154.550 Section 154.550 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY... and Process Piping Systems § 154.550 Excess flow valve: Bypass. If the excess flow valve allowed...

  9. 20 CFR 631.38 - State by-pass authority.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false State by-pass authority. 631.38 Section 631.38 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS UNDER TITLE III OF THE JOB TRAINING PARTNERSHIP ACT State Administration § 631.38 State by-pass authority. (a...

  10. 20 CFR 631.38 - State by-pass authority.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false State by-pass authority. 631.38 Section 631.38 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS UNDER TITLE III OF THE JOB TRAINING PARTNERSHIP ACT State Administration § 631.38 State by-pass authority. (a...

  11. Bearing-Bypass Loading On Bolted Composite Joints

    NASA Technical Reports Server (NTRS)

    Crews, John H.; Naik, Rajiv-Vikas A.

    1989-01-01

    Unexpected interaction between effects of bypass and bearing loads reported. Combined experimental and analytical study described in NASA technical memorandum conducted to investigate effects of simultaneous bearing and bypass loading on graphite/epoxy laminate. Results important in emerging technology of composites for use in wide range of applications. Includes applications in aircraft, boats, and automobiles, in which bolted connections to composites increasingly important.

  12. Reverse bias protected solar array with integrated bypass battery

    NASA Technical Reports Server (NTRS)

    Landis, Geoffrey A (Inventor)

    2012-01-01

    A method for protecting the photovoltaic cells in a photovoltaic (PV) array from reverse bias damage by utilizing a rechargeable battery for bypassing current from a shaded photovoltaic cell or group of cells, avoiding the need for a bypass diode. Further, the method mitigates the voltage degradation of a PV array caused by shaded cells.

  13. At 1050 Gallery, Block 65, view of coaster gate bypass ...

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

    At 1050 Gallery, Block 65, view of coaster gate bypass valve (for turbine-generator unit G-10, this bypass-valve unit manufactured by Western Koppers Co., Fort Wayne, Ind., 1938), looking southeast. - Columbia Basin Project, Grand Coulee Dam & Franklin D. Roosevelt Lake, Across Columbia River, Southeast of Town of Grand Coulee, Grand Coulee, Grant County, WA

  14. The in situ saphenous vein bypass graft: radiologic aspects.

    PubMed

    Schwarz, W; Nozick, J; Richmand, D; Rodgers, B; Simpson, A; Argila, C; Honickman, S

    1986-03-01

    The use of the in situ saphenous vein for bypassing arterial occlusions in the lower extremities appears to have a higher patency rate than other bypass procedures but presents unique technical problems, such as lysing valves and occluding venous tributaries. Forty-four patients undergoing in situ bypasses had preoperative arteriograms. Special attention was paid to the small runoff vessels around the ankle, which are not suitable for reversed bypass procedures but may be adequate for in situ bypasses. Eight patients also had preoperative saphenous venograms, which revealed surgically important abnormalities in six cases. Postoperative arteriograms obtained within 2 weeks in 10 patients and within 2-12 months in 15 patients revealed persistent arteriovenous fistulas in four patients, stenoses in nine, occlusions in five, and progressive disease in the nonbypassed arteries in five patients. Early recognition of these problems led to 11 surgical repairs; nine repairs used the interventional radiologic procedures of balloon angioplasty, transcatheter embolization, and catheter thrombolysis. In this group of 44 patients, five patients died with patent bypasses and three patients required amputation despite functioning bypasses. Only four amputations were attributed to bypass failure. This low figure may be due to the close cooperation of the vascular surgeons and the vascular radiologists in dealing with these complicated cases.

  15. 46 CFR 154.550 - Excess flow valve: Bypass.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 5 2011-10-01 2011-10-01 false Excess flow valve: Bypass. 154.550 Section 154.550 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY... and Process Piping Systems § 154.550 Excess flow valve: Bypass. If the excess flow valve allowed under...

  16. 46 CFR 154.550 - Excess flow valve: Bypass.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 5 2014-10-01 2014-10-01 false Excess flow valve: Bypass. 154.550 Section 154.550 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY... and Process Piping Systems § 154.550 Excess flow valve: Bypass. If the excess flow valve allowed under...

  17. 46 CFR 154.550 - Excess flow valve: Bypass.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 5 2013-10-01 2013-10-01 false Excess flow valve: Bypass. 154.550 Section 154.550 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY... and Process Piping Systems § 154.550 Excess flow valve: Bypass. If the excess flow valve allowed under...

  18. 46 CFR 154.550 - Excess flow valve: Bypass.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 5 2012-10-01 2012-10-01 false Excess flow valve: Bypass. 154.550 Section 154.550 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY... and Process Piping Systems § 154.550 Excess flow valve: Bypass. If the excess flow valve allowed under...

  19. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cardiopulmonary bypass cardiotomy return sucker. 870.4420 Section 870.4420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... from the chest or heart during cardiopulmonary bypass surgery. (b) Classification. Class...

  20. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cardiopulmonary bypass cardiotomy return sucker. 870.4420 Section 870.4420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... from the chest or heart during cardiopulmonary bypass surgery. (b) Classification. Class...

  1. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cardiopulmonary bypass cardiotomy return sucker. 870.4420 Section 870.4420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... from the chest or heart during cardiopulmonary bypass surgery. (b) Classification. Class...

  2. 21 CFR 870.4420 - Cardiopulmonary bypass cardiotomy return sucker.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass cardiotomy return sucker. 870.4420 Section 870.4420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... from the chest or heart during cardiopulmonary bypass surgery. (b) Classification. Class...

  3. 20 CFR 631.18 - Federal by-pass authority.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Federal by-pass authority. 631.18 Section 631.18 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS UNDER... Secretary's intent to exercise by-pass authority and an opportunity to request and to receive a hearing...

  4. 20 CFR 631.18 - Federal by-pass authority.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Federal by-pass authority. 631.18 Section 631.18 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS UNDER... Secretary's intent to exercise by-pass authority and an opportunity to request and to receive a hearing...

  5. [Cardiac rehabilitation after coronary artery bypass surgery].

    PubMed

    Dayan, Victor; Ricca, Roberto

    2014-01-01

    Ischemic heart disease is the leading cause of death worldwide with an increase in the incidence in younger populations. Today revascularization strategies are capable of alleviating acute ischemia and/or chronic ischemia. These can be performed percutaneously or through surgery. Even if we improve myocardial perfusion by these methods, the main determinant in maintaining patency of coronary arteries and bypass is a correctly instituted secondary prevention. This is the main focus of cardiac rehabilitation proposals. Although much has been published about the role of cardiac rehabilitation after percutaneous revascularization, there is little work able to synthesize the current state of cardiac rehabilitation in patients undergoing coronary artery bypass surgery. The aim of this paper is to review the effect of rehabilitation in the return to work, survival, functional capacity, depression and anxiety, as well as compare centralized vs. home rehabilitation in this patient population. Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  6. Previous gastric bypass surgery complicating total thyroidectomy.

    PubMed

    Alfonso, Bianca; Jacobson, Adam S; Alon, Eran E; Via, Michael A

    2015-03-01

    Hypocalcemia is a well-known complication of total thyroidectomy. Patients who have previously undergone gastric bypass surgery may be at increased risk of hypocalcemia due to gastrointestinal malabsorption, secondary hyperparathyroidism, and an underlying vitamin D deficiency. We present the case of a 58-year-old woman who underwent a total thyroidectomy for the follicular variant of papillary thyroid carcinoma. Her history included Roux-en-Y gastric bypass surgery. Following the thyroid surgery, she developed postoperative hypocalcemia that required large doses of oral calcium carbonate (7.5 g/day), oral calcitriol (up to 4 μg/day), intravenous calcium gluconate (2.0 g/day), calcium citrate (2.0 g/day), and ergocalciferol (50,000 IU/day). Her serum calcium levels remained normal on this regimen after hospital discharge despite persistent hypoparathyroidism. Bariatric surgery patients who undergo thyroid surgery require aggressive supplementation to maintain normal serum calcium levels. Preoperative supplementation with calcium and vitamin D is strongly recommended.

  7. Conduit options in coronary artery bypass surgery.

    PubMed

    Canver, C C

    1995-10-01

    The choice of graft conduit is crucial to the success of coronary artery bypass grafting (CABG) because the patency of a coronary conduit is closely associated with an uneventful postoperative course and a better long-term patient survival. The standard conduits used for CABG are the greater saphenous vein (GSV) and the internal thoracic artery (ITA). An excellent substitute conduit for coronary bypass operations that can be taken "off the shelf" is certainly the dream of every practicing cardiac surgeon. However, virtually every synthetic and biologic alternative to arterial conduits or autologous fresh saphenous vein has proved disappointing. Fortunately, patients with absolutely no autologous conduit alternatives are uncommon. Circumstances exist, however, that often necessitate the use of alternative conduits such as young hyperlipemic patients, absent or unsuitable autologous ITAs and GSV as a result of previous myocardial revascularization, peripheral arterial reconstruction, and varicose vein ligation procedures. This review provides an update on the clinical work done with all coronary conduits available for myocardial surgical revascularization.

  8. Jet noise from ultrahigh bypass turbofan engines

    NASA Astrophysics Data System (ADS)

    Posey, Joe W.; Norum, Thomas D.; Brown, Martha C.; Bhat, Thonse R. S.

    2002-05-01

    Modern commercial jet transport aircraft are powered by turbofan engines. Thrust from a turbofan engine is derived in part from the exhaust of a ducted fan, which may or may not be mixed with the core exhaust before exiting the nacelle. The historical trend has been toward ever higher bypass ratios (BPRs). The BPR is the ratio of air mass passing through the fan to that going through the core. The higher BPR engines can be more efficient and quieter. In general, a higher BPR results in lower average exhaust velocities and less jet noise. In order to address a scarcity of noise data for BPRs greater than 6, an extensive database collection effort was undertaken using the Jet Engine Simulator in NASA Langley's Low Speed Aeroacoustic Wind Tunnel. Forward flight simulations of Mach 0.1, 0.2, and 0.28 were used with BPRs of 5, 8, 11, and 14. Data was taken over the entire operating line of the simulated engines along with parametric deviations to provide a complete set of sensitivity measurements. The results will be used to develop an empirical jet noise prediction capability for ultrahigh bypass engines.

  9. Predicting Functional Status Following Amputation After Lower Extremity Bypass

    PubMed Central

    Suckow, Bjoern D.; Goodney, Philip P.; Cambria, Robert A.; Bertges, Daniel J.; Eldrup-Jorgensen, Jens; Indes, Jeffrey E.; Schanzer, Andres; Stone, David H.; Kraiss, Larry W.; Cronenwett, Jack L.

    2012-01-01

    differ compared with no amputation (BK amputation 87%, p = 0.14, AK amputation 89%, p = 0.27); however, this part of the analysis was limited by its sample size (n = 212). In multivariable analysis, we found that the patients most likely to remain ambulatory and live independently despite undergoing a lower extremity amputation were those living at home preoperatively (hazard ratio [HR]: 6.8, 95% confidence interval [CI]: 0.94–49, p = 0.058) and those with preoperative statin use (HR: 1.6, 95% CI: 1.2–2.1, p = 0.003), whereas the presence of several comorbidities identified patients less likely to achieve a good functional outcome: coronary disease (HR: 0.6, 95% CI: 0.5–0.9, p = 0.003), dialysis (HR: 0.5, 95% CI: 0.3–0.9, p = 0.02), and congestive heart failure (HR: 0.5, 95% CI: 0.3–0.8, p = 0.005). Conclusions A postoperative amputation at any level impacts functional outcomes following LEB surgery, and the extent of amputation is directly related to the effect on functional outcome. It is possible, based on preoperative patient characteristics, to identify patients undergoing LEB who are most or least likely to achieve good functional outcomes even if a major amputation is ultimately required. These findings may assist in patient education and surgical decision making in patients who are poor candidates for lower extremity bypass. PMID:22176876

  10. Cardiopulmonary bypass: development of John Gibbon's heart-lung machine

    PubMed Central

    Passaroni, Andréia Cristina; Silva, Marcos Augusto de Moraes; Yoshida, Winston Bonetti

    2015-01-01

    Objective To provide a brief review of the development of cardiopulmonary bypass. Methods A review of the literature on the development of extracorporeal circulation techniques, their essential role in cardiovascular surgery, and the complications associated with their use, including hemolysis and inflammation. Results The advancement of extracorporeal circulation techniques has played an essential role in minimizing the complications of cardiopulmonary bypass, which can range from various degrees of tissue injury to multiple organ dysfunction syndrome. Investigators have long researched the ways in which cardiopulmonary bypass may insult the human body. Potential solutions arose and laid the groundwork for development of safer postoperative care strategies. Conclusion Steady progress has been made in cardiopulmonary bypass in the decades since it was first conceived of by Gibbon. Despite the constant evolution of cardiopulmonary bypass techniques and attempts to minimize their complications, it is still essential that clinicians respect the particularities of each patient's physiological function. PMID:26107456

  11. Minimally invasive coronary bypass surgery: postoperative pain management using intermittent bupivacaine infiltration.

    PubMed

    Borges, M F; Coulson, A S

    1998-04-01

    Minimally invasive direct coronary artery bypass grafting (MIDCAB) is becoming a popular adjunct to standard cardiac bypass surgery in selected patients with accessible single or double vessel disease. However, the limited anterior thoracotomy used to access the heart involves trauma to the muscle tissue during removal of the fourth costal cartilage and a small piece of connected rib, perhaps leading to more severe postoperative pain compared with patients undergoing routine sternotomy. Intrathecal opioids can be used but have limited therapeutic duration and there is concern regarding anticoagulation. We present a case where soft tissue catheters were placed into the depths of the surgical wounds and pain was diminished greatly by intermittent regular infiltration with bupivacaine.

  12. Hypomethylated Pollen Bypasses the Interploidy Hybridization Barrier in Arabidopsis[C][W

    PubMed Central

    Schatlowski, Nicole; Wolff, Philip; Santos-González, Juan; Schoft, Vera; Siretskiy, Alexey; Scott, Rod; Tamaru, Hisashi; Köhler, Claudia

    2014-01-01

    Plants of different ploidy levels are separated by a strong postzygotic hybridization barrier that is established in the endosperm. Deregulated parent-of-origin specific genes cause the response to interploidy hybridizations, revealing an epigenetic basis of this phenomenon. In this study, we present evidence that paternal hypomethylation can bypass the interploidy hybridization barrier by alleviating the requirement for the Polycomb Repressive Complex 2 (PRC2) in the endosperm. PRC2 epigenetically regulates gene expression by applying methylation marks on histone H3. Bypass of the barrier is mediated by suppressed expression of imprinted genes. We show that the hypomethylated pollen genome causes de novo CHG methylation directed to FIS-PRC2 target genes, suggesting that different epigenetic modifications can functionally substitute for each other. Our work presents a method for the generation of viable triploids, providing an impressive example of the potential of epigenome manipulations for plant breeding. PMID:25217506

  13. 75 FR 71145 - San Joaquin River Restoration Program: Reach 4B, Eastside Bypass, and Mariposa Bypass Channel and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ... bypasses and maintain the current flood operations and conveyance capacity of the system. Additionally, the Proposed Action may result in an opportunity for improvements to the existing flood system. These..., and the Mariposa Bypass. The planning and environmental review for the Proposed Action is...

  14. Bypassing the Kohn-Sham equations with machine learning.

    PubMed

    Brockherde, Felix; Vogt, Leslie; Li, Li; Tuckerman, Mark E; Burke, Kieron; Müller, Klaus-Robert

    2017-10-11

    Last year, at least 30,000 scientific papers used the Kohn-Sham scheme of density functional theory to solve electronic structure problems in a wide variety of scientific fields. Machine learning holds the promise of learning the energy functional via examples, bypassing the need to solve the Kohn-Sham equations. This should yield substantial savings in computer time, allowing larger systems and/or longer time-scales to be tackled, but attempts to machine-learn this functional have been limited by the need to find its derivative. The present work overcomes this difficulty by directly learning the density-potential and energy-density maps for test systems and various molecules. We perform the first molecular dynamics simulation with a machine-learned density functional on malonaldehyde and are able to capture the intramolecular proton transfer process. Learning density models now allows the construction of accurate density functionals for realistic molecular systems.Machine learning allows electronic structure calculations to access larger system sizes and, in dynamical simulations, longer time scales. Here, the authors perform such a simulation using a machine-learned density functional that avoids direct solution of the Kohn-Sham equations.

  15. Management of super-super obese patients: comparison between one anastomosis (mini) gastric bypass and Roux-en-Y gastric bypass.

    PubMed

    Parmar, Chetan; Abdelhalim, Mohamed A; Mahawar, Kamal K; Boyle, Maureen; Carr, William R J; Jennings, Neil; Small, Peter K

    2016-12-15

    Gastric bypass can be technically challenging in super-super obese patients. Both Roux-en-Y gastric bypass (RYGB) and one anastomosis (mini) gastric bypass (OAGB/MGB) have been described in these patients, but direct comparisons are lacking. The purpose of this study was to compare the early outcomes with these two procedures in patients with body mass index (BMI) of ≥60 kg/m(2) in our unit. We identified all super-super obese patients who underwent either OAGB/MGB or RYGB from our prospectively maintained database. Information was also obtained from the case notes and from hospital computerized records. We obtained data regarding patient demographics, operative details, complications, and weight loss, in both groups, and compared them using standard statistical methods. This study compares our results with 19 OAGB/MGB and 47 RYGB super-super obese patients performed in our unit between October 2012 and June 2015. OAGB/MGB group patients had a significantly higher weight and body mass index. There was no mortality or major complication in either group. There were two late complications in the OAGB/MGB group compared to six in the RYGB group. One patient in the OAGB/MGB group needed conversion to RYGB for persistent reflux symptoms. OAGB/MGB patients achieved a significantly higher EWL of 70.4% at 2 years compared to 57.1% in the RYGB group. The difference between TWL of 44.4 and 33.4%, respectively, was also significant at 2 years. TWL of 43.0 and 29.3%, respectively, in OAGB/MGB and RYGB groups at 18 months was also significantly different, but the difference in EWL at 18 months did not reach significance. One anastomosis (mini) gastric bypass yields superior weight loss at 18 and 24 months in comparison with Roux-en-Y gastric bypass in patients with BMI of ≥60 kg/m(2). Findings need confirmation in larger randomized studies.

  16. Transient Diabetes Insipidus Following Cardiopulmonary Bypass.

    PubMed

    Ekim, Meral; Ekim, Hasan; Yilmaz, Yunus Keser; Bolat, Ali

    2015-04-01

    Diabetes insipidus (DI) results from inadequate output of Antidiuretic Hormone (ADH) from the pituitary gland (central DI) or the inability of the kidney tubules to respond to ADH (nephrogenic DI). ADH is an octapeptide produced in the supraoptic and paraventricular nuclei of the hypothalamus and stored in the posterior lobe of the pituitary gland. Cardiopulmonary Bypass (CPB) has been shown to cause a six-fold increased circulating ADH levels 12 hours after surgery. However, in some cases, ADH release may be transiently suppressed due to cardioplegia (cardiac standstill) or CPB leading to DI. We present the postoperative course of a 60-year-old man who developed transient DI after CPB. He was successfully treated by applying nasal desmopressin therapy. Relevant biochemical parameters should be monitored closely in patients who produce excessive urine after open heart surgery.

  17. Outcomes of coronary artery bypass graft surgery

    PubMed Central

    Hawkes, Anna Louise; Nowak, Madeleine; Bidstrup, Benjamin; Speare, Richard

    2006-01-01

    This review article summarizes the major studies that have investigated the outcomes of coronary artery bypass graft surgery (CABG). The article includes a review of the literature in the areas of: history of CABG; indications for CABG; and measurement of quality of life following CABG, including prolongation of life, physical functioning (ie, relief from angina and dyspnea, physical activity, as well as complications of surgery and re-hospitalization), psychological functioning, and social functioning. Overall, the literature demonstrates that the outcomes of CABG have historically been measured in terms of mortality and morbidity; however, it has now been well recognized that adjustment to CABG is a multidimensional phenomenon that is not fully explained by medical factors. Therefore, in addition to studying mortality and morbidity outcomes following CABG, many recent studies have identified that it is important to investigate various physical, psychological, and social variables that have a significant impact on post-operative adjustment to CABG. PMID:17323602

  18. Factor V Leiden and Cardiopulmonary Bypass.

    PubMed

    Uppal, Victor; Rosin, Mark; Marcoux, Jo-Anne; Olson, Marnie; Bezaire, Jennifer; Dalshaug, Gregory

    2015-12-01

    We present a case of a patient with factor V Leiden with an antithrombin III activity of 67% who received a successful aortic valve replacement supported by cardiopulmonary bypass (CPB). A safe level of anticoagulation was achieved by monitoring activated clotting time (ACT) and heparin concentration ensuring adequate anticoagulation throughout the procedure. Results from ACT, heparin dose response, heparin protamine titration, and thrombelastography are given. Factor V Leiden patients can be safely anti-coagulated using heparin for CPB procedures when monitored with ACT, heparin protamine titration, and thrombelastography. Postoperative chest tube losses were 360 mL, less than half our institutional average. Anticoagulation for the pre-and post-operative phase is also discussed.

  19. [Nutritional follow-up after gastric bypass].

    PubMed

    Gasteyger, C; Giusti, V

    2006-03-29

    Roux-en-Y gastric bypass has become one of the main bariatric procedures. This surgical operation shows excellent results in weight evolution and quality of life and allows a decrease of mortality. However, it leads, relatively often, to nutritional deficiencies which need an effective post-operative follow-up. This follow-up includes not only medical and dietetic encounters but also regular blood analyses made every 3 months during the first post-operative year, every 6 months the second year, then each year. The most frequent deficiencies are those in vitamin B12, iron and folic acid. The secondary hyperparathyroidism characterized by an increase of PTH associated to a low vitamin D and a normal calcium, is quite frequent.

  20. Angiographic assessment of biografts for femoropopliteal bypass.

    PubMed

    Boontje, A H

    1986-01-01

    A series of 257 femoropopliteal bypass procedures with a Biograft is analysed. The cumulative patency rate after 6 years is 64% for the whole series. This corresponds with a cumulative patency rate of 74% for AK cases and 44% for BK cases. Follow-up angiography to assess the morphology of the Biografts, was performed after 1 year and after 3-5 years. Angiography after 1 year (N = 126) showed few alterations: tortuosity in 3%, segmentation or wrinkling in 3%, slight diffuse dilatation in 4% and local stenosis in 2%. Angiography after 3-5 years (N = 82) revealed interesting changes. Besides tortuosity in 6% and segmentation in 29%, there were anastomotic aneurysms in 2%. Changes in the diameter of the body of the graft were remarkable and occurred in 46%. Diffuse regular or irregular dilatation, local ectasia or stenosis was found. Clinical implications are discussed.

  1. Biventricular bypass: alternative to univentricular bypass and total artificial heart-bridge.

    PubMed

    Chilaya, S M; Khodeli, N G

    1991-10-01

    Left ventricular and biventricular bypasses (LVBs, BVBs) were performed in 102 experiments in sheep, goats, and donkeys. Biventricular bypass was performed in the assisted circulation mode or in the paracorporeal artificial heart bridge (PCAHB) mode when the natural heart fibrillates. During implantation of artificial ventricles instead of a heart-lung bypass, counterpulsation was used. Several types of connective conduits were developed and tested in experiments. The conduits included bifurcational connective pipes that permit "intake" of blood into artificial ventricles from atria and ventricles of the natural heart simultaneously and consequently provide effective blood flow through shunts not depending on the state of the natural heart (acute cardiac weakness or asystole). Monitoring gas content (PO2, PCO2, and pH) in the myocardium of both ventricles suggested development of right ventricular failure under conditions of LVB before hemodynamic changes occurred and confirmed the preferability of BVB over other methods of assisted circulation, as it is most effective and capable of normalizing short-term cardiac disturbances in the course of the 1st 2 days. Survival time of experimental animals (2-3 days for dogs, 5-12 days for sheep, goats, and donkeys) is sufficient to overcome acute cardiac insufficiency. This suggests that BVB in the assisted circulation mode or PCAHB mode can serve as a bridge for cardiac transplantation for the time of search for the available organ.

  2. Comparison of neutrophil:lymphocyte ratios following coronary artery bypass surgery with or without cardiopulmonary bypass.

    PubMed

    Aldemir, Mustafa; Baki, Elif Doğan; Adali, Fahri; Çarşanba, Görkem; Tecer, Evren; Taş, Hanife Uzel

    2015-01-01

    Coronary artery bypass graft (CABG) surgery may induce postoperative systemic changes in leukocyte counts, including leukocytosis, neutrophilia or lymphopenia. This retrospective clinical study investigated whether off-pump coronary artery bypass (OPCAB) surgery working on the beating heart without extracorporeal circulation could favourably affect leukocyte counts, including neutrophil-tolymphocyte (N:L) ratio, after CABG. In this study, 30 patients who underwent isolated CABG with cardiopulmonary bypass (CPB), and another 30 patients who underwent the same operation without CPB between May 2010 and May 2013, were screened from the computerised database of our hospital. Pre-operative, and first and fifth postoperative day differential counts of leukocytes with the N:L ratio of peripheral blood were obtained. A significant increase in total leukocyte and neutrophil counts and N:L ratio, and a decrease in lymphocyte counts were observed at all time points after surgery in both groups. N:L ratio was significantly higher in the CPB group compared with the OPCAB group on the first postoperative day (20.73 ± 13.85 vs 10.19 ± 4.55, p < 0.001), but this difference disappeared on the fifth postoperative day. CPB results in transient but significant changes in leukocyte counts in the peripheral blood stream in terms of N:L ratio compared with the off-pump technique of CABG.

  3. Comparison of neutrophil:lymphocyte ratios following coronary artery bypass surgery with or without cardiopulmonary bypass

    PubMed Central

    Aldemir, Mustafa; Adalı, Fahri; Çarşanba, Görkem; Tecer, Evren; Bakı, Elif Doğan; Taş, Hanife Uzel

    2015-01-01

    Objective Coronary artery bypass graft (CABG) surgery may induce postoperative systemic changes in leukocyte counts, including leukocytosis, neutrophilia or lymphopenia. This retrospective clinical study investigated whether offpump coronary artery bypass (OPCAB) surgery working on the beating heart without extracorporeal circulation could favourably affect leukocyte counts, including neutrophil-tolymphocyte (N:L) ratio, after CABG. Methods In this study, 30 patients who underwent isolated CABG with cardiopulmonary bypass (CPB), and another 30 patients who underwent the same operation without CPB between May 2010 and May 2013, were screened from the computerised database of our hospital. Pre-operative, and first and fifth postoperative day differential counts of leukocytes with the N:L ratio of peripheral blood were obtained. Results A significant increase in total leukocyte and neutrophil counts and N:L ratio, and a decrease in lymphocyte counts were observed at all time points after surgery in both groups. N:L ratio was significantly higher in the CPB group compared with the OPCAB group on the first postoperative day (20.73 ± 13.85 vs 10.19 ± 4.55, p < 0.001), but this difference disappeared on the fifth postoperative day. Conclusion CPB results in transient but significant changes in leukocyte counts in the peripheral blood stream in terms of N:L ratio compared with the off-pump technique of CABG. PMID:25903477

  4. Laparoscopic Conversion of One Anastomosis Gastric Bypass to a Standard Roux-en-Y Gastric Bypass.

    PubMed

    Amor, Imed Ben; Petrucciani, Niccolo; Kassir, Radwan; Al Munifi, Abdullah; Piche, Thierry; Debs, Tarek; Gugenheim, Jean

    2017-05-01

    One anastomosis gastric bypass (OAGB) demonstrated results similar to traditional Roux-en-Y procedures [1-3], in terms of weight loss and resolution of obesity-related comorbidities. The main controversy regarding OAGB is the concern for an association between biliary alkaline gastritis and esophageal or gastric cancer raised by some studies [4]. We present the case of a 51-year-old woman with a BMI of 41 kg/m2 who underwent a laparoscopic OAGB in 2014. One year later, she consulted for recurrent heartburns. An upper GI endoscopy showed pouchitis and bile reflux in the esophagus. Medical treatment of gastroesophageal reflux disease was ineffective. We decided to convert the OAGB to a Roux-en-Y gastric bypass (RYGB). In this video, we show how to revise an OAGB to treat chronic bile reflux, by converting the procedure to a standard RYGB. The intervention starts by restoring the normal anatomy of the small bowel, with the resection of the gastrojejunal anastomosis, which was located at 250-cm du Treitz's ligament. Then, the gastric pouch is created. A standard Roux-en-Y gastric bypass is performed. The resection of the gastrojejunal anastomosis allows fashioning the Roux-en-Y limb with the classical measures. This technique allows a conversion to a standard RYGB and is effective in treating the biliary reflux.

  5. Diagnostic tools for post-gastric bypass hypoglycaemia.

    PubMed

    Emous, M; Ubels, F L; van Beek, A P

    2015-10-01

    In spite of its evident success, several late complications can occur after gastric bypass surgery. One of these is post-gastric bypass hypoglycaemia. No evidence-based guidelines exist in the literature on how to confirm the presence of this syndrome. This study aims to describe and compare the tests aimed at making a diagnosis of post-gastric bypass hypoglycaemia and to provide a diagnostic approach based upon the available evidence. A search was conducted in PubMed, Cochrane and Embase. A few questionnaires have been developed to measure the severity of symptoms in post-gastric bypass hypoglycaemia but none has been validated. The gold standard for provocation of a hypoglycaemic event is the oral glucose tolerance test or the liquid mixed meal tolerance test. Both show a high prevalence of hypoglycaemia in post-gastric bypass patients with and without hypoglycaemic complaints as well as in healthy volunteers. No uniformly established cut-off values for glucose concentrations are defined in the literature for the diagnosis of post-gastric bypass hypoglycaemia. For establishing an accurate diagnosis of post-gastric bypass hypoglycaemia, a validated questionnaire, in connection with the diagnostic performance of provocation tests, is the most important thing missing. Given these shortcomings, we provide recommendations based upon the current literature. © 2015 World Obesity.

  6. The reliability of bypass diodes in PV modules

    NASA Astrophysics Data System (ADS)

    Dhere, Neelkanth G.; Shiradkar, Narendra; Schneller, Eric; Gade, Vivek

    2013-09-01

    The operating conditions of bypass diodes in PV modules deployed in the field are considerably harsher than the conditions at which the diode manufacturers test the diodes. This has a potential to significantly reduce the operating life of bypass diodes and has raised concerns about the safety and reliability of PV modules as a whole. The study of modes and mechanisms of the failures encountered in bypass diodes used in PV modules can provide important information which would be useful to predict the module lifetime. This paper presents the review of the failure modes and mechanisms observed in bypass diodes and current work related to reliability testing of bypass diodes. The International PV Module Quality Assurance Task Force has recommended following four potential areas of research to understand the reliability issues of bypass diodes: Electrostatic Discharge, reverse bias thermal runaway testing, forward bias overheating and transition testing of forward bias to reverse bias. As a joint collaborative effort between Florida Solar Energy Center and Solar and Environmental Test Laboratory at Jabil Inc., laboratory testing of bypass diodes on the guidelines provided by the International PV Module Quality Assurance Task Force has been initiated. Preliminary results from this work are presented in this paper.

  7. Alongshore sediment bypassing as a control on river mouth morphodynamics

    NASA Astrophysics Data System (ADS)

    Nienhuis, Jaap H.; Ashton, Andrew D.; Nardin, William; Fagherazzi, Sergio; Giosan, Liviu

    2016-04-01

    River mouths, shoreline locations where fluvial and coastal sediments are partitioned via erosion, trapping, and redistribution, are responsible for the ultimate sedimentary architecture of deltas and, because of their dynamic nature, also pose great management and engineering challenges. To investigate the interaction between fluvial and littoral processes at wave-dominated river mouths, we modeled their morphologic evolution using the coupled hydrodynamic and morphodynamic model Delft3D-SWAN. Model experiments replicate alongshore migration of river mouths, river mouth spit development, and eventual spit breaching, suggesting that these are emergent phenomena that can develop even under constant fluvial and wave conditions. Furthermore, we find that sediment bypassing of a river mouth develops though feedbacks between waves and river mouth morphology, resulting in either continuous bypassing pathways or episodic bar bypassing pathways. Model results demonstrate that waves refracting into the river mouth bar create a zone of low alongshore sediment transport updrift of the river mouth, which reduces sediment bypassing. Sediment bypassing, in turn, controls the river mouth migration rate and the size of the river mouth spit. As a result, an intermediate amount of river discharge maximizes river mouth migration. The fraction of alongshore sediment bypassing can be predicted from the balance between the jet and the wave momentum flux. Quantitative comparisons show a match between our modeled predictions of river mouth bypassing and migration rates observed in natural settings.

  8. CFD Analysis of Core Bypass Phenomena

    SciTech Connect

    Richard W. Johnson; Hiroyuki Sato; Richard R. Schultz

    2010-03-01

    The U.S. Department of Energy is exploring the potential for the VHTR which will be either of a prismatic or a pebble-bed type. One important design consideration for the reactor core of a prismatic VHTR is coolant bypass flow which occurs in the interstitial regions between fuel blocks. Such gaps are an inherent presence in the reactor core because of tolerances in manufacturing the blocks and the inexact nature of their installation. Furthermore, the geometry of the graphite blocks changes over the lifetime of the reactor because of thermal expansion and irradiation damage. The existence of the gaps induces a flow bias in the fuel blocks and results in unexpected increase of maximum fuel temperature. Traditionally, simplified methods such as flow network calculations employing experimental correlations are used to estimate flow and temperature distributions in the core design. However, the distribution of temperature in the fuel pins and graphite blocks as well as coolant outlet temperatures are strongly coupled with the local heat generation rate within fuel blocks which is not uniformly distributed in the core. Hence, it is crucial to establish mechanistic based methods which can be applied to the reactor core thermal hydraulic design and safety analysis. Computational Fluid Dynamics (CFD) codes, which have a capability of local physics based simulation, are widely used in various industrial fields. This study investigates core bypass flow phenomena with the assistance of commercial CFD codes and establishes a baseline for evaluation methods. A one-twelfth sector of the hexagonal block surface is modeled and extruded down to whole core length of 10.704m. The computational domain is divided vertically with an upper reflector, a fuel section and a lower reflector. Each side of the sector grid can be set as a symmetry boundary

  9. CFD Analysis of Core Bypass Phenomena

    SciTech Connect

    Richard W. Johnson; Hiroyuki Sato; Richard R. Schultz

    2009-11-01

    The U.S. Department of Energy is exploring the potential for the VHTR which will be either of a prismatic or a pebble-bed type. One important design consideration for the reactor core of a prismatic VHTR is coolant bypass flow which occurs in the interstitial regions between fuel blocks. Such gaps are an inherent presence in the reactor core because of tolerances in manufacturing the blocks and the inexact nature of their installation. Furthermore, the geometry of the graphite blocks changes over the lifetime of the reactor because of thermal expansion and irradiation damage. The existence of the gaps induces a flow bias in the fuel blocks and results in unexpected increase of maximum fuel temperature. Traditionally, simplified methods such as flow network calculations employing experimental correlations are used to estimate flow and temperature distributions in the core design. However, the distribution of temperature in the fuel pins and graphite blocks as well as coolant outlet temperatures are strongly coupled with the local heat generation rate within fuel blocks which is not uniformly distributed in the core. Hence, it is crucial to establish mechanistic based methods which can be applied to the reactor core thermal hydraulic design and safety analysis. Computational Fluid Dynamics (CFD) codes, which have a capability of local physics based simulation, are widely used in various industrial fields. This study investigates core bypass flow phenomena with the assistance of commercial CFD codes and establishes a baseline for evaluation methods. A one-twelfth sector of the hexagonal block surface is modeled and extruded down to whole core length of 10.704m. The computational domain is divided vertically with an upper reflector, a fuel section and a lower reflector. Each side of the one-twelfth grid can be set as a symmetry boundary

  10. Miniaturized cardiopulmonary bypass: the Hammersmith technique

    PubMed Central

    2013-01-01

    Background Conventional Cardiopulmonary Bypass (cCPB) is a trigger of systemic inflammatory reactions, hemodilution, coagulopathy, and organ failure. Miniaturised Cardiopulmonary Bypass (mCPB) has the potential to reduce these deleterious effects. Here, we describe our standardised ‘Hammersmith’ mCPB technique, used in all types of adult cardiac operations including major aortic surgery. Methods The use of mCPB remains limited by the diversity of technologies which range from extremely complex, micro systems to ones very similar to cCPB. Our approach is designed around the principle of balancing the benefits of miniaturisation; reducing foreign surface area while maintaining patient safety. Results From January 2010 to March 2011, a single surgeon performed 184 consecutive operations (Euro score Logistic 8.4+/-9.9): 61 aortic valve replacements, 78 CABGs, 25 aortic valve replacement and CABG and 17 other procedures (major aortic surgery, re-do operations or double/triple valve replacements). Our clinical experience suggests that: i. Venous drainage is optimally maintained using kinetic energy. ii. Venous collapse pressure depends on the patient’s anatomy and cannula size, but most importantly on the negative pressure generated by venous drainage. iii. The patient-prime interaction is optimised with antegrade and retrograde autologous priming, which mixes the blood and prime away from the tissues and results in a reduced oncotic destabilization. iv. mCPB is a safe and reproducible technique Conclusion The Hammersmith mCPB is a “next generation” system which uses standard commercially available components. It aims to maintain safety margin and the benefit of miniaturised system whilst reducing the human factor demands. PMID:23731623

  11. Mechanically fastened composite laminates subjected to combined bearing-bypass and shear loading

    NASA Technical Reports Server (NTRS)

    Madenci, Erdogan

    1993-01-01

    contact stress distribution and the contact region are not known a priori, they did not directly impose the boundary conditions appropriate for modelling the contact and on-contact regions between the fastener and the hole. Furthermore, finite element analysis is not suitable for iterative design calculations for optimizing laminate construction in the presence of fasteners under complex loading conditions. In this study, the solution method developed by Madenci and Ileri (1992a,b) has been extended to determine the contact stresses in mechanical joints under combined bearing-bypass and shear loading, and bearing-bypass loading in compression resulting in dual contact regions.

  12. The Staphylococcus aureus FASII bypass escape route from FASII inhibitors.

    PubMed

    Morvan, Claire; Halpern, David; Kénanian, Gérald; Pathania, Amit; Anba-Mondoloni, Jamila; Lamberet, Gilles; Gruss, Alexandra; Gloux, Karine

    2017-10-01

    Antimicrobials targeting the fatty acid synthesis (FASII) pathway are being developed as alternative treatments for bacterial infections. Emergence of resistance to FASII inhibitors was mainly considered as a consequence of mutations in the FASII target genes. However, an alternative and efficient anti-FASII resistance strategy, called here FASII bypass, was uncovered. Bacteria that bypass FASII incorporate exogenous fatty acids in membrane lipids, and thus dispense with the need for FASII. This strategy is used by numerous Gram-positive low GC % bacteria, including streptococci, enterococci, and staphylococci. Some bacteria repress FASII genes once fatty acids are available, and "constitutively" shift to FASII bypass. Others, such as the major pathogen Staphylococcus aureus, can undergo high frequency mutations that favor FASII bypass. This capacity is particularly relevant during infection, as the host supplies the fatty acids needed for bacteria to bypass FASII and thus become resistant to FASII inhibitors. Screenings for anti-FASII resistance in the presence of exogenous fatty acids confirmed that FASII bypass confers anti-FASII resistance among clinical and veterinary isolates. Polymorphisms in S. aureus FASII initiation enzymes favor FASII bypass, possibly by increasing availability of acyl-carrier protein, a required intermediate. Here we review FASII bypass and consequences in light of proposed uses of anti-FASII to treat infections, with a focus on FASII bypass in S. aureus. Copyright © 2017 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.

  13. Monitoring microemboli during cardiopulmonary bypass with the EDAC quantifier.

    PubMed

    Lynch, John E; Wells, Christopher; Akers, Tom; Frantz, Paul; Garrett, Donna; Scott, M Lance; Williamson, Lisa; Agnew, Barbara; Lynch, John K

    2010-09-01

    Gaseous emboli may be introduced into the bypass circuit both from the surgical field and during perfusionist interventions. While circuits provide good protection against massive air embolism, they do not remove gaseous microemboli (GME) from the bypass circuit. The purpose of this preliminary study is to assess the incidence of GME during bypass surgery and determine if increased GME counts were associated with specific events during bypass surgery. In 30 cases divided between 15 coronary artery bypass grafts and 15 valve repairs, GME were counted and sizedt the three locations on the bypass circuit using the EDAC" Quantifier (Luna Innovations, Roanoke, VA). A mean of 45,276 GME were detected after the arterial line filter during these 30 cases, with significantly more detected (p = .04) post filter during valve cases (mean = 72,137 +/- 22,113) than coronary artery bypass graft cases (mean = 18,416 +/- 7831). GME detected post filter were significantly correlated in time with counts detected in the venous line (p < .001). Specific events associated with high counts included the initiation of cardiopulmonary bypass, heart manipulations, insertion and removal of clamps, and the administration of drugs. Global factors associated with increased counts post filter included higher venous line counts and higher post reservoir/bubble trap counts. The mean number of microemboli detected during bypass surgery was much higher than reported in other studies of emboli incidence, most likely due to the increased sensitivity of the EDAC Quantifier compared to other detection modalities. The results furthermore suggest the need for further study of the clinical significance of these microemboli and what practices may be used to reduce GME incidence. Increased in vitro testing of the air handling capability of different circuit designs, along with more clinical studies assessing best clinical practices for reducing GME activity, is recommended.

  14. Effect of cardiopulmonary bypass on gastrointestinal perfusion and function.

    PubMed

    Gaer, J A; Shaw, A D; Wild, R; Swift, R I; Munsch, C M; Smith, P L; Taylor, K M

    1994-02-01

    Gastric mucosal tonometry was used to determine the adequacy of gastrointestinal perfusion in 10 patients undergoing elective myocardial revascularization. Patients were prospectively randomized to receive either pulsatile or nonpulsatile flow during cardiopulmonary bypass. All patients showed a reduction in gastric mucosal perfusion during bypass, manifested by a reduction in the gastric mucosal pH, which occurred independently of variations in the arterial pH. In the group of patients receiving nonpulsatile flow, this reduction was significantly greater (p < 0.05). Cardiopulmonary bypass using nonpulsatile flow is associated with the development of a gastric mucosal acidosis, which may have implications for the development of postoperative complications.

  15. Coronary artery bypass grafting in an achondroplastic dwarf.

    PubMed

    Balaguer, J M; Perry, D; Crowley, J; Moran, J M

    1995-01-01

    To our knowledge, coronary bypass for complications of coronary artery disease in achondroplasia has not previously been described. Achondroplasia, in and of itself, is not a contraindication to coronary bypass. Although the anatomic reserve of saphenous vein is less in achondroplastic dwarfs than in people of normal stature, that vessel and the internal mammary artery can be harvested in routine fashion. A 60-year-old woman with several risk factors for coronary artery disease underwent successful bypass surgery, which included the use of both a saphenous vein and the left internal mammary artery.

  16. [Bypass spanning the knee joint with synthetic prosthesis].

    PubMed

    Müller-Wiefel, H

    1989-01-01

    Synthetic tubes are the second choice for below-knee bypass materials. The ring-reinforced thin-walled Goretex-PTFE graft is an approved material which was tested in a multicenter study. The primary 3 years patency for below-knee femoral-popliteal bypass was 64%, for crural bypass 39%. A total of 195 grafts have been implanted. Long-term patency depends very much on the run-off conditions (81% in good and 43% in bad cases). The over-all limb salvage rate was 80% after 3 years.

  17. Retinal Blood Vessel Distribution Correlates With the Peripapillary Retinal Nerve Fiber Layer Thickness Profile as Measured With GDx VCC and ECC

    PubMed Central

    Resch, Hemma; Pereira, Ivania; Weber, Stephanie; Holzer, Stephan; Fischer, Georg

    2015-01-01

    Purpose: Aim of the present study was to evaluate whether there is a correlation between retinal blood vessel density (RVD) and the peripapillary retinal nerve fiber layer (RNFL) thickness profile. Methods: RNFL thickness of 106 healthy subjects was measured using scanning laser polarimetry, GDx variable corneal compensation (VCC), and GDx enhanced corneal compensation (ECC). A proprietary software was developed in MATLAB to measure the peripapillary retinal vessels using scanning laser ophthalmoscopy fundus images, centered on the optic disc measured by Cirrus spectral domain optical coherence tomography. The individual retinal vessel positions and thickness values were integrated in a 64-sector RVD profile and intrasubject and intersubject correlations were calculated. Results: The mean R value±SD for intrasubject correlation between RVD and RNFL thickness measured with GDx VCC and GDx ECC was 0.714±0.157 and 0.629±0.140, with 105 of 106 subjects presenting significant correlations. In the intersubject linear regression analysis for GDx VCC, 33 of 64 (52%) sectors presented a significant Pearson correlation coefficient between RNFL thickness and RVD values, with a mean R value of 0.187±0.135 (P<0.05). Conclusions: Peripapillary RNFL thickness profiles correlate with the RVD over 50% of the sectors and might explain up to 26% of the interindividual variance of the peripapillary RNFL thickness values as measured with GDx VCC. To our opinion, taking into account RVD might reduce interindividual variation in peripapillary RNFL thickness profiles measured with scanning laser polarimetry. PMID:25719231

  18. Inhibition of oxygen-induced hypoxia-inducible factor-1alpha degradation unmasks estradiol induction of vascular endothelial growth factor expression in ECC-1 cancer cells in vitro.

    PubMed

    Molitoris, Kristin Happ; Kazi, Armina A; Koos, Robert D

    2009-12-01

    Estradiol (E(2)) rapidly and strongly induces vascular endothelial growth factor (VEGF) transcription in uterine endometrial epithelial cells in vivo. We have shown that this is mediated by both the estrogen receptor-alpha and hypoxia-inducible factor (HIF)-1alpha. By contrast, E(2) induces little or no VEGF expression in cultured breast or endometrial cancer cells, which lack HIF-1alpha due to the abnormally high concentration of oxygen ( approximately 20%) to which they are exposed. To test the hypothesis that restoring HIF-1alpha in cultured cells would restore the ability of E(2) to induce VEGF expression, we treated human endometrial cancer cells (ECC-1) with cobalt chloride (CoCl(2);100 microm), which prevents oxygen-induced HIF-1alpha degradation. HIF-1alpha was absent in untreated ECC-1 cells but detectable by 4 h after treatment with CoCl(2) alone, as was a significant increase in VEGF mRNA. E(2) plus CoCl(2) induced detectable HIF-1alpha expression at 2 h and an even higher level than that induced by CoCl(2) alone at 4 h; this HIF-1alpha was localized in the nuclei. This was accompanied by increasing VEGF expression, with the increase at 4 h severalfold higher than that induced by CoCl(2) alone and was concurrent with recruitment of both HIF-1alpha and estrogen receptor-alpha to the VEGF promoter. These results confirm that HIF-1alpha plays an essential role in E(2)-induced expression of VEGF. Through the induction of increased microvascular permeability and the consequent exudation of plasma growth factors, VEGF in turn may play an essential role in cancer cell proliferation in vivo.

  19. 34 CFR 300.192 - Notice of intent to implement a by-pass.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Notice of intent to implement a by-pass. 300.192... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility By-Pass for Children in Private Schools § 300.192 Notice of intent to implement a by-pass. (a) Before taking any final action to implement a by-pass,...

  20. 34 CFR 300.198 - Continuation of a by-pass.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Continuation of a by-pass. 300.198 Section 300.198... CHILDREN WITH DISABILITIES State Eligibility By-Pass for Children in Private Schools § 300.198 Continuation of a by-pass. The Secretary continues a by-pass until the Secretary determines that the SEA, LEA or...

  1. 34 CFR 300.191 - Provisions for services under a by-pass.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Provisions for services under a by-pass. 300.191 Section... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility By-Pass for Children in Private Schools § 300.191 Provisions for services under a by-pass. (a) Before implementing a by-pass, the Secretary consults with...

  2. 34 CFR 300.198 - Continuation of a by-pass.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Continuation of a by-pass. 300.198 Section 300.198... CHILDREN WITH DISABILITIES State Eligibility By-Pass for Children in Private Schools § 300.198 Continuation of a by-pass. The Secretary continues a by-pass until the Secretary determines that the SEA, LEA or...

  3. 34 CFR 300.191 - Provisions for services under a by-pass.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Provisions for services under a by-pass. 300.191... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility By-Pass for Children in Private Schools § 300.191 Provisions for services under a by-pass. (a) Before implementing a by-pass, the Secretary consults with...

  4. 34 CFR 300.191 - Provisions for services under a by-pass.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Provisions for services under a by-pass. 300.191... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility By-Pass for Children in Private Schools § 300.191 Provisions for services under a by-pass. (a) Before implementing a by-pass, the Secretary consults with...

  5. 34 CFR 300.198 - Continuation of a by-pass.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Continuation of a by-pass. 300.198 Section 300.198... CHILDREN WITH DISABILITIES State Eligibility By-Pass for Children in Private Schools § 300.198 Continuation of a by-pass. The Secretary continues a by-pass until the Secretary determines that the SEA, LEA or...

  6. 34 CFR 300.198 - Continuation of a by-pass.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Continuation of a by-pass. 300.198 Section 300.198... CHILDREN WITH DISABILITIES State Eligibility By-Pass for Children in Private Schools § 300.198 Continuation of a by-pass. The Secretary continues a by-pass until the Secretary determines that the SEA, LEA or...

  7. 34 CFR 300.191 - Provisions for services under a by-pass.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Provisions for services under a by-pass. 300.191 Section... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility By-Pass for Children in Private Schools § 300.191 Provisions for services under a by-pass. (a) Before implementing a by-pass, the Secretary consults with...

  8. Beating heart versus conventional cardiopulmonary bypass: the octopus experience: a randomized comparison of 281 patients undergoing coronary artery bypass surgery with or without cardiopulmonary bypass.

    PubMed

    van Dijk, Diederik; Diephuis, Jan C; Nierich, Arno P; Keizer, Annemieke M A; Kalkman, Cor J

    2006-06-01

    In the Octopus Study, 281 coronary artery bypass surgery patients were randomized to surgery with or without cardiopulmonary bypass. The primary objective was to compare cognitive outcome between off-pump and on-pump coronary artery bypass surgery. Before and after surgery, psychologists administered a battery of 10 neuropsychological tests to the patients. Cognitive decline was defined as a decrease in an individual's performance of at least 20% from baseline, in at least 20% of the main variables. According to this definition, cognitive decline was present in 21% in the off-pump group and 29% in the on-pump group, 3 months after the procedure (P = .15). At 12 months, cognitive decline was present in 31% in the off-pump group and 34% in the on-pump group (P = .69). These results indicated that patients undergoing coronary artery bypass surgery without cardiopulmonary bypass had improved cognitive outcomes 3 months after the procedure, but the effects were limited and became negligible at 12 months. The same definition of cognitive decline was also applied to 112 volunteers not undergoing surgery. The definition labeled 28% of the control subjects as suffering from cognitive decline, 3 months after their first assessment. This suggests that the natural fluctuations in performance during repeated neuropsychological testing should be included in the statistical analysis of cognitive decline. Using an alternative definition of cognitive decline that takes these natural fluctuations in performance into account, the proportions of coronary artery bypass surgery patients displaying cognitive decline were substantially lower. This indicates that the incidence of cognitive decline after coronary artery bypass surgery has been overestimated.

  9. Sensitivity of the downward to sweeping velocity ratio to the bypass flow percentage along a guide wall for downstream fish passage

    USGS Publications Warehouse

    Mulligan, Kevin; Towler, Brett; Haro, Alexander J.; Ahlfeld, David P.

    2017-01-01

    Partial-depth impermeable guidance structures (or guide walls) are used as a method to assist in the downstream passage of fish at a hydroelectric facility. However, guide walls can result in a strong downward velocity causing the approaching fish to pass below the wall and into the direction of the turbine intakes. The objective of this study was to describe how the ratio of the vertical velocity to the sweeping velocity magnitude changes along the full length and depth of a guide wall under a wide range of bypass flow percentages within a power canal. This paper focused on two guide wall configurations, each set at an angle of 45 ° to the approaching flow field and at a depth of 10 and 20 ft (3.05 and 6.10 m). The hydraulic conditions upstream of each guide wall configuration were shown to be impacted by a change in the bypass flow percentage, not only near the bypass but also at upstream sections of the guide wall. Furthermore, the effect of changing the bypass flow percentage was similar for both guide wall depths. In both cases, the effect of increasing the bypass flow percentage was magnified closer to the bypass and deeper in the water column along the guide wall.

  10. 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

    2016-06-03

    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 postoperative 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's clinical importance. Linitis plastica of the excluded stomach after RYGB is a very rare entity. This case report shows the importance of long-term postoperative 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.

  11. Effects of coronary artery bypass grafting on cellular immunity with or without cardiopulmonary bypass: changes in lymphocytes subsets.

    PubMed

    Akbas, Haluk; Erdal, A Cenk; Demiralp, Emel; Alp, Mete

    2002-12-01

    Cell-mediated immunity responses decrease after all kinds of surgical procedures. Either anesthesia or surgical trauma plays an important role in this effect. Identification of functional lymphocyte subsets, by using appropriate monoclonal antibodies and analysis of flow cytometry data, appears to provide an accurate measurement of cellular immune competence. We found a significant decrease in the total number of T helper/inducer cells (p<0.035), B cells (p<0.043) and natural killer cells (NK) (p<0.018) but in contrast, increase in NK cell activity (p<0.012) in the peripheral arterial blood of ten patients undergoing coronary artery bypass grafting with cardiopulmonary bypass (group 1) immediately after surgery and postoperative day 1 (POD1). On the other hand, there was no significant change of these parameters occurred in the peripheral arterial blood of ten patients (group 2) who were undergoing coronary artery bypass grafting without cardiopulmonary bypass. Therefore, we conclude that coronary artery bypass grafting (CABG) with cardiopulmonary bypass induce a greater decrease in immunologic response than CABG without cardiopulmonary bypass (off pump) operations. Nevertheless, off pump CABG operations do not induce a greater decrease in immunologic response than other surgical operations.

  12. Shunt for bypass graft of the cavernous carotid artery: an anatomical and technical study.

    PubMed

    al-Mefty, O; Khalil, N; Elwany, M N; Smith, R R

    1990-11-01

    During direct surgery of neoplastic and vascular lesions of the cavernous sinus, the intracavernous carotid artery may be injured beyond repair, or its total isolation may be necessary for surgical management of these lesions. The newly developed procedure of a saphenous vein graft bypass of the cavernous carotid artery allows re-establishment of carotid circulation. Patients with poor collateral circulation are at high risk for ischemic complications induced by the prolonged temporary occlusion required to perform the bypass graft. Optimal management of these patients is to perform the venous bypass graft for permanent vascularization while maintaining carotid cerebral circulation through an intraoperative shunt. We studied this procedure in cadavers, and three shunt types were evaluated: the external intrapetrous-supraclinoid shunt (Type A), the internal intrapetrous-supraclinoid shunt (Type B), and the neck internal carotid-supraclinoid shunt (Type C). Anatomical landmarks, techniques, distances, caliber, and materials used are presented. The rationale and candidates for such a procedure are discussed. The specifications of an optimal balloon shunt are presented, and the three procedures are compared.

  13. Vitamin a deficiency after gastric bypass surgery: an underreported postoperative complication.

    PubMed

    Zalesin, Kerstyn C; Miller, Wendy M; Franklin, Barry; Mudugal, Dharani; Rao Buragadda, Avdesh; Boura, Judith; Nori-Janosz, Katherine; Chengelis, David L; Krause, Kevin R; McCullough, Peter A

    2011-01-01

    Introduction. Few data are available on vitamin A deficiency in the gastric bypass population. Methods. We performed a retrospective chart review of gastric bypass patients (n = 69, 74% female). The relationship between serum vitamin A concentration and markers of protein metabolism at 6-weeks and 1-year post-operative were assessed. Results. The average weight loss at 6-weeks and 1-year following surgery was 20.1 ± 9.1 kg and 44.1 ± 17.1 kg, respectively. At 6 weeks and 1 year after surgery, 35% and 18% of patients were vitamin A deficient, (<325 mcg/L). Similarly, 34% and 19% had low pre-albumin levels (<18 mg/dL), at these time intervals. Vitamin A directly correlated with pre-albumin levels at 6 weeks (r = 0.67, P < 0.001) and 1-year (r = 0.67,  P < 0.0001). There was no correlation between the roux limb length measurement and pre-albumin or vitamin A serum concentrations at these post-operative follow-ups. Vitamin A levels and markers of liver function testing were also unrelated. Conclusion. Vitamin A deficiency is common after bariatric surgery and is associated with a low serum concentration of pre-albumin. This fat-soluble vitamin should be measured in patients who have undergone gastric bypass surgery and deficiency should be suspected in those with evidence of protein-calorie malnutrition.

  14. Key details of the duodenal-jejunal bypass in type 2 diabetes mellitus rats

    PubMed Central

    Han, Li-Ou; Zhou, Li-Hong; Cheng, Su-Jun; Song, Chun; Song, Chun-Fang

    2011-01-01

    AIM: To investigate which surgical techniques and perioperative regimens yielded the best survival rates for diabetic rats undergoing gastric bypass. METHODS: We performed Roux-en-Y gastric bypass with reserved gastric volume, a procedure in which gastrointestinal continuity was reestablished while excluding the entire duodenum and proximal jejunal loop. We observed the procedural success rate, long-term survival, and histopathological sequelae associated with a number of technical modifications. These included: use of anatomical markers to precisely identify Treitz’s ligament; careful dissection along surgical planes; careful attention to the choice of regional transection sites; reconstruction using full-thickness anastomoses; use of a minimally invasive procedure with prohemostatic pretreatment and hemorrhage control; prevention of hypothermic damage; reduction in the length of the procedure; and accelerated surgical recovery using fast-track surgical modalities such as perioperative permissive underfeeding and goal-directed volume therapy. RESULTS: The series of modifications we adopted reduced operation time from 110.02 ± 12.34 min to 78.39 ± 7.26 min (P < 0.01), and the procedural success rate increased from 43.3% (13/30) to 90% (18/20) (P < 0.01), with a long-term survival of 83.3% (15/18) (P < 0.01). CONCLUSION: Using a number of fast-track and damage control surgical techniques, we have successfully established a stable model of gastric bypass in diabetic rats. PMID:22174553

  15. An experimental study of the electrical activity of the bypassed stomach in the Roux-en-Y gastric bypass.

    PubMed

    Ferraz, Alvaro Antônio Bandeira; Leão, Cristiano Souza; Campos, Josemberg Marins; Coelho, Antônio Roberto Barros; Zilbestein, Bruno; Ferraz, Edmundo Machado

    2007-01-01

    Surgical options for morbid obesity are diverse, and the Roux-en-Y gastric bypass, initially described by Fobi has gained popularity. Knowledge about the physiology of the bypassed stomach is limited because this newly produced segment of the stomach is inaccessible to endoscopic or contrast radiological studies. To evaluate the myoelectric activity of the bypassed stomach and its reply to the feeding. An experimental protocol was conducted to evaluate postoperative gastric bypassed motility in dogs submitted to the Roux-en-Y gastric bypass procedure. Two groups of five animals were studied on postoperative fasting and after a standard meal, recording electrical response and control activity. Both control and Roux-en-Y gastric bypass operated study group had a pair of electrodes placed on three points of the remaining stomach: fundus, body and antrum. Data registration was performed after complete ileus resolution, and analysed with DATA Q Inst. series 200. The results achieved on the conditions of this study suggest that: 1. the remaining stomach maintain the same pattern of motility; 2. there is a reduced fasting electromyography activity following the Roux-en-Y gastric bypass procedure; 3. significantly reduced fasting electric control activity when compared both groups, and a markedly reduced fasting response electric activity and; 4. the electric response to the feeding kept the same standard of the stomach, however in a statistically reduced way. The electrical activity of the bypassed stomach of Roux-en-Y gastric bypass procedure kept the same pattern but in a statistically reduced number of contraction.

  16. Outcome of off-pump coronary artery bypass in renal dialysis patients.

    PubMed

    Liu, J-F; Lin, C-H; Chua, C-H; Chiang, S-S; Hung, H-F; Lu, M-J; Hung, C-R

    2008-10-01

    Renal dialysis patients are a subgroup at major operative risk when undergoing coronary artery bypass grafting (CABG). Even though CABG without cardiopulmonary bypass (CPB) has decreased the surgical risk and provided good short-term results, the long-term survival seems uncertain. We report here on the long-term outcome of CABG without CPB in renal dialysis patients. From 1998 to 2002, 44 renal dialysis patients underwent elective CABG without CPB, including 17 minimally invasive direct coronary artery bypass (MIDCAB) and 27 off-pump CABG (OPCAB) procedures. There were 5 one-vessel, 12 two-vessel and 27 multi-vessel coronary artery disease patients, who mainly had left internal thoracic artery (LITA) to left anterior descending coronary artery (LAD) grafting with an additional saphenous vein graft to non-LAD coronaries. All 44 patients were followed up for 44.4 +/- 31.2 months. Three (6.8 %) surgical deaths within 30 days occurred and 25 late mortalities happened over a period of 2 - 79 months. The 5-year cumulative rate of total survival is 38.2 % and the freedom from cardiac death is 70.9 %. Using hazard analysis, old age (> 60 years) and incomplete coronary revascularization was found to significantly affect the total survival. CABG without CPB provided an acceptable surgical mortality and morbidity. The high incidence of non-cardiac death associated with dialysis complications had an adverse impact on the overall outcome. The LITA bypass operation method combined with intensive care for dialysis complications would hopefully fulfill the goal to improve the short- and long-term results in this subgroup.

  17. The role of dumping syndrome in weight loss after gastric bypass surgery.

    PubMed

    Banerjee, Ambar; Ding, Yi; Mikami, Dean J; Needleman, Bradley J

    2013-05-01

    Roux-en-Y gastric bypass is the most commonly performed operation for the treatment of morbid obesity in the US. Dumping syndrome is an expected and desired part of the behavior modification caused by gastric bypass surgery; it can deter patients from consuming energy-dense food. In this study we assessed the role dumping has in weight loss and its relationship with the patient's eating behavior. Fifty patients who underwent gastric bypass between January 2008 and June 2008 were enrolled. Two questionnaires, the dumping syndrome questionnaire and the Three-Factor Eating Questionnaire (TFEQ), were used to record the patients' responses. The diagnosis of dumping syndrome was based on the Sigstad scoring system, where a score of 7 and above was considered positive. TFEQ evaluated the patients' eating behavior under three scales: cognitive restraint, uncontrolled eating, and emotional eating. The results were analyzed with descriptive and parametric statistics where applicable. The prevalence of dumping syndrome was 42 %, with 66.7 % of the subjects being women. The nondumpers were observed to have a greater mean decrease in body mass index than the dumpers at 1 and 2 years (18.5 and 17.8 vs. 14.4 and 13.7 respectively). There was no definite relationship between the presence of dumping syndrome and the eating behavior of the patient. However, the cognitive restraint scores, greater than 80 %, were associated with an average decrease in BMI of 19 and 20.8 at 1 and 2 years compared with 14.6 and 12.4 in those with scores less than 80 % (p = 0.01 and p = 0.03, respectively). The presence of dumping syndrome after gastric bypass does not influence weight loss, though eating behaviors may directly influence it.

  18. Does extubation result in haemodynamic instability in patients following coronary artery bypass grafts?

    PubMed

    Walthall, H; Ray, S; Robson, D

    2001-10-01

    Coronary heart disease and its management continue to be at the centre of Government health policy. The present political climate demands clinical effectiveness and best practice should be established, while maintaining the philosophy of cost-effectiveness and resource management. These directives have led practitioners to question the care of patients following coronary artery bypass surgery, in particular the role of mechanical ventilation and the subsequent act of extubation. A retrospective study of 89 patients who had coronary artery bypass grafts (emergency and elective) was undertaken, to establish if extubation had a significant effect on the haemodynamic status of patients with variable degrees of left ventricular function (19% with poor left ventricular function). The study found that extubation was achieved within a mean time of 4.97 hours following return from surgery. Extubation resulted in a significant increase in heart rate (P = 0.001), as well as a respiratory acidosis (pCO2: P = 0.000; pH: P = 0.000). However, the stability of the patient was not compromised, with neither mean arterial blood pressure (P = 0.825) nor oxygenation levels (P = 0.267) being significantly altered by extubation. On multivariate analysis, the act of extubation had no significant effect on any of the dependent variables. These results suggest that it is not extubation alone that has an impact on the haemodynamic stability of patients following coronary artery bypass grafts, but that this is indeed multifactorial. Therefore extubation is 'safe' practice for patients with varying degrees of left ventricular function following coronary artery bypass grafts. Limitations of the study are acknowledged.

  19. Apicoaortic Valve Conduit for a Patient with Aortic Valve Stenosis and Patent Coronary Bypass Grafts Using Cardiopulmonary Bypass

    PubMed Central

    Shackelford, Anthony G.; Relle, Margaret A.; Lombardi, Sarah A.

    2015-01-01

    Abstract: In adults over 65 years of age, aortic valve stenosis has been found to be present in 2–9% within this group. Furthermore, aortic valve replacements in patients whom have had a previous coronary artery bypass grafting surgery have a mortality rate as high as 18%. A non-conventional effective surgical approach of bypassing the aortic valve by inserting an apicoaortic valve conduit (AVC) connecting the left ventricular apex to the descending thoracic aorta has been previously documented. We describe the case of a successful implantation of an AVC in a 64-year-old Caucasian male using cardiopulmonary bypass. PMID:26834287

  20. Apicoaortic Valve Conduit for a Patient with Aortic Valve Stenosis and Patent Coronary Bypass Grafts Using Cardiopulmonary Bypass.

    PubMed

    Shackelford, Anthony G; Relle, Margaret A; Lombardi, Sarah A

    2015-12-01

    In adults over 65 years of age, aortic valve stenosis has been found to be present in 2-9% within this group. Furthermore, aortic valve replacements in patients whom have had a previous coronary artery bypass grafting surgery have a mortality rate as high as 18%. A non-conventional effective surgical approach of bypassing the aortic valve by inserting an apicoaortic valve conduit (AVC) connecting the left ventricular apex to the descending thoracic aorta has been previously documented. We describe the case of a successful implantation of an AVC in a 64-year-old Caucasian male using cardiopulmonary bypass.

  1. Method of treating emissions of a hybrid vehicle with a hydrocarbon absorber and a catalyst bypass system

    DOEpatents

    Roos, Bryan Nathaniel; Gonze, Eugene V; Santoso, Halim G; Spohn, Brian L

    2014-01-14

    A method of treating emissions from an internal combustion engine of a hybrid vehicle includes directing a flow of air created by the internal combustion engine when the internal combustion engine is spinning but not being fueled through a hydrocarbon absorber to collect hydrocarbons within the flow of air. When the hydrocarbon absorber is full and unable to collect additional hydrocarbons, the flow of air is directed through an electrically heated catalyst to treat the flow of air and remove the hydrocarbons. When the hydrocarbon absorber is not full and able to collect additional hydrocarbons, the flow of air is directed through a bypass path that bypasses the electrically heated catalyst to conserve the thermal energy stored within the electrically heated catalyst.

  2. Bypass Flow Resistance in Prismatic Gas-Cooled Nuclear Reactors

    SciTech Connect

    McEligot, Donald M.; Johnson, Richard W.

    2016-12-20

    Available computational fluid dynamics (CFD) predictions of pressure distributions in the vertical bypass flow between blocks in a prismatic gas-cooled reactor (GCR) have been analyzed to deduce apparent friction factors and loss coefficients for systems and network codes. We performed calculations for vertical gap spacings "s" of 2, 6 and 10 mm, horizontal gaps between the blocks of two mm and two flow rates, giving a range of gap Reynolds numbers ReDh of about 40 to 5300. Laminar predictions of the fully-developed friction factor ffd were about three to ten per cent lower than the classical infinitely-wide channel In the entry region, the local apparent friction factor was slightly higher than the classic idealized case but the hydraulic entry length Lhy was approximately the same. The per cent reduction in flow resistance was greater than the per cent increase in flow area at the vertical corners of the blocks. The standard k-ϵ model was employed for flows expected to be turbulent. Its predictions of ffd and flow resistance were significantly higher than direct numerical simulations for the classic case; the value of Lhy was about thirty gap spacings. Initial quantitative information for entry coefficients and loss coefficients for the expansion-contraction junctions between blocks is also presented. Our study demonstrates how CFD predictions can be employed to provide integral quantities needed in systems and network codes.

  3. Bypass Flow Resistance in Prismatic Gas-Cooled Nuclear Reactors

    DOE PAGES

    McEligot, Donald M.; Johnson, Richard W.

    2016-12-20

    Available computational fluid dynamics (CFD) predictions of pressure distributions in the vertical bypass flow between blocks in a prismatic gas-cooled reactor (GCR) have been analyzed to deduce apparent friction factors and loss coefficients for systems and network codes. We performed calculations for vertical gap spacings "s" of 2, 6 and 10 mm, horizontal gaps between the blocks of two mm and two flow rates, giving a range of gap Reynolds numbers ReDh of about 40 to 5300. Laminar predictions of the fully-developed friction factor ffd were about three to ten per cent lower than the classical infinitely-wide channel In themore » entry region, the local apparent friction factor was slightly higher than the classic idealized case but the hydraulic entry length Lhy was approximately the same. The per cent reduction in flow resistance was greater than the per cent increase in flow area at the vertical corners of the blocks. The standard k-ϵ model was employed for flows expected to be turbulent. Its predictions of ffd and flow resistance were significantly higher than direct numerical simulations for the classic case; the value of Lhy was about thirty gap spacings. Initial quantitative information for entry coefficients and loss coefficients for the expansion-contraction junctions between blocks is also presented. Our study demonstrates how CFD predictions can be employed to provide integral quantities needed in systems and network codes.« less

  4. Heparin-coated cardiopulmonary bypass circuits: current status.

    PubMed

    Hsu, L C

    2001-09-01

    Heparin-coated circuits have been subjected to vigorous testing, both experimentally and clinically, for the past decade. When the functions of heparin are preserved on the surface, the heparinized surface plays multiple roles in attenuating the systemic inflammatory response. These include the ability to attenuate contact activation, coagulation activation, complement activation and, directly or indirectly, platelet and leukocyte activation. The heparinized surface also renders the cardiopulmonary bypass (CPB) circuits hydrophilic and protein resistant and augments lipoprotein binding. The multifunctional nature of the heparinized surface contributes to the overall biocompatibility of the surface. Clinically, heparin-coated circuits become most effective in reducing systemic inflammatory response and in improving morbidity, mortality, and other patient outcome related parameters when material-independent blood activation is controlled or minimized through a global biocompatibility strategy. Techniques involved in the global biocompatibility strategy are readily available and are being effectively and safely practiced at several centers. With the global biocompatibility strategy, outstanding and reproducible results have been routinely achieved with conventional CPB techniques. Alternative revascularization procedures should equal or surpass conventional CPB, using best clinically proven strategies with respect to patient outcome and long-term graft patency.

  5. 1. PLENUM INTERIOR, SHOWING HEATING COILS AND BYPASS Hot ...

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

    1. PLENUM INTERIOR, SHOWING HEATING COILS AND BY-PASS - Hot Springs National Park, Bathhouse Row, Fordyce Bathhouse: Mechanical & Piping Systems, State Highway 7, 1 mile north of U.S. Highway 70, Hot Springs, Garland County, AR

  6. Oil Bypass Filter Technology Performance Evaluation - January 2003 Quarterly Report

    SciTech Connect

    Laurence R. Zirker; James E. Francfort

    2003-01-01

    This report details the initial activities to evaluate the performance of the oil bypass filter technology being tested by the Idaho National Engineering and Environmental Laboratory (INEEL) for the U.S. Department of Energy's FreedomCAR & Vehicle Technologies Program. Eight full-size, four-cycle diesel-engine buses used to transport INEEL employees on various routes have been equipped with oil bypass systems from the puraDYN Corporation. Each bus averages about 60,000 miles a year. The evaluation includes an oil analysis regime to monitor the presence of necessary additives in the oil and to detect undesirable contaminants. Very preliminary economic analysis suggests that the oil bypass system can reduce life-cycle costs. As the evaluation continues and oil avoidance costs are quantified, it is estimated that the bypass system economics may prove increasingly favorable, given the anticipated savings in operational costs and in reduced use of oil and waste oil avoidance.

  7. Oil Bypass Filter Technology Performance Evaluation - First Quarterly Report

    SciTech Connect

    Zirker, L.R.; Francfort, J.E.

    2003-01-31

    This report details the initial activities to evaluate the performance of the oil bypass filter technology being tested by the Idaho National Engineering and Environmental Laboratory (INEEL) for the U.S. Department of Energy's FreedomCAR & Vehicle Technologies Program. Eight full-size, four-cycle diesel-engine buses used to transport INEEL employees on various routes have been equipped with oil bypass systems from the puraDYN Corporation. Each bus averages about 60,000 miles a year. The evaluation includes an oil analysis regime to monitor the presence of necessary additives in the oil and to detect undesirable contaminants. Very preliminary economic analysis suggests that the oil bypass system can reduce life-cycle costs. As the evaluation continues and oil avoidance costs are quantified, it is estimated that the bypass system economics may prove increasingly favorable, given the anticipated savings in operational costs and in reduced use of oil and waste oil avoidance.

  8. 14. DRAGLINE BEGINNING CONSTRUCTION OF THE BYPASS CHANNEL CONNECTING THE ...

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

    14. DRAGLINE BEGINNING CONSTRUCTION OF THE BY-PASS CHANNEL CONNECTING THE DIVERSION GATE ALONG THE OUTLET CHANNEL WITH THE ORIGINAL CHANNEL OF THE SOURIS RIVER - Upper Souris National Wildlife Refuge, Dam 83, Souris River Basin, Foxholm, Surrey (England), ND

  9. [Preliminary study of colloid osmotic pressure for cardiopulmonary bypass].

    PubMed

    Wang, D; Xiang, L; Luo, J

    1996-12-01

    The ideal colloid osmotic pressure is beneficial to decrease the fluid accumulated in the pulmonary and other tissue during cardiopulmonary bypass. Schupbach reported the proper colloidosmotic pressure for cardiopulmonary bypass was 2.1 kPa (16 mmHg). Colloid osmotic pressures of blood and priming fluid during cardiopulmonary bypass were measured in 28 patients with heart disease by using colloid osmotic pressure detection apparatus. The value of colloid osmotic pressure suitable for the designed standard was apparently different among the Gelofusine group and other groups. P value was 0.005. Priming fluid for cardiopulmonary bypass needs to satisfy the quality and the quantity of colloid osmotic pressure. Using Albumin isn't economical. Whole blood and plazma are not suitable for increasing colloid osmotic pressure. Hydroxyethyl starch or Gelofusine is best choice in priming to get designed standard of colloid osmotic pressure. The ratio of hydroxyethyl starch or Gelofusine in priming fluid should beyond 1/2.

  10. Spasm in Arterial Grafts in Coronary Artery Bypass Grafting Surgery.

    PubMed

    He, Guo-Wei; Taggart, David P

    2016-03-01

    Spasm of arterial grafts in coronary artery bypass grafting surgery is still a clinical problem, and refractory spasm can occasionally be lethal. Perioperative spasm in bypass grafts and coronary arteries has been reported in 0.43% of all coronary artery bypass grafting surgery, but this may be an underestimate. Spasm can develop not only in the internal mammary artery but more frequently in the right gastroepiploic and radial artery. The mechanism of spasm can involve many pathways, particularly those involving regulation of the intracellular calcium concentration. Endothelial dysfunction also plays a role in spasm. Depending on the clinical scenario, the possibility of spasm during and after coronary artery bypass grafting should be confirmed by angiography. If present, immediate intraluminal injection of vasodilators is often effective, although other procedures such as an intraaortic balloon pump or extracorporeal membrane oxygenation may also become necessary to salvage the patient. Prevention of spasm involves many considerations, and the principles are discussed in this review article.

  11. [Kinetics of ceftazidime in prophylactic administration during cardiopulmonary bypass].

    PubMed

    Lonský, V; Dominik, J; Lonská, V; Hejzlar, M; Mand'ák, J; Pozlerová, E; Marsíková, M; Snítilová, M; Kubícek, J

    1999-01-01

    Serum ceftazidime levels were followed in 21 patients in which routine coronary bypass surgery with cardiopulmonary bypass was performed. Each patient received one gram of ceftazidime intravenously with anesthesia induction. Antibiotic concentrations were estimated using the microbiologic assay diffusion plate method. The average operation time was 220 +/- 41 minutes (range 130-310). The start of cardiopulmonary bypass was 86 +/- 21 minutes and the full flow time was 104 +/- 21 minutes after starting of ceftazidime application. It can be stated that the decline of ceftazidime serum levels after starting of cardiopulmonary bypass was faster in comparison with standard serum curves of this antibiotic. The concentrations of ceftazidime at the end of some operations were under the supposed minimal inhibitory concentrations for some microorganisms possibly implicated. No infection was recorded.

  12. What to Expect After Coronary Artery Bypass Grafting

    MedlinePlus

    ... What To Expect After Coronary Artery Bypass Grafting Recovery in the Hospital After surgery, you'll typically ... for 3 to 5 days before going home. Recovery at Home Your doctor will give you specific ...

  13. [Psychoprophylaxis in patients after coronary artery bypass graft operations].

    PubMed

    Rymaszewska, Joanna; Chładzińska-Kiejna, Sylwia; Górna, Renata; Kustrzycki, Wojciech

    2004-05-01

    The paper presented problems of quality of life and psychosocial functioning of patients following coronary artery bypass grafting operations. Possibilities of psychoprophylactic effects towards these patients and its efficacy were described.

  14. Protection of semiconductor converters for controlled bypass reactors

    SciTech Connect

    Dolgopolov, A. G.; Akhmetzhanov, N. G.; Karmanov, V. F.

    2010-05-15

    Possible ways of protecting thyristor converters in systems for magnetizing 110 - 500 kV controlled bypass reactors during switching and automatic reclosing are examined based on experience with the development of equipment, line tests, and mathematical modelling.

  15. Subarachnoid-subarachnoid bypass for spinal adhesive arachnoiditis.

    PubMed

    Tachibana, Toshiya; Moriyama, Tokuhide; Maruo, Keishi; Inoue, Shinichi; Arizumi, Fumihiro; Yoshiya, Shinichi

    2014-11-01

    The authors report a case of adhesive arachnoiditis (AA) and arachnoid cyst successfully treated by subarachnoid to subarachnoid bypass (S-S bypass). Arachnoid cysts or syringes sometimes compress the spinal cord and cause compressive myelopathy that requires surgical treatment. However, surgical treatment for AA is challenging. A 57-year-old woman developed leg pain and gait disturbance. A dorsal arachnoid cyst compressed the spinal cord at T7-9, the spinal cord was swollen, and a small syrinx was present at T9-10. An S-S bypass was performed from T6-7 to T11-12. The patient's gait disturbance resolved immediately after surgery. Two years later, a small arachnoid cyst developed. However, there was no neurological deterioration. The myelopathy associated with thoracic spinal AA, subarachnoid cyst, and syrinx improved after S-S bypass.

  16. What to Expect during Coronary Artery Bypass Grafting

    MedlinePlus

    ... support from an anesthesiologist, perfusionist (heart-lung bypass machine specialist), other surgeons, and nurses. There are several ... The tube will connect to a ventilator (a machine that supports breathing). The surgeon will make an ...

  17. Roux-en-Y Gastric Bypass Operation in Rats

    PubMed Central

    Bueter, Marco; Abegg, Kathrin; Seyfried, Florian; Lutz, Thomas A.; le Roux, Carel W.

    2012-01-01

    Currently, the most effective therapy for the treatment of morbid obesity to induce significant and maintained body weight loss with a proven mortality benefit is bariatric surgery1,2. Consequently, there has been a steady rise in the number of bariatric operations done worldwide in recent years with the Roux-en-Y gastric bypass (gastric bypass) being the most commonly performed operation3. Against this background, it is important to understand the physiological mechanisms by which gastric bypass induces and maintains body weight loss. These mechanisms are yet not fully understood, but may include reduced hunger and increased satiation4,5, increased energy expenditure6,7, altered preference for food high in fat and sugar8,9, altered salt and water handling of the kidney10 as well as alterations in gut microbiota11. Such changes seen after gastric bypass may at least partly stem from how the surgery alters the hormonal milieu because gastric bypass increases the postprandial release of peptide-YY (PYY) and glucagon-like-peptide-1 (GLP-1), hormones that are released by the gut in the presence of nutrients and that reduce eating12. During the last two decades numerous studies using rats have been carried out to further investigate physiological changes after gastric bypass. The gastric bypass rat model has proven to be a valuable experimental tool not least as it closely mimics the time profile and magnitude of human weight loss, but also allows researchers to control and manipulate critical anatomic and physiologic factors including the use of appropriate controls. Consequently, there is a wide array of rat gastric bypass models available in the literature reviewed elsewhere in more detail 13-15. The description of the exact surgical technique of these models varies widely and differs e.g. in terms of pouch size, limb lengths, and the preservation of the vagal nerve. If reported, mortality rates seem to range from 0 to 35%15. Furthermore, surgery has been carried out

  18. Roux-en-Y gastric bypass operation in rats.

    PubMed

    Bueter, Marco; Abegg, Kathrin; Seyfried, Florian; Lutz, Thomas A; le Roux, Carel W

    2012-06-11

    Currently, the most effective therapy for the treatment of morbid obesity to induce significant and maintained body weight loss with a proven mortality benefit is bariatric surgery. Consequently, there has been a steady rise in the number of bariatric operations done worldwide in recent years with the Roux-en-Y gastric bypass (gastric bypass) being the most commonly performed operation. Against this background, it is important to understand the physiological mechanisms by which gastric bypass induces and maintains body weight loss. These mechanisms are yet not fully understood, but may include reduced hunger and increased satiation, increased energy expenditure, altered preference for food high in fat and sugar, altered salt and water handling of the kidney as well as alterations in gut microbiota. Such changes seen after gastric bypass may at least partly stem from how the surgery alters the hormonal milieu because gastric bypass increases the postprandial release of peptide-YY (PYY) and glucagon-like-peptide-1 (GLP-1), hormones that are released by the gut in the presence of nutrients and that reduce eating. During the last two decades numerous studies using rats have been carried out to further investigate physiological changes after gastric bypass. The gastric bypass rat model has proven to be a valuable experimental tool not least as it closely mimics the time profile and magnitude of human weight loss, but also allows researchers to control and manipulate critical anatomic and physiologic factors including the use of appropriate controls. Consequently, there is a wide array of rat gastric bypass models available in the literature reviewed elsewhere in more detail. The description of the exact surgical technique of these models varies widely and differs e.g. in terms of pouch size, limb lengths, and the preservation of the vagal nerve. If reported, mortality rates seem to range from 0 to 35%. Furthermore, surgery has been carried out almost exclusively in male

  19. How safe is it to train residents to perform off-pump coronary artery bypass surgery?

    PubMed

    Smith, Tanya A; Asimakopoulos, George

    2015-05-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was, in [patients undergoing off-pump CABG] are [postoperative mortality and morbidity outcomes] acceptable when performed by [trainees]? Altogether more than 597 papers were found using the reported search, of which 8 represented the best evidence to answer the clinical question. Six retrospective cohort studies directly compared the performance of trainees and experienced surgeons in off-pump coronary artery bypass graft surgery. Of the remaining papers, one recorded the performance of trainees in on- and off-pump operations and finally one paper evaluated a single trainee's performance in off-pump coronary artery bypass graft surgery, both supervised and unsupervised, over a 1-year period. It is important to note that the two respective cohort studies included in our analysis compared similar cohorts of patients. However, both studies were included in our paper as they provide additional information regarding trainee performance. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Although a heterogeneous range of postoperative complications were recorded in the identified studies, we were able to determine that, overall, there was no significant difference in the 30-day mortality seen in operations performed by trainees or experienced surgeons. The incidence of myocardial infarction and stroke were also similar among cases performed by both groups. However, senior surgeons were more likely to operate on patients with more complex or severe disease, or those requiring more urgent operations. Therefore, it was not possible to directly compare outcomes between trainees and experienced surgeons in operations of similar complexity. However, we conclude that despite the absence of randomized controlled trials comparing the performance of trainees and

  20. Hypoparathyroidism after total thyroidectomy in patients with previous gastric bypass.

    PubMed

    Droeser, Raoul A; Ottosson, Johan; Muth, Andreas; Hultin, Hella; Lindwall-Åhlander, Karin; Bergenfelz, Anders; Almquist, Martin

    2017-03-01

    Case reports suggest that patients with previous gastric bypass have an increased risk of severe hypocalcemia after total thyroidectomy, but there are no population-based studies. The prevalence of gastric bypass before thyroidectomy and the risk of hypocalcemia after thyroidectomy in patients with previous gastric bypass were investigated. By cross-linking The Scandinavian Quality Registry for Thyroid, Parathyroid and Adrenal Surgery with the Scandinavian Obesity Surgery Registry patients operated with total thyroidectomy without concurrent or previous surgery for hyperparathyroidism were identified and grouped according to previous gastric bypass. The risk of treatment with intravenous calcium during hospital stay, and with oral calcium and vitamin D at 6 weeks and 6 months postoperatively was calculated by using multiple logistic regression in the overall cohort and in a 1:1 nested case-control analysis. We identified 6115 patients treated with total thyroidectomy. Out of these, 25 (0.4 %) had undergone previous gastric bypass surgery. In logistic regression, previous gastric bypass was not associated with treatment with i.v. calcium (OR 2.05, 95 % CI 0.48-8.74), or calcium and/or vitamin D at 6 weeks (1.14 (0.39-3.35), 1.31 (0.39-4.42)) or 6 months after total thyroidectomy (1.71 (0.40-7.32), 2.28 (0.53-9.75)). In the nested case-control analysis, rates of treatment for hypocalcemia were similar in patients with and without previous gastric bypass. Previous gastric bypass surgery was infrequent in patients undergoing total thyroidectomy and was not associated with an increased risk of postoperative hypocalcemia.

  1. Off-pump coronary artery bypass: techniques, pitfalls, and results.

    PubMed

    Hoff, Steven J

    2009-01-01

    In an attempt to advance the surgical treatment of coronary artery disease, surgeons sought a way to offer the proven benefits of coronary revascularization and avoid the side effects of cardiopulmonary bypass by performing revascularization in the beating heart (off-pump coronary artery bypass). This review will describe the development and refinement of the technique, pitfalls to its widespread adoption, and an up-to-date assessment of current results.

  2. Effect of clopidogrel on bleeding after coronary artery bypass surgery.

    PubMed

    Yende, S; Wunderink, R G

    2001-12-01

    Platelet dysfunction is a common cause of bleeding after coronary artery bypass graft surgery. This study explores the effects of clopidogrel on bleeding complications after coronary artery bypass graft surgery. Prospective observational study of patients undergoing coronary artery bypass graft. Tertiary care center. A total of 247 patients undergoing coronary artery bypass graft surgery. None. Primary end point was need for reexploration secondary to bleeding. Secondary end points included need for transfusion of blood products and chest tube output. Eight (3.3%) of 247 patients required reexploration secondary to bleeding. Clopidogrel recipients had higher incidence of reexploration for bleeding (9.8 vs. 1.6, p =.01) with an odds ratio of 6.9 (95% confidence interval, 1.6-30). Clopidogrel also increased the percentage of patients receiving packed red blood cell transfusion (72.6 vs. 51.6%, p =.007), the number of packed red blood cell units (3 vs. 1.6, p =0.0004), and the number of cryoprecipitate units (2.4 vs. 1.2, p =.04) transfused after coronary artery bypass graft surgery. Among clopidogrel recipients, a trend for increased transfusion of platelet units (4.3 vs. 1.7, p =.05) and fresh frozen plasma units (1.1 vs. 0.6, p =.08) also was found. Preoperative use of clopidogrel in combination with aspirin is associated with increased need for surgical reexploration as well as risk of packed red blood cell and cryoprecipitate transfusions after coronary artery bypass graft surgery.

  3. Femoropopliteal bypass: the preferred site for distal anastomosis.

    PubMed

    Rosenthal, D; Levine, K; Stanton, P E; Lamis, P A

    1983-01-01

    In many patients undergoing femoropopliteal bypass, an occluded superficial femoral artery may reconstitute at the adductor canal and the popliteal artery will be patent. For these patients, uncertainty exists as to whether the preferred site for the distal anastomosis is an above-knee (AK) or below-knee (BK) bypass graft. Operation is, therefore, often based on personal preference rather than fact. To evaluate this problem, we undertook a 6-year review of the cases of 90 patients who had femoropopliteal bypass to a patent popliteal artery. Seventy AK bypass grafts were performed: 20 with autogenous vein, 25 with Dacron, and 25 with polytetrafluoroethylene (PTFE). Based on the life table analysis method, the late patency rate was 70% for vein, 68% for PTFE, and 64% for Dacron. These results were compared against results in 25 patients who had BK femoropopliteal bypass with autogenous vein, in whom the late patency rate was 65%. There was no statistical difference between these groups (P less than 0.25). An AK femoropopliteal bypass with a prosthesis yielded long-term patency rates that were similar to those of AK or BK vein grafts. When the popliteal artery is patent and the distal anastomosis can be done proximal to the knee joint, a prosthetic graft should be used. A prosthetic graft will reduce operative time, shorten recuperation time, and spare the saphenous vein for use in the coronary or infrapopliteal vessels if the need arises.

  4. Cardiac Compression of Lung Lower Lobes after Coronary Artery Bypass Graft with Cardiopulmonary Bypass

    PubMed Central

    Neves, Flávio H.; Carmona, Maria J.; Auler, José O. C.; Rodrigues, Roseny R.; Rouby, Jean Jacques; Malbouisson, Luiz M. S.

    2013-01-01

    Background Atelectasis is a major cause of hypoxemia after coronary artery bypass grafting (CABG) and is commonly ascribed to general anesthesia, high inspiratory oxygen concentration and cardiopulmonary bypass (CPB). The objective of this study was to evaluate the role of heart-induced pulmonary compression after CABG with CPB. Methods Seventeen patients without pre-operative cardiac failure who were scheduled for coronary artery bypass graft underwent pre- and postoperative thoracic computed tomography. The cardiac mass, the pressure exerted on the lungs by the right and left heart and the fraction of collapsed lower lobe segments below and outside of the heart limits were evaluated on a computed tomography section 1 cm above the diaphragmatic cupola. Results In the postoperative period, cardiac mass increased by 32% (117±31 g versus 155±35 g, p<0.001), leading to an increase in the pressure that was exerted on the lungs by the right (2.2±0.6 g.cm−2 versus 3.2±1.2 g.cm−2, p<0.05) and left heart (2.4±0.7 g.cm−2 versus 4.2±1.8 g.cm−2, p<0.001). The proportion of collapsed lung segments beneath the heart markedly increased [from 6.7% to 32.9% on the right side (p<0.001) and from 6.2% to 29% on the left side (p<0.001)], whereas the proportion of collapsed lung segments outside of the heart limits slightly increased [from 0.7% to 10.8% on the right side (p<0.001) and from 1.5% to 12.6% on the left side (p<0.001)]. Conclusion The pressure that is exerted by the heart on the lungs increased postoperatively and contributed to the collapse of subjacent pulmonary segments. PMID:24244331

  5. Cardiac compression of lung lower lobes after coronary artery bypass graft with cardiopulmonary bypass.

    PubMed

    Neves, Flávio H; Carmona, Maria J; Auler, José O C; Rodrigues, Roseny R; Rouby, Jean Jacques; Malbouisson, Luiz M S

    2013-01-01

    Atelectasis is a major cause of hypoxemia after coronary artery bypass grafting (CABG) and is commonly ascribed to general anesthesia, high inspiratory oxygen concentration and cardiopulmonary bypass (CPB). The objective of this study was to evaluate the role of heart-induced pulmonary compression after CABG with CPB. Seventeen patients without pre-operative cardiac failure who were scheduled for coronary artery bypass graft underwent pre- and postoperative thoracic computed tomography. The cardiac mass, the pressure exerted on the lungs by the right and left heart and the fraction of collapsed lower lobe segments below and outside of the heart limits were evaluated on a computed tomography section 1 cm above the diaphragmatic cupola. In the postoperative period, cardiac mass increased by 32% (117±31 g versus 155±35 g, p<0.001), leading to an increase in the pressure that was exerted on the lungs by the right (2.2±0.6 g.cm(-2) versus 3.2±1.2 g.cm(-2), p<0.05) and left heart (2.4±0.7 g.cm(-2) versus 4.2±1.8 g.cm(-2), p<0.001). The proportion of collapsed lung segments beneath the heart markedly increased [from 6.7% to 32.9% on the right side (p<0.001) and from 6.2% to 29% on the left side (p<0.001)], whereas the proportion of collapsed lung segments outside of the heart limits slightly increased [from 0.7% to 10.8% on the right side (p<0.001) and from 1.5% to 12.6% on the left side (p<0.001)]. The pressure that is exerted by the heart on the lungs increased postoperatively and contributed to the collapse of subjacent pulmonary segments.

  6. Variations in dietary intake after bypass surgery for obesity. Possible relation to development of fatty liver after jejunoileal bypass

    SciTech Connect

    Rogus, J.; Blumenthal, S.A.

    1981-01-01

    Consumption of nutrients and food energy was compared, with concomitant chemical and radiologic measurements of hepatic fat content, preoperatively and postoperatively in 25 patients who underwent gastric or jejunoileal bypass for obesity. Patients in the two operative groups ingested similar quantities of food before surgery. After surgery, caloric intake from all sources decreased in both groups but to a significantly greater extent in the gastric bypass patients. During the first six months postoperatively, the 13 gastric bypass patients showed no changes in hepatic fat content, whereas substantial increases in liver fat uniformly occurred in the 12 patients who had jejunoileal bypasses. It is suggested that dietary carbohydrate may have contributed to the accretion of liver fat in these 12 patients.

  7. Current status of mini-gastric bypass

    PubMed Central

    Mahawar, Kamal K.; Kumar, Parveen; Carr, William RJ; Jennings, Neil; Schroeder, Norbert; Balupuri, Shlok; Small, Peter K.

    2016-01-01

    Mini-gastric bypass (MGP) is a promising bariatric procedure. Tens of thousands of this procedure have been performed throughout the world since Rutledge performed the first procedure in the United States of America in 1997. Several thousands of these have even been documented in the published scientific literature. Despite a proven track record over nearly two decades, this operation continues to polarise the bariatric community. A large number of surgeons across the world have strong objections to this procedure and do not perform it. The risk of symptomatic (bile) reflux, marginal ulceration, severe malnutrition, and long-term risk of gastric and oesophageal cancers are some of the commonly voiced concerns. Despite these expressed fears, several advantages such as technical simplicity, shorter learning curve, ease of revision and reversal, non-inferior weight loss and comorbidity resolution outcomes have prompted some surgeons to advocate a wider adoption of this procedure. This review examines the current status of these controversial aspects in the light of the published academic literature in English. PMID:27251826

  8. Ultra-High Bypass Ratio Jet Noise

    NASA Technical Reports Server (NTRS)

    Low, John K. C.

    1994-01-01

    The jet noise from a 1/15 scale model of a Pratt and Whitney Advanced Ducted Propulsor (ADP) was measured in the United Technology Research Center anechoic research tunnel (ART) under a range of operating conditions. Conditions were chosen to match engine operating conditions. Data were obtained at static conditions and at wind tunnel Mach numbers of 0.2, 0.27, and 0.35 to simulate inflight effects on jet noise. Due to a temperature dependence of the secondary nozzle area, the model nozzle secondary to primary area ratio varied from 7.12 at 100 percent thrust to 7.39 at 30 percent thrust. The bypass ratio varied from 10.2 to 11.8 respectively. Comparison of the data with predictions using the current Society of Automotive Engineers (SAE) Jet Noise Prediction Method showed that the current prediction method overpredicted the ADP jet noise by 6 decibels. The data suggest that a simple method of subtracting 6 decibels from the SAE Coaxial Jet Noise Prediction for the merged and secondary flow source components would result in good agreement between predicted and measured levels. The simulated jet noise flight effects with wind tunnel Mach numbers up to 0.35 produced jet noise inflight noise reductions up to 12 decibels. The reductions in jet noise levels were across the entire jet noise spectra, suggesting that the inflight effects affected all source noise components.

  9. Pregnancy after gastric bypass surgery in adolescents.

    PubMed

    Roehrig, Helmut R; Xanthakos, Stavra A; Sweeney, Jenny; Zeller, Meg H; Inge, Thomas H

    2007-07-01

    There is no previous research or documentation of the incidence of pregnancy or pregnancy outcomes in female adolescents after undergoing bariatric surgery. Retrospective chart reviews were conducted for female patients who had bariatric surgery in our adolescent program from 2001-2007. Descriptive and clinical data were abstracted from the medical records, including data from the initial assessment and from follow-up clinic visits pre- and postoperatively. 47 adolescents (age <19 years) underwent Roux-en-Y gastric bypass (RYGBP). 7 pregnancies occurred in 6 Caucasian females and resulted in 6 reported healthy term deliveries (1 pending). 6 of the 7 pregnancies were conceived between 10 and 22 months following surgery. In this small cohort of adolescent females, the pregnancy rate was 12.8%. The program pregnancy rate for adolescent females in this cohort was greater than anticipated, compared with national pregnancy rates for age and race-matched females in the USA. Risk factors that may contribute to an increased incidence of adolescent pregnancy in this unique bariatric population are unclear, but may include poor adherence to contraceptive therapy and psychosocial factors. Further research is required to define risk factors, improve adherence to contraceptive therapy, and encourage postponement of pregnancy after surgery.

  10. Evaluation of intracardiac recordings in diagnosis of impulse formation and concealed conduction in atrioventricular nodal bypass tracts.

    PubMed Central

    Castellanos, A; Agha, A S; Mendoza, I J; Sung, R J

    1977-01-01

    Invasive electrophysiological studies were performed in 2 symptomatic patients with recurrent arrhythmias in which impulse formation presumably occured within atrioventricular nodal bypass tracts. Case 1 had ectopic beats arising within, or close to, the upper end of a left-sided atrioventricular nodal bypass tract of the type described by Brechenmacher. In addition, this conduction was 'concealed' during sinus rhythm and right atrial pacing because the relatively prolonged right-to-left atrial conduction time allowed right atrial impulses to reach the His bundle via the atrioventricular node before they could do so through the atrioventricular nodal bypass tract. Case 2 had ectopic beats arising in a right-sided atrioventricular nodal bypass tract which did not conduct in either forward or retrograde directions, its presence being detected only when initiating impulses. However, it could not be determined whether this tract was an 'abnormal' atrio-His connection or a 'normal' transitional (atrio-atrioventricular nodal) tract. Though intracardiac studies complement body surface recordings, they should be interpreted with knowledge of their inherent limitations. PMID:884022

  11. Neonatal repair of left atrial diverticulum with gigantic thrombus without cardiopulmonary bypass.

    PubMed

    Higashida, Akihiko; Hoashi, Takaya; Sakaguchi, Heima; Ichikawa, Hajime

    2017-04-08

    A 5-day-old neonate with coarctation of the aorta, hypoplastic aortic arch, large apical muscular ventricular septal defect, and patent ductus arteriosus developed pulmonary over-circulation and systemic hypoperfusion underwent bilateral pulmonary artery banding through median sternotomy as a part of hybrid stage I palliation. At operation, left atrial diverticulum with gigantic thrombus formation at the base of the left atrial appendage was incidentally detected by intraoperative direct echocardiography, and therefore, was successfully resected with the whole thrombus inside it without use of cardiopulmonary bypass. Histopathological finding was compatible with diverticulum. The patient was free from atrial arrhythmia and recurrent thrombus formation.

  12. [Palliative biliary-digestive bypass with a Kehr tube for neoplastic surgical cholestatic jaundice].

    PubMed

    Revetria, P; Bonardi, L; Gambetta, G; Ferro, A; Bertino, C

    1993-03-31

    The authors, in some rare cases of surgical neoplastic icterus operation, had to adopt a technique of biliary-digestive bypass with prosthesis on account of the technical-anatomical and general conditions of the patients. That prosthesis has been made out of the typical Keher's duct which can be generally found in every general surgery. The above mentioned authors describe the operations they have carried out, their directions and the results of six cases which have been treated with a technique similar to Kron's.

  13. [The peculiarties of nitric oxide synthesis in patients after coronary bypass surgery].

    PubMed

    Bulanova, E L; Drapkina, O M; Kutepov, Iu S; Ivashkin, V T

    2007-01-01

    Nitric oxide (NO) participates in many physiological processes including those taking place in the cardiovascular system. The peculiarities of NO synthesis in patients after coronary bypass surgery were studied. The systems of NO generation responded in different ways. Changes in the levels of end-products of NO metabolism may be used as an additional prognostic criterion of the course of the postoperative period. The study found a direct correlation between the levels of end-products of NO metabolism and left ventricular ejection fraction as well as a reverse correlation between the level of end-products of NO metabolism and atherogenic lipids.

  14. By-pass pigs for two-phase flow pipelines

    SciTech Connect

    Wu, H.L.; Spronsen, G. van; Klaus, E.H.; Stewart, D.M.

    1996-12-31

    Pigging two-phase pipelines normally leads to the generation of large liquid slug volumes in front of the pig requiring excessively large separators or slug catchers. The concept of using a high by-pass pig to disperse the liquid and reduce the maximum liquid production rate prior to pig arrival is under investigation by Shell Exploration and Production companies. A simulation model of the dynamics of the pig and related two-phase flow behavior in the pipeline was used to predict the performance of by-pass pigs. Field trials in a dry gas pipeline were carried out to provide friction data and to validate the model. It was then used to explore operating possibilities in a two-phase lie which led to the follow-up trial in a 15.6 km, 20 inch OD two-phase offshore interfield pipeline with risers. Whereas the volume of liquid swept in front of the pig would be 179 m{sup 3} if the by-pass fraction were zero, a reduction of 70% to 53m{sup 3} was achieved in the field with a by-pass fraction of 10%. The predicted mobility of the high by-pass pig in the pipeline and risers was verified and the beneficial effects due to the by-pass concept exceeded the prediction of the simplified model. The significant gains of using a by-pass pig in modifying gas and liquid production rates during pigging operation have been demonstrated. The method can widen the possibility of applying two-phase flow pipeline transportation to cases where separator or slug catcher capacity are limited for reasons of practicality or cost.

  15. Metabolic Profiles Predict Adverse Events Following Coronary Artery Bypass Grafting

    PubMed Central

    Shah, Asad A.; Craig, Damian M.; Sebek, Jacqueline K.; Haynes, Carol; Stevens, Robert C.; Muehlbauer, Michael J.; Granger, Christopher B.; Hauser, Elizabeth R.; Newby, L. Kristin; Newgard, Christopher B.; Kraus, William E.; Hughes, G. Chad; Shah, Svati H.

    2012-01-01

    Objectives Clinical models incompletely predict outcomes following coronary artery bypass grafting. Novel molecular technologies may identify biomarkers to improve risk stratification. We examined whether metabolic profiles can predict adverse events in patients undergoing coronary artery bypass grafting. Methods The study population comprised 478 subjects from the CATHGEN biorepository of patients referred for cardiac catheterization who underwent coronary artery bypass grafting after enrollment. Targeted mass spectrometry-based profiling of 69 metabolites was performed in frozen, fasting plasma samples collected prior to surgery. Principal-components analysis and Cox proportional hazards regression modeling were used to assess the relation between metabolite factor levels and a composite outcome of post-coronary artery bypass grafting myocardial infarction, need for percutaneous coronary intervention, repeat coronary artery bypass grafting, or death. Results Over a mean follow-up of 4.3 ± 2.4 years, 126 subjects (26.4%) suffered an adverse event. Three principal-components analysis-derived factors were significantly associated with adverse outcome in univariable analysis: short-chain dicarboxylacylcarnitines (factor 2, P=0.001); ketone-related metabolites (factor 5, P=0.02); and short-chain acylcarnitines (factor 6, P=0.004). These three factors remained independently predictive of adverse outcome after multivariable adjustment: factor 2 (adjusted hazard ratio 1.23; 95% confidence interval [1.10-1.38]; P<0.001), factor 5 (1.17 [1.01-1.37], P=0.04), and factor 6 (1.14 [1.02-1.27], P=0.03). Conclusions Metabolic profiles are independently associated with adverse outcomes following coronary artery bypass grafting. These profiles may represent novel biomarkers of risk that augment existing tools for risk stratification of coronary artery bypass grafting patients and may elucidate novel biochemical pathways that mediate risk. PMID:22306227

  16. Results with heparin bonded polytetrafluoroethylene grafts for femorodistal bypasses.

    PubMed

    Peeters, P; Verbist, J; Deloose, K; Bosiers, M

    2006-08-01

    Expanded polytetrafluoroethylene (ePTFE) grafts are commonly used for femoropopliteal (FP) and femorocrural (FC) bypass grafting. Especially in below-knee (BK) reconstructions, patency is often inferior to the outcome in patients eligible for venous bypass grafting. This study assesses whether the Carmeda BioActive Surface (CBAS), which employs covalent end-point linkage to retain heparin on the device surface, as it is used on the Propaten vascular graft successfully, can prolong patency. From June 2002 to December 2005, 138 patients (97 men and 41 women; mean age: 73 years) received the CBAS-ePTFE graft for 153 infrainguinal bypass procedures. Seventy-five above-knee (AK) and 78 BK (including 37 FC) procedures were performed. Follow-up evaluations consisted of clinical examinations, ultrasonographic studies, and distal pulse assessments. Patency and limb salvage rates were assessed by using life-table analyses. The overall primary and secondary 2-year patency rates were 73.6% and 86%, respectively. Two-year primary patency rates according to bypass type were 76.2%, 72.6%, and 68.9% for AK FP, BK FP, and FC bypasses, respectively; the corresponding secondary patency rates were 87.5%, 87.8%, and 79.4%. The 2-year limb salvage rate in patients with critical limb ischemia (n=68) was 89.9%. Our findings show that CBAS-ePTFE bypass grafts appear to give prolonged patency rates and indicate that the use of this graft may represent a viable alternative for BK bypasses, which have traditionally yielded less than desirable outcomes. A prospective randomized trial is required to provide more definitive information about the graft's patency and limb salvage performance.

  17. Brain damage after coronary artery bypass grafting.

    PubMed

    Bendszus, Martin; Reents, Wilko; Franke, Dorothea; Müllges, Wolfgang; Babin-Ebell, Jörg; Koltzenburg, Martin; Warmuth-Metz, Monika; Solymosi, Laszlo

    2002-07-01

    Coronary artery bypass grafting (CABG) is associated with a risk for focal neurological deficits and neuropsychological impairment postoperatively. To examine the brain damage after CABG using diffusion-weighted magnetic resonance imaging and (1)H-magnetic resonance spectroscopy (MRS) and to correlate the results with neurological and neuropsychological findings. Thirty-five consecutive patients undergoing elective CABG were included. Patients underwent a neurological and neuropsychological examination before and after CABG. The magnetic resonance protocol was applied before and after (mean, 3 days) surgery and included a diffusion-weighted sequence and single-voxel MRS measurements in the frontal lobes. None of the patients revealed a new focal neurological deficit after surgery. Diffusion-weighted magnetic resonance imaging demonstrated new ischemic lesions in 9 (26%) of the patients. The presence of an ischemic lesion was not related to impaired postoperative test performance (P>.50). The apparent diffusion coefficient values in the cerebellum and the centrum semiovale exhibited an increase after surgery (P<.01), consistent with vasogenic edema. Following surgery, MRS revealed a significant decrease in the metabolite ratio of N-acetylaspartate-creatine (mean +/- SD, 1.69 +/- 0.20 vs 1.52 +/- 0.19; P<.001). The extent of deterioration in neuropsychological test performance after surgery was closely related to the degree of the N-acetylaspartate-creatine ratio decrease (P<.01). A follow-up MRS scan revealed a normalization of the N-acetylaspartate-creatine ratio, which accompanied the recovery in psychological test performance. Postoperative impairment in neuropsychological test performance is associated with a transient metabolic neuronal disturbance. Focal ischemic lesions after CABG are more frequent than the apparent neurological complication rate; however, they are not related to the diffuse postoperative encephalopathy.

  18. Annular MHD Physics for Turbojet Energy Bypass

    NASA Technical Reports Server (NTRS)

    Schneider, Steven J.

    2011-01-01

    The use of annular Hall type MHD generator/accelerator ducts for turbojet energy bypass is evaluated assuming weakly ionized flows obtained from pulsed nanosecond discharges. The equations for a 1-D, axisymmetric MHD generator/accelerator are derived and numerically integrated to determine the generator/accelerator performance characteristics. The concept offers a shockless means of interacting with high speed inlet flows and potentially offers variable inlet geometry performance without the complexity of moving parts simply by varying the generator loading parameter. The cycle analysis conducted iteratively with a spike inlet and turbojet flying at M = 7 at 30 km altitude is estimated to have a positive thrust per unit mass flow of 185 N-s/kg. The turbojet allowable combustor temperature is set at an aggressive 2200 deg K. The annular MHD Hall generator/accelerator is L = 3 m in length with a B(sub r) = 5 Tesla magnetic field and a conductivity of sigma = 5 mho/m for the generator and sigma= 1.0 mho/m for the accelerator. The calculated isentropic efficiency for the generator is eta(sub sg) = 84 percent at an enthalpy extraction ratio, eta(sub Ng) = 0.63. The calculated isentropic efficiency for the accelerator is eta(sub sa) = 81 percent at an enthalpy addition ratio, eta(sub Na) = 0.62. An assessment of the ionization fraction necessary to achieve a conductivity of sigma = 1.0 mho/m is n(sub e)/n = 1.90 X 10(exp -6), and for sigma = 5.0 mho/m is n(sub e)/n = 9.52 X 10(exp -6).

  19. Photovoltaic-module bypass-diode encapsulation. Annual report

    SciTech Connect

    Not Available

    1983-06-20

    The design and processing techniques necessary to incorporate bypass diodes within the module encapsulant are presented in this annual report. A comprehensive survey of available pad-mounted PN junction and Schottky diodes led to the selection of Semicon PN junction diode cells for this application. Diode junction-to-heat spreader thermal resistance measurements, performed on a variety of mounted diode chip types and sizes, have yielded values which are consistently below 1/sup 0/C per watt, but show some instability when thermally cycled over the temperature range from -40 to 150/sup 0/C. Based on the results of a detailed thermal analysis, which covered the range of bypass currents from 2 to 20 amperes, three representative experimental modules, each incorporating integral bypass diode/heat spreader assemblies of various sizes, were designed and fabricated. Thermal testing of these modules has enabled the formation of a recommended heat spreader plate sizing relationship. The production cost of three encapsulated bypass diode/heat spreader assemblies were compared with similarly rated externally-mounted packaged diodes. An assessment of bypass diode reliability, which relies heavily on rectifying diode failure rate data, leads to the general conclusion that, when proper designed and installed, these devices will improve the overall reliability of a terrestrial array over a 20 year design lifetime.

  20. Bearing-Bypass Loading on Bolted Composite Joints

    NASA Technical Reports Server (NTRS)

    Crews, J. H., Jr.; Naik, R. A.

    1988-01-01

    A combined experimental and analytical study has been conducted to investigate the effects of simultaneous bearing and bypass loading on a graphite/epoxy (T300/5208) laminate. Tests were conducted with a test machine that allows the bearing-bypass load ratio to be controlled while a single-fastener coupon is loaded to failure in either tension or compression. Test coupons consisted of 16-ply quasi-isotropic graphite/epoxy laminates with a centrally-located 6.35 mm bolt having a clearance fit. Onset-damage and ultimate strengths were determined for each test case. Next, a finite element stress analysis was conducted for each test case. The computed local stresses were used with appropriate failure criteria to analyze the observed failure modes and strengths. An unexpected interaction of the effect of the bypass and bearing loads was found for the onset of compression-reacted bearing damage. This interaction was caused by a decrease in the bolt-hole contact arc and a corresponding increase in the severity of the bearing loads. The amount of bolt-hole contact had a significant effect on local stresses and, thus, on the calculated damage-onset and ultimate strengths. An offset-compressible failure mode was identified for laminate failure under compression bearing-bypass loading. This failure mode appears to be unique to compression bearing-bypass loading and, therefore, cannot be predicted from simple tests.